ENGLAND AND WALES – Where the Bill stands and how assisted dying would work
05 November 2025
Guest article by Nathan Stilwell*
The Terminally Ill Adults (End of Life) Bill is a Private Member’s Bill, meaning a proposal introduced by an individual MP rather than the Government. It’s sponsored by Kim Leadbeater MBE MP, with the Government officially neutral and politicians free to vote as they want. In June 2025, the Bill cleared its decisive Third Reading in the House of Commons, the final major vote in our lower elected chamber, by 314 votes to 291. It is now being led in the House of Lords by Lord Falconer of Thoroton, where the unelected members of the House of Lords (known as peers) are examining potential changes.
The legislation process
The UK’s law-making process requires a bill to pass multiple debates and amendment stages in both houses, Commons and Lords, before it can receive Royal Assent, where the King officially signs it and it becomes law. In this case, Parliament has signalled an unusually thorough approach: debates have been longer and evidence-taking more extensive than is typical, and the bill must still complete all remaining stages by the end of the current parliamentary session in spring 2026.
The House of Lords can be difficult to explain to an international audience. There are still hereditary peers, a title passed down through generations, although this is ending soon. There are 26 Church of England Bishops who by right have a place in the Lords, and they speak and vote. Normally, the House of Lords doesn’t do a “yes or no” vote on laws, because they are not elected, they tend to only make revisions and small changes. But the bishops have publicly said they intend to force such a “yes or no” vote on the Terminally Ill Adults (End of Life) Bill, and with over 850 members of the House of Lords, not all of whom will turn up for such votes, the outcome remains difficult to predict.
Peers had an extraordinary Second Reading debate (which is about the general principle) across two days in which nearly 180 peers spoke, the largest debate on any Private Member’s Bill on record. Furthermore, peers have created a Select Committee specifically to take even more evidence about assisted dying, the first time such a committee has been established for something like this and a rarity even for UK government legislation. The Committee is taking evidence from professional bodies, coroners, clinicians, and Ministers, and will report by 7 November. We are worried that the committee is made up of more peers who oppose assisted dying than supporters, and the experts they have chosen to give evidence have been incredibly one-sided.
Proposed assisted dying procedure
So what would the proposed law actually do? In plain terms, it would allow mentally competent, UK-resident adults who are terminally ill with a life expectancy of six months or less to seek an assisted death. In addition to full mental capacity, a person must have a clear, settled, and informed wish to end their life.
First, the person makes a witnessed written declaration. A specially trained medical doctor then conducts an assessment, followed by a mandatory seven-day pause. A second, independent, trained medical doctor repeats the assessment, followed by a fourteen-day reflection period. An independent panel consisting of a lawyer, a psychiatrist, and a social worker, then reviews the case. If approval is granted, one of the assessing doctors provides the medication and remains present and the patient self-administers.
Safeguards run through every step. At each interaction, clinicians and panel members test for mental capacity and coercion, with standard safeguarding duties engaged if any abuse is suspected. Training in domestic abuse, including coercive control and financial abuse, is mandatory. The Bill also creates serious criminal penalties: inducing someone to have an assisted death through dishonesty, coercion, or pressure would carry a life sentence, with additional offences for falsifying documents.
What would change?
Why does this Bill and legalising assisted dying in the UK matter in real life? Right now, more than one Briton a week travels to Switzerland to end their suffering and life. But this is only available for those with the ability and strength to do so. Others take their own lives, usually alone and in dangerous ways, with all the negative consequences thereof for themselves, their loved ones, and everyone around them. Some people die in pain and misery, when even the best care can’t alleviate their suffering. The Bill could change this terrible ending for some.
Outlook
From here, peers will now spend the next few months debating and voting on potential changes to the Bill. Once they’re done with this, they send it back to the Commons for a process called “ping-pong”, where they send the proposed law back and forth until they agree.
The Bill has already now set a new record for evidence-based, cross-party consideration and hours of debate. If passed this session, England and Wales (Scotland, Jersey and the Isle of Man have their own bills) would join a growing list of jurisdictions opting for a carefully safeguarded right and freedom to choose the end of one’s own suffering and life, anchored in autonomy, compassion, and dignity.
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Nathan Stilwell is Campaign Manager at “My Death, My Decision”, a grassroots campaign group that wants the law in England and Wales to allow those who are terminally ill or intolerably suffering the option of a legal, safe, and compassionate assisted death.
