Assisted Dying Bill: The story so far

The Assisted Dying Bill 2023 can now be signed and sent for Royal Assent

Earlier today, the Isle of Man became the first place in the British Isles to approve assisted dying legislation.

The Legislative Council this morning (25 March) voted to accept the House of Keys' changes to the proposals.

Under the provisions in the Assisted Dying Bill 2023, eligible adults over the age of 18 with a prognosis of 12 months or less to live - who have lived on the Island for at least five years - will be given the right to choose to die.

Does this mean that we will see assisted deaths taking place on the Island imminently?

In short - no.

WHAT HAPPENS NEXT

Today's developments essentially mean the bill can now be signed and sent for Royal Assent, whereafter it will become law.

The wider health and social care framework will then need to be put into place to facilitate the practice here.

Just last month, the health minister confirmed no provision has been made for an assisted dying service yet, and preparatory work is still yet to be undertaken.

Claire Christian said it 'wouldn't be appropriate to' dedicate time to doing so until the bill was passed:

Ramsey MHK - and mover of the private members bill - Dr Alex Allinson says he is 'hopeful' it could become law later this year, with assisted dying potentially available for terminally ill residents from 2027.  

HOW DID WE GET HERE

So how did we get to this stage?

Well, it's been a long journey so far.

2022

At the sitting of the House of Keys on Tuesday 24 May 2022, Dr Alex Allinson, MHK for Ramsey was given leave to introduce a Private Members’ Bill to 'enable adults who are terminally ill to be provided at their request with specified assistance to end their own life; and for connected purposes'.

"Sometimes all the best support, pain relief, treatment and empathy cannot help lessen the existential angst of your impending death.

"I say your death, because I would like all of you to take a few brief seconds to imagine yourself in a situation many of you will have already witnessed in others.

"What support, choice and options would you wish for yourself?" - Dr Alex Allinson, first debate on his Private Member' Bill, May 2022

The motion passed with 22 MHKs voting for, and two against - Kate Lord-Brennan (Glenfaba and Peel) and Andrew Smith (Laxey).

Speaking after that sitting, Dr Allinson said there was 'a long road ahead':

Mr Smith's decision not to back the proposed bill led to controversy in his consistency, with a requisition meeting held in August 2022 by residents who felt he had performed an alleged ‘U-turn'.

He was invited to face questions from his constituents after he reportedly spoke of his support for new assisted dying laws whilst out on the campaign trail.

At that meeting, he argued there were too many 'anomalies' in the bill for him to support it with a 'clear conscience':

You can read more HERE.

In December 2022, a public consultation opened into the proposals, with Dr Allinson saying it was important people got involved.

The Manx branch of ‘My Death My Decision’ welcomed the release of the consultation and urged people to make their voices heard.

2023

The public consultation closed on 26 January 2023; with feedback received from people both locally and internationally.  

But before then, leaflets arguing against the potential legislation were dropped through the doors of households across the Isle of Man.

The group behind them called themselves 'Manx Duty of Care', and Siobhán Fletcher spoke to them:

One of the informal group was the then-president of the Island's Medical Society, Dr Ben Harris, who later said he believed the bill would make the Island less appealing to prospective medics.

Manx Duty of Care also invited medical professionals to speak on the Island, such as Retired Palliative Care Medicine Consultant, Dr Claud Regnard - a prominent opponent of assisted dying in the UK.

In February 2023, we heard from another group of vocal opponents of the proposals - the Catholic Union of Great Britain.

The group labelled the bill an 'extreme form of assisted suicide' and urged Tynwald members to instead focus on improving palliative care for people on the Island and making healthcare provision better for the ageing population.

"It’s particularly worrying that the law could include people who are not terminally ill. We have seen this happen in Canada and the results are shocking. 

"Proposals to allow people to collect lethal medication over the counter at pharmacies and store it at home are also deeply concerning. Such a law would hugely undermine the dignity of life." - Catholic Union of Great Britain Director Nigel Parker.

But four days later, we heard from Manx Radio listener Cliff Burdett, who lives in Leicester.

He said he wanted to go to Dignitas years ago due to his Motor Neurone Disease and was interested to see how things developed here.

In April 2023, Dr Allinson released the results of the consultation.

He revealed over 3,300 people responded to it with a 'wide range' of views, and evidence in support for and against.

The results and responses in full can be found HERE.

On Tuesday 27 June 2023, the bill began its passage through the House of Keys, with its first reading.

Its second reading took place on Tuesday 31 October 2023.

Ahead of that sitting, Dignity in Dying argued the current ‘blanket ban’ on assisted dying was ‘unsafe, unfair and unregulated’.

Meanwhile, Churches Alive in Mann held a meeting where almost 100 people gathered for a time of prayer and reflection about assisted dying.

It was attended by those representing local Christian Churches of all denominations - and Beth Espey had this report:

A survey published that month of more than 1,200 Manx residents found that 53 per cent of respondents were strongly in favour of a change in the law to allow mentally competent, terminally ill residents the option of seeking assistance in their death.

