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Other Bills before Parliament

Patient (Assisted Dying) Bill [HL]


Patient (Assisted Dying) Bill [HL]

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A

Bill

To

Enable a competent adult who is suffering unbearably as a result of a terminal

or a serious and progressive physical illness to receive medical help to die at

his own considered and persistent request; and to make provision for a person

suffering from such a condition to receive pain relief medication.                                                                            

Be it enacted by the Queen’s most Excellent Majesty, by and with the advice and

consent of the Lords Spiritual and Temporal, and Commons, in this present

Parliament assembled, and by the authority of the same, as follows:—

 1     Authorisation of assisted dying

     (1)    Subject to the provisions of this Act, it shall be lawful for a physician to assist

a patient who is a qualifying patient, and who has made a declaration in

accordance with this Act that is for the time being in force, to die.

     (2)    For the purposes of this Act—

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                    “assisted dying” means the attending physician, at the patient’s request,

either providing the patient with the means to end his life or ending the

patient’s life;

                    “attending physician” means the physician who has primary

responsibility for the care of the patient and the treatment of the

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patient’s illness;

                    “competent” means having the capacity to make an informed decision,

and “competence” shall be construed accordingly;

                    “consulting physician” means a consultant physician who is qualified by

speciality to make a professional diagnosis and prognosis regarding the

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patient’s illness;

                    “declaration” means a witnessed declaration in writing made by the

qualifying patient in the form set out in the Schedule to this Act, as

amended from time to time by regulations;

                    “informed decision” means a decision by a qualifying patient to request

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medical assistance to die, which is based on an appreciation of the

relevant facts and after being fully informed by the attending physician

of—

                  (a)                 his medical diagnosis;

 
HL Bill 3753/2
 
 

Patient (Assisted Dying) Bill [HL]

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                  (b)                 his prognosis;

                  (c)                 the process and probable consequences of being assisted to die;

                  (d)                 the alternatives, including, but not limited to, palliative care,

care in a hospice and the control of pain;

                    “irremediable condition” means a terminal or a serious physical illness;

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                    “medical care team” means a person or persons assisting the attending

physician in the provision of medical care to a patient, and includes but

without limitation a nurse, pharmacist or other registered medical

practitioner;

                    “monitoring commission” means a commission set up by the Secretary of

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State to monitor the workings of this Act in a country or region forming

a part of Great Britain;

                    “patient” means a person who is under the care of a physician;

                    “physician” means a registered medical practitioner;

                    “qualifying conditions” means those conditions set out in sections 2, 3 and

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4;

                    “qualifying patient” means a patient who has reached the age of majority,

who has been resident in Great Britain for not less than twelve months

as at the date of the declaration and in respect of whom all the

qualifying conditions under sections 2, 3 and 4 are met;

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                    “serious physical illness” means a serious incurable and progressive

physical illness;

                    “terminal illness” means an incurable and physical illness which the

consulting physician has determined as being likely to result in the

patient’s death within six months of the date when he confirmed the

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prognosis of the attending physician;

                    “unbearable suffering” means unbearable suffering whether by reason of

pain or otherwise as a result of an irremediable condition, the ending of

which suffering would be a humane act for that particular patient; and

“suffering unbearably” shall be construed accordingly;

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                    “waiting period” means the period of time after the date when the

declaration is made which must elapse before the declaration comes

into force and in the case of a patient with a terminal illness the waiting

period shall be 7 days and in the case of a patient with a serious physical

illness the waiting period shall be 30 days.

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 2     Qualifying conditions

     (1)    Before the attending physician can assist a qualifying patient to die the

conditions specified in sections 2, 3 and 4 must be satisfied.

     (2)    The attending physician shall have—

           (a)           been informed by the patient that he wishes to be helped to die and be

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satisfied that his request has been made voluntarily and that it is not the

result of external pressure;

           (b)           examined the patient and satisfied himself that the patient is

competent;

           (c)           made a determination that the patient has an irremediable condition;

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           (d)           concluded that the patient is suffering unbearably as a result of that

irremediable condition;

           (e)           informed the patient of—

                  (i)                 his medical diagnosis;

 

 

Patient (Assisted Dying) Bill [HL]

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                  (ii)                his prognosis;

                  (iii)               the process and probable consequences of being assisted to die;

                  (iv)                the alternatives, including, but not limited to, palliative care,

care in a hospice and the control of pain; and

           (f)           referred the patient to a consulting physician.

