Terminally Ill Adults (End of Life) Bill

A Bill to allow adults who are terminally ill, subject to safeguards and protections, to request and be provided with assistance to end their own life; and for connected purposes.


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Page 1

Eligibility to be provided with lawful assistance to voluntarily end own life

 
"Assisted dying"

Source HL Bill 112 Explanatory Notes

44 Clause 1 sets out the circumstances in which assistance can be provided to a person to end their own life.

45 The person must:

  • be terminally ill (as defined by clause 2);
  • have the necessary capacity to make the decision (which is determined by the existing provisions of the Mental Capacity Act 2005)
  • be aged 18 or over,
  • be ordinarily resident in England and Wales and has been ordinarily resident there for at least 12 months,
  • be registered as a patient with a GP practice in England or Wales, and
  • be in England or Wales.

46 A person is considered ordinarily resident if they are living in England and Wales: lawfully; voluntarily; and for settled purposes as part of the regular order of their life for the time being, whether for a long or short duration

47 The assistance must be provided in accordance with clauses 8 to 30. Those clauses, amongst other things, require steps to be taken to ensure that the person-

  • has a clear, settled and informed wish to end their own life, and
  • has made the decision that they wish to end their own life voluntarily and has not been coerced or pressured by any other person in making that decision.

48 Subsection (3) requires that the steps taken under clauses 8 (first declaration), 10 (first doctor's assessment), 11 (second doctor's assessment) and 19 (second declaration) must be taken when the terminally ill person is in England or Wales, and that the steps taken under clauses 10 and 11 - first and second doctor's assessment - must be made by persons in England or Wales.

1
Assisted dying
 
 
(1)
A terminally ill person in England or Wales who—
 
 
(a)
has the capacity to make a decision to end their own life (see section
 
 
3 ),
5
 
(b)
is aged 18 or over at the time the person makes a first declaration (see
 
 
section 8 ),
 
 
(c)
is ordinarily resident in England and Wales and has been so resident
 
 
for at least 12 months ending with the date of the first declaration,
 
 
and
10
 
(d)
is registered as a patient with a general medical practice in England
 
 
or Wales,
 
 
may, on request, be provided in England or Wales with assistance to end
 
 
their own life in accordance with sections 8 to 30 .
 
 
(2)
Sections 8 to 30 , in particular, require steps to be taken to establish that the
15
 
person—
 
 
(a)
has a clear, settled and informed wish to end their own life, and
 
 
(b)
has made the decision that they wish to end their own life voluntarily
 
 
and has not been coerced or pressured by any other person into
 
 
making it.
20
 
(3)
The steps to be taken under sections 8 , 10 , 11 and 19 must be taken—
 
 
(a)
when the terminally ill person is in England or Wales, and
 
 
(b)
in the case of the steps under sections 10 and 11 , by persons in England
 
 
or Wales.
 

Page 2

"Terminal illness"

Source HL Bill 112 Explanatory Notes

49 Subsection (1) defines when a person is "terminally ill" for the purposes of the Bill. The person must have an inevitably progressive illness or disease that cannot be reversed by treatment. The person must also be expected to die within 6 months.

50 Subsection (2) provides that a person who would not otherwise meet the requirements of subsection (1) shall not be considered to meet them solely as a result of not eating or drinking.

51 Subsection (3) sets out that treatment which only relieves the symptoms of the inevitably progressive illness or disease temporarily is not to be regarded as treatment which can reverse that illness or disease.

52 Subsection (4) provides that a person is not considered to be "terminally ill" only because they have a disability or mental disorder or both. A person would need to meet the requirements in subsection (1) to qualify for assistance.

2
Terminal illness
 
 
(1)
For the purposes of this Act, a person is terminally ill if—
 
 
(a)
the person has an inevitably progressive illness or disease which cannot
 
 
be reversed by treatment, and
 
 
(b)
the person’s death in consequence of that illness or disease can
5
 
reasonably be expected within six months.
 
 
(2)
A person who would not otherwise meet the requirements of subsection (1)
 
 
shall not be considered to meet those requirements solely as a result of
 
 
voluntarily stopping eating or drinking.
 
 
(3)
For the purposes of subsection (1) , treatment which only relieves the symptoms
10
 
of an inevitably progressive illness or disease temporarily is not to be regarded
 
 
as treatment which can reverse that illness or disease.
 
 
(4)
For the avoidance of doubt, a person is not to be considered to be terminally
 
 
ill only because they are a person with a disability or mental disorder (or
 
 
both).
15
 
Nothing in this subsection results in a person not being regarded as terminally
 
 
ill for the purposes of this Act if (disregarding this subsection) the person
 
 
meets the conditions in paragraphs (a) and (b) of subsection (1) .
 
"Capacity"

Source HL Bill 112 Explanatory Notes

53 Clause 3 provides that the test of whether a person has capacity to make a decision to end their own life is to be determined in accordance with the Mental Capacity Act 2005. Sections 1 and 2 of that Act establish the principles and criteria for assessing a person's capacity to make decisions.

54 Section 2 of that Act provides that a person lacks capacity in relation to a particular matter if the person is unable to make a decision for themselves in relation to that matter because of an impairment of, or a disturbance in the functioning of, the mind or brain. Section 3 of that Act defines what it means to lack capacity. Section 3 provides that a person lacks capacity if they are unable to:

  • Understand the information relevant to the decision,
  • Retain that information,
  • Use and weigh that information as part of the decision-making process, or
  • Communicate their decision.
3
Capacity
 
 
In this Act, references to a person having capacity are to be read in accordance
20
 
with the Mental Capacity Act 2005.
 

Voluntary Assisted Dying Commissioner

 
"Voluntary Assisted Dying Commissioner"

Source HL Bill 112 Explanatory Notes

55 Clause 4 provides for there to be a Voluntary Assisted Dying Commissioner (the Commissioner), who would oversee the assisted dying process in England and Wales.

56 The Commissioner would be appointed by the Prime Minister (subsection (2)) and must hold or have held office as a judge of the Supreme Court, the Court of Appeal, or the High Court (subsection (3)).

57 Subsection (4) lists the principal functions of the Commissioner: receiving documents made under the Bill; making appointments to a list of persons eligible to sit on Assisted Dying Review Panels (schedule 2); referring cases to such panels (clause 16); monitoring the operation of the Bill and reporting annually on it (set out in clause 47).

4
Voluntary Assisted Dying Commissioner
 
 
(1)
There is to be a Voluntary Assisted Dying Commissioner.
 
 
(2)
The Commissioner is to be appointed by the Prime Minister.
25
 
(3)
The person appointed must hold or have held office as a judge of—
 
 
(a)
the Supreme Court,
 
 
(b)
the Court of Appeal, or
 
 
(c)
the High Court.
 
 
(4)
The Commissioner’s principal functions are—
30
 
(a)
receiving documents made under this Act;
 
 
(b)
making appointments to a list of persons eligible to sit on Assisted
 
 
Dying Review Panels (see Schedule 2 );
 
 
(c)
making arrangements in relation to such panels and referring cases
 
 
to them (see section 16 );
35
 
(d)
determining applications for reconsideration of panel decisions under
 
 
section 18 ;
 
 
(e)
monitoring the operation of this Act and reporting annually on it (see
 
 
section 49 ).
 

Page 3

 
(5)
In this Act “the Commissioner” means the Voluntary Assisted Dying
 
 
Commissioner.
 
 
(6)
Schedule 1 makes provision about the Commissioner.
 

Preliminary discussions

 
"Preliminary discussions with registered medical practitioners"

Source HL Bill 112 Explanatory Notes

58 Subsection (1) makes clear that no doctor is under a duty to raise the subject of the provision of assistance under the Bill with a person. But that does not prevent a doctor exercising their professional judgement to discuss the matter with a person (see subsection (2)).

59 Subsection (3) provides that, where a person in England or Wales indicates to a doctor that they wish to seek assistance end their own life in accordance with the Bill, the doctor may (but is not required to) discuss the matter with the patient.

60 Subsection (4) provides for adjustments for language and literacy barriers, including the use of interpreters.

61 If a preliminary discussion takes place, subsection (5) provides that the registered medical practitioner must explain to and discuss with the person:

a. the person's diagnosis and prognosis;

b. any available treatment and its likely effect; and

C. all appropriate palliative, hospice or other care, including symptom management, psychological support, and offer of a referral to a specialist for further discussion.

62 A preliminary discussion cannot be said to have taken place for the purposes of this Bill unless it has included an explanation of and discussion about the matters mentioned in (a) to (c) above.

63 If the doctor is unwilling or unable to conduct the discussion, subsection (6) requires them to ensure that the person who has requested it is directed to where they can find information and have the preliminary discussion.

5
Preliminary discussions with registered medical practitioners
5
 
(1)
No registered medical practitioner is under any duty to raise the subject of
 
 
the provision of assistance in accordance with this Act with a person.
 
 
(2)
But nothing in subsection (1) prevents a registered medical practitioner
 
 
exercising their professional judgement to decide if, and when, it is appropriate
 
 
to discuss the matter with a person.
10
 
(3)
Where a person in England or Wales indicates to a registered medical
 
 
practitioner their wish to seek assistance to end their own life in accordance
 
 
with this Act, the registered medical practitioner may (but is not required to)
 
 
conduct a preliminary discussion about the requirements that need to be met
 
 
for such assistance to be provided.
15
 
(4)
If a registered medical practitioner conducts such a preliminary discussion
 
 
with a person, the practitioner must first ensure the provision of adjustments
 
 
for language and literacy barriers, including the use of interpreters.
 
 
(5)
If a registered medical practitioner conducts such a preliminary discussion
 
 
with a person, the practitioner must explain to and discuss with that person—
20
 
(a)
the person’s diagnosis and prognosis;
 
 
(b)
any treatment available and the likely effect of it;
 
 
(c)
all appropriate palliative, hospice or other care, including symptom
 
 
management and psychological support, and offer to refer them to a
 
 
registered medical practitioner who specialises in such care for the
25
 
purpose of further discussion.
 
 
(Accordingly, such a preliminary discussion may not be conducted in isolation
 
 
from an explanation of, and discussion about, the matters mentioned in
 
 
paragraphs (a) to (c) .)
 
 
(6)
A registered medical practitioner who is unwilling or unable to conduct the
30
 
preliminary discussion mentioned under subsection (3) is not required to refer
 
 
the person to another medical practitioner but must ensure that the person
 
 
is directed to where they can obtain information and have the preliminary
 
 
discussion.
 
"No health professional shall raise assisted dying with a person under 18"

Source HL Bill 112 Explanatory Notes

64 Under this clause no health professional is able to raise the subject of provision of assistance to end one's own life with a person under 18.

6
No health professional shall raise assisted dying with a person under 18
35
 
No registered medical practitioner or other health professional shall raise the
 
 
subject of the provision of assistance in accordance with this Act with a person
 
 
under the age of 18.
 

Page 4

"Recording of preliminary discussion"

Source HL Bill 112 Explanatory Notes

65 Clause 7 applies where a registered medical practitioner conducts a preliminary discussion with a person (subsection 1).

66 If the registered medical practitioner who conducts the preliminary discussion is a practitioner at the person's GP practice, subsection (2) requires them to record the preliminary discussion in the person's medical records as soon as practicable.

67 Where a registered medical practitioner who conducts the preliminary discussion is not a practitioner at the person's GP practice, subsection (3) requires them to provide a written record of the preliminary discussion to a registered medical practitioner with the person's GP practice as soon as practicable. The practitioner at the person's GP practice must then include the record of the preliminary discussion it in the person's medical records as soon as practicable.

7
Recording of preliminary discussion
 
 
(1)
This section applies where a registered medical practitioner (“the practitioner”)
 
 
conducts a preliminary discussion with a person.
 
 
(2)
Where the practitioner is a practitioner with the person’s GP practice, they
 
 
must, as soon as practicable, record the preliminary discussion in the person’s
5
 
medical records.
 
 
(3)
In any other case—
 
 
(a)
the practitioner must, as soon as practicable, give a written record of
 
 
the preliminary discussion to a registered medical practitioner with
 
 
the person’s GP practice, and
10
 
(b)
that registered medical practitioner must, as soon as practicable, include
 
 
the record in the person’s medical records.
 

Procedure, safeguards and protections

 
"Initial request for assistance: first declaration"

Source HL Bill 112 Explanatory Notes

68 Clauses 8 to 30 set out steps that must be taken, and safeguards and protections that operate, when a person decides to seek assistance to end their own life in accordance with the Bill. In summary, assistance can only be provided if:

  • The person has made a first declaration under clause 8;
  • Two registered medical practitioners have carried out assessments of the person to ensure, amongst other things, that the person
  • Ο has a terminal illness,
  • Ο has the capacity to make the decision to end their own life,
  • Ο has a clear, settled and informed wish to end their own life, and
  • Ο has made the decision voluntarily and has not been coerced or pressured by anyone else;
  • There is a period of at least 7 days (“the first period of reflection") between the first and second assessments;
  • The Multidisciplinary Panel has granted a certificate of eligibility;
  • The person has made a second declaration under clause 19;
  • There is a period of at least 14 days ("the second period for reflection") between the court declaration and the person making the second declaration (or if the person is expected to die within one month of the court declaration, a period of at least 48 hours).

69 A person who wishes to be provided with assistance to end their own life must make a declaration under this clause (a "first declaration")

70 Subsection (2) requires that a first declaration must be:

a. in the form set out in regulations made by the Secretary of State;

b. signed and dated by the person making the declaration (where the person is unable to sign, clause 21 enables the declaration to be signed by a proxy); and

C. witnessed by the coordinating doctor and another person (clause 52 sets out factors that disqualify a person from acting as a witness or proxy).

71 Subsection (3) requires the coordinating doctor to provide a copy of the first declaration to the Commissioner as soon as reasonably practicable.

72 Subsection (4) requires regulations made under subsection (2)(a) to provide that the first declaration contains particular information, including the full name, address, NHS number and contact details of the GP practice for the person seeking assistance. Those regulations must also provide the first declaration contains further declarations by the person, including a declaration that the person meets the initial conditions for eligibility.

73 Subsection (5) sets out that the “initial conditions for eligibility" are that the person making the declaration: is aged 18 or over; is ordinarily resident in England and Wales and has been so for at least 12 months; and is registered with a general medical practice in England or Wales.

74 Subsection (6) gives a definition for "the coordinating doctor" in the Bill, as a registered medical practitioner who meets the eligibility criteria listed in paragraphs (a) to (d). This includes that the practitioner meets the requirements specified in regulations under subsection (7); who has indicated to the person making the declaration that they are able and willing to carry out the functions of the coordinating doctor under the Bill; who is not a relative of the person; and is not a beneficiary under a will of the person or who may otherwise benefit (financially or in any other material way) from the death of the person.

75 Subsection (7) places a duty on the Secretary of State to make regulations which make provision about the training, qualifications and experience that a registered medical practitioner must have in order to act as a coordinating doctor.

76 Subsection (8) requires that regulations (made under subsection (7)) provide that the practitioner must have had training about assessing capacity; assessing whether a person has been coerced or pressured by any other person; providing reasonable adjustments and safeguards for autistic people and people with a learning disability; and domestic abuse.

77 Under subsection (9), regulations may provide that the required training, qualifications or experience be determined by a person that is specified in the regulations. A specified person could include a regulatory body which sets professional training.

78 Training in respect of domestic abuse, including coercive control and financial abuse, is mandatory under subsection (10)

79 Subsection (11) sets out that a person may not witness a first declaration if they are disqualified under clause 52 from being a witness

8
Initial request for assistance: first declaration
 
 
(1)
A person who wishes to be provided with assistance to end their own life in
15
 
accordance with this Act must make a declaration to that effect (a “first
 
 
declaration”).
 
 
(2)
A first declaration must be—
 
 
(a)
in the form set out in regulations made by the Secretary of State,
 
 
(b)
signed and dated by the person making the declaration, and
20
 
(c)
witnessed by—
 
 
(i)
the coordinating doctor in relation to that person, and
 
 
(ii)
another person,
 
 
both of whom must see the declaration being signed.
 
 
(3)
The coordinating doctor must give a copy of the first declaration to the
25
 
Commissioner as soon as reasonably practicable after it has been made.
 
 
(4)
Regulations under subsection (2) (a) must provide that the first declaration
 
 
contains—
 
 
(a)
the following information—
 
 
(i)
the person’s full name and address;
30
 
(ii)
the person’s NHS number;
 
 
(iii)
contact details for the person’s GP practice;
 
 
(b)
the following further declarations by the person—
 
 
(i)
a declaration that they meet the initial conditions for eligibility
 
 
(see subsection (5) );
35
 
(ii)
a declaration that they have had a preliminary discussion with
 
 
a registered medical practitioner, that they were aged 18 or
 
 
over when they had that discussion, and that they understand
 
 
the information referred to in section 5 (5) (a) to (c) that was
 
 
provided during that discussion;
40

Page 5

 
(iii)
a declaration that they are content to be assessed, for the
 
 
purposes of this Act, by medical practitioners;
 
 
(iv)
a declaration that they are making the first declaration
 
 
voluntarily and have not been coerced or pressured by any
 
 
other person into making it;
5
 
(v)
a declaration that they understand that they may cancel the
 
 
first declaration at any time.
 
 
(5)
In subsection (4) (b) (i) “the initial conditions for eligibility” are that the person
 
 
making the declaration—
 
 
(a)
is aged 18 or over,
10
 
(b)
is ordinarily resident in England and Wales and has been so resident
 
 
for at least 12 months, and
 
 
(c)
is registered with a general medical practice in England or Wales.
 
 
(6)
In this Act, “the coordinating doctor" means a registered medical practitioner—
 
 
(a)
who meets the requirements specified in regulations under subsection
15
 
(7) ,
 
 
(b)
who has indicated to the person making the declaration that they are
 
 
able and willing to carry out the functions under this Act of the
 
 
coordinating doctor in relation to the person,
 
 
(c)
who is not a relative of the person making the declaration, and
20
 
(d)
who does not know or believe that they—
 
 
(i)
are a beneficiary under a will of the person, or
 
 
(ii)
may otherwise benefit financially or in any other material way
 
 
from the death of the person.
 
 
(7)
The Secretary of State must by regulations make provision about the training,
25
 
qualifications and experience that a registered medical practitioner must have
 
 
in order to act as the coordinating doctor.
 
 
(8)
The regulations must provide that the practitioner must have had training
 
 
about the following—
 
 
(a)
assessing capacity;
30
 
(b)
assessing whether a person has been coerced or pressured by any
 
 
other person;
 
 
(c)
reasonable adjustments and safeguards for autistic people and people
 
 
with a learning disability;
 
 
(d)
domestic abuse.
35
 
(9)
Subject to that, the regulations may in particular provide that the required
 
 
training, qualifications or experience is to be determined by a person specified
 
 
in the regulations.
 
 
(10)
Regulations under subsection (7) must specify that training in respect of
 
 
domestic abuse, including coercive control and financial abuse, is mandatory.
40
 
(11)
A person may not witness a first declaration under subsection (2) (c) (ii) if they
 
 
are disqualified under section 52 from being a witness.
 

Page 6

"Witnessing first declaration: requirements"

Source HL Bill 112 Explanatory Notes

80 This clause requires a person making a first declaration under clause 8 to provide both the coordinating doctor and the independent witness with two forms of proof of identity.

81 Subsection (3) enables the Secretary of State to make provision about acceptable forms of proof of identity in regulations.

82 Subsections (4) and (5) allow the coordinating doctor to witness the first declaration only if:

a. they have been provided with two forms proof of identity by the person seeking assistance;

b. a preliminary discussion with the person has been conducted by the coordinating doctor or another registered medical practitioner;

C. and the coordinating doctor has made or seen a written record of the preliminary discussion.

9
Witnessing first declaration: requirements
 
 
(1)
This section applies in relation to the making of a first declaration by a person.
 
 
(2)
The person must, before signing that declaration, provide two forms of proof
 
 
of identity to the coordinating doctor and the witness mentioned in section
 
 
8 (2) (c) (ii) .
5
 
(3)
The Secretary of State may, by regulations, make provision about the forms
 
 
of proof of identity that are acceptable for the purposes of subsection (2) .
 
 
(4)
The coordinating doctor may witness the first declaration only if satisfied
 
 
that the requirements of subsection (2) have been met.
 
