A BILL TO Enable competent adults who are terminally ill
to be provided at their request
with specified assistance to end their own life;
and for connected purposes.

BE IT ENACTED by the Queen’s most Excellent Majesty,
by and with the advice and consent of the Lords Spiritual and Temporal,
and Commons, in this present Parliament assembled,
and by the authority of the same, as follows:—

1 Assisted dying

(1) Subject to the consent of the High Court (Family Division) pursuant to subsection (2),
a person who is terminally ill may request and lawfully be provided
with assistance to end his or her own life.

(2) Subsection (1) applies only if the High Court (Family Division),
by order, confirms that it is satisfied that the person—

(a) has a voluntary, clear, settled and informed wish to end his or her own life;

(b) has made a declaration to that effect in accordance with section 3; and

(c) on the day the declaration is made—

(i) is aged 18 or over;

(ii) has capacity to make the decision to end his or her own life; and

(iii) has been ordinarily resident in England and Wales for not less than one year.


2 Terminal illness

(1) For the purposes of this Act, a person is terminally ill if that person—

(a) has been diagnosed by a registered medical practitioner
as having an inevitably progressive condition
which cannot be reversed by treatment (“a terminal illness”); and

(b) as a consequence of that terminal illness,
is reasonably expected to die within six months.

(2) Treatment which only relieves the symptoms
of an inevitably progressive condition temporarily
is not to be regarded as treatment which can reverse that condition.


3 Declaration

(1) An application may be made to the High Court (Family Division)
under section 1(2) only if—

(a) the person has made and signed a declaration
that he or she has a voluntary, clear, settled and informed wish
to end his or her life in the form in the Schedule
in the presence of a witness
(who must not be a relative or directly involved in the person’s care or treatment)
who signed the declaration in the person’s presence; and

(b) that declaration has been countersigned in accordance with subsection (3) by—

(i) a suitably qualified registered medical practitioner
from whom the person has requested assistance to end their life (“the attending doctor”); and

(ii) another suitably qualified registered medical practitioner (“the independent doctor”)
who is not a relative, partner or colleague in the same practice or clinical team, of the attending doctor;
neither of whom may also be the witness required under paragraph (a).

(2) The attending doctor (but not the independent doctor)
may, but need not be, the registered medical practitioner
who diagnosed that the person is terminally ill
or first informed the person of that diagnosis.

(3) Before countersigning a person’s declaration
the attending doctor and the independent doctor,
having separately examined the person and the person’s medical records
and each acting independently of the other, must be satisfied that the person—

(a) is terminally ill;

(b) has the capacity to make the decision to end their own life; and

(c) has a clear and settled intention to end their own life
which has been reached voluntarily, on an informed basis and without coercion or duress.

(4) In deciding whether to countersign a declaration under subsection (3),
the attending doctor and the independent doctor
must be satisfied that the person making it has been fully informed
of the palliative, hospice and other care which is available to that person.

(5) If the attending doctor or indpendent doctor has doubt
as to a person’s capacity to make a decision under subsection (3)(b) or (c),
before deciding whether to countersign a declaration made by that person
the doctor must—

(a) refer the person for assessment by an appropriate specialist; and

(b) take account of any opinion provided by the appropriate specialist in respect of that person.

(6) A declaration under this section shall be valid and take effect
on such date as the High Court (Family Division) may order.

(7) A person who has made a declaration under this section
may revoke it at any time and revocation need not be in writing.

(8) For the purpose of subsection (1)(b)(ii),
an attending or independent doctor is suitably qualified
if that doctor holds such qualification or has such experience,
including in respect of the diagnosis and management of terminal illness
as the Secretary of State may specify in regulations
(which may make different provision for different purposes). 

(9) In this section, “appropriate specialist” means a registered practitioner
(other than the attending doctor or independent doctor)
who is registered in the specialty of psychiatry
in the Special Register kept by the General Medical Council.


4 Assistance in dying

(1) The attending doctor of a person who has made a valid declaration
may prescribe medicines for that person to enable that person to end their own life.

(2) Any medicines prescribed under subsection (1)
shall only be delivered to the person for whom they are prescribed—

(a) by the attending doctor; or

(b) by—
(i) another registered medical practitioner; or
(ii) a registered nurse; who has been authorised to do so by the attending doctor;

(c) after the assisting health professional has confirmed
that the person has not revoked and does not wish to revoke their declaration; and

(d) after a period of not less than 14 days
has elapsed since the day on which the person’s declaration took effect.