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     (3)    The consulting physician shall have—

           (a)           examined the patient and the patient’s medical records and satisfied

himself that the patient is competent;

           (b)           confirmed the diagnosis and prognosis of the attending physician;

           (c)           satisfied himself that the patient is suffering unbearably as a result of

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the irremediable condition;

           (d)           informed the patient of the alternatives including, but not limited to,

palliative care, care in a hospice and the control of pain;

           (e)           if the patient persists with his request to be helped to die, satisfied

himself that the request is made voluntarily and that it is not the result

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of external pressure and that the patient has made an informed

decision; and

           (f)           advised the patient that prior to such help the patient will be required

to complete a declaration which he can revoke at any time.

     (4)    Only once the requirements under subsections (2) and (3) have ben satisfied

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may the patient make the declaration in the form set out in the Schedule.

 3     Declaration made in advance

     (1)    The declaration must be witnessed by two individuals one of whom shall be a

solicitor who holds a current practising certificate.

     (2)    The solicitor may only witness the declaration if he is satisfied that the patient

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understands the full force and effect of the declaration.

     (3)    The patient and witnesses shall sign and witness the declaration respectively

at the same time and in each other’s presence.

     (4)    The attending or consulting physician, psychiatrist or a relative or partner (by

blood, marriage or adoption) of the qualifying patient signing this request may

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not be a witness.

     (5)    No witness shall be entitled to any portion of the person’s estate upon death.

     (6)    No person who owns, operates or is employed at a health care establishment

where the person is a patient or resident may be a witness.

     (7)    The declaration shall come into force after the requisite waiting period has

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elapsed and shall remain in force (unless revoked) for six months.

     (8)    A patient may re-execute a declaration made under this section, and such a

declaration, if validly made and not revoked, shall remain in force for a period

of six months from the date of re-execution.

 4     Further duties of attending physician

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Before taking any step to help the patient to die the attending physician shall

have—

           (a)           satisfied himself that the patient has made an informed decision;

 

 

Patient (Assisted Dying) Bill [HL]

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           (b)           informed the patient of his right to revoke the declaration at any time;

           (c)           verified immediately before assisting the patient to die that the

declaration is in force and that it has not been revoked by the patient;

and

           (d)           asked the patient immediately before assisting him to die whether he

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wishes to revoke the declaration.

 5     Revocation of declaration

     (1)    A patient may revoke his declaration at any time whether orally or in any other

manner without regard to his physical or mental state.

     (2)    In the event of a declaration being revoked, the attending physician shall

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ensure that a note recording its revocation is made on the patient’s file and that

the declaration is removed from the patient’s medical file and destroyed.

 6     Duties of physicians, and conscientious objection

     (1)    No person shall be under any duty, whether by contract or by any statutory or

other legal requirement, to participate in any diagnosis, treatment or other

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action authorised by this Act to which he has a conscientious objection.

     (2)    If an attending physician whose patient makes a request to be assisted to die in

accordance with this Act or to receive pain relief under section 14 has a

conscientious objection as provided in subsection (1), he shall refer the patient

without delay to an attending physician who does not have such a

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conscientious objection.

     (3)    If a consulting physician to whom a patient has been referred in accordance

with section 2(2)(f) has a conscientious objection as provided in subsection (1),

he shall refer the patient without delay to a consulting physician who does not

have such a conscientious objection.

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 7     Psychiatric referral

     (1)    If in the opinion of either the attending or the consulting physician a patient

who wishes to make or has made a declaration may not be competent, the

attending physician shall refer the patient to a psychiatrist for a psychiatric

opinion.

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     (2)    No assistance to end that patient’s life may be given unless the psychiatrist has

determined that the patient is not suffering from a psychiatric or psychological

disorder causing impaired judgement, and that the patient is competent.

 8     Notification of next of kin

The attending physician shall recommend to the patient that he notifies his

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next of kin of his request for assistance to die.

 9     Protection for physicians, and other medical personnel

     (1)    A physician, acting in good faith, who assists a qualifying patient to die, or

attempts to do so, in accordance with the requirements of this Act, shall not be

guilty of an offence.

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Patient (Assisted Dying) Bill [HL]

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     (2)    A member of a medical care team, acting in good faith, who helps a physician

to assist a qualifying patient to die, or to attempt to do so, in accordance with

what he reasonably believes to be the requirements of this Act, shall not be

guilty of an offence.