 
(5)
The coordinating doctor may witness the first declaration only if—
10
 
(a)
the coordinating doctor has conducted a preliminary discussion with
 
 
the person or is satisfied that another registered medical practitioner
 
 
has conducted such a discussion, and
 
 
(b)
the coordinating doctor has made or seen a written record of the
 
 
preliminary discussion.
15
"First doctor’s assessment (coordinating doctor)"

Source HL Bill 112 Explanatory Notes

83 Where a first declaration is made by a person, the coordinating doctor who witnessed the first declaration must carry out an assessment of the person. The purpose of the assessment is to establish whether the person:

  • Is terminally ill;
  • Has capacity to make the decision to end their own life;
  • Was aged 18 or over at the time the first declaration was made;
  • Is in England and Wales;
  • Is ordinarily resident;
  • Is registered with a GP practice in England or Wales;
  • Has a clear, settled and informed wish to end their own life; and
  • Made the first declaration under clause 8 voluntarily and has not been coerced or pressured by another person into making it.

84 After carrying out the first assessment, subsection (3) requires the coordinating doctor to make a report about the first assessment and give a copy of that report to: the person who was assessed; if the coordinating doctor is not a practitioner with the person's GP practice, a registered medical practitioner with that practice; and any other person that Secretary of State specifies in regulations.

85 If the coordinating doctor is satisfied that all the matters in subsection (2) have been met), they must refer the person to an independent doctor to conduct the second assessment. The independent doctor must be a registered medical practitioner who is able and willing to carry out the second assessment, and who meets all of the requirements set out in clause 11(8).

86 Subsection (4) places a duty on the Secretary of State to make provision through regulations about the content and form of the coordinating doctor's report.

87 Subsection (5) requires the regulations to provide that the coordinating doctor's report must include particular information, such as whether the coordinating doctor is satisfied that all the matters in subsection (2) have been met and the reasoning for their decision. The coordinating doctor must also confirm that a record of the preliminary discussion and the making of a first declaration have been recorded in the person's medical records. They must also confirm that the first declaration has not been cancelled. The report must be signed and dated by the coordinating doctor.

88 Subsections (6) and (7) enable a second referral to be made if the independent doctor dies or through illness is unable or unwilling to carry out their functions. Where a new referral is made, the new independent doctor is required to carry out the same functions as the independent doctor to whom the first referral was made. These functions are set out in clauses 11 (second doctor's assessment) to 13 (second opinion) and 15 (replacing the coordinating doctor or the independent doctor where unable or unwilling to continue to act).

10
First doctor’s assessment (coordinating doctor)
 
 
(1)
The coordinating doctor must, as soon as reasonably practicable after a first
 
 
declaration is made by a person, carry out the first assessment.
 
 
(2)
“The first assessment” is an assessment to ascertain whether, in the opinion
 
 
of the coordinating doctor, the person—
20
 
(a)
is terminally ill,
 
 
(b)
has capacity to make the decision to end their own life,
 
 
(c)
was aged 18 or over at the time the first declaration was made,
 
 
(d)
is in England and Wales,
 
 
(e)
is ordinarily resident in England and Wales and has been so resident
25
 
for at least 12 months ending with the date of the first declaration,
 
 
(f)
is registered as a patient with a general medical practice in England
 
 
or Wales,
 
 
(g)
has a clear, settled and informed wish to end their own life, and
 
 
(h)
made the first declaration voluntarily and has not been coerced or
30
 
pressured by any other person into making it.
 
 
(3)
After carrying out the first assessment, the coordinating doctor must—
 
 
(a)
make a report about the assessment (which must meet the requirements
 
 
of regulations under subsection (4) );
 
 
(b)
give a copy of the report to—
35
 
(i)
the person who was assessed (“the assessed person”),
 
 
(ii)
if the coordinating doctor is not a practitioner with the person’s
 
 
GP practice, a registered medical practitioner with that practice,
 
 
and
 
 
(iii)
any other person specified in regulations made by the Secretary
40
 
of State;
 

Page 7

 
(c)
if satisfied as to all of the matters mentioned in subsection (2) (a) to
 
 
(h) , refer the assessed person to another registered medical practitioner
 
 
who meets the requirements of section 11 (8) and is able and willing
 
 
to carry out the second assessment (“the independent doctor”).
 
 
(4)
The Secretary of State must by regulations make provision about the content
5
 
and form of the report.
 
 
(5)
The regulations must provide that the report must—
 
 
(a)
contain a statement indicating whether the coordinating doctor is
 
 
satisfied as to all of the matters mentioned in subsection (2) (a) to (h) ;
 
 
(b)
contain an explanation of why the coordinating doctor is, or (as the
10
 
case may be) is not, so satisfied;
 
 
(c)
contain a statement indicating whether the coordinating doctor is
 
 
satisfied as to the following—
 
 
(i)
that a record of the preliminary discussion has been included
 
 
in the person’s medical records;
15
 
(ii)
that the making of the first declaration has been recorded in
 
 
the person’s medical records;
 
 
(iii)
that the first declaration has not been cancelled;
 
 
(d)
be signed and dated by the coordinating doctor.
 
 
(6)
Where—
20
 
(a)
a referral is made under subsection (3) (c) ,
 
 
(b)
the independent doctor dies or through illness is unable or unwilling
 
 
to act as the independent doctor, and
 
 
(c)
no report under section 11 has been made by virtue of the referral,
 
 
a further referral may be made under subsection (3) (c) .
25
 
(7)
Where a referral is made to a registered medical practitioner by virtue of
 
 
subsection (6) , that practitioner becomes the independent doctor (replacing
 
 
the registered medical practitioner to whom a referral was originally made)
 
 
and sections 11 to 13 and 15 apply accordingly.
 
"Second doctor’s assessment (independent doctor)"

Source HL Bill 112 Explanatory Notes

89 This clause applies where the coordinating doctor refers the person under clause 10(3)(c) for a second assessment by the independent doctor (subsection 1). The purpose of the second assessment of the person carried out by the independent doctor is to establish whether the person:

  • Is terminally ill;
  • Has capacity to make the decision to end their own life;
  • Is aged 18 or over;
  • Has a clear, settled and informed wish to end their own life; and
  • Made the first declaration under clause 8 voluntarily and has not been coerced or pressured by another person into making it.

90 The second assessment must take place after “the first period for reflection". This period begins with the day the coordinating doctor makes their report under clause 10 and lasts for 7 days.

91 Subsection (4) sets out that the independent doctor must carry out the second assessment independently of the coordinating doctor.

92 After carrying out the second assessment, subsection (5) requires the independent doctor to make a report about the assessment. They give a copy to the person who was assessed; the coordinating doctor; if neither the independent doctor nor coordinating doctor is a practitioner with the person's GP practice, a registered medical practitioner with that practice; and any other person that the Secretary of State may specify in regulations.

93 Subsection (6) places a duty on the Secretary of State to make provision through regulations about the content and form of the report.

94 Subsection (7) requires the regulations to provide that the independent doctor's report must include particular information, such as whether the independent doctor is satisfied of all the matters in subsection (2) and an explanation of their decision. Additionally, the report should contain a statement indicating whether the independent doctor is satisfied:

a. that a record of the preliminary discussion has been included in the person's medical records;

b. that the person signed the first declaration;

C. that the making of the first declaration has been recorded in the person's medical records; and

d. that the first declaration has not been cancelled.

95 The report should also be signed and dated by the independent doctor.

96 A registered medical practitioner can only act as the independent doctor if they meet the requirements set out in subsection (8) In particular, they must meet the requirements (about the training, qualifications and experience) specified by the Secretary of State in regulations under subsection (9). To ensure independence, the practitioner must not have provided the person with treatment or care in relation to their terminal illness and must not be in the same medical practice or clinical team as the coordinating doctor. The independent doctor must also not know or believe that they are a beneficiary under the person's will or may otherwise benefit from that person's death.

97 Subsection (9) places a duty on the Secretary of State to make provision through regulations about the training, qualifications and experience that a registered medical practitioner must have to carry out the functions of an independent doctor.

98 Subsection (10) requires these regulations provide that the practitioner must have had training about mental capacity, coercion or pressure by another person, and domestic abuse.

99 Under subsection (11), the regulations may provide that the required training, qualifications or experience is to be determined by a person that is specified in the regulations. A specified person could include a regulatory body which sets professional training.

100 Subsection (12) sets out that the reference to “terminal illness” in subsection (8)(b) means the illness or disease mentioned in section 2(1)(a).

101 Subsection (13) requires that the regulations required under subsection (9) specify that training in respect of domestic abuse, including coercive control and financial abuse is mandatory.

11
Second doctor’s assessment (independent doctor)
30
 
(1)
Where a referral is made under section 10 (3) (c) , the independent doctor must
 
 
carry out the second assessment of the person as soon as reasonably practicable
 
 
after the first period for reflection has ended.
 
 
(2)
“The second assessment” is an assessment to ascertain whether, in the opinion
 
 
of the independent doctor, the person who made the first declaration—
35
 
(a)
is terminally ill,
 
 
(b)
has capacity to make the decision to end their own life,
 
 
(c)
was aged 18 years or over at the time the first declaration was made,
 
 
(d)
has a clear, settled and informed wish to end their own life, and
 
 
(e)
made the first declaration voluntarily and has not been coerced or
40
 
pressured by any other person into making it.
 

Page 8

 
(3)
In subsection (1) “the first period for reflection” means the period of seven
 
 
days beginning with the day the coordinating doctor made the report under
 
 
section 10 (3) .
 
 
(4)
The independent doctor must carry out the second assessment independently
 
 
of the coordinating doctor, subject to section 12 (7) (sharing of specialists’
5
 
opinions).
 
 
(5)
After carrying out the second assessment, the independent doctor must—
 
 
(a)
make a report about the assessment (which must meet the requirements
 
 
of regulations under subsection (6) ), and
 
 
(b)
give a copy of the report to—
10
 
(i)
the person who was assessed,
 
 
(ii)
the coordinating doctor,
 
 
(iii)
if neither the independent doctor nor the coordinating doctor
 
 
is a practitioner with the person’s GP practice, a registered
 
 
medical practitioner with that practice, and
15
 
(iv)
any other person specified in regulations made by the Secretary
 
 
of State.
 
 
(6)
The Secretary of State must by regulations make provision about the content
 
 
and form of the report.
 
 
(7)
The regulations must provide that the report must—
20
 
(a)
contain a statement indicating whether the independent doctor is
 
 
satisfied as to all of the matters mentioned in subsection (2) (a) to (e) ;
 
 
(b)
contain an explanation of why the independent doctor is, or (as the
 
 
case may be) is not, so satisfied;
 
 
(c)
contain a statement indicating whether the independent doctor is
25
 
satisfied as to the following—
 
 
(i)
that a record of the preliminary discussion has been included
 
 
in the person’s medical records;
 
 
(ii)
that the person signed the first declaration;
 
 
(iii)
that the making of the first declaration has been recorded in
30
 
the person’s medical records;
 
 
(iv)
that the first declaration has not been cancelled;
 
 
(d)
be signed and dated by the independent doctor.
 
 
(8)
A registered medical practitioner may carry out the functions of the
 
 
independent doctor under this Act only if that practitioner—
35
 
(a)
meets the requirements specified in regulations under subsection (9) ,
 
 
(b)
has not provided treatment or care for the person being assessed in
 
 
relation to that person’s terminal illness,
 
 
(c)
is not a relative of the person being assessed,
 
 
(d)
is not a partner or colleague in the same practice or clinical team as
40
 
the coordinating doctor,
 
 
(e)
did not witness the first declaration made by the person being assessed,
 
 
and
 
 
(f)
does not know or believe that they—
 

Page 9

 
(i)
are a beneficiary under a will of the person, or
 
 
(ii)
may otherwise benefit financially or in any other material way
 
 
from the death of the person.
 
 
(9)
The Secretary of State must by regulations make provision about the training,
 
 
qualifications and experience that a registered medical practitioner must have
5
 
in order to carry out the functions of the independent doctor.
 
 
(10)
The regulations must provide that the practitioner must have had training
 
 
about the following—
 
 
(a)
assessing capacity;
 
 
(b)
assessing whether a person has been coerced or pressured by any
10
 
other person;
 
 
(c)
domestic abuse.
 
 
(11)
Subject to that, the regulations may in particular provide that the required
 
 
training, qualifications or experience is to be determined by a person specified
 
 
in the regulations.
15
 
(12)
In subsection (8) (b) the reference to “terminal illness” means the illness or
 
 
disease mentioned in section 2 (1) (a) .
 
 
(13)
Regulations under subsection (9) must specify that training in respect of
 
 
domestic abuse, including coercive control and financial abuse, is mandatory.
 
"Doctors’ assessments: further provision"

Source HL Bill 112 Explanatory Notes

102 Clause 12 makes provision about the assessment by the coordinating doctor under clause 10 and the assessment by the independent doctor under clause 11 (subsection 1).

103 In particular, subsection (2) sets out things each of the doctors carrying out an assessment under the Act must do. These include a requirement to:

a. examine the person and their relevant medical records;

b. make enquiries of any health and social care professionals who are providing or have recently provided care to the person as the assessing doctor considers appropriate;

c. explain to and discuss with the person their diagnosis and prognosis; any treatment available and the likely effects; any available palliative, hospice or other care, including symptom management, psychological support, and offer of a referral to a specialist for further discussion.

d. discuss with the person what their wishes are in the event of complications;

e. inform the person of the further steps that must be taken before assistance to end their own life in accordance with the act can be provided; and that the person may decide at any time not to take those steps (and how to cancel the first declaration and any further steps)

f. advise the person to inform a registered medical practitioner with the person's GP practice that the person is requesting assistance to end their own life;

g. if appropriate, to advise the person to consider discussing the request with their next of kin and any other persons they are close to.

104 Subsections (3) and (4) require the assessing doctor to consult a health or social care professional with relevant qualifications or experience, if they consider there is a need to do so. Where such a consultation takes place, the assessing doctor must give a written record of the consultation to the other assessing doctor.

105 Under subsection (5) it is provided that an assessing doctor must make provision of adjustment for language and literacy barriers

106 Subsection (6) sets out that if the doctor carrying out the assessment has a doubt as to whether the person being assessed is terminally ill, the doctor must obtain an opinion from a specialist in the illness, disease or condition in question. If the doctor carrying out the assessment has doubt as to the capacity of the person being assessed, they must refer the person for assessment by a psychiatrist or other suitably qualified person. The assessing doctor must take account of any opinion provided by the above mentioned medical practitioners.

107 Subsections (7) and (8) require that any opinion provided to one assessing doctor under subsection (6) is shared with the other assessing doctor and that if the independent doctor is required to obtain an opinion under subsection (6)(a) then that duty may either be discharged by an opinion sought by the coordinating doctor or by their own referral.

12
Doctors’ assessments: further provision
20
 
(1)
In this section “assessing doctor” means—
 
 
(a)
the coordinating doctor carrying out the first assessment;
 
 
(b)
the independent doctor carrying out the second assessment.
 
 
(2)
The assessing doctor must—
 
 
(a)
examine the person and examine such of their medical records as
25
 
appear to the assessing doctor to be relevant;
 
 
(b)
make such enquiries of professionals who are providing or have
 
 
recently provided health or social care to the person as the assessing
 
 
doctor considers appropriate, and such other enquiries as the assessing
 
 
doctor considers appropriate;
30
 
(c)
explain to and discuss with the person being assessed—
 
 
(i)
the person’s diagnosis and prognosis;
 
 
(ii)
any treatment available and the likely effect of it;
 
 
(iii)
any available palliative, hospice or other care, including
 
 
symptom management and psychological support;
35
 
(iv)
the nature of the substance that is to be provided to assist the
 
 
person to end their own life (including how it will bring about
 
 
death and how it will be administered);
 
 
(d)
discuss with the person their wishes in the event of complications
 
 
arising in connection with the self-administration of an approved
40
 
substance under section 25 ;
 
 
(e)
inform the person—
 

Page 10

 
(i)
of the further steps that must be taken before assistance can
 
 
be provided to the person to end their own life in accordance
 
 
with this Act;
 
 
(ii)
that the person may decide at any time not to take any of those
 
 
steps (and of how to cancel the first declaration and any of
5
 
those further steps);
 
 
(f)
advise the person to inform a registered medical practitioner with the
 
 
person’s GP practice that the person is requesting assistance to end
 
 
their own life (unless the assessing doctor is themselves a practitioner
 
 
with that practice);
10
 
(g)
in so far as the assessing doctor considers it appropriate, advise the
 
 
person to consider discussing the request with their next of kin and
 
 
other persons they are close to.
 
 
(3)
To inform their assessment, the assessing doctor must—
 
 
(a)
consider whether they should consult a health professional or social
15
 
care professional with qualifications in, or experience of, a matter
 
 
relevant to the person being assessed;
 
 
(b)
consult such a professional if they consider that there is a need to do
 
 
so.
 
 
(4)
Where an assessing doctor consults a professional under subsection (3) (b)
20
 
, the assessing doctor must give a written record of the consultation to the
 
 
other assessing doctor.
 
 
(5)
When carrying out an assessment in accordance with subsection (2) , the
 
 
assessing doctor must first ensure the provision of adjustments for language
 
 
and literacy barriers, including the use of interpreters.
25
 
(6)
To inform their assessment, the assessing doctor—
 
 
(a)
must, if they have doubt as to whether the person being assessed is
 
 
terminally ill, refer the person for assessment by a registered medical
 
 
practitioner who holds qualifications in or has experience of the
 
 
diagnosis and management of the illness or disease in question;
30
 
(b)
must, if they have doubt as to the capacity of the person being
 
 
assessed, refer the person for assessment by a registered medical
 
 
practitioner who is a practising psychiatrist registered in one of the
 
 
psychiatry specialisms in the Specialist Register kept by the General
 
 
Medical Council or who otherwise holds qualifications in or has
35
 
experience of the assessment of capacity;
 
 
(c)
must, if they make a referral under paragraph (a) or (b) , take account
 
 
of any opinion provided by that other registered medical practitioner.
 
 
(7)
An opinion provided to one assessing doctor under subsection (6) (a) or (b)
 
 
must be shared with the other assessing doctor.
40
 
(8)
Where the independent doctor is required to obtain an opinion under
 
 
subsection (6) (a) —
 
 
(a)
that duty may be discharged by an opinion obtained under that
 
 
provision by the coordinating doctor, or
 

Page 11

 
(b)
the independent doctor may make their own referral under that
 
 
provision.
 
"Another independent doctor: second opinion"

Source HL Bill 112 Explanatory Notes

108 Clause 13 applies where the independent doctor has carried out the second assessment and made a report stating that they are not satisfied that all the matters in section 11(2) have been met (subsection 1).

109 Subsections (2) and (3) permit the coordinating doctor to refer the person, if they request, to another registered medical professional who meets the requirements for the independent doctor for a further assessment. This independent doctor must be provided with the report from the initial independent doctor and if they disagree with that doctor's assessment then must produce their own report both of which must be made available to any subsequent decision makers.

110 Subsection (4) provides that where a referral is made to a doctor under this section they shall be treated as the independent doctor and the provisions of clauses 11, 12 and 15 also apply to this assessment.

111 Subsection (5) provides that only one referral for a second opinion can be made under this clause. This is subject to clause 13(6) and 15(6)(a)(ii). which applies in circumstances where the independent doctor is unwilling or unable to continue to act.

112 Subsection (6) permits a further referral in circumstances where, after the first referral was made under subsection (2), the independent doctor dies or through illness is unable or unwilling to act as the independent doctor, and so has not made a report.

13
Another independent doctor: second opinion
 
 
(1)
This section applies where the independent doctor has—
 
 
(a)
carried out the second assessment, and
5
 
(b)
made a report stating that they are not satisfied as to all of the matters
 
 
mentioned in section 11 (2) (a) to (e) .
 
 
(2)
The coordinating doctor may, if requested to do so by the person who made
 
 
the first declaration, refer that person to a different registered medical
 
 
practitioner who meets the requirements of section 11 (8) and is able and
10
 
willing to carry out a further assessment of the kind mentioned in section
 
 
11 (2) .
 
 
(3)
Where a referral is made to a registered medical practitioner under subsection
 
 
(2) —
 
 
(a)
the coordinating doctor must provide that new registered medical
15
 
practitioner with the report by the independent doctor setting out
 
 
their reasons for refusal;
 
 
(b)
if the new registered medical practitioner reaches a different conclusion
 
 
from the original independent doctor, they must produce a report
 
 
setting out why they disagree;
20
 
(c)
those two reports must be made available to any subsequent decision
 
 
maker under this Act and to the Commissioner.
 
