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The Assisted Dying Bill- what you need to know:

What is the Assisted Dying ill?

The Terminally Ill Adults (End of Life) Bill proposes legalising assisted dying for terminally ill individuals. This would allow a doctor to provide approved life ending medication that the patient takes themselves to end their life.

Key features of the bill include:

  • The medication must not be administered by anyone else.
  • The doctor stays with the patient until they pass away.
  • Patients can change their minds at any point, and the medication will be withdrawn.
  • Doctors can opt out of participating.

Eligibility criteria

To qualify for assisted dying under this bill, a patient must:

  • Be a resident of England or Wales and registered with a GP for at least 12 months.
  • Have the mental capacity to make an informed decision free from coercion.
  • Be expected to die within six months.
  • Make two signed declarations, witnessed by independent individuals.
  • Be assessed by two independent doctors who must agree on eligibility.
  • Undergo an additional review by a High Court judge, who can also question the patient, or others as needed.

(There is a separate bill under discussion in Scotland)

The current status of the bill:

As of December 2024, the bill is progressing through parliament as initiated by Labour MP Kim Leadbeater.  In November 2024, MPs voted in favour, allowing the bill to progress to the committee stage for detailed review and potential amendments.  If it passes all stages and receives Royal Assent, it will become law, a process that may take several years.

Assisted dying vs Euthanasia:

While both assisted dying and euthanasia are ways to end a patient’s life, there are distinct differences. Assisted dying involves a terminally ill patient receiving lethal drugs from a doctor and the patient taking the drug themselves. In contrast, Euthanasia involves the doctor administering the lethal drug. The patient does not have to be terminal to undergo euthanasia.

Additionally, assisted dying is sometimes confused with assisted suicide, which involves intentionally helping someone end their life outside of a medical framework. Assisted suicide remains illegal in the UK.

Implications for future medicine:

If the bill becomes law, it could have significant effects on medical practice, including:

  • Ethical Challenges: Doctors may face pressure from patients wanting assisted dying and opposition from family members.
  • End-of-Life Care: It may transform palliative care or reduce its demand.
  • Doctors having a greater role in assessing mental capacity in eligible patients.
  • Legal Involvement: Doctors will work more closely with legal professionals to assess patient eligibility.
  • Training Needs: Medical students may learn about assisted dying, with newer doctors potentially being more willing to participate over their senior colleagues

How it works in other countries:

Countries permitting assisted dying or euthanasia include:

  • Australia, Belgium, Canada, Colombia, Ecuador, Germany, Luxembourg, Netherlands, New Zealand, Portugal, Spain, and some U.S. states.

Canada as a case study:

Canada allows both euthanasia and assisted dying under its Medical Assistance in Dying (MAID) programme. Unlike the UK’s proposed bill, Canada’s criteria have expanded to include mental illness and homelessness. In 2023, MAID accounted for 4.7% of deaths, mostly among terminally ill patients. This example shows how medical laws can evolve to include broader eligibility.

How this might come up in medical school interviews:

Like any ethical or hot topic, interviewers want to see that candidates understand the moral and ethical dilemma involved. They also assess for a holistic answer that considers both sides of the argument, ultimately ending with a balanced and well thought out conclusion.

Things to consider in your answer:

  • What stage the bill is at, at the time of the interview
  • Giving a clear definition and not confusing assisted dying with euthanasia
  • Not being overly opinionated or having extreme viewpoints
  • Considering how it applies to the 4 ethical pillars
  • The benefits and disadvantages of the bill
  • The impact on doctors and patients

Example questions:

  1. What is the difference between euthanasia and assisted dying?
  2. What is your understanding of the assisted dying bill in the UK?
  3. What are the ethical arguments against medically assisted dying?
  4. What are the ethical arguments in support of medically assisted dying?
  5. How do you think the bill will affect the role of the doctor?

Main takeaways:

The Assisted Dying bill is a very complex and ethically challenging topic. Nevertheless, it is one of the hottest topics in healthcare at present, therefore, may come up at interview. For help on answering complex ethical questions or any part of the medical school application, reach out to Future Doc for 1-1 tutoring.

Written by Luiza