Terminally Ill Adults (End of Life) Bill: June 2025 legal update

In November, we published an article on this Bill the day before it passed its last major vote in the Second Reading in the House of Commons. This marked the first time that MPs have supported the principle of assisted dying for England and Wales. As readers will be aware, the issues that arise from this are incredibly complex, both legally and ethically. It is for that reason that the courts have consistently chosen to abstain from making decisions on this issue, instead leaving any substantial consideration to Parliament.

The Bill has just concluded its last step of the legislative process in the House of Commons; the Report Stage and Third Reading. At the Third Reading, MPs voted for the Bill (by 314 votes to 291) to progress with the amendments made most recently at Report Stage. This was a momentous vote for the Bill; if voted down, it would have been rejected entirely and removed from the legislative process.

During the Committee Stage and the Report Stage, several amendments were made to the Bill. Whilst there is not time to cover all of these, we discuss below those which are of particular note. The next stage in the legislative process now that it has passed Third Reading is a repeat of the whole process so far, but in the House of Lords instead of the House of Commons. Any amendments made in the Lords will then get passed back to the Commons, then to the Lords, and back and forth (so-called “ping pong”) until an agreement is reached.

Replacing judicial oversight with Assisted Dying Review Panels 

When the Bill arrived at the Public Bills Committee after Second Reading, Clause 12 provided that the High Court would have the power to make, or refuse to make, a declaration that the necessary requirements of the Bill had been met, as a procedural step to someone having an assisted death.  

Clause 12 was subject to much criticism before the Second Reading, in particular from the former head judge of the Family Division (a branch of the High Court), Sir James Munby. Following this, the Committee replaced the role of judicial oversight with a new regulatory role for a Voluntary Assisted Dying Commission. This would be led by a Commissioner and Deputy Commissioner, both of whom must be current or former Supreme Court judges. Upon receipt of the preceding requirements, the Commission would be required as soon as reasonably practicable to refer the person’s case to an Assisted Dying Review Panel to determine their eligibility. If the panel is satisfied that the person is eligible, it must grant a certificate of eligibility progressing the application to the next stage. This panel, therefore, is directly substituted in for the judicial oversight mechanism. It is made up of a legal member (judge of High Court or higher, or King’s Counsel), a psychiatrist member, and a social worker member. The idea behind the change was to involve those with more expertise in what is ultimately a medical assessment, notably involving an assessment of capacity. In addition, whilst the High Court requirement had been criticised as expensive and time-consuming, a specialist panel may provide speedier and more pragmatic outcomes. 

The amended Bill requires that the Panel must hear from, and may question, one of the doctors that approved the individual’s initial eligibility application, and the individual themselves. They may also hear from and may question any other person. The broad nature of this power of the panel seems sensible given the gravity of the decisions they will be making and its importance in the new process – it is by far the hurdle in the application for an assisted death at which the most scrutiny will be applied. Given this, it is odd that the Bill does not grant the panel the power to compel witnesses to give evidence under oath, the power to test the material provided to it, or to control the publication of information relating to a hearing that has/will have taken place, all of which a High Court could do. 

Extension of scope of conscientious objection clause

The conscientious objection clause, which provided that no health professional would be under any duty to participate in providing assistance with dying, if they so choose, has been broadened out. An amendment has broadened this out to all persons engaged in the process. Under the new amendment, no registered medical practitioner (other than those assigned the coordinating and independent doctor roles) is under any duty to perform any function in connection with this Bill, save for those which are purely administrative, such as recording that the person had an assisted death in their medical records. Additionally, no person is under any duty to become the coordinating or independent doctor, at which point they would take on formal duties under this law. The new provisions also explicitly rule out any duty of health and social care professionals to respond to a doctor asking for assistance with assessing an individual’s capacity. It also explicitly carves out pharmacists from being under any duty in connection with the approved lethal substances. 

Indirect coercion: prohibition on medical professionals raising assisted dying with under-18s and advertisement banned

Also at Report Stage, MPs voted to include an amendment to the Bill prohibiting health professionals from raising the possibility of an assisted death with a patient who is not yet 18. This is despite the fact that many children can have capacity, as there is no minimum age for a child to competently consent to their own medical decisions. Whilst there is a general presumption that children under 16 do not have capacity, any child under 16 can have capacity to consent provided they have a sufficient understanding and intelligence to fully comprehend the details of that decision. The current amendment goes a step further in preventing clinicians from initiating any conversation with under-18s, regardless of whether they are Gillick-competent, about any assisted dying option that may be open to them once they turn 18.  

In a similar vein, MPs at the Report Stage also voted to ban the advertisement of assisted dying services, if the Bill becomes law. This move, alongside the above, reflects growing concern among MPs about the normalisation (and commercialisation) of assisted dying, particularly in digital spaces. This voted-in ban was, however, only a broad one. The amendment passed stipulates that the Secretary of State must make regulations which prohibit “the publication, printing, distribution or designing (anywhere) of advertisements whose purpose or effect is to promote a voluntary assisted dying service”. These regulations may contain exceptions, such as for the provision of certain information to service users or providers, but the amendment did not say that certain exceptions must be carved out by those regulations.

To find out more, please visit our dedicated page to this topic.

If you would like to discuss any of the above issues or anything in the public law field, please contact Melanie Carter, Partner and Head of our Public Law and Regulatory Team.