(3) If the attending doctor and the independent doctor agree
that a person’s death from terminal illness is reasonably expected
to occur within one month of the day on which a declaration takes effect,
the period specified in subsection (2)(d) is reduced to six days.

(4) In respect of a medicine which has been prescribed for a person under subsection (1),
an assisting health professional may—

(a) prepare that medicine for self-administration by that person;

(b) prepare a medical device which will enable that person to self-administer the medicine; and

(c) assist that person to ingest or otherwise self-administer the medicine;
but the decision to self-administer the medicine and the final act of doing so
must be taken by the person for whom the medicine has been prescribed.

(5) Subsection (4) does not authorise an assisting health professional
to administer a medicine to another person
with the intention of causing that person’s death.

(6) The assisting health professional must remain with the person until the person has—

(a) self-administered the medicine and died; or

(b) decided not to self-administer the medicine;
and for the purpose of this subsection the assisting health professional
is to be regarded as remaining with the person if the assisting health professional
is in close proximity to, but not in the same room as, the person.

(7) The Secretary of State may by regulations specify—

(a) the medicines which may be prescribed under this section;

(b) the form and manner in which such prescriptions are to be issued; and

(c) the manner and conditions under which such medicines
are to be dispensed, stored, transported, used and destroyed.

(8) Regulations under subsection (7)(c) shall provide that an assisting health professional—

(a) must only deliver any medicine prescribed under this section
to the person for whom they have been prescribed
immediately before their intended use; and

(b) in the event that the person decides not to self-administer the medicine,
must immediately remove it from that person
and, as soon as reasonably practicable,
return it to the pharmacy from which it was dispensed.

(9) Regulations under subsection (7) may—

(a) make different provision for different purposes; and

(b) include consequential, incidental, supplementary or transitional provisions.

(10) In this section, “assisting health professional” means the attending doctor
or a person authorised by the attending doctor in accordance with subsection (2)(b).

5 Conscientious objection

A person shall not be under any duty
(whether by contract or arising from any statutory or other legal requirement)
to participate in anything authorised by this Act
to which that person has a conscientious objection.


6 Criminal liability

(1) A person who provides any assistance in accordance with this Act
shall not be guilty of an offence.

(2) In the Suicide Act 1961, after section 2B (course of conduct), insert—

“2C Assisted dying Sections 2, 2A and 2B shall not apply to any person
in respect of the provision of assistance to another person
in accordance with the Assisted Dying Act 2016.”.

7 Inquests, death certification etc.

(1) A person is not to be regarded as having died in circumstances
to which section 1(2)(a) or (b) of the Coroners and Justice Act 2009
(duty to investigate certain deaths)
apply only because the person died as a consequence
of the provision of assistance in accordance with this Act.

(2) In the Births and Deaths Registration Act 1953,
after section 39A (regulations made by the Minister: further provisions), insert—

“39B Regulations: assisted dying

(1) The Secretary of State may make regulations—

(a) providing for any provision of this Act relating to the registration of deaths
to apply in respect of deaths which arise from the provision of assistance
in accordance with the Assisted Dying Act 2016
with such modifications as may be prescribed in respect of—

(i) the information which is to be provided concerning such deaths;

(ii) the form and manner in which the cause of such deaths is to be certified; and

(iii) the form and manner in which such deaths are to be registered;

(b) requiring the Registrar General to prepare
at least once each year a report providing a statistical analysis of deaths
which have arisen from the provision of assistance
in accordance with the Assisted Dying Act 2016;

(c) containing such incidental, supplemental and transitional provisions
as the Secretary of State considers appropriate.

(2) Any regulations made under subsection (1)(a)(ii) shall provide
for the cause of death to be recorded as “assisted death”.

(3) Any report prepared by the Registrar General
in accordance with regulations made under subsection (1)(b)
shall be laid before Parliament by the Secretary of State.

(4) The power of the Secretary of State to make regulations
under this section is exercisable by statutory instrument.

(5) A statutory instrument containing regulations made under this section
by the Secretary of State is subject to annulment
in pursuance of a resolution of either House of Parliament.”.


