Can a change be expected? Will the UK Law Change?

“Now 99% chance of a change, effective by the Autumn of 2029”

SUMMARY

In June 2025 The House of Commons voted by 314 to 291 to pass the final stage of the Bill to legalise Assisted Dying in England and Wales. The Bill must now pass through the House of Lords before returning, briefly, to the House of Commons and then receiving the Royal Assent. Such progress will have been completed by the end of October 2025 and it will then be Law. However, the Government will then have a further four years in order to make the Bill fully operational.

The new Bill, when passed, will allow a terminal dose of medication to be prescribed for someone who is incurably ill with less than six months to live. They will need to be over eighteen and a citizen of the UK. The decision will be their own. It will need to be supported by two doctors. The patient’s decision and the verdicts of the two doctors will need to be approved by a “panel of experts”. As originally drafted, the Bill made no reference to such a panel. Instead, each decision had to be signed off by a High Court Judge. This provision was changed during the Committee Stage because such close involvement of Judges would have been both impractical and financially expensive. Without the change, the Bill might not have passed at all.

It will no longer be an offence for anyone to help the patient through the process. Because no offence will have been committed, the Forfeiture Rule will not apply. The criteria for acceptance mean that patients with Parkinsons, any form of Dementia, Lewy Bodies or Motor Neurone Disease will still not be able to receive help in the form of an Assisted Death. The Bill will therefore have only a limited effect. It is estimated that the number of British people travelling to Switzerland to end their lives will fall by 30% but no more.

THE SITUATION NOW

The new Bill is likely to become Law in the Autumn of 2025 but will not become operational until 2029. Until then, assisting a suicide will remain an offence in England and Wales, though a prosecution will be unlikely if the helper was motivated purely by compassion. If the helper had any financial motive, such as inheritance under a Will, then the Forfeiture Rule might still apply and their inheritance could be reduced or lost. Helping to arrange a visit to Switzerland still runs a serious risk of prosecution and the triggering of the Forfeiture Rule

It is possible that the House of Lords will make some further amendments to the Bill but these are unlikely to be substantial. It is also likely that their Lordships will threaten further delay and all sorts of other tactics to prevent it reaching the Statute Book. Such efforts simply face failure.

Far more likely is a big problem over money. The various hoops and hurdles added to the Bill in the name of “safeguards” have now resulted in the astonishing cost of £15,000 per case. There are 570,000 natural deaths each year in England and Wales so if only 1% of those were to request an Assisted Voluntary Death, the total cost would be £86 million. The NHS is unprepared for such an additional bill.

It is surely remarkable that the elaborations, introduced solely in the UK, should have resulted in a cost of £15,000 each whilst the established Swiss AVD providers are quoting prices between £8,500 and £10,500 for a full AVD service that includes a cremation, funeral and registration of death.

PARKINSONS, MND, ALZHEIMERS AND OTHER NEUROLOGICAL ILLNESS

These illnesses can destroy your quality of life but do not usually end it.   They are diseases you die “with” rather than “of”.   The inclusion of the six-month safeguard has therefore rendered the new legislation almost irrelevant to such sufferers.

The Swiss law does not impose a six-month safeguard. Similarly, there is no such limitation in Canada, though Switzerland remains the only country in the world that permits inward visits from foreign citizens for the purposes of an assisted death.

During the recent campaign for the England and Wales Bill, Dignity in Dying campaigned strongly in favour of the six-month rule. The other organisation supporting a “Yes” vote, My Death My Decision, actively campaigned against it.

A third organisation campaigning for change is Friends at the End (FATE).   This is an exclusively Scottish organisation and is, so far, the most successful of all three.   A Bill by Liam Macarthur MSP was introduced to the Scottish Parliament in 2024 and is expected to pass by the end of 2025.  

It is widely supported by the Scottish people as a whole and by their representatives in the Parliament.   The Macarthur Bill does not contain the six month safeguard.   It does contain a “conscience” clause enabling doctors and nurses to opt out of any procedure for which the intended purpose is death.   As in Switzerland, the drug will need to be self-administered.

Sadly, but inevitably, the forthcoming Scottish facilities will only be available to people who have been resident in Scotland for at least a year. That is also likely to be the case in the Isle of Man and in the Channel Islands. Interestingly, though, the forthcoming change in Ireland should also make assisted suicide legally available to citizens of Northern Ireland.