 
(4)
Where a referral is made to a registered medical practitioner under subsection
 
 
(2) , that referral is treated as a referral under section 10 (3) (c) , the practitioner
 
 
becomes the independent doctor (replacing the registered medical practitioner
25
 
to whom a referral was originally made) and sections 11 , 12 and 15 apply
 
 
accordingly.
 
 
(5)
In consequence of a particular first declaration made by a person, the
 
 
coordinating doctor may make only one referral for a second opinion under
 
 
subsection (2) ; but this is subject to subsection (6) and section 15 (6) (a) (ii) .
30
 
(6)
Where—
 
 
(a)
a referral is made under subsection (2) to a practitioner,
 
 
(b)
the practitioner dies or through illness is unable or unwilling to act
 
 
as the independent doctor, and
 
 
(c)
no report under section 11 has been made by virtue of the referral,
35
 
a further referral may be made under subsection (2) .
 
"Replacing the coordinating doctor on death etc"

Source HL Bill 112 Explanatory Notes

113 The coordinating doctor who witnesses the first declaration under clause 8 has a variety of functions under the Bill. This clause enables the Secretary of State to make regulations providing for cases where the original coordinating doctor becomes unable or unwilling to continue to carry out these functions part way through the process. This will ensure continuity of care for the person who made the first declaration.

114 Equivalent provision is not needed for the independent doctor, as their functions are confined to the second assessment under clause 11. If they become unable or unwilling to continue to act before the second assessment is completed, a new referral could be made to an independent doctor for a second assessment.

14
Replacing the coordinating doctor on death etc
 
 
(1)
The Secretary of State may, by regulations, make provision about cases where,
 
 
after a first declaration has been witnessed by the coordinating doctor, that
 
 
doctor dies or through illness or otherwise is unable or unwilling to continue
40
 
to carry out the functions of the coordinating doctor.
 

Page 12

 
(2)
Regulations under subsection (1) may, in particular, make provision—
 
 
(a)
relating to the appointment, with the agreement of the person who
 
 
made the declaration, of a replacement coordinating doctor who meets
 
 
the requirements of section 8 (6) and is able and willing to carry out
 
 
the functions of the coordinating doctor;
5
 
(b)
to ensure continuity of care for that person despite the change in the
 
 
coordinating doctor.
 
"Replacing the coordinating or independent doctor where unable or unwilling"

Source HL Bill 112 Explanatory Notes

115 Clause 15 applies where after a first declaration has been witnessed by a coordinating doctor that doctor is unable or unwilling to continue with their functions after they have witnessed the first declaration, or where an independent doctor is unable or unwilling to carry out their functions after a referral is made under clause 10(3)(c) or clause 13(4) but before a report under clause 11 has been made (subsection 1). In this clause they are referred to as “the outgoing doctor".

116 Subsection (2) requires the outgoing doctor to give written notice of their inability or unwillingness to continue to carry out their functions to the person seeking assistance; the Commissioner; and, where the outgoing doctor is the independent doctor, to the coordinating doctor. This must be done as soon as practicable.

117 Subsection (3) provides that once the outgoing doctor gives written notice, their functions under the Bill cease, except for their duties under subsections (8) or (9).

118 Subsections (4) and (5) enable the Secretary of State to make regulations relating to the appointment (with agreement of the person seeking assistance) of a replacement coordinating doctor who meets the requirements of clause 8(6) and who is able and willing to carry out the functions of the coordinating doctor. The regulations may make provision to ensure continuity of care for the person seeking assistance despite the change in the coordinating doctor.

119 Subsection (6) provides that where an independent doctor gives written notice that they are unable or unwilling to continue with their functions, a further referral may be made, and the registered medical practitioner to whom that referral is made becomes the independent doctor and replaces the outgoing doctor.

120 Subsections (7), (8) and (9) provide that where the coordinating doctor gives notice that they are unable or unwilling to continue with their functions, or a coordinating doctor receives such notice from an independent doctor, it is the original coordinating doctor's responsibility to take steps to ensure that the giving of notice is recorded in the person's medical records.

121 If the coordinating doctor is already a registered medical practitioner at the person's GP practice, they must record that notice in the person's medical records as soon as practicable. If the coordinating doctor is not a practitioner with the person's GP practice, they must notify a practitioner with that practice that notice has been given. The practitioner who is notified must then record the notice in the person's medical records as soon as practicable.

 
15
Replacing the coordinating or independent doctor where unable or unwilling
 

to continue to act

 
 
(1)
This section applies where—
10
 
(a)
after a first declaration has been witnessed by the coordinating doctor,
 
 
that doctor is unable or unwilling to continue to carry out the functions
 
 
of the coordinating doctor, or
 
 
(b)
after a referral is made under section 10 (3) (c) (including a referral to
 
 
which section 13 (4) applies ) , but before a report under section 11 has
15
 
been made by virtue of that referral, the independent doctor is unable
 
 
or unwilling to continue to carry out the functions of the independent
 
 
doctor,
 
 
and in this section such a coordinating or independent doctor is referred to
 
 
as “the outgoing doctor”.
20
 
(2)
The outgoing doctor must as soon as practicable give written notice of their
 
 
inability or unwillingness to continue to carry out their functions under this
 
 
Act to—
 
 
(a)
the person seeking assistance,
 
 
(b)
the Commissioner, and
25
 
(c)
if the outgoing doctor is the independent doctor, the coordinating
 
 
doctor.
 
 
(3)
Any duty or power of the outgoing doctor under this Act that arose in
 
 
consequence of the declaration or referral mentioned in subsection (1) ceases
 
 
to have effect from the time the outgoing doctor complies with subsection
30
 
(2) ; but this does not apply to any duty under subsection (8) or (9) .
 
 
(4)
The Secretary of State may by regulations make provision relating to the
 
 
appointment, with the agreement of the person seeking assistance, of a
 
 
replacement coordinating doctor who meets the requirements of section 8 (6)
 
 
and who is able and willing to carry out the functions of the coordinating
35
 
doctor.
 
 
(5)
Regulations under subsection (4) may, in particular, make provision to ensure
 
 
continuity of care for the person seeking assistance despite the change in the
 
 
coordinating doctor.
 
 
(6)
Where the independent doctor gives a notice under subsection (2) —
40
 
(a)
a further referral may be made—
 
 
(i)
under section 10 (3) (c) (if section 13 does not apply), or
 

Page 13

 
(ii)
where section 13 applies, under subsection (2) of that section,
 
 
and
 
 
(b)
the registered medical practitioner to whom that referral is made
 
 
becomes the independent doctor (replacing the outgoing doctor) and
 
 
sections 11 to 13 (and this section) apply accordingly.
5
 
(7)
Subsections (8) and (9) apply where the coordinating doctor—
 
 
(a)
gives a notice under subsection (2) to the person seeking assistance,
 
 
or
 
 
(b)
receives a notice under that subsection given by the independent
 
 
doctor in relation to the person seeking assistance.
10
 
(8)
Where the coordinating doctor is a practitioner with the person’s GP practice,
 
 
the coordinating doctor must, as soon as practicable, record the giving of the
 
 
notice in the person’s medical records.
 
 
(9)
In any other case—
 
 
(a)
the coordinating doctor must, as soon as practicable, notify a registered
15
 
medical practitioner with that practice of the giving of the notice, and
 
 
(b)
the practitioner notified under paragraph (a) must, as soon as
 
 
practicable, record the giving of the notice in the person’s medical
 
 
records.
 
"Referral by Commissioner of case to multidisciplinary panel"

Source HL Bill 112 Explanatory Notes

122 Clause 16 sets out the process for the referral of a case from the Commissioner to an Assisted Dying Review Panel (panel). As per subsection (1) and (2), where the Commissioner receives a first declaration made by a person seeking assistance and the reports of the coordinating and independent doctors confirming their eligibility (under clauses 10 and 11), the Commissioner must, as soon as reasonably practicable, convene a panel from the list of eligible members, and refer the person's case to that panel.

123 Subsection (3) provides that where the Commissioner is notified that a first declaration has been cancelled, they must not refer the case to a panel, or must notify the panel of the cancellation if the case has already been referred.

124 Subsection (4) signposts to schedule 2 for further provision about the panels.

16
Referral by Commissioner of case to multidisciplinary panel
20
 
(1)
This section applies where the Commissioner receives—
 
 
(a)
a first declaration made by a person,
 
 
(b)
a report about the first assessment of the person which contains a
 
 
statement indicating that the coordinating doctor is satisfied as to all
 
 
of the matters mentioned in section 10 (2) (a) to (h) , and
25
 
(c)
a report about the second assessment of the person which contains a
 
 
statement indicating that the independent doctor is satisfied as to all
 
 
of the matters mentioned in section 11 (2) (a) to (e) .
 
 
(2)
The Commissioner must, as soon as reasonably practicable, refer the person’s
 
 
case to an Assisted Dying Review Panel for determination of the person’s
30
 
eligibility to be provided with assistance under section 25 .
 
 
(3)
But where the Commissioner receives a notification that the first declaration
 
 
has been cancelled—
 
 
(a)
the Commissioner must not refer the person’s case to such a panel,
 
 
and
35
 
(b)
if the person’s case has already been so referred, the Commissioner
 
 
must notify the panel of the cancellation.
 
 
(4)
Schedule 2 makes provision about Assisted Dying Review Panels.
 
"Determination by panel of eligibility for assistance"

Source HL Bill 112 Explanatory Notes

125 Clause 17 sets out the process for the consideration of a case by an Assisted Dying Review Panel (subsection 1).

126 Subsection 2 requires the panel to determine whether it is satisfied of the same matters assessed by the coordinating and independent doctor in clauses 10 and 11. The panel must also determine:

a. whether the requirements on the coordinating and independent doctor to determine eligibility under clauses 8 to 12 have been met in regard to the first declaration, the first and second assessments, and the report on these assessments; and

b. that before making the first declaration, but when the person was aged 18 or over, a registered medical practitioner conducted a preliminary discussion with the person.

127 Subsection 3 allows a panel to adopt a procedure as it considers appropriate for the case (subject to the following and Schedule 2).

128 Subsection (4) sets out that the panel must hear from and may question the coordinating doctor or the independent doctor, and the person seeking assistance (unless exceptional circumstances apply (as outlined in subsection (6)).

129 The panel may also hear from and may question the proxy of the person seeking assistance, and any other person, including those with relevant knowledge or experience relating to the person. This could include family members or other individuals interested in the welfare of the person, as well as other experts.

130 When hearing from the person seeking assistance, the doctors, and the person's proxy, this must be in person or by live video or audio link. Where the panel consider it appropriate for medical reasons, subsection (5) allows for the use of pre-recorded audio or video material.

131 Subsections (7) and (8) provide that only where a panel is satisfied (with the agreement from all three panel members as laid out in schedule 2), that the requirements of the Bill have been met, it must grant a certificate of eligibility. It must also notify the person to whom the referral relates, the coordinating doctor, the Commissioner, and any other person specified in regulations.

132 If notified that a first declaration has been cancelled, subsection (9) requires that the panel must cease to act and must not grant a certificate.

17
Determination by panel of eligibility for assistance
 
 
(1)
This section applies where a person’s case is referred under section 16 or 18
40
 
to an Assisted Dying Review Panel (“the panel”).
 

Page 14

 
(2)
The panel’s function is to determine whether it is satisfied of all of the
 
 
following matters—
 
 
(a)
that the requirements of sections 8 to 12 have been met in relation
 
 
to—
 
 
(i)
the first declaration,
5
 
(ii)
the first assessment and the report under section 10 on that
 
 
assessment, and
 
 
(iii)
the second assessment and the report under section 11 on that
 
 
assessment;
 
 
(b)
that the person is terminally ill;
10
 
(c)
that the person has capacity to make the decision to end their own
 
 
life;
 
 
(d)
that the person was aged 18 or over at the time the first declaration
 
 
was made;
 
 
(e)
that before making the first declaration, but when the person was aged
15
 
18 or over, a registered medical practitioner conducted a preliminary
 
 
discussion with the person;
 
 
(f)
that the person is ordinarily resident in England and Wales and has
 
 
been so resident for at least 12 months ending with the date of the
 
 
first declaration;
20
 
(g)
that the person is registered as a patient with a general medical practice
 
 
in England or Wales;
 
 
(h)
that the person has a clear, settled and informed wish to end their
 
 
own life;
 
 
(i)
that the person made the first declaration voluntarily and was not
25
 
coerced or pressured by any other person into making that declaration.
 
 
(3)
Subject to the following and to Schedule 2 , the panel may adopt such
 
 
procedure as it considers appropriate for the case.
 
 
(4)
The panel—
 
 
(a)
must hear from, and may question, the coordinating doctor or the
30
 
independent doctor (and may hear from and question both);
 
 
(b)
must (subject to subsection (6) ) hear from, and may question, the
 
 
person to whom the referral relates;
 
 
(c)
in a case to which section 21 applies, may hear from and may question
 
 
the person’s proxy;
35
 
(d)
may hear from and may question any other person;
 
 
(e)
may ask any person appearing to it to have relevant knowledge or
 
 
experience to report to it on such matters relating to the person to
 
 
whom the referral relates as it considers appropriate.
 
 
In paragraphs (a) to (c) the reference to hearing from or questioning a person
40
 
is to hearing from them, or questioning them, in person or by live video or
 
 
audio link.
 
 
(5)
Where the panel considers it appropriate for medical reasons, it may make
 
 
provision for the use of pre-recorded audio or video material for the purposes
 
 
of subsection (4).
45

Page 15

 
(6)
The duty under subsection (4) (b) to hear from the person to whom the referral
 
 
relates does not apply if the panel is of the opinion that there are exceptional
 
 
circumstances which justify not hearing from that person.
 
 
(7)
The panel—
 
 
(a)
must, if it is satisfied of all of the matters mentioned in subsection (2)
5
 
, grant a certificate to that effect (a “certificate of eligibility”);
 
 
(b)
must refuse to do so in any other case.
 
 
(8)
The panel must notify the following of its decision—
 
 
(a)
the person to whom the referral relates;
 
 
(b)
the coordinating doctor;
10
 
(c)
the Commissioner;
 
 
(d)
any other person specified in regulations made by the Secretary of
 
 
State.
 
 
Where it grants a certificate of eligibility, it must give a copy of the certificate
 
 
to each of these persons.
15
 
(9)
If the panel is notified that the first declaration has been cancelled, it must
 
 
cease to act in relation to the referral (and, in particular, it may not grant a
 
 
certificate of eligibility).
 
"Reconsideration of panel decisions refusing certificate of eligibility"

Source HL Bill 112 Explanatory Notes

133 Under clause 18, where a panel refuses to grant a certificate of eligibility, the person seeking assistance may apply to the Commissioner for their case to be reconsidered. Such an application can only be made once (subsections (1) and (2)).

134 If the Commissioner is satisfied that any of the following grounds apply, subsections (3) and (4) requires that they, as soon as is reasonably practicable, refer the case to a second panel for a fresh determination:

a. error of law;

b. Irrationality; and

C. procedural unfairness.

135 As detailed in subsections (5) and (6), the Commissioner must provide written reasons for their decision as to whether the application meets the criteria to be referred to a second panel. They must also notify the person who made the application, the coordinating doctor, and any person specified in regulations of their decision.

18
Reconsideration of panel decisions refusing certificate of eligibility
 
 
(1)
This section applies where—
20
 
(a)
a person’s case is referred under section 16 to an Assisted Dying
 
 
Review Panel (“the first panel”), and
 
 
(b)
the first panel refuses to grant a certificate of eligibility in respect of
 
 
the person.
 
 
(2)
The person may apply to the Commissioner for their case to be reconsidered
25
 
on the ground that the first panel’s decision—
 
 
(a)
contains an error of law,
 
 
(b)
is irrational, or
 
 
(c)
is procedurally unfair.
 
 
(3)
The Commissioner must consider an application without a hearing.
30
 
(4)
On the application—
 
 
(a)
if the Commissioner is satisfied that any of the grounds mentioned in
 
 
subsection (2) applies, they must as soon as reasonably practicable
 
 
refer the person’s case to a different Assisted Dying Review Panel for
 
 
a fresh determination under section 17 ;
35
 
(b)
in any other case, the Commissioner must dismiss the application.
 
 
(5)
The Commissioner must give reasons, in writing, for their decision.
 
 
(6)
The Commissioner must notify the following of the outcome of the application,
 
 
and give them a document containing their reasons for their decision—
 
 
(a)
the person who made the application;
40
 
(b)
the coordinating doctor;
 

Page 16

 
(c)
any other person specified in regulations made by the Secretary of
 
 
State.
 
"Confirmation of request for assistance: second declaration"

Source HL Bill 112 Explanatory Notes

136 Under subsection (1), where a person who wishes to be provided with assistance to end their own life has been granted a certificate of eligibility by a panel, and the second period of reflection has come to an end, the person must then make a further declaration under this clause ("the second declaration"). But the second declaration cannot be made until "the second period for reflection" has ended.

137 The second period for reflection begins on the day the certificate of eligibility is granted and lasts for 14 days, or, where the coordinating doctor reasonably believes that the person's death is likely to occur within one month, begins on the day the certificate was granted and lasts for 48 hours (subsection (2)).

138 Subsection (3) requires that the second declaration must be in the form set out in regulations made by the Secretary of State. It must be signed and dated by the person making the declaration and both the coordinating doctor and the witness must see the declaration being signed.

139 Subsection (4) requires the regulations to provide that the second declaration must contain particular information, including the person's full name, address and NHS number. It must also contain further declarations from the person seeking assistance, confirming that they have made a first declaration and have not cancelled it; they understand that they must make a second declaration; they are making the second declaration voluntarily and have not been coerced and pressured by any other person into making it; and that they understand that they may cancel the second declaration at any time.

140 As per subsection (5), the coordinating doctor may only witness the second declaration if the coordinating doctor is satisfied that the person making the declaration:

  • is terminally ill,
  • has the capacity to make the decision to end their own life,
  • has a clear, settled and informed wish to end their own life, and
  • is making the declaration voluntarily and has not been coerced or pressured by any other person into making it.

141 Under subsection (5) the coordinating doctor must make a statement to the effect that they are satisfied of the above if they are.

142 Subsection (7) requires that the statement must be in the form set out by the Secretary of State via regulations. It must be signed and dated by the coordinating doctor and witnessed by the same person who witnessed the second declaration under subsection 3(c).

143 Subsection (8) requires the regulations under subsection (7)(a) to provide that a statement under subsection (6) contain particular information, including the person's full name, address and NHS number. It must also contain the following declarations by the coordinating doctor (in addition to a declaration that they are satisfied the criteria in clause (5) are met):

a. a declaration that the coordinating doctor is satisfied that a certificate of eligibility has been granted;

b. a declaration that the second declaration was made after the end of the second period of reflection;

C. if the second declaration was made before the end of the period of 14 days, a declaration that they believe that the person's death is likely to occur before the end of the period of one month (beginning with the day the certificate of eligibility was granted); and

d. a declaration that neither the first declaration nor the second declaration has been cancelled.

144 Subsection (9) prevents a person from witnessing a declaration under subsection (3)(c)(ii) if they are disqualified from being a witness under clause 52.

145 Under subsection (10), where the coordinating doctor has witnessed a second declaration or has made or refused to make a statement under subsection (6), they must notify the Commissioner and provide a copy of the second declaration or any other statement under subsection (6).

19
Confirmation of request for assistance: second declaration
 
 
(1)
Where—
 
 
(a)
a certificate of eligibility has been granted in respect of a person, and
5
 
(b)
the second period for reflection has come to an end,
 
 
if the person wishes to be provided with assistance to end their own life in
 
 
accordance with this Act, the person must make a further declaration to that
 
 
effect (the “second declaration”).
 
 
(2)
In this section “the second period for reflection” means—
10
 
(a)
the period of 14 days beginning with the day on which the certificate
 
 
of eligibility was granted, or
 
 
(b)
where the coordinating doctor reasonably believes that the person’s
 
 
death is likely to occur before the end of the period of one month
 
 
beginning with the day that the certificate was granted, the period of
15
 
48 hours beginning with that day.
 
 
(3)
A second declaration must be—
 
 
(a)
in the form set out in regulations made by the Secretary of State,
 
 
(b)
signed and dated by the person making the declaration, and
 
 
(c)
witnessed by—
20
 
(i)
the coordinating doctor, and
 
 
(ii)
a person other than the coordinating doctor or the independent
 
 
doctor,
 
 
both of whom must see the declaration being signed.
 