8 Codes of practice

(1) The Secretary of State may issue one or more codes of practice in connection with—
 
(a) the assessment of whether a person has a clear and settled intention
to end their own life, including—

(i) assessing whether the person has capacity to make such a decision;

(ii) recognising and taking account of the effects of depression
or other psychological disorders that may impair a person’s decision-making;

(iii) the information which is made available on treatment and end of life care options
available to them and of the consequences of deciding to end their own life;

(iv) the counselling and guidance which should be made available
to a person who wishes to end his or her own life; and

(v) the arrangements for delivering medicines to the person
for whom they have been prescribed under section 4,
and the assistance which such a person may be given
to ingest or self-administer them; and

(b) such other matters relating to the operation of this Act
as the Secretary of State thinks fit.

(2) Before issuing a code under this section
the Secretary of State shall consult such persons
as the Secretary of State thinks appropriate.

(3) A code does not come into operation until the Secretary of State by order so provides. 

(4) The power conferred by subsection (3) is exercisable by statutory instrument.

(5) An order bringing a code into operation
may not be made unless a draft of the order has been laid before Parliament
and approved by a resolution of each House.

(6) When a draft order is laid,
the code to which it relates must also be laid.

(7) A person performing any function under this Act
must have regard to any relevant provision of a code and failure to do so
shall not of itself render a person liable to any criminal or civil proceedings
but may be taken into account in any proceedings.


9 Monitoring

(1) The relevant Chief Medical Officer shall—

(a) monitor the operation of the Act,
 including compliance with its provisions
and any regulations or code of practice made under it;

(b) inspect and report to the relevant national authority
on any matter connected with the operation of the Act
which the relevant national authority refers to the relevant Chief Medical Officer; and

(c) submit an annual report to the relevant national authority on the operation of the Act.

(2) The Chief Medical Officers may combine their annual reports
for the same year in a single document (“a combined report“)
in such manner as they consider appropriate.

(3) The relevant national authority must publish each annual report
or combined report it receives under this section and—

(a) the Secretary of State must lay a copy of each report before Parliament; and

(b) the Welsh Ministers must lay a copy of each report before the National Assembly for Wales.

(4) In this section—

“relevant Chief Medical Officer” means—

(a) in England, the Chief Medical Officer to the Department of Health; and

(b) in Wales, the Chief Medical Officer to the Welsh Assembly Government;

“relevant national authority” means—

(a) in England, the Secretary of State; and

(b) in Wales, the Welsh Ministers.


10 Offences

(1) A person commits an offence if the person—

(a) makes or knowingly uses a false instrument
which purports to be a declaration made under section 3 by another person; or

(b) wilfully conceals or destroys a declaration made under section 3 by another person.

(2) A person (A) commits an offence if, in relation to another person (B)
who is seeking to make or has made a declaration under section 3,
A knowingly or recklessly provides a medical or other professional opinion in respect of B
which is false or misleading in a material particular.

(3) A person guilty of an offence under subsection (1)(a)
which was committed with the intention of causing the death of another person
is liable, on conviction on indictment, to imprisonment for life or a fine or both.

(4) Unless subsection (3) applies, a person convicted of an offence under this section is liable—

(a) on summary conviction, to imprisonment for a term not exceeding 6 months
or a fine not exceeding the statutory maximum (or both);

(b) on conviction on indictment, to imprisonment
for a period not exceeding five years or a fine or both.


11 Regulations

(1) Any power of the Secretary of State under this Act
to make regulations is exercisable by statutory instrument.

(2) A statutory instrument containing regulations under this Act
is subject to annulment in pursuance of a resolution of either House of Parliament.


12 Interpretation In this Act—

“attending doctor” has the meaning given in section 3;

“capacity” shall be construed in accordance with the Mental Capacity Act 2005;

“independent doctor” has the meaning given in section 3;

“relative”, in relation to any person, means—

(a) the spouse or civil partner of that person;

(b) any lineal ancestor, lineal descendant, sibling, aunt, uncle or cousin
of that person or the person’s spouse or civil partner; or

(c) the spouse or civil partner of any relative mentioned in paragraph (b),
and for the purposes of deducing any such relationship
a spouse or civil partner includes a former spouse or civil partner,
a partner to whom the person is not married,
and a partner of the same sex; and

“terminal illness” has the meaning given in section 2(1)(a).


13 Extent, commencement, repeal and short title

(1) This Act does not extend to Scotland or Northern Ireland.

(2) The following come into force on the day on which this Act is passed—

(a) sections 4, 7 and 11 so far as they confer a power to make regulations;

(b) section 8 so far as it confers a power to issue codes of practice;

(c) sections 11 and 12; and (d) this section.