But the legislation was ‘vehemently’ opposed by Autism in Mann, who described proposed safeguards contained in a consultation document as ‘vague and (in places) contradictory’.

Campaigner for Humanists UK - a group which wanted the bill to go further - addressed Manx politicians on 26 October 2023. 

When the bill had its second reading on 31 October, people from both sides of the debate demonstrated outside the House of Keys.

It was an emotive day, with the Island's MHKs engaging in an extensive six-hour debate.

It was of course, by its very nature, a divisive debate – and the first opportunity that MHKs had to discuss, at length, the main principles of the bill.

They ultimately voted for progressing the legislation through the Island's parliament, moving it to the clauses stage, with 17 for and seven against.

Votes in the House of Keys on 31 October 2023, at the bill's second reading

We followed all the proceedings that day in a live blog, available in full HERE.

The next week, on 7 November 2023, MHKs voted to form a committee to look at the clauses of the Assisted Dying Bill.

The motion was brought to the House by Onchan MHK Rob Callister, with 13 members voting for, and 11 against.

The committee was tasked with considering the clauses and reporting back to the House by the end of February 2024.

It consisted of: David Ashford, Rob Callister, Alex Allinson, Michelle Haywood and Lawrie Hooper.

2024

In early February 2024, Baroness Tanni Grey-Thompson, a former Paralympian and crossbench peer in Westminster, and Dr Gordon Macdonald from Care Not Killing spoke to Tynwald members about their concerns around the bill.

The findings from the aforementioned committee were also delayed, as it was waiting on two key pieces of evidence before presenting its findings.

In March 2024, we heard warnings from a campaigner from Canada, Alex Schadenberg (Chair of the Euthanasia Prevention Coalition).

Canada introduced laws similar to those being considered on the Isle of Man in 2016, before widening the groups able to request an assisted death in 2021.

Mr Schadenberg told Phil Gawne that once assisted dying is legalised, it's hard to stop the criteria for those eligible being expanded:

Later that summer we also heard from a Canadian doctor, Dr Ramona Coelho from Quebec who warned of spiralling numbers in Canada, telling Manx Radio there were 13,000 assisted deaths in 2022 and around 16,000 in 2023.

In April, the committee tasked with looking at the clauses of the bill published its report.

It came up with 14 conclusions – including amendments to some of the proposed legislation – to ensure assisted dying could be a legal and safe choice for terminally ill people who choose it.

They included a recommendation that those applying for an assisted death must have been resident on the Isle of Man for five years.

That marked a significant change to the original requirement for a patient to be ordinarily resident for not less than one year which the committee found ‘insufficient’.

You can read the report in full HERE.

In May, politicians considered a raft of suggested changes put forward by several MHKs.

These included an attempt to have assisted dying delivered by a charitable organisation instead of Manx Care - proposed by Glenfaba and Peel MHK Kate Lord-Brennan - which was ultimately defeated.

Ayre and Michael MHK Alfred Cannan even attempted to propose a referendum on the topic, telling members there comes a 'time and a place when the people need their say':

This was backed by Manx Duty of Care, but ultimately failed to garner support (12 MHKs voted against a referendum on 1 July 2024).

On 14 May, MHKs heard from expert witnesses in the House of Keys.

They spoke to Manx Radio whilst on the Island too, you can hear those interviews HERE.

In June, the debate around how assisted dying laws could work on the Isle of Man continued, with more experts giving evidence to the House of Keys and the then-Health Minister, Lawrie Hooper, revealed staffing our Island's health and social care system if assisted dying is approved was of 'real concern' to him.

Efforts to delay further debate on 25 June by Ayre and Michael MHK Alfred Cannan were quashed by politicians.

Mr Cannan wanted to adjourn the debate until November, but 14 MHKs voted against the move.

Meanwhile, at that sitting, Middle MHK Jane Poole-Wilson saw her proposal for a new offence - making it illegal to ignore when a patient changes their mind over having an assisted death - approved; and Ramsey MHK Lawrie Hooper's bid - for a custodial sentence for anyone who coerces someone into agreeing to assisted dying - also got the green light.

On Tuesday 9 July, debates continued.

It saw the focus turn to the potential for an 'opt-in' system for healthcare professionals to join a register to provide assisted dying services.

An extra sitting of the House of Keys was also tabled for 23 July 2024.

On that date, the bill's third reading took place; and after months of debate, Members of the House of Keys voted to approve the Assisted Dying Bill.

Sixteen voted in favour while eight were against.

Arbory, Castletown and Malew's Tim Glover and Onchan's Julie Edge voiced concerns as they voted against:

But Douglas North MHK David Ashford was confident enough in the final Bill to vote in favour:

Mover of the bill, Ramsey MHK Dr Allinson again reiterated that it was 'right that the legislation isn't rushed' and said there was a 'very good chance' the Assisted Dying legislation won't come into force during this administration.