 
(4)
Regulations under subsection (3) (a) must provide that a second declaration
25
 
contains—
 
 
(a)
the following information—
 
 
(i)
the person’s full name and address;
 
 
(ii)
the person’s NHS number;
 
 
(iii)
contact details for the person’s GP practice;
30
 
(iv)
specified information about the certificate of eligibility;
 
 
(b)
the following further declarations by the person—
 
 
(i)
a declaration that they have made a first declaration and have
 
 
not cancelled it;
 
 
(ii)
a declaration that they understand that they must make a
35
 
second declaration in order for assistance to be provided under
 
 
this Act;
 
 
(iii)
a declaration that they are making the second declaration
 
 
voluntarily and have not been coerced or pressured by any
 
 
other person into making it;
40
 
(iv)
a declaration that they understand that they may cancel the
 
 
second declaration at any time.
 
 
In this subsection “specified” means specified in the regulations.
 

Page 17

 
(5)
The coordinating doctor may witness a second declaration only if the
 
 
coordinating doctor is satisfied (immediately before witnessing it) that the
 
 
person making the declaration—
 
 
(a)
is terminally ill,
 
 
(b)
has the capacity to make the decision to end their own life,
5
 
(c)
has a clear, settled and informed wish to end their own life, and
 
 
(d)
is making the declaration voluntarily and has not been coerced or
 
 
pressured by any other person into making it.
 
 
(6)
If the coordinating doctor is so satisfied, they must make a statement to that
 
 
effect.
10
 
(7)
The statement under subsection (6) must be—
 
 
(a)
in the form set out in regulations made by the Secretary of State,
 
 
(b)
signed and dated by the coordinating doctor, and
 
 
(c)
witnessed by the same person who witnessed the second declaration
 
 
under subsection (3) (c) (ii) .
15
 
(8)
Regulations under subsection (7) (a) must provide that a statement under
 
 
subsection (6) contains—
 
 
(a)
the following information—
 
 
(i)
the person’s full name and address;
 
 
(ii)
the person’s NHS number;
20
 
(iii)
the coordinating doctor’s full name and work address;
 
 
(iv)
specified information about the certificate of eligibility;
 
 
(b)
the following declarations by the coordinating doctor (in addition to
 
 
a declaration that they are satisfied of all of the matters mentioned in
 
 
subsection (5) (a) to (d) )—
25
 
(i)
a declaration that they are satisfied that a certificate of eligibility
 
 
has been granted in respect of the person;
 
 
(ii)
a declaration that the second declaration was made after the
 
 
end of the second period for reflection;
 
 
(iii)
if the second declaration was made before the end of the period
30
 
mentioned in subsection (2) (a) , a declaration that they have the
 
 
belief mentioned in subsection (2) (b) ;
 
 
(iv)
a declaration that they are satisfied that neither the first
 
 
declaration nor the second declaration has been cancelled.
 
 
In this subsection “specified” means specified in the regulations.
35
 
(9)
A person may not witness a declaration under subsection (3) (c) (ii) if they are
 
 
disqualified under section 52 from being a witness.
 
 
(10)
Where the coordinating doctor has—
 
 
(a)
witnessed a second declaration, or
 
 
(b)
made or refused to make a statement under subsection (6) ,
40
 
the doctor must notify the Commissioner and give them a copy of the second
 
 
declaration or (as the case may be) any statement under subsection (6) .
 

Page 18

"Cancellation of declarations"

Source HL Bill 112 Explanatory Notes

146 This clause enables a person who has made a first or second declaration to cancel the declaration by giving notice to the coordinating doctor or to a doctor at their GP's practice. Notice may be given orally or in writing, or the cancellation indicated by a means of communication known to be used by the person concerned.

147 Subsection (2) provides that where the coordinating doctor receives a notice or an indication that the person seeking assistance wishes to cancel their declaration, they must notify the Commissioner of the cancellation as soon as practicable.

148 Where notice or an indication that the person wishes to cancel their declaration is given to a registered medical practitioner, subsection (3) requires that practitioner to notify the coordinating doctor and the Commissioner of the cancellation as soon as practicable.

149 A cancellation takes effect as soon as the notice or indication is given, and no further steps are then taken in reliance on the declaration.

20
Cancellation of declarations
 
 
(1)
A person who has made a first declaration or a second declaration may cancel
 
 
it by giving oral or written notice of the cancellation (or otherwise indicating
 
 
their decision to cancel in a manner of communication known to be used by
 
 
the person) to—
5
 
(a)
the coordinating doctor, or
 
 
(b)
any registered medical practitioner with the person’s GP practice.
 
 
(2)
Where notice or an indication is given to the coordinating doctor under
 
 
subsection (1) (a) , the doctor must as soon as practicable notify the
 
 
Commissioner of the cancellation.
10
 
(3)
Where notice or an indication is given to a registered medical practitioner
 
 
under subsection (1) (b) , the practitioner must, as soon as practicable, notify
 
 
the coordinating doctor and the Commissioner of the cancellation.
 
 
(4)
A cancellation under subsection (1) has effect from the time the notice or
 
 
indication is given.
15
 
(5)
From the time a first declaration is cancelled, any duty or power of the
 
 
coordinating doctor or the independent doctor under sections 10 to 12
 
 
(assessments, statements and referrals) that arose in consequence of that
 
 
declaration ceases to have effect.
 
"Signing by proxy"

Source HL Bill 112 Explanatory Notes

150 This clause makes provision for cases where the person intending to make a first declaration or a second declaration is unable to sign their own name.

151 Subsection (1) provides that they can authorise another person to sign the declaration on their behalf.

152 Subsection (2) sets out that a declaration signed by a person’s proxy in that person’s presence and in accordance with subsection (3) has the same effect as if signed by the person themselves.

153 Subsection (3) requires that the proxy add their full name and address, the capacity in which they qualify as a proxy, a statement that they have signed as a proxy, and the reason why the person was unable to sign their own name.

154 Under subsection (4) a proxy may not sign a declaration

a. unless they are satisfied that the person understands the nature and effect of the declaration,

b. if disqualified from being a proxy under section 52,

c. if it is a second declaration and the proxy signed the first declaration as a witness.

155 Under subsection (5), “proxy” is given the definition of a person who has known the person making the declaration personally for at least two years, or someone who meets the description specified in regulations made by Secretary of State.

156 Subsection (6) sets out that the provisions for the signing of declarations by proxies also include their cancellation.

157 Clause 52 provides that a proxy:

  • must be aged 18 or over,
  • must not be a relative of the person making the declaration, and
  • must not know or believe that they are a beneficiary under that person’s will or may otherwise benefit from the death of the person.
21
Signing by proxy
20
 
(1)
This section applies where a person intending to make a first declaration or
 
 
a second declaration—
 
 
(a)
declares to a proxy that they are unable to sign their own name (by
 
 
reason of physical impairment, being unable to read or for any other
 
 
reason), and
25
 
(b)
authorises the proxy to sign the declaration on their behalf.
 
 
(2)
A declaration signed by a proxy—
 
 
(a)
in the presence of the person, and
 
 
(b)
in accordance with subsection (3) ,
 
 
has the same effect as if signed by the person themselves.
30
 
(3)
Where a proxy signs a declaration, the proxy is to add, after their signature—
 
 
(a)
their full name and address,
 
 
(b)
the capacity in which they qualify as a proxy,
 
 
(c)
a statement that they have signed in that capacity as a proxy, and
 
 
(d)
the reason why the person was unable to sign their name.
35
 
(4)
A proxy may not sign a declaration—
 
 
(a)
unless satisfied that the person understands the nature and effect of
 
 
the making of the declaration,
 
 
(b)
if disqualified under section 52 from being a proxy, or
 
 
(c)
if it is a second declaration and the proxy signed the first declaration
40
 
as a witness.
 

Page 19

 
(5)
In this section “proxy” means—
 
 
(a)
a person who has known the person making the declaration personally
 
 
for at least two years, or
 
 
(b)
a person of a description specified in regulations made by the Secretary
 
 
of State.
5
 
(6)
For the purposes of this section “declaration” includes the cancellation of a
 
 
declaration.
 
"Independent advocate"

Source HL Bill 112 Explanatory Notes

158 This clause sets out the appointment of an independent advocate whose role is to provide support and advocacy to qualifying persons to enable them to effectively understand and engage with the Act.

159 Subsection (1) requires the Secretary of State to make provision for the appointment of persons as independent advocates through regulations.

160 Subsection (2) sets out what may, in particular, be included in regulations including who may appoint independent advocates, the training of those advocates, payments made for or in relation to carrying out the role, and obligations for persons performing functions included in the Act to ensure the presence of an independent advocate for qualifying persons.

161 Subsection (3) provides a description of the role of the independent advocate as providing support and advocacy for a qualifying person to enable them to effectively engage with and understand the Act.

162 Under subsection (4) are the qualifications for a person to have an independent advocate. A person is a "qualifying person" if they

a. have a learning disability, a mental disorder under section 1 of the Mental Health Act 1983, or autism

b. may experience substantial difficulty in understanding the process as set out under the Act and information relating to it or in communicating their views, wishes, or feelings

C. meet the qualifications as set out by the Secretary of State in regulations.

163 Subsection (5) requires that the regulations be made through the affirmative procedure.

22
Independent advocate
 
 
(1)
The Secretary of State must by regulations make provision as to the
 
 
appointment of persons as independent advocates.
10
 
(2)
The regulations may, in particular, provide—
 
 
(a)
that a person may act as an independent advocate only in such
 
 
circumstances, or only subject to such conditions, as may be specified
 
 
in the regulations;
 
 
(b)
for the appointment of a person as an independent advocate to be
15
 
subject to approval in accordance with the regulations;
 
 
(c)
persons that may appoint independent advocates;
 
 
(d)
provision for payments to be made to, or in relation to, persons
 
 
carrying out the function of an independent advocate under this
 
 
section;
20
 
(e)
training that such advocates must undertake before being appointable;
 
 
(f)
obligations on persons performing functions on this Act to ensure the
 
 
presence of an independent advocate for a qualifying person.
 
 
(3)
The role of independent advocates is to provide support and advocacy to a
 
 
qualifying person who is seeking to understand options around end of life
25
 
care, including the possibility of requesting assistance to end their own life,
 
 
to enable them to effectively understand and engage with all the provisions
 
 
of this Act.
 
 
(4)
For the purposes of subsection (2) a person is a “qualifying person” if they—
 
 
(a)
have—
30
 
(i)
a learning disability,
 
 
(ii)
a mental disorder under section 1 of the Mental Health Act
 
 
1983, or
 
 
(iii)
autism,
 
 
(b)
they may experience substantial difficulty in understanding the
35
 
processes or information relevant to those processes or communicating
 
 
their views, wishes or feelings, or
 
 
(c)
they meet criteria that the Secretary of State may specify by regulations.
 
 
(5)
Regulations may not be made under this section unless a draft of the statutory
 
 
instrument containing them has been laid before and approved by a resolution
40
 
of each House of Parliament.
 

Page 20

Information in medical records

 
"Recording of declarations, reports etc"

Source HL Bill 112 Explanatory Notes

164 Clause 23 provides a list of “recordable events", which are events which must be recorded in a person's medical records if they occur. These events are listed in subsection (1) and include where:

a. a first declaration is made;

b. a report about a first or second assessment is made under clause 10 or 11 respectively;

C. a certificate of eligibility has been granted;

d. a panel has refused to grant a certificate of eligibility;

e. a second declaration is made by a person;

f. and a statement is made under clause 19(6) or the coordinating doctor refuses to make such a statement.

165 Subsection (2) makes clear that "recordable event" means those events mentioned in subsection (1).

166 Where a coordinating doctor is a registered medical practitioner with the person's GP practice, subsection (3) requires them to record the occurrence of a recordable event in the person's medical records.

167 Where the coordinating doctor is not a registered medical practitioner with the person's GP practice, subsection requires them to notify a registered medical practitioner with that practice of the occurrence of the recordable event. The practitioner who has been notified must then record the occurrence of the recordable event in the person's medical records as soon as practicable.

168 Subsection (5) requires that a record made under subsection (3) or (4) include the original declaration, report or statement.

23
Recording of declarations, reports etc
 
 
(1)
This section applies where—
 
 
(a)
a first declaration is made by a person;
 
 
(b)
a report about the first assessment of a person is made under section
5
 
10 ;
 
 
(c)
a report about the second assessment of a person is made under section
 
 
11 ;
 
 
(d)
a certificate of eligibility has been granted in respect of a person;
 
 
(e)
a panel has refused to grant such a certificate;
10
 
(f)
a second declaration is made by a person;
 
 
(g)
a statement is made under section 19 (6) , or the coordinating doctor
 
 
refuses to make such a statement, in relation to a person.
 
 
(2)
In this section “recordable event” means an event mentioned in a paragraph
 
 
of subsection (1) .
15
 
(3)
Where the coordinating doctor is a practitioner with the person’s GP practice,
 
 
the coordinating doctor must, as soon as practicable, record the occurrence
 
 
of the recordable event in the person’s medical records.
 
 
(4)
In any other case—
 
 
(a)
the coordinating doctor must, as soon as practicable, give a registered
20
 
medical practitioner with that practice notice of the occurrence of the
 
 
recordable event, and
 
 
(b)
that practitioner must, as soon as practicable, record the occurrence
 
 
of the recordable event in the person’s medical records.
 
 
(5)
A record made under subsection (3) or (4) of a declaration, report or statement
25
 
within subsection (1) must include the original declaration, report or statement.
 
"Recording of cancellations"

Source HL Bill 112 Explanatory Notes

169 This clause provides for a cancellation of a first or second declaration to be recorded in the person's medical records.

170 Subsections (1) to (3) set out that if a notice or indication of a cancellation of a first or second declaration is given to a doctor at the person's GP practice then they must record it in the person's medical records as soon as practicable. If the doctor to whom the cancellation is given is not with the person's GP practice then they must notify a doctor who is and they must enter it into the persons medical records.

24
Recording of cancellations
 
 
(1)
This section applies where a person cancels a first declaration or a second
 
 
declaration under section 20 .
 
 
(2)
If the notice or indication under that section is given to a registered medical
30
 
practitioner with the person’s GP practice, that practitioner must, as soon as
 
 
practicable, record the cancellation in the person’s medical records.
 
 
(3)
In any other case—
 
 
(a)
the registered medical practitioner to whom notice or indication of
 
 
the cancellation is given must, as soon as practicable, notify a registered
35
 
medical practitioner with that practice of the cancellation, and
 
 
(b)
the practitioner notified under paragraph (a) must, as soon as
 
 
practicable, record the cancellation in the person’s medical records.
 

Page 21

Provision of assistance to end life

 
"Provision of assistance"

Source HL Bill 112 Explanatory Notes

171 This clause applies where a certificate of eligibility has been granted, the second period for reflection (see clause 19 (2)) has ended, the person has made a second declaration (which has not been cancelled) and the coordinating doctor has made the statement under clause 19(6). It governs the provision of assistance in the form of an approved substance (see clause 27), with which the person may end their own life.

172 If requirements under subsection (1) have been met, subsection (2) permits the coordinating doctor to provide that person with an approved substance with which they can end their own life.

173 Subsection (3) provides that the approved substance must be provided directly, and in person, by the coordinating doctor.

174 When providing an approved substance, subsection (4) requires the coordinating doctor to explain to the person that they do not have to proceed with an assisted death and may still cancel their declaration.

175 Subsection (5) provides that, at the time the approved substance is provided, the coordinating doctor must be satisfied that the person:

  • has capacity to make the decision to end their own life,
  • has a clear, settled and informed wish to end their own life, and
  • is requesting provision of that assistance voluntarily and has not been coerced or pressured by any other person into doing so.

176 Subsection (6) permits the coordinating doctor to be accompanied by other persons, including health professionals as the coordinating doctor thinks necessary.

177 Subsection (7) permits an approved substance to be provided to the person to whom assistance is being provided through a device to help with self-administration of the substance. The device must be provided directly, and in person, by the co-ordinating doctor.

178 Subsection (8) permits the coordinating doctor to prepare the approved substance for self-administration by the person, and to assist that person to ingest or self-administer the substance.

179 Subsections (9) makes clear that the decision to self-administer the approved substance, and the final act of doing so, must be taken by the person who has been given the substance.

180 Subsection (10) prohibits a coordinating doctor from administering an approved substance to another person with the intention of causing that person's death.

181 Subsection (11) provides that the coordinating doctor must remain with the person until either: the person has self-administered the substance and has either died or the procedure has failed; or the person has decided not to self-administer the approved substance.

182 Subsection (12) provides that the coordinating doctor conducting functions under subsection (11) does not need to be in the same room as the person who has been given assistance.

183 If the person informs or indicates to the coordinating doctor that they do not want to self-administer the approved substance, subsection (13) requires the coordinating doctor to remove the approved substance immediately from that person.

25
Provision of assistance
 
 
(1)
This section applies where—
 
 
(a)
a certificate of eligibility has been granted in respect of a person,
 
 
(b)
the second period for reflection (within the meaning of section 19 (2)
5
 
) has ended,
 
 
(c)
that person has made a second declaration which has not been
 
 
cancelled, and
 
 
(d)
the coordinating doctor has made the statement under section 19 (6) .
 
 
(2)
The coordinating doctor may, in accordance with this section, provide that
10
 
person with an approved substance (see section 27 ) with which the person
 
 
may end their own life.
 
 
(3)
The approved substance must be provided directly and in person by the
 
 
coordinating doctor to that person.
 
 
(4)
When providing a substance under subsection (2) the coordinating doctor
15
 
must explain to the person that they do not have to go ahead and
 
 
self-administer the substance and that they may still cancel their declaration.
 
 
(5)
The coordinating doctor must be satisfied, at the time the approved substance
 
 
is provided, that the person to whom it is provided—
 
 
(a)
has capacity to make the decision to end their own life,
20
 
(b)
has a clear, settled and informed wish to end their own life, and
 
 
(c)
is requesting provision of that assistance voluntarily and has not been
 
 
coerced or pressured by any other person into doing so.
 
 
(6)
The coordinating doctor may be accompanied by such other health
 
 
professionals, and such other persons, as the coordinating doctor thinks
25
 
necessary.
 
 
(7)
An approved substance may be provided to a person under subsection (2)
 
 
by—
 
 
(a)
preparing a device which will enable that person to self-administer
 
 
the substance, and
30
 
(b)
providing that person with the device.
 
 
In the case of an approved substance so provided, the reference in subsection
 
 
(3) to the approved substance is to be read as a reference to the device.
 
 
(8)
In respect of an approved substance which is provided to the person under
 
 
subsection (2) , the coordinating doctor may—
35
 
(a)
prepare that substance for self-administration by that person, and
 
 
(b)
assist that person to ingest or otherwise self-administer the substance.
 
 
(9)
But the decision to self-administer the approved substance and the final act
 
 
of doing so must be taken by the person to whom the substance has been
 
 
provided.
40

Page 22

 
(10)
Subsection (8) does not authorise the coordinating doctor to administer an
 
 
approved substance to another person with the intention of causing that
 
 
person’s death.
 
 
(11)
The coordinating doctor must remain with the person until—
 
 
(a)
the person has self-administered the approved substance and—
5
 
(i)
the person has died, or
 
 
(ii)
it is determined by the coordinating doctor that the procedure
 
 
has failed, or
 
 
(b)
the person has decided not to self-administer the approved substance.
 
 
(12)
For the purposes of subsection (11) , the coordinating doctor need not be in
10
 
the same room as the person to whom the assistance is provided.
 
 
(13)
Where the person informs the coordinating doctor that they have decided
 
 
not to self-administer the approved substance, or there is any other reason
 
 
to believe that the substance will not be used, the coordinating doctor must
 
 
remove it immediately from that person.
15
"Authorising another doctor to provide assistance"

Source HL Bill 112 Explanatory Notes

184 Subsection (1) provides that the coordinating doctor may authorise another named registered medical practitioner to exercise the coordinating doctor's functions under clause 25 in connection with the provision of assistance to a person. The authorisation must be in writing.

185 Subsection (2) sets out that an authorisation can only be made with the consultation and the consent, in writing, of the person who wishes to be provided with assistance. The Secretary of State can also set out in regulations the training, qualification and experience which the practitioner would require before they could be authorised under subsection (1).

