The Terminally Ill Adults (End of Life) Bill, also known as the Assisted Dying Bill, was introduced on 11 November 2024, is progressing through the House of Lords after completing its passage through the Commons on 20 June 2025. If enacted, it will create a legal framework allowing terminally ill adults in England and Wales, who meet strict eligibility criteria, to request and receive assistance to end their own life.
In this article we summarise the current legal framework proposed, highlight concerns over mental capacity and oversight and outline areas in which some believe further clarification is needed.
The Assisted Dying Bill includes multiple safeguards to reduce the risk of coercion, undue influence, or poorly informed decision-making. Eligibility must be confirmed by two independent doctors; each assessing whether the person has a terminal illness and meets the relevant statutory criteria. A mandatory reflection period is also required, ensuring a gap between the initial request and provision of assistance.
New criminal offences are also introduced within the bill with the aim of preventing abuse, including penalties for coercion or falsifying documents. The bill also protects professionals who choose not to participate. No health or social care staff are obliged to initiate discussions or participate in any stage of the process.
Despite these safeguards, concerns remain. A key issue is how the Assisted Dying Bill addresses the assessment of a person’s mental capacity to make the decision to end their life. The Mental Capacity Act 2005, currently the framework for assessing capacity for those living in England and Wales, was not designed for decisions of this nature. Critics highlight that many clinicians may lack the specialist training or experience required for such assessments, increasing the risk of inconsistent or flawed decisions. Questions have also been raised about whether psychological assessments should be mandatory to identify depression, impaired judgment, or other factors that may affect capacity.
Another concern relates to procedural oversight. The bill replaces High Court sign off with a panel of experts, prompting questions about impartiality and the consistency of scrutiny in individual cases. Vulnerable groups, including older adults, people with disabilities, and those with mental health conditions, may be particularly at risk if assessments are not thorough enough.
Some professional bodies have expressed caution. The Royal College of Psychiatrists withdrew support in May 2025, citing concerns about vulnerable patients and the impact on psychiatry professionals. The Royal College of General Practitioners has taken a neutral stance, reflecting member views: 47.6% opposed, 33.7% supported, and 13.6% were neutral.
Critics have highlighted several areas where further detail could clarify how the Assisted Dying Bill would operate in practice, including:
These points have been raised as important considerations in assessing how the bill might be implemented safely and effectively.
The Assisted Dying Bill represents a major step toward legalising voluntary assisted dying in England and Wales. It includes safeguards intended to protect vulnerable people and ensure that requests are voluntary. However, concerns remain, particularly around capacity assessments, professional training, advocacy support, and procedural oversight. Professional bodies are calling for clarity in these areas before fully supporting the legislation.
The bill is currently under scrutiny in the House of Lords, with a committee report expected by 7 November 2025. For further information, please contact our trusts and estates team.
