Authored By: Zainab Ahmed
De Montfort University
Introduction
The discussion surrounding assisted suicide and euthanasia has long been a contentious issue in the UK, raising profound ethical, legal, and societal questions. At the heart of this discussion lies the tension between respect for personal autonomy and the need to protect vulnerable individuals. The introduction of the Terminally Ill Adults (End of Life) Bill 2024-25 marks another crucial moment in the UK’s consideration of this complex issue. This article examines the current legal framework, the proposed legislation, and relevant case law, drawing on principles of the European Convention on Human Rights (ECHR) and domestic judicial rulings.
Current Legal Framework
Under the Suicide Act 1961, while both suicide and attempted suicide are not considered criminal offences in England and Wales, helping or encouraging someone to end their life is still a crime. Section 2(1) of the Act states that it is an offence to intentionally encourage or assist the suicide or attempted suicide of another person, punishable by up to 14 years’ imprisonment. Prosecutions require the consent of the Director of Public Prosecutions (DPP), who must assess the evidence and determine whether prosecution serves the public interest.[1]
This strict prohibition reflects the societal interest in safeguarding life, especially for vulnerable individuals who may feel pressured to end their lives due to external factors such as illness, disability, or societal stigma.
The Terminally Ill Adults (End of Life) Bill
This bill was introduced by Labour MP Kim Leadbeater in October 2024 and aims to legalise assisted dying for terminally ill adults with a prognosis of six months or less to live.[2] The legislation proposes strict safeguards, including: (1) Confirmation by two independent doctors that the individual meets eligibility criteria, (2) A judicial review by the High Court to ensure compliance with the law, (3) A mandatory reflection period of 14 days, reduced to 48 hours if death is imminent, and (4) The self-administration of an “approved substance” prescribed by a doctor.
If enacted, the bill would amend the Suicide Act 1961 to decriminalise acts of assistance within the defined legal framework. However, assistance falling outside these parameters would still remain a criminal offence.
Judicial Perspectives & Human Rights
The debate over assisted suicide is heavily influenced by human rights considerations under the ECHR. Key rights engaged include:
- Article 2: The right to life
- Article 3: The prohibition of inhuman or degrading treatment
- Article 8: The right to respect for private and family life
- Article 14: The prohibition of discrimination.
In the case of R (Nicklinson) v Ministry of Justice,[3] the UK Supreme Court recognised that Article 8 includes the right to make decisions about how and when to end one’s life. However, the Court chose not to declare Section 2(1) of the Suicide Act as incompatible, highlighting that Parliament is the appropriate body for addressing the issue. This approach upholds the principle of separation of powers, asserting that any modifications to the law regarding assisted suicide should come from democratic discussions rather than judicial action.
The European Court of Human Rights (ECHR) has taken a similar stance, granting states a wide “margin of appreciation” to balance competing interests. In Pretty v United Kingdom,[4] the ECHR upheld the UK’s prohibition on assisted suicide, concluding that it pursued the legitimate aim of protecting vulnerable individuals and preserving public confidence in medical ethics.
The proposed bill includes judicial oversight, a feature first proposed by Lord Pannick in the 2014 Assisted Dying Bill. Judicial approval ensures that decisions are free from coercion and meet the legal criteria. However, this approach has drawn criticism from some quarters. Former High Court judge Sir James Munby has expressed concerns about the bill’s procedural uncertainties, particularly concerning the evidentiary standards judges should use, the rights of appeal, and the principle of open justice.[5]
While proponents claim that judicial involvement adds an essential layer of protection, critics question whether it is the judiciary’s role to approve life-ending decisions. These concerns highlight the ethical complexity of balancing judicial safeguards with personal autonomy.
Parliamentary History
The UK Parliament has previously debated assisted dying, particularly in 2015, when the Assisted Dying (No 2) Bill was rejected by 330 votes to 118.[6] Critics of the 2024 bill have pointed to the limited time allocated for private members’ bills and the risk of inadequate scrutiny. Nonetheless, the decision to allow a free vote on the matter, with the government taking a neutral stance, emphasises the bill’s moral and ethical importance.