186 Subsection (3) enables regulations made under subsection (2)(b) to provide that the required training, qualifications, and experience of an authorised registered medical practitioner is to be determined by a person specified in the regulations. A specified person could include a regulatory body which sets professional training.

187 Subsection (4) provides that the provisions under section 25 apply to the doctor authorised under subsection (1) as if they were the coordinating doctor.

188 Subsection (5) provides that where an authorised registered medical practitioner is not satisfied that all the matters mentioned in clause 25(5) have been met, they must notify the coordinating doctor immediately.

189 Subsection (6) disqualifies someone from providing written consent as required under subsection (2)(a) as a proxy if they have acted as a witness to the person's first or second declarations.

190 Under subsection (7) it is specified that regulations under subsection (2)(b) must include that training in respect of domestic abuse, including coercive control and financial abuse is mandatory.

26
Authorising another doctor to provide assistance
 
 
(1)
Subject to subsection (2) , the coordinating doctor may authorise, in writing,
 
 
a named registered medical practitioner to carry out the coordinating doctor’s
 
 
functions under section 25 .
 
 
(2)
A registered medical practitioner may be authorised under subsection (1)
20
 
only if—
 
 
(a)
the person to whom the assistance is being provided has been
 
 
consulted and has consented, in writing, to the authorisation of that
 
 
practitioner, and
 
 
(b)
that practitioner has completed such training, and gained such
25
 
qualifications and experience, as the Secretary of State may specify by
 
 
regulations.
 
 
(3)
Regulations under subsection (2) (b) may in particular provide that the required
 
 
training, qualifications or experience is to be determined by a person specified
 
 
in the regulations.
30
 
(4)
Where a registered medical practitioner is authorised under subsection (1) ,
 
 
section 25 applies as if references to the coordinating doctor were to that
 
 
registered medical practitioner.
 
 
(5)
Where a registered medical practitioner who is authorised under subsection
 
 
(1) is not satisfied of all of the matters mentioned in section 25 (5) , they must
35
 
notify the coordinating doctor immediately.
 
 
(6)
Section 21 (signing by proxy) applies in relation to a consent under subsection
 
 
(2) (a) as it applies in relation to a first or second declaration, except that, for
 
 
these purposes, section 21 (4) has effect as if for paragraph (c) there were
 
 
substituted—
40
 
“(c)
if the proxy signed the first or second declaration as a witness.”
 

Page 23

 
(7)
Regulations under subsection (2) (b) must specify that training in respect of
 
 
domestic abuse, including coercive control and financial abuse is mandatory.
 
"Meaning of “approved substance”"

Source HL Bill 112 Explanatory Notes

191 Subsection (1) requires the Secretary of State to make regulations specifying drugs or other substances for the purposes of the Bill.

192 Subsection (2) provides that in the Bill "approved substance" means a substance which is specified in regulations under subsection (1).

193 Subsection (3) signposts to clause 37, which contains powers to make provision about approved substances and devices for use in connection with the self-administration of approved substances.

27
Meaning of “approved substance”
 
 
(1)
The Secretary of State must, by regulations, specify one or more drugs or
 
 
other substances for the purposes of this Act.
5
 
(2)
In this Act “approved substance” means a drug or other substance specified
 
 
in regulations under subsection (1) .
 
 
(3)
See section 37 for powers to make provision about—
 
 
(a)
approved substances, and
 
 
(b)
devices for use or used in connection with the self-administration of
10
 
approved substances.
 
"Final Statement"

Source HL Bill 112 Explanatory Notes

194 Where a person has been provided with assistance to end their own life and the person has died as a result, subsections (1), (2) and (3) require the coordinating doctor to make a 'final statement' which must be in the form set out in regulations by the Secretary of State and signed and dated by the coordinating doctor.

195 Subsection (4) requires the coordinating doctor to give a copy of the final statement to the Commissioner as soon as practicable.

196 Subsection (5) requires regulations under subsection (3)(a) to provide that a final statement contains certain information, including the person's full name, date of birth, sex, ethnicity, last permanent address, and whether the person had a disability (other than a disability consisting of the illness or disease which caused the person to be terminally ill). This information could be potentially included by the Commissioner under duties laid out on clause 49.

197 Under subsections (6), (7) and (8) the making of the statement must be recorded in the person's medical records, and the original statement included as part of that record.

28
Final Statement
 
 
(1)
This section applies where a person has been provided with assistance to end
 
 
their own life in accordance with this Act and has died as a result.
 
 
(2)
The coordinating doctor must complete a statement to that effect (a “final
15
 
statement”).
 
 
(3)
The statement mentioned in subsection (2) must be—
 
 
(a)
in the form set out in regulations made by the Secretary of State, and
 
 
(b)
signed and dated by the coordinating doctor.
 
 
(4)
The coordinating doctor must, as soon as practicable, give a copy of the final
20
 
statement to the Commissioner.
 
 
(5)
Regulations under subsection (3) (a) must provide that a final statement
 
 
contains the following information—
 
 
(a)
the person’s full name, date of birth, sex, ethnicity, and last permanent
 
 
address;
25
 
(b)
whether, immediately before death, the person had a disability within
 
 
the meaning of section 6 of the Equality Act 2010 (other than a
 
 
disability consisting of the illness or disease which caused the person
 
 
to be terminally ill within the meaning of this Act);
 
 
(c)
the person’s NHS number;
30
 
(d)
the name and address of the person’s GP practice (at the time of
 
 
death);
 
 
(e)
the coordinating doctor’s full name and work address;
 
 
(f)
the date of each of the following—
 
 
(i)
the first declaration;
35
 
(ii)
the report about the first assessment of the person;
 
 
(iii)
the report about the second assessment of the person;
 
 
(iv)
the certificate of eligibility;
 
 
(v)
the second declaration;
 
 
(vi)
the statement under section 19 (6) ;
40

Page 24

 
(g)
details of the illness or disease which caused the person to be
 
 
terminally ill (within the meaning of this Act);
 
 
(h)
the approved substance provided;
 
 
(i)
the date and time of death;
 
 
(j)
the time between use of the approved substance and death.
5
 
(6)
Where the coordinating doctor is a practitioner with the person’s GP practice,
 
 
the coordinating doctor must, as soon as practicable, record the making of
 
 
the statement in the person’s medical records.
 
 
(7)
In any other case—
 
 
(a)
the coordinating doctor must, as soon as practicable, inform a
10
 
registered medical practitioner with that practice of the making of the
 
 
statement, and
 
 
(b)
the practitioner so informed must, as soon as practicable, record the
 
 
statement in the person’s medical records.
 
 
(8)
A record made under subsection (6) or (7) must include the original statement.
15
"Report where assistance not provided because coordinating doctor not"

Source HL Bill 112 Explanatory Notes

198 As per subsection (1), clause 29 applies where a person is not provided with assistance to end their own life (clause 25) because the coordinating doctor is not satisfied that all the matters mentioned in clause 25(5) have been met.

199 In such circumstances, subsection (2) requires the coordinating doctor to make a report setting out why they are not satisfied.

200 Subsection (3) enables the Secretary of State to make provision through regulations about the content or form of the coordinating doctor's report.

201 Under subsection (4), the coordinating doctor is required to provide a copy of this report to the person denied assistance; if the coordinating doctor is not a practitioner with the person's GP's practice, a registered medical practitioner with that practice; and the Commissioner.

 
29
Report where assistance not provided because coordinating doctor not
 

satisfied of all relevant matters

 
 
(1)
This section applies where a person is not provided with assistance under
 
 
section 25 because the coordinating doctor is not satisfied as to all of the
 
 
matters mentioned in section 25 (5) .
20
 
(2)
The coordinating doctor must make a report which—
 
 
(a)
sets out the matters as to which they are not satisfied, and
 
 
(b)
contains an explanation of why they are not satisfied of those matters.
 
 
(3)
The Secretary of State may by regulations make provision about the content
 
 
or form of the report.
25
 
(4)
The coordinating doctor must give a copy of the report to—
 
 
(a)
the person,
 
 
(b)
if the coordinating doctor is not a practitioner with the person’s GP’s
 
 
practice, a registered medical practitioner with that practice, and
 
 
(c)
the Commissioner.
30
"Other matters to be recorded in medical records"

Source HL Bill 112 Explanatory Notes

202 This clause ensures that, where a person decides not to take an approved substance provided under clause 25 or the procedure fails for any reason, appropriate records are made in the person's medical record.

203 Subsection (2) requires that the coordinating doctor must notify the Commissioner, as soon as practicable, if a person decides not to take an approved substance or the procedure fails.

204 Subsection (3) and (4) require that, if the coordinating doctor is a practitioner in the person's GP practice, then they must record that a person has been provided with assistance to end their own life in their medical records as soon as practicable. If the coordinating doctor is outside of the person's GP practice then they must inform a doctor within it as soon as practicable who must enter the record into the person's medical records.

30
Other matters to be recorded in medical records
 
 
(1)
This section applies where a person is provided with assistance to end their
 
 
own life in accordance with this Act and either—
 
 
(a)
the person decides not to take the substance, or
 
 
(b)
the procedure fails.
35
 
(2)
The coordinating doctor must, as soon as practicable, notify the Commissioner
 
 
that this has happened.
 
 
(3)
Where the coordinating doctor is a practitioner with the person’s GP practice,
 
 
the coordinating doctor must, as soon as practicable, record that this has
 
 
happened in the person’s medical records.
40

Page 25

 
(4)
In any other case—
 
 
(a)
the coordinating doctor must, as soon as practicable, inform a
 
 
registered medical practitioner with that practice that this has
 
 
happened, and
 
 
(b)
the practitioner so informed must, as soon as practicable, record that
5
 
fact in the person’s medical records.
 

Protections for health professionals and others

 
"No obligation to provide assistance etc"

Source HL Bill 112 Explanatory Notes

205 Subsection (1) provides that no person is required to participate in the provision of assistance under the Bill.

206 Subsection (2) makes it clear that no registered medical practitioner is under a duty to become a coordinating doctor or independent doctor.

207 Subsection (3) provides that no registered medical practitioner, apart from the coordinating doctor or the independent doctor, is under any duty to perform any function in the Bill other than the giving of notifications and the recording of matters in medical records (as laid out in subsection (7)).

208 Subsection (4) provides that no health professional or social care professional is required to assist an assessing doctor who seeks their view under clause 12(3)b (requirement for assessing doctor to consult professional with relevant qualifications or experience).

209 Under subsection (5), registered pharmacists and registered pharmacy technicians are not required to participate in the supply of an approved substance for use in accordance with clause 25 (provision of assistance).

210 Subsection (6) provides that no one is obligated to act as a witness or as a proxy under the Bill.

211 Subsection (7) lists certain activities that cannot be opted out of and must be complied with. These relate to the giving of notifications under the Bill or the recording of matters in a person's medical records; keeping records or to provide information; and a professional responding to an assessing doctor about the health or social care they are providing, or have recently provided, to a person seeking an assisted death.

212 Subsection (8) amends the Employment Rights Act 1996 to protect workers from being subjected to detriment from their employer in the provision of assistance under the Bill or for exercising their right to refuse to do so.

213 Subsection (9) defines a “duty” in section 31 to include requirements arising from any contract, statute or otherwise. Subsection (9) also defines a "registered pharmacist" and "registered pharmacy technician" as having the same definition as in the Pharmacy Order 2010 (S.1. 2010/231).

31
No obligation to provide assistance etc
 
 
(1)
No person is under any duty to participate in the provision of assistance in
 
 
accordance with this Act.
10
 
(2)
No registered medical practitioner is under any duty to become—
 
 
(a)
the coordinating doctor in relation to any person, or
 
 
(b)
the independent doctor in relation to any person.
 
 
(3)
No registered medical practitioner, other than the coordinating doctor or the
 
 
independent doctor, is under any duty to perform any function under or in
15
 
connection with this Act other than—
 
 
(a)
a function relating to the giving of notifications, or
 
 
(b)
a function relating to the recording of matters in a person’s medical
 
 
records.
 
 
(4)
No health professional or social care professional is under any duty to respond
20
 
when consulted under section 12 (3) (b) (requirement for assessing doctor to
 
 
consult professional with relevant qualifications or experience).
 
 
(5)
No registered pharmacist or registered pharmacy technician is under any
 
 
duty to participate in the supply of an approved substance to a registered
 
 
medical practitioner for use in accordance with section 25 .
25
 
(6)
No person is under any duty to—
 
 
(a)
act as a witness under this Act, or
 
 
(b)
act as a proxy under this Act.
 
 
(7)
Nothing in this section affects—
 
 
(a)
any duty relating to the giving of notifications under this Act or the
30
 
recording of matters in a person’s medical records,
 
 
(b)
any duty relating to a requirement to keep records or to provide
 
 
information, or
 
 
(c)
any duty of a professional to respond to enquiries made under section
 
 
12 (2) (b) (enquiries by assessing doctor) relating to health or social care
35
 
the professional is providing, or has recently provided, to a person
 
 
seeking assistance under this Act.
 
 
(8)
Schedule 3 amends the Employment Rights Act 1996 to make provision to
 
 
protect employees and other workers from being subjected to any detriment
 
 
for—
40

Page 26

 
(a)
exercising (or proposing to exercise) a right under this section not to
 
 
participate in an activity or perform a function, or
 
 
(b)
participating in the provision of assistance in accordance with this Act
 
 
or performing any other function under this Act.
 
 
(9)
In this section—
5
 
(a)
a reference to a duty includes any duty, whether arising from any
 
 
contract, statute or otherwise;
 
 
(b)
“registered pharmacist” and “registered pharmacy technician” have
 
 
the same meaning as in the Pharmacy Order 2010 (S.I. 2010/231) (see
 
 
article 3 of that Order ).
10
"Criminal liability for providing assistance"

Source HL Bill 112 Explanatory Notes

214 Subsection (1) provides that a person is not guilty of an offence by virtue of:

  • providing assistance to a person in accordance with the Bill; or performing any other function under and in accordance with the Bill; or
  • assisting a person seeking to end their own life in accordance with the Bill, in connection with the doing of anything under the Bill

215 Subsection (2) provides that subsection (1) does not limit the circumstances in which a court can otherwise find a person who has assisted another to end their life has not committed an offence.

216 Additionally, subsection (3) amends the Suicide Act 1961 to insert a new section 2AA.

217 Section 2AA(1) provides that the following acts will not amount to an offence under section 2 of that Act (criminal liability for complicity in another person's suicide):

a. providing assistance to a person in accordance with the Bill;

b. performing any other function under and in accordance with the Bill; or

C. assisting a person seeking to end their own life in accordance with the Bill, in connection with the doing of anything under the Bill.

218 The offence under section 2 of the Suicide Act 1961 will continue to apply to other cases where a person encourages or assists the suicide or attempted suicide of another person. The new section 2AA inserted by clause 29(3) provides a defence to a charge under section 2 of the Suicide Act 1961 where the person proves that they:

  • reasonably believed they were acting in accordance with the Bill, and
  • took all reasonable precautions and exercised all due diligence to avoid the commission of the offence.
32
Criminal liability for providing assistance
 
 
(1)
A person is not guilty of an offence by virtue of—
 
 
(a)
providing assistance to a person to end their own life in accordance
 
 
with this Act, or performing any other function under this Act in
 
 
accordance with this Act, or
15
 
(b)
assisting a person seeking to end their own life in accordance with
 
 
this Act, in connection with the doing of anything under this Act.
 
 
(2)
Subsection (1) does not limit the circumstances in which a court can otherwise
 
 
find that a person who has assisted another to end their own life (or to attempt
 
 
to do so) has not committed an offence.
20
 
(3)
In the Suicide Act 1961, after section 2A (acts capable of encouraging or
 
 
assisting suicide) insert—
 
 
“2AA
Assistance provided under Terminally Ill Adults (End of Life) Act
 
 
2025
 
 
(1)
In sections 2(1) and 2A(1), a reference to an act that is capable of
25
 
encouraging or assisting suicide or attempted suicide does not
 
 
include—
 
 
(a)
providing assistance to a person to end their own life in
 
 
accordance with the Terminally Ill Adults (End of Life) Act
 
 
2025, or performing any other function under that Act in
30
 
accordance with that Act, or
 
 
(b)
assisting a person seeking to end their own life in accordance
 
 
with that Act, in connection with the doing of anything under
 
 
that Act.
 
 
(2)
It is a defence for a person charged with an offence under section 2
35
 
to prove that they—
 
 
(a)
reasonably believed they were acting in accordance with the
 
 
Terminally Ill Adults (End of Life) Act 2025, and
 
 
(b)
took all reasonable precautions and exercised all due diligence
 
 
to avoid the commission of the offence.”
40

Page 27

"Civil liability for providing assistance etc"

Source HL Bill 112 Explanatory Notes

219 Under subsection (1), providing assistance to a person to end their own life; performing any other function under the Bill; and assisting a person seeking to end their own life does not by its very nature give rise to any civil liability.

220 Subsection (2) makes clear that acts done dishonestly or not in good faith or that gives rise to a liability in tort from a breach of duty of care, such as clinically negligent healthcare, are not excused from civil liability.

221 Subsection (3) sets out that subsection (1) does not limit the circumstances in which a court can otherwise find a person not subject to civil liability.

33
Civil liability for providing assistance etc
 
 
(1)
The doing of any of the following does not, of itself, give rise to any civil
 
 
liability—
 
 
(a)
providing assistance to a person to end their own life in accordance
 
 
with this Act;
5
 
(b)
performing any other function under this Act in accordance with this
 
 
Act;
 
 
(c)
assisting a person seeking to end their own life in accordance with
 
 
this Act, in connection with the doing of anything under this Act.
 
 
(2)
Subsection (1) does not apply—
10
 
(a)
in relation to an act done dishonestly, or in some other way done
 
 
otherwise than in good faith, or
 
 
(b)
to any liability in tort arising from a breach of a duty of care owed to
 
 
a person.
 
 
(3)
Subsection (1) does not limit the circumstances in which a court can otherwise
15
 
find that a person who has assisted another person to end their own life, or
 
 
to attempt to do so, is not subject to civil liability.
 

Offences

 
"Dishonesty, coercion or pressure"

Source HL Bill 112 Explanatory Notes

222 This clause creates two new criminal offences.

223 Firstly, subsection (1) provides that a person commits an offence if, by dishonesty, coercion or pressure, they induce another person to make a first or second declaration under the Bill, or induce them not to cancel such a declaration. The maximum penalty for this offence is 14 years imprisonment (subsection (3)).

224 Secondly, subsection (2) provides that a person commits an offence if, by dishonesty, coercion or pressure, they induce another person to self-administer an approved substance provided in accordance with the Bill. The maximum penalty for this offence is life imprisonment (subsection (4)).

225 Proceedings for an offence under this clause may be brought only by or with the consent of the Director of Public Prosecutions as per subsection (5).

34
Dishonesty, coercion or pressure
 
 
(1)
A person who, by dishonesty, coercion or pressure, induces another person
20
 
to make a first or second declaration, or not to cancel such a declaration,
 
 
commits an offence.
 
 
(2)
A person who, by dishonesty, coercion or pressure, induces another person
 
 
to self-administer an approved substance provided under this Act commits
 
 
an offence.
25
 
(3)
A person who commits an offence under subsection (1) is liable on conviction
 
 
on indictment to imprisonment for a term not exceeding 14 years.
 
 
(4)
A person who commits an offence under subsection (2) is liable, on conviction
 
 
on indictment, to imprisonment for life.
 
 
(5)
Proceedings for an offence under this section may be instituted only by or
30
 
with the consent of the Director of Public Prosecutions.
 
"Falsification or destruction of documentation"

Source HL Bill 112 Explanatory Notes

226 This clause creates four new criminal offences relating to documentation in connection with the provision of assistance under the Bill.

227 Subsection (1)(a) makes it an offence to make or knowingly use a false instrument which purports to be a first or second declaration or a certificate of eligibility.

228 Subsection (1)(b) makes it an offence to intentionally or recklessly conceal or destroy a first or second declaration made by another person.

229 Subsection (2) makes it an offence to knowingly or recklessly provide, in relation to a person who has made a first declaration, a medical or other professional opinion which is in respect of a relevant matter and is false or misleading in a way that is significant.

230 Subsection (3) makes clear that the offence under subsection (2) relates only to an opinion about a matter relating to a function under the Bill (rather than, for example, a separate medical issue that the person seeking assistance under the Bill may happen to have).