On 22 October 2024, the focus turned to the Legislative Council, where members voted in favour of the principles of the Assisted Dying Bill and progressed it to the clauses stage.

The MLC moving the assisted dying bill through the Legislative Council, Peter Greenhill, said he believed there may need to be further changes to the residency requirement (in December, members voted in favour of an amendment to reduce the amount of time a person has to have been resident on the Island from five years to one, but added that they must have been resident at the time of their diagnosis).

The clauses stage in LegCo began on 26 November.

Elsewhere in November last year, the UK made moves to mirror the Island's progress.

Details of the UK's assisted dying proposals - to legalise assisted dying in England and Wales - were made public, and it was said to have many of the same safeguards as the Isle of Man's legislation.

Dr Allinson said at the time that the progression of the UK's assisted dying bill showed 'convergence of opinion from parliamentarians' and a 'change in public attitudes'.

"I haven't spoken to [Labour MP Kim Leadbeater] personally, but what we're both doing is trying to follow the will of the people that elected us, and certainly progress this through our respective parliaments." - Dr Alex Allinson on the UK's legislation.

2025

This year began with bereaved relatives gathering outside the Tynwald building from 8am on Tuesday 28 January in a show of support for Dr Allinson's bill, ahead of its third reading in the Legislative Council.

That day, members voted seven to one in favour of progressing the proposals, which would allow terminally ill Manx residents to request medical help to end their life.

Paul Craine was the only member voting against the bill, raising concerns that the safeguards in place were "too weak".

That meant it was sent back to the House of Keys, for MHKs to consider the amendments made by 'the other place'.

It hit the Keys floor on 25 February, with Dr Allinson suggesting that members should agree with ten amendments, disagree with three, and amend another.

Ultimately, members voted to return three amendments on the Assisted Dying Bill to the Legislative Council, and another amendment, suggested by MLCs, was amended itself and was also sent back.

This morning (25 March), the Legislative Council gathered to take another look at the legislation.

Ultimately, members voted to accept Keys' changes, despite some members still voicing concerns about the restrictions.

Bishop of Sodor and Man Tricia Hillas sought support for a new amendment looking to ensure no-one had to go through an assisted death alone:

That amendment wasn't supported.

Rob Mercer moved the bill in Legislative Council, and believes it's now stronger than it was at the start of the legislative process:

Manx Radio's Sian Cowper was listening across proceedings today, and has this report:

Ultimately, today's vote means the bill can now be signed and sent for Royal Assent.

REACTION

As mentioned above, proponents and opponents of assisted dying have been a vocal presence at various sittings within the Tynwald building (for both the Legislative Council and the House of Keys) over the past couple of years.

"This is for Sue Biggerstaff’s husband Simon and Millie Blenkinsop-French’s son James, who died without choice over their deaths." - Chief Executive of Dignity in Dying Sarah Wootton

Reacting to today's news, the Chief Executive of Dignity in Dying, Sarah Wootton said: "This is a historic moment for compassion in the Isle of Man and for the whole of the British Isles.

"We pay tribute to Dr Allinson MHK for bringing forward this change and his commitment to a detailed and comprehensive legislative process. 

"This is for Sue Biggerstaff’s husband Simon and Millie Blenkinsop-French’s son James, who died without choice over their deaths; and for many more families who have tirelessly called for change. Sue and Millie have led the charge for choice in the Isle of Man and their campaigning means no one will be forced to suffer at the end."

She added: “Dying people and their families are the lifeblood of the movement for choice at the end of life, powering progress right across the British Isles.

"Increasingly parliamentarians are listening to their experience, acting upon evidence from around the world and crafting legislation that is safe, fair, and right for each society, culture and healthcare system.

"Change is coming across the British Isles and the Isle of Man has led the way.” 

Millie Blenkinsop-French twice petitioned Tynwald on the matter of assisted dying - once in 2014 and then again in 2019.

It was after watching her son James suffer, as she told us back in 2021:

"History has been made today and Simon’s legacy is that people like him will soon be granted the compassion and choice that they deserve.” - Sue Biggerstaff 

Sue Biggerstaff, from Ballabeg, was married to husband Simon for 17 years before his "agonising" death in May 2022.

We heard her story back in February 2024.

You can read it HERE.

Last month, she protested outside the House of Keys, and spoke to Manx Radio's John Moss:

Reacting today, Sue said: "I am delighted that dying people like my husband Simon will soon have choice over their deaths.

"No one should have to suffer like he did at the end.

"I thank members of both Houses for their dedication and hard work on this process.

"History has been made today and Simon’s legacy is that people like him will soon be granted the compassion and choice that they deserve."

ALLINSON

Elsewhere, mover of the bill Ramsey MHK Alex Allinson will be reacting to the latest developments on Manx Radio's Breakfast programme tomorrow morning (26 March).

Manx Radio Breakfast with Ben Hartley is on air every weekday from 6am.