One key aspect of the current bill is its limited scope, which applies only to terminally ill adults with a prognosis of six months or less. While this limitation aims to prevent a “slippery slope” towards broader eligibility, critics argue that it could lead to claims of discrimination under Article 14 of the ECHR. For example, individuals with chronic, non-terminal conditions or those experiencing intolerable suffering may argue that their exclusion infringes upon their rights to equal treatment.
Public Opinion
Public opinion on assisted suicide still remains divided. Supporters emphasise the importance of personal autonomy and dignity, arguing that terminally ill individuals should have the right to choose how and when they die. Organisations such as Dignity in Dying advocate for legal reform, highlighting cases where people have travelled abroad to access assisted dying services, often facing significant financial and emotional burdens.
On the other hand, opponents, including religious groups and disability rights advocates, warn against the potential for abuse and the risk of normalising assisted suicide.[7] They argue that making assisted dying legal could undermine efforts to improve palliative care and worsen societal inequalities, especially for marginalised groups who may feel pressured to choose assisted death.
Comparative Perspectives
Many countries including Canada, Switzerland, and the Netherlands, have legalised some form of assisted dying. These jurisdictions offer valuable insights into the implementation of safeguards and the long-term societal impact of such laws. For example, Canada’s Medical Assistance in Dying (MAID) legislation has been gradually expanded, raising concerns about incremental changes to eligibility criteria.
The UK’s careful approach reflects a desire to avoid similar outcomes. However, supporters of the 2024 bill argue that its strict safeguards and judicial oversight set it apart from more lenient systems.
Conclusion
The Terminally Ill Adults (End of Life) Bill 2024-25 represents a significant step in the UK’s ongoing debate over assisted suicide and euthanasia. By including strict safeguards, judicial oversight, and a narrowly defined scope, the bill aims to strike a balance between respect for personal autonomy and the need to protect vulnerable individuals.
However, as the bill progresses through Parliament, it faces significant legal, ethical, and practical challenges. The outcome of this debate will not only shape the legal landscape but also reflect society’s changing views on life, death, and the role of the state in deeply personal decisions.
References
Cases:
Pretty v United Kingdom (2002) 35 EHRR 1
R (Nicklinson) v Ministry of Justice [2014] UKSC 38
Statutes:
Suicide Act 1961, s 2(1)
Terminally Ill Adults (End of Life) Bill 2024-25, cls 1-4
Articles:
Sir James Munby, ‘Judicial Safeguards in Assisted Dying Legislation’ (2024) https://www.judicialreviewjournal.co.uk <accessed 30 December 2024>
Websites:
Dignity in Dying, ‘The Case for Assisted Dying’ (2024) https://www.dignityindying.org.uk <accessed 30 December 2024>
House of Commons Library, ‘Terminally Ill Adults (End of Life) Bill 2024-25: Key Issues’ (16 October 2024) https://www.parliament.uk <accessed 30 December 2024>
Sir James Munby, ‘Judicial Safeguards in Assisted Dying Legislation’ (2024) https://www.judicialreviewjournal.co.uk <accessed 30 December 2024>
[1] Suicide Act 1961, s 2(1)
[2] House of Commons Library, ‘Terminally Ill Adults (End of Life) Bill 2024-25: Key Issues’ (16 October 2024) https://www.parliament.uk <accessed 30 December 2024>
[3] R (Nicklinson) v Ministry of Justice [2014] UKSC 38
[4] Pretty v United Kingdom (2002) 35 EHRR 1
[5] Sir James Munby, ‘Judicial Safeguards in Assisted Dying Legislation’ (2024) https://www.judicialreviewjournal.co.uk <accessed 30 December 2024>
[6] HC Deb 11 September 2015, vol 599, col 656
[7] Dignity in Dying, ‘The Case for Assisted Dying’ (2024) https://www.dignityindying.org.uk <accessed 30 December 2024>