231 Subsection (4) makes it an offence for a medical practitioner to fail to comply with an obligation under clause 20(2) or (3), which relate to the notification of a cancellation of declaration, or an obligation under clause 24, which relates to the recording of such a cancellation.

232 Under subsection (5) a person who commits an offence under this section is liable to imprisonment for a term not exceeding the general limit un a magistrate's court or a fine or both is on a summary conviction. On conviction on indictment they are liable to imprisonment for a term not exceeding five years, or a fine, or both.

233 Proceedings for an offence under this clause may be brought only by or with the consent of the Director of Public Prosecutions, as per subsection (6).

35
Falsification or destruction of documentation
 
 
(1)
A person commits an offence if they—
 
 
(a)
make or knowingly use a false instrument which purports to be—
 
 
(i)
a first declaration,
35
 
(ii)
a second declaration, or
 
 
(iii)
a certificate of eligibility, or
 
 
(b)
intentionally or recklessly conceal or destroy a first declaration or a
 
 
second declaration by another person.
 

Page 28

 
(2)
A person commits an offence if, in relation to another person who has made
 
 
a first declaration under this Act, they knowingly or recklessly provide a
 
 
medical or other professional opinion in respect of a relevant matter which
 
 
is false or misleading in a material particular.
 
 
(3)
In subsection (2) “relevant matter” means a matter relating to any function
5
 
under this Act.
 
 
(4)
A person commits an offence if they intentionally or recklessly fail to comply
 
 
with an obligation under—
 
 
(a)
section 20 (2) or (3) (notification of cancellation of declaration), or
 
 
(b)
section 24 (recording of cancellations).
10
 
(5)
A person who commits an offence under this section is liable—
 
 
(a)
on summary conviction, to imprisonment for a term not exceeding
 
 
the general limit in a magistrates’ court or a fine, or both;
 
 
(b)
on conviction on indictment to imprisonment for a term not exceeding
 
 
5 years or a fine, or both.
15
 
(6)
Proceedings for an offence under this section may be instituted only by or
 
 
with the consent of the Director of Public Prosecutions.
 
"Falsification of documentation etc with intent to facilitate provision of"

Source HL Bill 112 Explanatory Notes

234 This clause creates three new criminal offences relating to documentation, in connection with the provision of assistance under the Bill.

235 Subsection (1) creates offences where a person acts with an intention to facilitate the provision of assistance to another person under the Bill to end their own life and does one of the following things:

  • makes or knowingly uses a false instrument which purports to be a first declaration, a second declaration or a certificate of eligibility (subsection (1)(a));
  • provides a false or misleading medical or other professional opinion in respect to the other person seeking assistance (subsection (1)(b)); or
  • fails to comply with an obligation under clause 20(2) or (3), which relate to the notification of a cancellation of a declaration (subsection (1)(c)).

236 Subsection (2) makes clear that reference in subsection (1) to assistance under the Bill also includes assistance purporting to be under the Bill.

237 Subsection (3) creates a maximum penalty of 14 years' imprisonment for an offence under this clause.

238 Proceedings for an offence under this clause may be brought only by or with the consent of the Director of Public Prosecutions, as per subsection (4).

 
36
Falsification of documentation etc with intent to facilitate provision of
 

assistance

 
 
(1)
A person commits an offence if, with the intention of facilitating the provision
20
 
of assistance to a person (B) under this Act to end their own life, they—
 
 
(a)
make or knowingly use a false instrument which purports to be—
 
 
(i)
a first declaration,
 
 
(ii)
a second declaration, or
 
 
(iii)
a certificate of eligibility,
25
 
(b)
provide a medical or other professional opinion in respect of B which
 
 
is false or misleading in a material particular, or
 
 
(c)
fail to comply with an obligation under section 20 (2) or (3) (notification
 
 
of cancellation of declaration).
 
 
(2)
In subsection (1) the reference to assistance under this Act includes assistance
30
 
purporting to be under this Act.
 
 
(3)
A person who commits an offence under this section is liable, on conviction
 
 
on indictment, to imprisonment for a term not exceeding 14 years.
 
 
(4)
Proceedings for an offence under this section may be instituted only by or
 
 
with the consent of the Director of Public Prosecutions.
35

Regulatory regime for approved substances

 
"Regulation of approved substances and devices for self-administration"

Source HL Bill 112 Explanatory Notes

239 Subsection (1) and (2) require that the Secretary of State makes regulations about approved substances. The regulations must include provisions about:

a. the supply of approved substances;

b. the transportation, storage, handling and disposal of approved substances; and

C. record keeping relating to approved substances.

240 Subsection (3) enables provision to be made through regulations about:

a. the manufacture, importation, preparation or assembly of approved substances;

b. the monitoring of matters relating to approved substances; and

C. requiring specified persons, in specified cases, to give information to the Secretary of State.

241 Subsection (4) allows regulations to make provision about approved substances that is similar to or corresponds with any provision of the Human Medicines Regulations 2012, with or without modifications.

242 Subsection (5) enables the Secretary of State to make regulations providing for devices used for the self-administration of approved substances.

243 As per subsection (6), regulations must be made about enforcement relating to approved substances (such as imposing civil penalties).

244 Subsection (7) that regulations under this clause may make any provision that could be made by Act of Parliament.

245 Subsection (8) defines 'device' as including information in electronic form for use in connection with device.

37
Regulation of approved substances and devices for self-administration
 
 
(1)
The Secretary of State must by regulations make provision about approved
 
 
substances.
 

Page 29

 
(2)
The regulations must make provision about—
 
 
(a)
the supply or offer for supply, or administration, of approved
 
 
substances;
 
 
(b)
the transportation, storage, handling and disposal of approved
 
 
substances;
5
 
(c)
the keeping of records of matters relating to approved substances.
 
 
(3)
The regulations may in particular make provision—
 
 
(a)
about the manufacture, importation, preparation or assembly of
 
 
approved substances;
 
 
(b)
for or in connection with the monitoring of matters relating to
10
 
approved substances;
 
 
(c)
requiring persons specified in the regulations, in specified cases, to
 
 
give information to the Secretary of State.
 
 
(4)
The regulations may in particular—
 
 
(a)
make provision relating to approved substances that is similar to, or
15
 
that corresponds to, any provision of the Human Medicines Regulations
 
 
2012 (S.I. 2012/1916);
 
 
(b)
make provision applying any provision of those Regulations , with or
 
 
without modifications, in relation to approved substances.
 
 
(The regulations may also amend the Human Medicines Regulations 2012 .)
20
 
(5)
The Secretary of State may by regulations make provision about devices made
 
 
for use or used for, or in connection with, the self-administration of approved
 
 
substances.
 
 
(6)
Regulations under this section must make provision about enforcement (which
 
 
must include, but need not be limited to, provision imposing civil penalties).
25
 
(7)
Regulations under this section may make any provision that could be made
 
 
by an Act of Parliament; but they may not amend this Act.
 
 
(8)
In this section “device” includes information in electronic form for use in
 
 
connection with a device.
 

Investigation of deaths etc

30
"Investigation of deaths etc"

Source HL Bill 112 Explanatory Notes

246 Subsection (1) requires that a death resulting from the self-administration of an approved substance, provided in accordance with the Bill, is not to be treated as “unnatural” for the purposes of the duty to investigate deaths under Chapter 1 of the Coroners and Justice Act 2009. Therefore, such a death, when occurring under the lawful framework established by the Bill, does not automatically trigger a coroner's duty to investigate under section 1(2)(a) of the 2009 Act (which applies where a death is suspected to have been violent or unnatural). This does not prevent anyone from referring a death to the coroner where they have concerns that the death has not occurred in line with the provisions of the Bill. Deaths which are not investigated by a coroner are instead scrutinised by a medical examiner.

247 Subsection (2) amends section 20 of the 2009 Act to enable the Secretary of State to make regulations concerning the certification of deaths that arise from assistance provided under the Bill. The regulations may replicate or adapt existing provisions relating to medical certificates of cause of death, and may include additional measures deemed appropriate by the Secretary of State. The regulations must require that where it appears, to the best of the knowledge and belief of the certifying individual, that the cause of death was the self-administration of an approved substance under the Bill, the certificate must record the cause of death as "assisted death" and include details of the person's terminal illness or disease under the terms of the Bill.

248 Subsection (3) amends Schedule 1 to the 2009 Act, which deals with the suspension of coroner investigations where criminal proceedings for a “homicide offence” are likely or have been brought. It expands the definition of a “homicide offence” for these purposes to include offences under clauses 32 (criminal liability for providing assistance etc), 33 (civil liability for providing assistance etc), or 34 (dishonesty, coercion or pressure) of this Bill.

38
Investigation of deaths etc
 
 
(1)
In section 1 of the Coroners and Justice Act 2009 (duty to investigate certain
 
 
deaths), after subsection (7) insert—
 
 
“(7A)
In this Chapter a reference to an “unnatural death” does not include
 
 
a death caused by the self-administration by the deceased of an
35
 
approved substance, within the meaning of the Terminally Ill Adults
 
 
(End of Life) Act 2025, that was provided to the deceased in accordance
 
 
with that Act.”
 

Page 30

 
(2)
In section 20 of that Act (medical certificate of cause of death), after subsection
 
 
(4) insert—
 
 
“(4A)
Regulations under subsection (1) may make, in respect of cases where
 
 
assistance was provided or purportedly provided to the deceased
 
 
under the Terminally Ill Adults (End of Life) Act 2025—
5
 
(a)
such provision that is similar to, or that corresponds to,
 
 
provision mentioned in subsection (1) as the Secretary of State
 
 
considers appropriate;
 
 
(b)
such further provision as the Secretary of State considers
 
 
appropriate.
10
 
(4B)
Regulations under subsection (1) must provide that in cases where
 
 
the cause of death appears, to the best of the knowledge and belief of
 
 
the person issuing a certificate under the regulations, to be the
 
 
self-administration by the deceased of an approved substance (within
 
 
the meaning of the Terminally Ill Adults (End of Life) Act 2025) that
15
 
was provided to the deceased in accordance with that Act, the
 
 
certificate must—
 
 
(a)
state the cause of death to be “assisted death”, and
 
 
(b)
contain a record of the illness or disease which caused the
 
 
person to be terminally ill within the meaning of that Act.”
20
 
(3)
In Schedule 1 to that Act (suspension of investigations etc), in the definition
 
 
in paragraph 1(6) of “homicide offence”, after paragraph (d) insert—
 
 
“(e)
an offence under section 34 , 35 or 36 of the Terminally Ill
 
 
Adults (End of Life) Act 2025;”.
 

Codes and guidance

25
"Codes of practice"

Source HL Bill 112 Explanatory Notes

249 Subsection (1) requires the Secretary of State to issue codes of practice in relation to various matters relating to the operation of the Bill, including:

  • the assessment of whether a person has a clear and settled intention to end their own life, including assessing the person's capacity and recognising and taking effect of depression and other mental disorders;
  • the information made available under sections 5 and 12 (on treatment or palliative, hospice or other care) and under section 12 (on consequences of deciding to their own life);
  • the provision of information and support to persons with learning disabilities, including the role of independent advocates;
  • ensuring effective communication in connection with persons seeking assistance, including the use of interpreters;
  • the arrangements for providing approved substances, and assistance which may be given to ingest or self-administer them;
  • the arrangement for receiving the support of an independent advocate under section 22;
  • responding to unexpected complications in administering the approved substance under section 25, including when the procedure fails;
  • the forms of proof and identity that are acceptable for the purposes of section 9.

250 Subsection (2) enables the Secretary of State to also issue one or more codes of practice in connection with any other matters relating to the operation of the Bill which are not mentioned in subsection (1).

251 Subsection (3) requires the Secretary of State to consult such persons as the Secretary of State considers appropriate before issuing any code under this section.

252 Subsection (4) provides that codes under this section do not come until force until the Secretary of State by regulations so provides.

253 Subsection (5) provides that the code to which draft regulations relate must be laid before Parliament at the same time as the draft regulations.

254 Subsection (6) requires any person performing any function under the Bill to have regard to any relevant provision of a code.

255 Subsection (7) provides that a failure to have regard to a relevant provision of a code does not of itself cause a person to be liable to criminal or civil proceedings, but may be taken into account in such proceedings.

39
Codes of practice
 
 
(1)
The Secretary of State must 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—
30
 
(i)
assessing whether the person has capacity to make such a
 
 
decision;
 
 
(ii)
recognising and taking account of the effects of depression or
 
 
other mental disorders (within the meaning of the Mental
 
 
Health Act 1983) that may impair a person’s decision-making;
35
 
(b)
the information which is made available as mentioned in sections 5
 
 
and 12 on treatment or palliative, hospice or other care available to
 
 
the person and under section 12 on the consequences of deciding to
 
 
end their own life;
 
 
(c)
the provision of information and support to persons with learning
40
 
disabilities who are eligible to request assistance to end their own life
 
 
under this Act, including the role of advocates for such persons;
 

Page 31

 
(d)
ensuring effective communication in connection with persons seeking
 
 
assistance under this Act to end their own lives, including the use of
 
 
interpreters;
 
 
(e)
the arrangements for providing approved substances to the person
 
 
for whom they have been prescribed, and the assistance which such
5
 
a person may be given to ingest or self-administer them;
 
 
(f)
the arrangements for a qualifying person requesting assistance to end
 
 
their own life to receive the support of an independent advocate under
 
 
section 22 ;
 
 
(g)
responding to unexpected complications that arise in relation to the
10
 
administration of the approved substance under section 25 , including
 
 
when the procedure fails;
 
 
(h)
the forms of proof of identity that are acceptable for the purposes of
 
 
section 9 .
 
 
(2)
The Secretary of State may issue one or more codes of practice in connection
15
 
with any matters relating to the operation of this Act not required under
 
 
subsection (1) as the Secretary of State considers appropriate.
 
 
(3)
Before issuing a code under this section the Secretary of State must consult
 
 
such persons as the Secretary of State considers appropriate.
 
 
(4)
A code issued under subsection (1) does not come into force until the Secretary
20
 
of State by regulations so provides.
 
 
(5)
When draft regulations are laid before Parliament in accordance with section
 
 
54 , the code to which they relate must also be laid before Parliament.
 
 
(6)
A person performing any function under this Act must have regard to any
 
 
relevant provision of a code.
25
 
(7)
A failure to do so does not of itself render a person liable to any criminal or
 
 
civil proceedings but may be taken into account in any proceedings.
 
"Guidance about operation of Act"

Source HL Bill 112 Explanatory Notes

256 Subsection (1) requires the Secretary of State to issue guidance relating to the operation of the Bill.

257 Subsection (2) clarifies that the guidance need not (but may) relate to Welsh devolved matters.

258 Subsection (3) requires the Secretary of State, before issuing guidance, to consult:

a. the Chief Medical Officer for England and the Chief Medical Officer for Wales;

b. persons with learnings disabilities and other persons who have protected characteristics (defined in subsection (9)) as the Secretary of State considers appropriate;

C. representatives of health and social care providers (including providers of palliative or end of life care) as the Secretary of State considers appropriate;

d. the Welsh Ministers, but only if the guidance relates to Welsh devolved matters; and

e. such other persons as the Secretary of State consider appropriate.

259 Subsection (4) enables the Welsh Ministers to issue guidance relating to the operation of the Bill, but only about matters within devolved competence.

260 Subsection (5) explains that “within devolved competence” means a matter that would be within the legislative competence of Senedd Cymru if it was contained in an Act of the Senedd.

261 Before issuing guidance, subsection (6) requires that Welsh Ministers consult the same descriptions of persons as the Secretary of State must consult under subsection (3), except they do not have to consult themselves or the Chief Medical Officer for England, and they must consult the Secretary of State.

262 Subsection (7) puts a duty on the “appropriate national authority" (defined in subsection (9) as the Secretary of State or the Welsh Ministers) to, when preparing guidance, have regard to the need to provide practical and accessible information to persons (including persons with learning disabilities) requesting assistance to end their own lives, the next of kin and families of such persons, and the general public.

263 Subsection (8) requires the appropriate national authority to publish any guidance they issue.

40
Guidance about operation of Act
 
 
(1)
The Secretary of State must issue guidance relating to the operation of this
 
 
Act.
30
 
(2)
The guidance need not (but may) relate to matters about which the Welsh
 
 
Ministers may issue guidance under subsection (4) (“Welsh devolved matters”).
 
 
(3)
Before issuing guidance under subsection (1) , the Secretary of State must
 
 
consult—
 
 
(a)
the Chief Medical Officer for England,
35
 
(b)
the Chief Medical Officer for Wales,
 
 
(c)
such persons with learning disabilities and other persons who have
 
 
protected characteristics as the Secretary of State considers appropriate,
 
 
(d)
such persons appearing to represent providers of health or care
 
 
services, including providers of palliative or end of life care, as the
40
 
Secretary of State considers appropriate,
 

Page 32

 
(e)
if any part of the guidance relates to Welsh devolved matters, the
 
 
Welsh Ministers, and
 
 
(f)
such other persons as the Secretary of State considers appropriate.
 
 
(4)
The Welsh Ministers may issue guidance relating to the operation of this Act
 
 
in Wales, but the guidance must only be about matters within devolved
5
 
competence.
 
 
(5)
For this purpose, a matter is “within devolved competence” if provision about
 
 
it would be within the legislative competence of Senedd Cymru if it were
 
 
contained in an Act of the Senedd.
 
 
(6)
Before issuing guidance under subsection (4) , the Welsh Ministers must
10
 
consult—
 
 
(a)
the Chief Medical Officer for Wales,
 
 
(b)
the Secretary of State,
 
 
(c)
such persons with learning disabilities and other persons who have
 
 
protected characteristics as the Welsh Ministers consider appropriate,
15
 
(d)
such persons appearing to represent providers of health or care
 
 
services, including providers of palliative or end of life care, as the
 
 
Welsh Ministers consider appropriate, and
 
 
(e)
such other persons as the Welsh Ministers consider appropriate.
 
 
(7)
When preparing guidance under this section, an appropriate national authority
20
 
must have regard to the need to provide practical and accessible information,
 
 
advice and guidance to—
 
 
(a)
persons (including persons with learning disabilities) requesting or
 
 
considering requesting assistance to end their own lives;
 
 
(b)
the next of kin and families of such persons;
25
 
(c)
the general public.
 
 
(8)
An appropriate national authority must publish any guidance issued under
 
 
this section.
 
 
(9)
In this section—
 
 
“appropriate national authority” means the Secretary of State or the
30
 
Welsh Ministers;
 
 
“protected characteristics” has the same meaning as in Part 2 of the
 
 
Equality Act 2010 (see section 4 of that Act).
 

Provision of and about voluntary assisted dying services

 
"Voluntary assisted dying services: England"

Source HL Bill 112 Explanatory Notes

264 Subsections (1) and (2) requires the Secretary of State to make regulations, to secure that arrangements are made for the commissioning of voluntary assisted dying (VAD) services in England, referred to as commissioned VAD services.

265 Under subsection (3), the Secretary of State may also make regulations about voluntary assisted dying services in England (whether or not those are commissioned VAD services).

266 Subsection (4) gives an example of what may be done by regulations made under this section - that particular references in the National Health Services Act 2006 to the health service include references to commissioned VAD services.

267 Subsection (5) requires that regulations must provide that section 1(4) of the National Health Service Act 2006 (services to be provided free of charge except where charging expressly provided for) applies in relation to commissioned VAD services.

268 Subsection (6) provides that regulations under this section may make any provision that could be made by an Act of Parliament, but they cannot amend this Bill.

269 Subsection (7) defines, “voluntary assisted dying services" as:

a. services for or in connection with the provision of assistance in accordance with this Bill, and

b. any other services provided by health professionals for the purposes of sections 5 to 30 except section 17.

41
Voluntary assisted dying services: England
35
 
(1)
The Secretary of State must by regulations make provision securing that
 
 
arrangements are made for the provision of voluntary assisted dying services
 
 
in England.
 
 
(2)
In this section “commissioned VAD services” means services provided by
 
 
virtue of regulations under subsection (1) .
40

Page 33

 
(3)
The Secretary of State may by regulations make other provision about
 
 
voluntary assisted dying services in England (whether or not the services are
 
 
commissioned VAD services).
 
 
(4)
Regulations under this section may for example provide that specified
 
 
references in the National Health Service Act 2006 to the health service
5
 
continued under section 1(1) of that Act include references to commissioned
 
 
VAD services.
 