     (3)    A physician to whom subsection (1) applies or, as the case may be, a member

5

of a medical care team to whom subsection (2) applies, shall be deemed not to

be in breach of any professional oath or affirmation.

     (4)    No physician, psychiatrist or member of a medical care team may take any part

whatsoever in assisting a qualifying patient to die, or in giving an opinion in

respect of such a patient, nor may any person act as a witness, if he has grounds

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for believing that he will benefit financially or in any other way as the result of

the death of that patient.

 10    Offences

     (1)    It shall be an offence punishable on indictment by a sentence of a maximum of

life imprisonment wilfully to falsify or forge a declaration with the intent or

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effect of causing the patient’s death.

     (2)    A person signing a declaration by way of attestation who wilfully puts his

signature to a statement he knows to be false shall have committed an offence

punishable by a maximum of five years’ imprisonment.

     (3)    A person who wilfully conceals or destroys a declaration shall be guilty of an

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offence punishable by a maximum of five years’ imprisonment.

     (4)    A physician, psychiatrist, member of a medical care team or witness who

contravenes the requirements of section 9(4) shall have committed an offence

punishable by a maximum of five years’ imprisonment.

     (5)    No provision of this Act shall be taken to affect a person’s liability on

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conviction to criminal penalties for conduct which is inconsistent with the

provisions of this Act.

 11    Insurance

No policy of insurance which has been in force for 12 months as at the date of

the patient’s death shall be invalidated by reason of a doctor having assisted a

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qualifying patient to die in accordance with this Act.

 12    Requirements as to documentation in medical records

     (1)    The attending physician shall ensure that the following are documented and

filed in the patient’s medical records—

           (a)           all evidence, data and records which demonstrate that the qualifying

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conditions required under sections 2, 3 and 4 have been met;

           (b)           any oral or written requests by the patient for assistance to end his life;

           (c)           the declaration; and

           (d)           a note by the attending physician stating that he was satisfied, at the

date and time of his having assisted the patient to die, that all

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requirements under this Act had been met and indicating the steps

taken to carry out the declaration including the description and

quantity of the medication prescribed.

 

 

Patient (Assisted Dying) Bill [HL]

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     (2)    The attending physician shall send a full copy of the file to the monitoring

commission for the country or region concerned within 7 days of the qualifying

patient having been assisted to die whether or not such assistance led to the

patient’s death.

 13    Monitoring commission and reporting requirements

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     (1)    There shall be established such number of monitoring commissions covering

countries or regions forming part of Great Britain as the Secretary of State may

determine, to review the operation of this Act and to hold and monitor records

maintained pursuant to this Act.

     (2)    A monitoring commission shall consist of 3 members appointed by the

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Secretary of State, of whom—

           (a)           one shall be a registered medical practitioner;

           (b)           one shall be a legal practitioner; and

           (c)           one shall be a lay person having first hand knowledge or experience in

caring for a person with an irremediable condition.

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     (3)    If, in relation to a file sent to a monitoring commission in accordance with

section 12(2), two of its members consider that the qualifying conditions have

not been met, they shall refer the matter to the district coroner or in Scotland to

the procurator fiscal for further investigation.

     (4)    A monitoring commission to which a file has been sent in accordance with

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section 12(2) shall confirm to the attending physician concerned whether the

qualifying conditions have been met within six weeks of the date of receiving

such notification of the patient having been assisted to die whether or not such

assistance led to the patient’s death.

     (5)    The Secretary of State shall publish an annual statistical report of information

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collected under this section.

 14    Administration of drugs to patients suffering severe distress

A patient suffering from an irremediable condition shall be entitled to request

and receive such medication as may be necessary to keep him free as far as

possible from pain and distress.

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 15    Power to make regulations

     (1)    The Secretary of State may make regulations under this Act—

           (a)           to ensure the intent of this Act is carried out;

           (b)           determining classes of persons who may or may not sign a declaration

by way of attestation;

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           (c)           regulating the custody of records and the collection of information

regarding the operation of this Act; and

           (d)           making provision about appointments to and the operation of the

monitoring commissions.

     (2)    No statutory instrument may be made under this Act unless a draft of the

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instrument has been laid before, and approved by a resolution of, each House

of Parliament.

 

 

 
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Revised 24 February 2003