The UK House of Commons is preparing for a landmark vote on the Terminally Ill Adults (End of Life) Bill, a private members bill aimed at granting terminally ill individuals the legal right to end their lives with medical assistance. The second reading of the bill, scheduled for Friday, marks a pivotal moment in a decades-long debate over end-of-life autonomy, pitting arguments of personal choice and dignity against concerns about potential abuse and the sanctity of life.

The Bill at a Glance

Under the proposed legislation, terminally ill, mentally competent adults residing in England and Wales would be eligible to request assistance to end their lives, provided they meet stringent criteria. These include:

• A diagnosis of terminal illness as defined in the bill.
• Demonstrated capacity to make the decision, assessed under the Mental Capacity Act 2005.
• A voluntary request supported by assessments from two independent doctors.
• Final approval by a High Court judge.

The patient would self-administer a life-ending substance prescribed following this process. The bill draws inspiration from similar laws in Australia, New Zealand, and parts of the United States, where assisted dying is tightly regulated and limited to specific cases.

Historical Context and Current Debate

This is not the first time an assisted dying bill has been brought before the UK Parliament. The earliest attempt, dating back to 1936, was followed by sporadic discussions and votes over the decades. Most recently, a 2015 bill was defeated by a significant margin. However, proponents argue that societal attitudes and evidence from jurisdictions where assisted dying is legal have shifted the debate.

Critics, however, remain staunchly opposed. A coalition of religious and spiritual leaders, including representatives from the Catholic Church, Muslim Council of Britain, and Hindu and Sikh communities, have voiced their objections, arguing that the bill undermines the sanctity of life and risks coercion of vulnerable individuals. Archbishop of Canterbury Justin Welby described the legislation as dangerous, while others caution against a potential “slippery slope” leading to broader applications beyond terminal illness.

Supporters Perspective

Advocates of the bill emphasize the importance of personal autonomy and compassionate choice for those suffering from incurable illnesses. They highlight safeguards designed to prevent abuse and ensure voluntariness, including judicial oversight and strict medical assessments. Proponents also argue that current laws offer no protection to those seeking to end their lives, with individuals often traveling abroad to jurisdictions like Switzerland, leaving families vulnerable to legal consequences under the Suicide Act 1961, which criminalizes assisting suicide.

Data from Victoria, Australia, where assisted dying was legalized in 2017, is often cited to allay fears of widespread misuse. In 2022, assisted deaths accounted for just 0.65% of all deaths in Victoria, with the majority of applicants being terminal cancer patients who had access to palliative care.

Legal and Ethical Dimensions

The debate also raises broader legal and ethical questions, particularly around human rights. The European Convention on Human Rights (ECHR) recognizes the right to a private life (Article 8) and allows member states discretion in balancing personal autonomy with protecting vulnerable individuals. The bills narrow scopelimiting eligibility to terminally ill adultsseeks to strike this balance, though some critics argue it could be seen as discriminatory against those excluded, such as individuals with non-terminal conditions.

The UK government has maintained a neutral stance on the issue, citing it as a matter of conscience for Parliament. Ministers have been advised to refrain from engaging in public debate, underscoring the contentious nature of the legislation.