 
(5)
Regulations under this section must provide that section 1(4) of that Act
 
 
(services to be provided free of charge except where charging expressly
 
 
provided for) applies in relation to commissioned VAD services.
10
 
(6)
Regulations under this section may make any provision that could be made
 
 
by an Act of Parliament; but they may not amend this Act.
 
 
(7)
In this section “voluntary assisted dying services” means—
 
 
(a)
services for or in connection with the provision of assistance to a
 
 
person to end their own life in accordance with this Act, and
15
 
(b)
any other services provided by health professionals for the purposes
 
 
of any of sections 5 to 30 except section 17 .
 
"Voluntary assisted dying services: Wales"

Source HL Bill 112 Explanatory Notes

270 Subsections (1) and (2) enable Welsh Ministers to make regulations, about VAD services in Wales. Such regulations may make any provision that could be made by an Act of Senedd Cymru, provided it is within the legislative competence of the Senedd.

271 Subsections (3), and (4)) give the Secretary of State the power to make regulations about voluntary assisted dying services in Wales. Such regulations may make any provision that could be made by an Act of Parliament, provided it is within the legislative competence of the Senedd.

272 Subsection (5) provides that regulations under section 42 cannot amend the Bill.

273 Subsection (6) gives “voluntary assisted dying services" the meaning given in clause 41 (7) that is, services for or in connection with providing assistance in accordance with this Bill, and any other services provided by health professionals for the purposes of sections 5 to 30 except section 17. Subsection (6) also makes clear that regulations made under this clause may include provision securing that arrangements are made for the commissioning of VAD services.

42
Voluntary assisted dying services: Wales
 
 
(1)
The Welsh Ministers may by regulations make provision about voluntary
 
 
assisted dying services in Wales.
20
 
(2)
Regulations under subsection (1) may make any provision that—
 
 
(a)
could be made by an Act of Senedd Cymru, and
 
 
(b)
would be within the legislative competence of the Senedd if it were
 
 
contained in such an Act.
 
 
(3)
The Secretary of State may by regulations make provision about voluntary
25
 
assisted dying services in Wales.
 
 
(4)
Regulations under subsection (3) may make any provision that—
 
 
(a)
could be made by an Act of Parliament, and
 
 
(b)
would not be within the legislative competence of the Senedd if it
 
 
were contained in an Act of the Senedd.
30
 
(5)
Regulations under this section may not amend this Act.
 
 
(6)
In this section—
 
 
(a)
“voluntary assisted dying services” has the meaning given by section
 
 
41 ;
 
 
(b)
a reference to provision about voluntary assisted dying services
35
 
includes in particular provision securing that arrangements are made
 
 
for the provision of such services.
 

Page 34

Advertising

 
"Prohibition on advertising"

Source HL Bill 112 Explanatory Notes

274 Subsection (1) imposes a duty on the Secretary of State to make regulations prohibiting advertisements whose purpose or effect is to promote a voluntary assisted dying service.

275 Subsection (2) provides that these regulations may include exemptions, such as providing certain information to users or providers of services.

276 Subsection (3) provides that regulations made under clause 43 may make any provision that could be made by an Act of Parliament. This would enable future regulations to amend other legislation in order to achieve the desired prohibitions on advertising.

277 Under subsection (4), any offence created by regulations must be punishable with a fine.

278 A "voluntary assisted dying service" is defined in subsection (5) as:

a. any service for or in connection with the provision of assistance to a person in accordance with the Bill, or

b. any other service provided for the purposes of any sections 5 to 30.

43
Prohibition on advertising
 
 
(1)
The Secretary of State must by regulations make provision prohibiting—
 
 
(a)
the publication, printing, distribution or designing (anywhere) of
 
 
advertisements whose purpose or effect is to promote a voluntary
5
 
assisted dying service;
 
 
(b)
causing the publication, printing, distribution or designing of such
 
 
advertisements.
 
 
(2)
The regulations may contain exceptions (for example, for the provision of
 
 
certain information to users or providers of services).
10
 
(3)
Regulations under this section may make any provision that could be made
 
 
by an Act of Parliament.
 
 
(4)
But regulations under this section—
 
 
(a)
may not amend this Act, and
 
 
(b)
must provide that any offence created by the regulations is punishable
15
 
with a fine.
 
 
(5)
In this section “voluntary assisted dying service” means—
 
 
(a)
any service for or in connection with the provision of assistance to a
 
 
person to end their own life in accordance with this Act, or
 
 
(b)
any other service provided for the purposes of any of sections 5 to 30 .
20

Notifications and information

 
"Notifications and provision of information to Commissioner"

Source HL Bill 112 Explanatory Notes

279 Subsection (1) enables the Secretary of State to make regulations requiring a registered medical practitioner to notify the Commissioner of specified information.

280 Subsection (2) enables the Secretary of State to make regulations conferring on the Commissioner the ability to mandate specified persons to provide specified information.

281 Subsections (3) and (4) provide that regulations may set out the specific information required in such notifications; how the notifications are given; and the means to enforce the regulations.

44
Notifications and provision of information to Commissioner
 
 
(1)
The Secretary of State may by regulations make provision requiring a
 
 
registered medical practitioner to notify the Commissioner of the occurrence
 
 
of an event of a specified description.
25
 
(2)
The Secretary of State may by regulations make provision enabling the
 
 
Commissioner, by notice, to require persons (or a specified description of
 
 
persons) to give the Commissioner information (or a specified description of
 
 
information).
 
 
(3)
Regulations under this section may—
30
 
(a)
specify the information which must be contained in a notification
 
 
under subsection (1) ;
 
 
(b)
specify the manner in which such a notification must be given;
 
 
(c)
make provision about enforcement of the regulations.
 
 
(4)
In this section “specified” means specified in the regulations.
35

Page 35

"Information sharing"

Source HL Bill 112 Explanatory Notes

282 Subsections (1) and (2) authorises the sharing of information between the Commissioner and certain persons.

283 Subsection (3) enables the sharing of information between the Commissioner and the Care Quality Commission, the General Medical Council, the General Pharmaceutical Council, and the Nursing and Midwifery Council for the purposes of any of their functions. The Secretary of State may also specify in regulations any other persons that the Commissioner may share information with and vice versa for the purposes of their respective functions.

284 Subsection (4) enables the sharing of information between the Commissioner and the Secretary of State for the purposes of any function of the Commissioner or any function of the Secretary of State relating to the operation of the Bill.

45
Information sharing
 
 
(1)
The Commissioner may disclose information to a person within subsection
 
 
(3) , for the purposes of any function of either of them.
 
 
(2)
A person within subsection (3) may disclose information to the Commissioner,
 
 
for the purposes of any function of either of them.
5
 
(3)
The persons within this subsection are—
 
 
(a)
the Care Quality Commission;
 
 
(b)
the General Medical Council;
 
 
(c)
the General Pharmaceutical Council;
 
 
(d)
the Nursing and Midwifery Council;
10
 
(e)
any other person specified in regulations made by the Secretary of
 
 
State.
 
 
(4)
The Commissioner and the Secretary of State may disclose information to
 
 
each other, for the purposes of—
 
 
(a)
any function of the Commissioner, or
15
 
(b)
any function of the Secretary of State relating to the operation of this
 
 
Act.
 
"Obligations of confidence etc"

Source HL Bill 112 Explanatory Notes

285 Subsection (1) clarifies that where there is a disclosure of information that is required or authorised under the Bill, this will not breach any obligation of confidence or other restriction on disclosure.

286 Subsection (2) clarifies that the data protection legislation still applies and must be complied with.

287 Subsection (3) notes that “the data protection legislation” under this Bill has the same definition as in the Data Protection Act 2018.

46
Obligations of confidence etc
 
 
(1)
A disclosure of information which is required or authorised by or under this
 
 
Act does not breach—
20
 
(a)
any obligation of confidence owed by the person making the disclosure,
 
 
or
 
 
(b)
any other restriction on disclosure (however imposed).
 
 
This is subject to subsection (2) .
 
 
(2)
This Act does not (and regulations under it may not) require or authorise the
25
 
disclosure of information which would contravene the data protection
 
 
legislation (but in determining whether a disclosure required or authorised
 
 
by or under this Act would do so, the requirement or authorisation is to be
 
 
taken into account).
 
 
(3)
In this section “the data protection legislation” has the same meaning as in
30
 
the Data Protection Act 2018 (see section 3 of that Act).
 

Monitoring and review

 
"Reporting on implementation of Act"

Source HL Bill 112 Explanatory Notes

288 Subsection (1) places a duty on Secretary of State to, as soon as reasonably practicable after the end of each reporting period, prepare and publish, and lay before Parliament, a report about:

a. progress made in that period in connection with the implementation of the Bill; and

b. the Secretary of State's plans for implementing the Bill in subsequent reporting periods (including the expected timetable for implementation).

289 Subsections (2) and (3) set out the reporting periods as the first anniversary of the Bill from the day it has passed, and every six months thereafter, until the sixth and final reporting period.

47
Reporting on implementation of Act
 
 
(1)
As soon as reasonably practicable after the end of each reporting period, the
 
 
Secretary of State must prepare and publish, and lay before Parliament, a
35
 
report about—
 
 
(a)
progress made in that period in connection with the implementation
 
 
of this Act, and
 

Page 36

 
(b)
the Secretary of State’s plans for implementing the Act in subsequent
 
 
reporting periods (including the expected timetable for
 
 
implementation).
 
 
(2)
For the purposes of this section the reporting periods are—
 
 
(a)
the period of one year beginning with the day on which this Act is
5
 
passed;
 
 
(b)
each subsequent period of six months (subject to subsection (3) ).
 
 
(3)
The sixth reporting period under subsection (2) (b) is the last reporting period.
 
 
(4)
For the first reporting period referred to under subsection (2) (a) the report
 
 
must set out an assessment of the state of health services to persons with
10
 
palliative and end of life care needs and the implications of this Act on those
 
 
services.
 
 
(5)
The report under subsection (4) must, in particular, include an assessment of
 
 
the availability, quality and distribution of appropriate health services to
 
 
persons with palliative and end of life care needs, including—
15
 
(a)
pain and symptom management;
 
 
(b)
psychological support for those persons and their families;
 
 
(c)
information about palliative care and how to access it.
 
"Disability Advisory Board on the implementation and implications of the"

Source HL Bill 112 Explanatory Notes

290 Subsection (1) requires the Commissioner to appoint a Disability Advisory Board within six months of their appointment.

291 Subsection (2) sets out that the Board must include people who have a

 
48
Disability Advisory Board on the implementation and implications of the
 

Act for disabled people

20
 
(1)
The Commissioner must, within six months of the Commissioner being
 
 
appointed under this Act, appoint a Disability Advisory Board to advise on
 
 
the implementation and impact of this Act in its operation on disabled people.
 
 
(2)
The Board must include—
 
 
(a)
people who have a disability under the Equality Act 2010,
25
 
(b)
representatives from disabled people’s organisations, and
 
 
(c)
other such persons or organisations as the Commissioner considers
 
 
relevant to the impact of the Act on disabled people.
 
 
(3)
Within six months of its appointment, the Advisory Board must report to the
 
 
Secretary of State and the Commissioner to advise on the implementation of
30
 
the Act and then annually thereafter report on the impact of the Act’s
 
 
operation on disabled people.
 
 
(4)
The Secretary of State must, within three months of receipt of any report
 
 
under subsection (3), lay the report before both Houses of Parliament.
 
49
Monitoring by Commissioner
35
 
(1)
The Commissioner must—
 
 
(a)
monitor the operation of the Act, including compliance with its
 
 
provisions and any regulations or code of practice made under it,
 

Page 37

 
(b)
investigate, and report to an appropriate national authority on, any
 
 
matter connected with the operation of the Act which the appropriate
 
 
national authority refers to the Commissioner, and
 
 
(c)
submit an annual report to each appropriate national authority on the
 
 
operation of the Act.
5
 
(2)
The annual report must include information about the occasions when—
 
 
(a)
a report about the first assessment of a person does not contain a
 
 
statement indicating that the coordinating doctor is satisfied as to all
 
 
of the matters mentioned in section 10 (2) (a) to (h) ;
 
 
(b)
a report about the second assessment of a person does not contain a
10
 
statement indicating that the independent doctor is satisfied as to all
 
 
of the matters mentioned in section 11 (2) (a) to (e) ;
 
 
(c)
a panel has refused to grant a certificate of eligibility;
 
 
(d)
the coordinating doctor has refused to make a statement under section
 
 
19 (6) .
15
 
(3)
An annual report must include information about the application of the Act
 
 
in relation to—
 
 
(a)
persons who have protected characteristics, and
 
 
(b)
any other description of persons specified in regulations made by the
 
 
Secretary of State.
20
 
(4)
When preparing an annual report, the Commissioner must consult—
 
 
(a)
the Chief Medical Officer for England,
 
 
(b)
the Chief Medical Officer for Wales, and
 
 
(c)
such persons appearing to the Commissioner to represent the interests
 
 
of persons who have protected characteristics as the Commissioner
25
 
considers appropriate.
 
 
(5)
An appropriate national authority must—
 
 
(a)
publish any report received under this section,
 
 
(b)
prepare and publish a response to any such report, and
 
 
(c)
lay before Parliament or Senedd Cymru (as the case may be) a copy
30
 
of the report and response.
 
 
(6)
In this section “appropriate national authority” means the Secretary of State
 
 
or the Welsh Ministers.
 
 
(7)
In this section “protected characteristics” has the same meaning as in Part 2
 
 
of the Equality Act 2010 (see section 4 of that Act).
35
50
Review of this Act
 
 
(1)
The Secretary of State must, during the period of 12 months beginning at the
 
 
end of the initial 5-year period—
 
 
(a)
undertake a review of the operation of this Act,
 
 
(b)
prepare a report on that review, and
40
 
(c)
as soon as reasonably practicable, publish and lay the report before
 
 
Parliament.
 

Page 38

 
(2)
“The initial 5-year period” means the period of five years beginning with the
 
 
day on which this Act is passed.
 
 
(3)
The report must, in particular, set out—
 
 
(a)
the extent to which the Act has successfully met its aim of allowing
 
 
adults who are terminally ill, subject to safeguards and protections,
5
 
to request and be provided with assistance to end their own lives;
 
 
(b)
an assessment of the availability, quality and distribution of appropriate
 
 
health services to persons with palliative and end of life care needs,
 
 
including—
 
 
(i)
pain and symptom management;
10
 
(ii)
psychological support for those persons and their families;
 
 
(iii)
information about palliative care and how to access it;
 
 
(c)
an assessment of the impact of this Act on persons with learning
 
 
disabilities, including any concerns about the operation of this Act in
 
 
relation to such persons;
15
 
(d)
any concerns with the operation of this Act which have been raised;
 
 
(e)
the Secretary of State’s response to any such concerns, including any
 
 
recommendations for changes to codes of practice, guidance or any
 
 
enactment (including this Act).
 

General and final

20
51
Provision about the Welsh language
 
 
(1)
In this section “relevant person” means a person in Wales who wishes to be
 
 
provided with assistance to end their own life in accordance with this Act.
 
 
(2)
Subsection (3) applies where the Welsh Ministers make regulations under
 
 
section 42 (voluntary assisted dying services: Wales).
25
 
(3)
Regulations under that section must make such provision as the Welsh
 
 
Ministers consider appropriate for the purpose of ensuring that, where a
 
 
relevant person indicates that they wish to communicate in Welsh, all
 
 
reasonable steps are taken to secure that—
 
 
(a)
communications made by a person providing a voluntary assisted
30
 
dying service to the relevant person are in Welsh, and
 
 
(b)
any report about the first or second assessment of the relevant person
 
 
is in Welsh.
 
 
(4)
Where a relevant person informs the Commissioner that they wish to
 
 
communicate in Welsh, the Commissioner must take all reasonable steps to
35
 
secure that—
 
 
(a)
communications made by the Commissioner to the relevant person
 
 
are in Welsh,
 
 
(b)
each member of the panel to which the relevant person’s case is
 
 
referred speaks Welsh, and
40
 
(c)
communications made by that panel to the relevant person are in
 
 
Welsh,
 

Page 39

 
and any certificate of eligibility issued by that panel must be in Welsh.
 
 
(5)
Regulations under section 8 , 10 , 11 , 19 or 28 that specify the form of—
 
 
(a)
a first or second declaration,
 
 
(b)
a report about the first or second assessment of a person, or
 
 
(c)
a final statement,
5
 
must make provision for the forms to be in Welsh (as well as in English).
 
 
(6)
Before making regulations in pursuance of subsection (5) , the Secretary of
 
 
State must consult the Welsh Ministers.
 
 
(7)
In this section—
 
 
“panel” and “referred” have the meaning given by paragraph 1 of
10
 
Schedule 2 ;
 
 
“voluntary assisted dying service” has the meaning given by section 41 .
 
52
Disqualification from being witness or proxy
 
 
(1)
The individuals specified in subsection (2) are disqualified from—
 
 
(a)
witnessing a first declaration by a person under section 8 (2) (c) (ii) ;
15
 
(b)
witnessing a second declaration by a person under section 19 (3) (c) (ii) ;
 
 
(c)
being a proxy for a person intending to have a document signed by
 
 
proxy under section 21 .
 
 
(2)
Those individuals are—
 
 
(a)
any relative of the person;
20
 
(b)
anyone who knows or believes that they—
 
 
(i)
are a beneficiary under a will of the person, or
 
 
(ii)
may otherwise benefit financially or in any other material way
 
 
from the death of the person;
 
 
(c)
any health professional who has provided treatment or care for the
25
 
person in relation to that person’s terminal illness;
 
 
(d)
any person who has not attained the age of 18.
 
 
(3)
In subsection (2) (c) , the reference to “terminal illness” means the illness or
 
 
disease mentioned in section 2 (1) (a) .
 
53
Power to make consequential and transitional provision etc
30
 
The Secretary of State may by regulations make—
 
 
(a)
such supplementary, incidental or consequential provision, or
 
 
(b)
such transitory, transitional or saving provision,
 
 
as the Secretary of State considers appropriate for the purposes or in
 
 
consequence of any provision made by this Act.
35
54
Regulations
 
 
(1)
A power to make regulations under any provision of this Act includes power
 
 
to make—
 

Page 40

 
(a)
different provision for different purposes, and
 
 
(b)
incidental, consequential, transitional or saving provision.
 
 
(2)
Regulations under this Act are to be made by statutory instrument.
 
 
(3)
The Secretary of State may not make a statutory instrument containing
 
 
(whether alone or with other provision) regulations under section 8 (7) , 11 (9) ,
5
 
37 , 39 (4) , 41 , 42 , or 43 unless a draft of the instrument has been laid before,
 
 
and approved by a resolution of, each House of Parliament.
 
 
(4)
Any other statutory instrument made by the Secretary of State containing
 
 
regulations under this Act is subject to annulment in pursuance of a resolution
 
 
of either House of Parliament.
10
 
(5)
The Welsh Ministers may not make a statutory instrument containing
 
 
regulations under section 42 unless a draft of the instrument has been laid
 
 
before, and approved by a resolution of, Senedd Cymru.
 
 
(6)
This section does not apply to regulations under section 58 (commencement).
 
55
Duty to consult before making regulations
15
 
(1)
Before making regulations under section 8 , 10 , 11 , 19 , 26 or 28 , the Secretary
 
 
of State must consult—
 
 
(a)
the Commission for Equality and Human Rights, and
 
 
(b)
such other persons as the Secretary of State considers appropriate.
 
 
(2)
The persons to be consulted under subsection (1) (b) must include—
20
 
(a)
persons appearing to the Secretary of State to have expertise in matters
 
 
relating to whether persons have capacity, and
 
 
(b)
persons appearing to the Secretary of State to have expertise in matters
 
 
relating to whether persons have been coerced,
 
 
unless the Secretary of State considers that, having regard to the subject-matter
25
 
of the proposed regulations, it would not be appropriate to consult such
 
 
persons.
 
56
Interpretation
 
 
(1)
In this Act, references to the provision of assistance to a person to end their
 
 
own life in accordance with this Act are to the provision of assistance to that
30
 
person to end their own life in circumstances where the provision is authorised
 
 
by section 1 .
 