(3) Subject to subsection (2), the provisions of this Act come into force
at the end of the period of two years
beginning with the day on which this Act is passed.

(4) At any time during the period of 12 months
beginning on the day ten years after the provisions in subsection (3) come into force,
this Act may be repealed by a resolution of each House of Parliament.

(5) This Act may be cited as the Assisted Dying Act 2016.

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SCHEDULE        Section 3
FORM OF DECLARATION

Declaration: Assisted Dying Act 2016

Name of declarant:
Date of Birth:
Address:

I have [condition], a terminal condition from which I am expected to die
within six months of the date of this declaration.

The Attending Doctor and Independent Doctor identified below
have each fully informed me about that diagnosis and prognosis
and the treatments available to me, including pain control and palliative care.

Having considered all this information,
I have a clear and settled intention to end my own life
and, in order to assist me to do so,
I have asked my attending doctor to prescribe medicines for me for that purpose.

I make this declaration voluntarily and in the full knowledge of its significance.
I understand that I may revoke this declaration at any time.

Signature:
Date:
Witness Name of witness:
Address:
This declaration was signed by [name of declarant]
in my presence and signed by me in [his/her] presence.

Signature:
Date:


Countersignature:
Attending Doctor

I confirm that [name], who at the date of this declaration is [age] years of age
and has been ordinarily resident in England and Wales for [time]:

(1) is terminally ill and that the diagnosis and prognosis set above is correct;

(2) has the capacity to make the decision to end their own life; and

(3) has a clear and settled intention to do so,
which has been reached on an informed basis,
without coercion or duress,
and having been informed of the palliative, hospice and other care which is available to [him/her].

Signature:
Date:
Name and Address of Attending Doctor:


Countersignature: Independent Doctor

I confirm that [name], who at the date of this declaration is [age] years of age
and has been ordinarily resident in England and Wales for [time]:

(1) is terminally ill and that the diagnosis and prognosis set above is correct;

(2) has the capacity to make the decision to end their own life; and

(3) has a clear and settled intention to do so,
which has been reached on an informed basis,
without coercion or duress,
and having been informed of the palliative, hospice and other care which is available to [him/her].

Signature:
Date:
Name and Address of Independent Doctor:

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    Here is an organized list of the 13 safeguards included in this bill,
beginning with the most important.
Each safeguard is linked to a full explanation on the Internet.
These hyperlinks also appear
whenever these safeguards appear in the bill above.

Judicial Consent

Requests for Death from the Patient

Informed Consent from the Patient

Physician's Statement of Condition and Prognosis

Independent Physician Reviews the Condition and Prognosis

Psychological Consultant Evaluates the Patient's Ability to Make Medical Decisions

Certification of Terminal Illness or Incurable Condition

Waiting Periods For Reflection

Opportunities for the Patient to Rescind or Postpone the Life-Ending Decision

The Patient Must be an Adult Resident of the State

Information about Palliative Care and other Alternatives to Death

Physician Agrees to Provide Life-Ending Chemicals

The Patient Must Be Conscious and Able to Achieve Death

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    The outstanding difference introduced by this bill
is the first safeguard mentioned above,
which appears in the first paragraph of this bill:
Judicial consent is the core of this proposed legislation:
Each patients who wishes to take advantage of this new right
must obtain the approval of a judge of the family court.

    This judge will assess all of the documents created
in support of the plan for this patient to die by gentle poison.
The specifics of how this judge might decide
are included in the full explanation of Judicial Consent.

    Otherwise, this bill does not differ much from previous attempts
all over the world, some successful and some not successful.

    An almost identical bill was rejected by the House of Commons in 2015.
So, even if the more elderly House of Lords does pass this bill,
it will not become law in the UK because of opposition in the House of Commons.

    Because this bill requires the patient to remain awake and capable
up until the last moment of life
and because it requires the patient to voluntarily take the gentle poison,
it clearly belongs to the largest category of right-to-die laws
---laws based on the inherent right of each individual to give up his or her life.
This might be called the suicide-model right-to-die.

    Contrast this with laws that allow termial sedation and withdrawing life-supports,
which generally do not require the patient to be awake and aware to the very end.
These are medical-model right-to-die laws.

    See the full explanation of the basic differences here:
Suicide-Model Right-to-Die vs. Medical Model Right-to-Die.

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Safeguards as Found in Various Laws and Proposed Laws.

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Go to the beginning of this website
James Leonard Park—Free Library

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