 
(2)
In this Act—
 
 
“approved substance” has the meaning given in section 27 (2) ;
 
 
“capacity” (except in section 21 (3) (b) ) is to be construed in accordance
35
 
with section 3 ;
 
 
“certificate of eligibility” has the same meaning as in section 17 ;
 
 
“the Commissioner” has the meaning given by section 4 ;
 
 
“the coordinating doctor” has the meaning given in section 8 (6) ;
 

Page 41

 
“domestic abuse” has the meaning given by section 1 of the Domestic
 
 
Abuse Act 2021 (and accordingly includes behaviour that is controlling
 
 
or coercive or that constitutes economic abuse);
 
 
“first assessment” has the same meaning as in section 10 ;
 
 
“first declaration” has the same meaning as in section 8 ;
5
 
“GP practice” , of a person, means the general medical practice with which
 
 
the person is registered;
 
 
“health professional” means—
 
 
(a)
a registered medical practitioner;
 
 
(b)
a registered nurse;
10
 
(c)
a registered pharmacist or a registered pharmacy technician
 
 
within the meaning of the Pharmacy Order 2010 (S.I. 2010/231)
 
 
(see article 3 of that Order);
 
 
“the independent doctor” has the meaning given in section 10 (3) (c) ;
 
 
“learning disability” has the meaning given by section 1(4) of the Mental
15
 
Health Act 1983;
 
 
“preliminary discussion” means a discussion of a kind mentioned in
 
 
section 5 (3) ;
 
 
“relative” , in relation to any person, means—
 
 
(a)
the spouse or civil partner of that person,
20
 
(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) ;
25
 
“second assessment” has the same meaning as in section 11 ;
 
 
“second declaration” has the same meaning as in section 19 .
 
 
(3)
For the purpose of deducing any relationship mentioned in the definition of
 
 
“relative” in subsection (2) —
 
 
(a)
a spouse or civil partner includes a former spouse or civil partner and
30
 
a partner to whom the person is not married, and
 
 
(b)
a step-child of any person is treated as that person’s child.
 
 
(4)
For the purposes of this Act, a registered medical practitioner is not to be
 
 
regarded as benefiting financially or in any other material way from the death
 
 
of a person by reason only of the practitioner receiving reasonable
35
 
remuneration for the provision of services in connection with the provision
 
 
of assistance to that person in accordance with this Act.
 
57
Extent
 
 
(1)
Subject as follows, this Act extends to England and Wales only.
 
 
(2)
Sections 37 , 43 , 54 and 56 , this section, and sections 58 and 59 extend to
40
 
England and Wales, Scotland and Northern Ireland.
 
 
(3)
Section 31 (8) and Schedule 3 extend to England and Wales and Scotland.
 

Page 42

58
Commencement
 
 
(1)
Sections 47 , 53 to 57 , this section and section 59 come into force on the day
 
 
on which this Act is passed.
 
 
(2)
Section 4 , except subsection (4) of that section, and Schedule 1 come into force
 
 
at the end of the period of one year beginning with the day on which this
5
 
Act is passed.
 
 
(3)
The other provisions of this Act come into force on such day or days as the
 
 
Secretary of State may by regulations appoint.
 
 
(4)
But if any provision of this Act has not been fully brought into force before
 
 
the end of the period of four years beginning with the day on which this Act
10
 
is passed, that provision (so far as not already in force) comes into force at
 
 
the end of that period.
 
 
(5)
Subsections (3) and (4) do not apply in relation to sections 42 (1) and (2) and
 
 
51 (2) and (3) , which come into force on such day as the Welsh Ministers may
 
 
by regulations appoint.
15
 
(6)
The Secretary of State may by regulations make transitional or saving provision
 
 
in connection with the coming into force of any provision of this Act.
 
 
(7)
The power to make regulations under this section includes power to make
 
 
different provision for different purposes.
 
 
(8)
Regulations under this section are to be made by statutory instrument.
20
59
Short title
 
 
This Act may be cited as the Terminally Ill Adults (End of Life) Act 2025.
 

Page 43

Schedules

 
 
Schedule 1
Section 4
 

The Voluntary Assisted Dying Commissioner

 

Status

 
 
1
(1)
The Commissioner is to be a corporation sole.
5
 
(2)
The Commissioner is not to be regarded as—
 
 
(a)
the servant or agent of the Crown, or
 
 
(b)
as enjoying any status, immunity or privilege of the Crown.
 
 
(3)
The Commissioner’s property is not to be regarded as property of, or
 
 
property held on behalf of, the Crown.
10

General powers

 
 
2
The Commissioner may do anything the Commissioner considers
 
 
appropriate for the purposes of, or in connection with, the Commissioner’s
 
 
functions.
 

Deputy Commissioner

15
 
3
(1)
The Prime Minister must appoint a person to be the Deputy Voluntary
 
 
Assisted Dying Commissioner (the “Deputy Commissioner”).
 
 
(2)
The person appointed must hold or have held office as a judge of—
 
 
(a)
the Supreme Court,
 
 
(b)
the Court of Appeal, or
20
 
(c)
the High Court.
 
 
(3)
The Commissioner may delegate any of the Commissioner’s functions to
 
 
the Deputy Commissioner, to the extent and on the terms that the
 
 
Commissioner determines.
 
 
(4)
The delegation of a function under sub-paragraph (3) does not prevent the
25
 
Commissioner from exercising that function.
 
 
(5)
The functions of the Commissioner are to be carried out by the Deputy
 
 
Commissioner if—
 
 
(a)
there is a vacancy in the office of the Commissioner, or
 
 
(b)
the Commissioner is for any reason unable or unwilling to act.
30

Appointment and tenure of office

 
 
4
(1)
A person holds and vacates office as the Commissioner or Deputy
 
 
Commissioner in accordance with the terms and conditions of their
 
 
appointment as determined by the Secretary of State, subject to the
 
 
provisions of this paragraph.
35

Page 44

 
(2)
An appointment as the Commissioner or Deputy Commissioner is to be
 
 
for a term not exceeding five years.
 
 
(3)
A person may not be appointed as the Commissioner or Deputy
 
 
Commissioner if a relevant appointment of them has been made on two
 
 
occasions.
5
 
“Relevant appointment” here means appointment as the Commissioner or
 
 
Deputy Commissioner.
 
 
(4)
The Commissioner or Deputy Commissioner may resign by giving written
 
 
notice to the Secretary of State.
 
 
(5)
The Secretary of State may by notice in writing remove a person from the
10
 
office of Commissioner or Deputy Commissioner if satisfied that the
 
 
person—
 
 
(a)
has behaved in a way that is not compatible with their continuing
 
 
in office, or
 
 
(b)
is unfit, unable or unwilling to properly discharge their functions.
15

Remuneration

 
 
5
The Secretary of State may pay to, or in respect of, the person holding
 
 
office as the Commissioner or Deputy Commissioner—
 
 
(a)
remuneration;
 
 
(b)
allowances;
20
 
(c)
sums by way of or in respect of pensions.
 

Staff: appointed by Commissioner

 
 
6
(1)
The Commissioner may appoint staff.
 
 
(2)
Staff are to be appointed on terms and conditions determined by the
 
 
Commissioner.
25
 
(3)
The terms and conditions on which a member of staff is appointed may
 
 
provide for the Commissioner to pay to or in respect of the member of
 
 
staff—
 
 
(a)
remuneration;
 
 
(b)
allowances;
30
 
(c)
sums by way of or in respect of pensions.
 
 
(4)
In making appointments under this paragraph, the Commissioner must
 
 
have regard to the principle of selection on merit on the basis of fair and
 
 
open competition.
 
 
(5)
The Employers’ Liability (Compulsory Insurance) Act 1969 does not require
35
 
insurance to be effected by the Commissioner.
 

Staff: secondment to Commissioner

 
 
7
(1)
The Commissioner may make arrangements for persons to be seconded to
 
 
the Commissioner to serve as members of the Commissioner’s staff.
 

Page 45

 
(2)
The arrangements may include provision for payments by the Commissioner
 
 
to the person with whom the arrangements are made or directly to seconded
 
 
staff (or both).
 
 
(3)
A period of secondment to the Commissioner does not affect the continuity
 
 
of a person’s employment with the employer from whose service he or she
5
 
is seconded.
 

Staff: general

 
 
8
(1)
Before appointing staff under paragraph 6 or making arrangements under
 
 
paragraph 7 (1) , the Commissioner must obtain the approval of the Secretary
 
 
of State as to the Commissioner’s policies on—
10
 
(a)
the number of staff to be appointed or seconded;
 
 
(b)
payments to be made to or in respect of staff;
 
 
(c)
the terms and conditions on which staff are to be appointed or
 
 
seconded.
 
 
(2)
A function of the Commissioner may be carried out by any of the
15
 
Commissioner’s staff to the extent authorised by the Commissioner (but
 
 
this is subject to sub-paragraph (3) ).
 
 
(3)
Sub-paragraph (2) does not apply in respect of—
 
 
(a)
the Commissioner’s function under paragraph 2 (1) of Schedule 2
 
 
of making appointments to the list of persons eligible to be panel
20
 
members;
 
 
(b)
the Commissioner’s function of determining applications for
 
 
reconsideration under section 18 .
 

Financial and other assistance from the Secretary of State

 
 
9
(1)
The Secretary of State may—
25
 
(a)
make payments to the Commissioner of such amounts as the
 
 
Secretary of State considers appropriate;
 
 
(b)
give such financial assistance to the Commissioner as the Secretary
 
 
of State considers appropriate.
 
 
(2)
The Secretary of State may—
30
 
(a)
provide staff in accordance with arrangements made by the Secretary
 
 
of State and the Commissioner under paragraph 7 ;
 
 
(b)
provide premises, facilities or other assistance to the Commissioner.
 

Accounts

 
 
10
(1)
The Commissioner must—
35
 
(a)
keep proper accounts and proper records in relation to them, and
 
 
(b)
prepare a statement of accounts in respect of each financial year in
 
 
the form specified by the Secretary of State.
 
 
(2)
The Commissioner must send a copy of each statement of accounts to the
 
 
Secretary of State and the Comptroller and Auditor General—
40

Page 46

 
(a)
before the end of August next following the end of the financial
 
 
year to which the statement relates, or
 
 
(b)
on or before such earlier date after the end of that year as the
 
 
Treasury may direct.
 
 
(3)
The Comptroller and Auditor General must—
5
 
(a)
examine, certify and report on the statement of accounts, and
 
 
(b)
send a copy of the certified statement and the report to the Secretary
 
 
of State.
 
 
(4)
The Secretary of State must lay before Parliament each document received
 
 
under sub-paragraph (3) (b) .
10
 
(5)
In this paragraph, “financial year” means—
 
 
(a)
the period beginning with the date on which the Commissioner is
 
 
established and ending with the second 31 March following that
 
 
date, and
 
 
(b)
each successive period of 12 months.
15

Application of seal and proof of documents

 
 
11
(1)
The application of the Commissioner’s seal is to be authenticated by the
 
 
signature of—
 
 
(a)
the Commissioner, or
 
 
(b)
a person who has been authorised by the Commissioner for that
20
 
purpose (whether generally or specially).
 
 
(2)
A document purporting to be duly executed under the Commissioner’s
 
 
seal or signed on the Commissioner’s behalf—
 
 
(a)
is to be received in evidence, and
 
 
(b)
is to be treated as duly executed or signed in that way, unless the
25
 
contrary is shown.
 

Public Records Act 1958

 
 
12
In Part 2 of the Table in paragraph 3 of the First Schedule to the Public
 
 
Records Act 1958 (bodies whose records are public records), at the
 
 
appropriate place insert—
30
 
“The Voluntary Assisted Dying Commissioner.”
 

House of Commons Disqualification Act 1975

 
 
13
In Part 3 of Schedule 1 to the House of Commons Disqualification Act 1975
 
 
(offices disqualifying person from membership of House of Commons), at
 
 
the appropriate place insert—
35
 
“The Voluntary Assisted Dying Commissioner or the Deputy
 
 
Voluntary Assisted Dying Commissioner.”
 

Page 47

Freedom of Information Act 2000

 
 
14
In Part 6 of Schedule 1 to the Freedom of Information Act 2000 (public
 
 
authorities for the purposes of the Act) , at the appropriate place insert—
 
 
“The Voluntary Assisted Dying Commissioner.”
 

Equality Act 2010

5
 
15
In Part 1 of Schedule 19 to the Equality Act 2010 (public authorities subject
 
 
to public sector equality duty), at the end of the group of entries for bodies
 
 
whose functions relate to health, social care and social security insert—
 
 
“The Voluntary Assisted Dying Commissioner.”
 
 
Schedule 2
Section 16
10

Assisted Dying Review Panels

 

Introduction

 
 
1
In this Schedule—
 
 
(a)
“referral” means a referral under section 16 or 18 (and similar
 
 
references are to be construed accordingly);
15
 
(b)
“panel” means an Assisted Dying Review Panel.
 

List of persons eligible to be panel members

 
 
2
(1)
The Commissioner must make appointments to a list of persons eligible to
 
 
sit as members of panels.
 
 
(2)
A person may be appointed to the list only if—
20
 
(a)
the person (a “legal member”)—
 
 
(i)
holds or has held high judicial office,
 
 
(ii)
is one of His Majesty’s Counsel, or
 
 
(iii)
has (at any time) been requested to act as a judge of the
 
 
Court of Appeal or the High Court by virtue of section 9 (1)
25
 
of the Senior Courts Act 1981 ,
 
 
(b)
the person (a “psychiatrist member”) is—
 
 
(i)
a registered medical practitioner,
 
 
(ii)
a practising psychiatrist, and
 
 
(iii)
registered in one of the psychiatry specialisms in the
30
 
Specialist Register kept by the General Medical Council, or
 
 
(c)
the person is registered as a social worker in a register maintained
 
 
by Social Work England or Social Work Wales (a “social worker
 
 
member”).
 
 
(3)
In this paragraph “high judicial office” means office as—
35
 
(a)
a judge of the Supreme Court,
 

Page 48

 
(b)
a judge of the Court of Appeal, or
 
 
(c)
a judge or deputy judge of the High Court.
 

Tenure of persons appointed to list

 
 
3
(1)
Subject to the provisions of this paragraph, persons on the list hold and
 
 
vacate their appointments in accordance with the terms on which they are
5
 
appointed.
 
 
(2)
An appointment to the list is to be for a period not exceeding five years.
 
 
(3)
A person who has held appointment to the list is eligible for re-appointment
 
 
for one further period not exceeding five years.
 

Membership of panels

10
 
4
(1)
The Commissioner must make arrangements for determining the
 
 
membership of a panel.
 
 
(2)
The arrangements must ensure that a panel consists of—
 
 
(a)
a legal member,
 
 
(b)
a psychiatrist member, and
15
 
(c)
a social worker member.
 
 
(3)
The Commissioner must ensure that each member of a panel has had
 
 
training in respect of domestic abuse, including coercive control and
 
 
financial abuse.
 

Decisions of panels

20
 
5
(1)
The legal member of a panel is to act as its chair.
 
 
(2)
Decisions of a panel may be taken by a majority vote; but this is subject
 
 
to sub-paragraph (3) .
 
 
(3)
The panel is to be treated as having decided to refuse to grant a certificate
 
 
of eligibility if any member—
25
 
(a)
votes against a decision to grant such a certificate, or
 
 
(b)
abstains from voting on such a decision.
 

Panel sittings

 
 
6
(1)
Panels are to determine referrals in public; but this is subject to
 
 
sub-paragraph (2) .
30
 
(2)
The chair of a panel may, at the request of the person to whom a referral
 
 
relates, decide that the panel is to sit in private.
 

Staff and facilities

 
 
7
The Commissioner may make staff and other facilities available to panels.
 

Page 49

Practice and procedure

 
 
8
(1)
The Commissioner may give guidance about the practice and procedure
 
 
of panels.
 
 
(2)
Panels must have regard to any such guidance in the exercise of their
 
 
functions.
5

Reasons

 
 
9
(1)
Panels must give reasons, in writing, for their decisions.
 
 
(2)
As soon as reasonably practicable after making a decision, a panel must
 
 
give the following a document containing its reasons for the decision—
 
 
(a)
the person to whom the referral in question relates;
10
 
(b)
the coordinating doctor in relation to the person;
 
 
(c)
the Commissioner.
 

Money

 
 
10
The Commissioner may pay to or in respect of members of panels—
 
 
(a)
remuneration;
15
 
(b)
allowances;
 
 
(c)
sums by way of or in respect of pensions.
 

House of Commons Disqualification Act 1975

 
 
11
In Part 3 of Schedule 1 to the House of Commons Disqualification Act 1975
 
 
(offices disqualifying persons from membership of House of Commons),
20
 
at the appropriate place insert—
 
 
“Person on the list of those eligible for membership of an Assisted
 
 
Dying Review Panel.”
 
 
Schedule 3
Section 31
 

Protection from detriment

25
 
1
The Employment Rights Act 1996 is amended as follows.
 
 
2
After section 43M insert—
 
 
“43N
Provision of assistance under Terminally Ill Adults (End of Life)
 
 
Act 2025
 
 
(1)
A worker has the right not to be subjected to any detriment by any
30
 
act, or any deliberate failure to act, by the worker’s employer done
 
 
on the ground that the worker has—
 
 
(a)
exercised (or proposed to exercise) a right conferred on the
 
 
worker under section 31 of the Terminally Ill Adults (End
 

Page 50

 
of Life) Act 2025 (no obligation to provide assistance etc),
 
 
or
 
 
(b)
participated in the provision of assistance to a person to end
 
 
their own life in accordance with that Act, or performed any
 
 
other function under that Act, in accordance with that Act.
5
 
(2)
Subsection (1) does not apply where—
 
 
(a)
the worker is an employee, and
 
 
(b)
the detriment in question amounts to dismissal within the
 
 
meaning of Part 10.
 
 
(3)
For the purposes of this section, and of sections 48 and 49 so far as
10
 
relating to this section, “worker” and “employer” have the extended
 
 
meaning given by section 43K.”
 
 
3
(1)
Section 48 (complaints to employment tribunals) is amended as follows.
 
 
(2)
After subsection (1) insert—
 
 
“(1WA)
A worker may present a complaint to an employment tribunal that
15
 
the worker has been subjected to a detriment in contravention of
 
 
section 43N (1) .”
 
 
(3)
In subsection (2) , after “(1)” insert “, (1WA) ”.
 
 
4
(1)
Section 49 (remedies) is amended as follows.
 
 
(2)
In subsection (1) , after “section 48(1)” insert “, (1WA) ”.
20
 
(3)
In subsection (2) , after “subsections” insert “ (5YA) ,”.
 
 
(4)
After subsection (5) insert—
 
 
“(5YA)
Where—
 
 
(a)
the complaint is made under section 48 (1WA) ,
 
 
(b)
the detriment to which the worker is subjected is the
25
 
termination of the worker’s contract, and
 
 
(c)
that contract is not a contract of employment,
 
 
any compensation must not exceed the compensation that would
 
 
be payable under Chapter 2 of Part 10 if the worker had been an
 
 
employee and had been dismissed for a reason specified in section
30
 
98C .”
 
 
5
After section 98B insert—
 
 
“98C
Provision of assistance under Terminally Ill Adults (End of Life)
 
 
Act 2025
 
 
An employee who is dismissed is to be regarded for the purposes
35
 
of this Part as unfairly dismissed if the reason (or if more than one,
 
 
the principal reason) for the dismissal is that the employee—
 
 
(a)
exercised (or proposed to exercise) a right conferred on the
 
 
employee under section 31 of the Terminally Ill Adults (End
 
 
of Life) Act 2025 (no obligation to provide assistance etc),
40
 
or
 

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(b)
participated in the provision of assistance to a person to end
 
 
their own life in accordance with that Act, or performed any
 
 
other function under that Act, in accordance with that Act.”
 
 
6
In section 105 (redundancy), after subsection (2A) insert—
 
 
“(2B)
This subsection applies if the reason (or, if more than one, the
5
 
principal reason) for which the employee was selected for dismissal
 
 
was one of those specified in section 98C .”
 
 
7
In section 108 (qualifying period of employment), in subsection (3), after
 
 
paragraph (aa) insert—
 
 
“(ab)
section 98C applies,”.
10
 
8
In section 205 (remedy for infringement of certain rights), after subsection
 
 
(1) insert—
 
 
“(1XA)
In relation to the right conferred by section 43N (1) , the reference in
 
 
subsection (1) to an employee has effect as a reference to a worker.”
 
 
9
In section 230 (definitions of employees, workers etc) in subsection (6)—
15
 
(a)
after “43K” insert “, 43N (3) ”;
 
 
(b)
after “Part IVA” insert “, section 43N ”.
 
Amendments

No amendments available.