UK assisted dying Bill: A blueprint for Malta?

The UK Assisted Dying Bill, introduced by Labour MP Kim Leadbeater, passed its second reading last week after a nuanced debate that divided MPs across party lines. 

The key focus of the debate was whether sufficient safeguards are in place to prevent abuse. While only a small number of MPs opposed the bill based on the sanctity of life, a broader concern emerged about the potential for a "slippery slope" effect, where legalising assisted dying could lead to unintended consequences. 

The safeguards in the bill 

The UK euthanasia bill establishes a legal framework for individuals with terminal or incurable illnesses to seek medical assistance in ending their lives. The UK euthanasia bill establishes a legal framework for individuals with terminal or incurable illnesses to seek medical assistance in ending their lives. Key provisions include eligibility criteria requiring the individual to be over 18, mentally competent, and suffering from unbearable pain due to a terminal or incurable illness. 

Two independent doctors must evaluate the patient’s condition to confirm eligibility, followed by judicial approval from a high court judge, who ensures that all legal safeguards are followed. The judge may question the patient, doctors, or others involved and requires a 14-day waiting period after the ruling. The bill also mandates consultation with family members, though the final decision lies with the patient, who retains the right to withdraw the request at any point before the procedure. 

Leadbeater, who introduced the assisted dying bill, has emphasized that the legislation is designed to offer terminally ill patients "genuine choice and autonomy." She argued that without the bill, many people would continue to suffer in "often unbearable pain and fear" without the option to choose a dignified death. 

A nuanced debate cutting across party lines 

The euthanasia bill has sparked a nuanced debate across party lines which was described by Green MP Sian Berry as one “full of caring and compassion on both sides – with all MPs listening respectfully to one another.” 

While Prime Minister and Labour leader Keir Starmer pledged a free vote for MPs, he personally voiced support for changing the law on assisted dying.  Other Labour figures, like Ed Miliband and Liz Kendall, also expressed support for the bill, emphasising the importance of individual autonomy in end-of-life decisions. However, others, like Wes Streeting, the Health Secretary, voiced opposition, citing concerns about the adequacy of palliative care and the potential risks of coercion, particularly for elderly people feeling pressured by family expectations. 

Former Labour leader Jeremy Corbyn, now an independent MP, also voted against, warning that in the absence of full access to palliative care badly hit by spending cuts, the proposed legislation “puts the poorest, the elderly, and disabled people at risk of serious neglect and discrimination.” 

Within the Conservative Party, opinions were also split. Some MPs, like Jeremy Hunt and former Prime Minister Rishi Sunak, supported the bill, while others, including new Tory leader Kemi Badenoch, voted against it, citing potential unintended consequences. Despite voting against the bill the new Tory leader immediately made it clear that while she “understands” the religious arguments on this matter, she does not agree with them.  

“I fundamentally believe that giving people a level of control over how they die can be a sacred thing in and of itself; is the right thing to do and something we must get right,” she argued.  But she could not support the Bill as proposed arguing that it did not contain enough safeguards. 

The final vote on the assisted dying bill saw 330 MPs voting in favour, while 275 voted against, resulting in a majority of 55 votes in support of the proposal. 

Breaking down the vote by party, a majority of Labour MPs supported the bill, with 233 voting for and 147 against. On the Conservative side, 23 MPs out of 121 voted in favour, including former prime minister Rishi Sunak, while the majority of Tory MPs opposed the bill.  Among the Liberal Democrats, the majority (61) voted in favour even if party leader Ed Davey and 10 other MPs, voted against. Reform Party leader Nigel Farage opposed the bill but three of his MPs voted in favour while all four green MPs supported the bill.   

Expected timeframe for approval  

While the bill's Second Reading marks a significant step, full approval and implementation may take up to two more years. After further committee reviews and potential amendments, the bill will need additional votes in parliament. Once passed, it will be enacted into law, with regulations laid out to guide its practical application.  

Euthanasia across the world 

Several countries, including the Netherlands, Belgium, and Canada, have legalised assisted dying, each with distinct provisions compared to the UK’s proposed bill. 

In the Netherlands, euthanasia is allowed not only for terminal illnesses but also for non-terminal conditions characterised by unbearable pain including severe psychiatric disorders, a broader scope than the UK bill, which limits eligibility to those with terminal conditions.  

Belgium, like the Netherlands, permits euthanasia for individuals experiencing unbearable suffering, but its law is more expansive in that it also allows minors under certain conditions. Belgium is the only country where euthanasia for children is legal, which contrasts with the UK bill that applies exclusively to adults. 

Canada’s Medical Assistance in Dying (MAID) law provides assisted dying to those with serious, incurable medical conditions but also includes more flexible criteria. Canada's law has evolved to allow patients who may not be near death but suffer from chronic, irreversible conditions causing intolerable pain. This provision is absent in the UK’s proposed law, which restricts eligibility to those facing terminal illness. 

The debate in Malta 

The Labour Party is presently committed to commencing a national discussion on euthanasia. The 2022 general election manifesto clearly stated: “The time has come for a national, mature discussion on the introduction of voluntary euthanasia for terminally ill patients.” 
Former Labour deputy leader Daniel Micallef had openly spoken about how he had come to support its introduction after his own father's death from a terminal illness.

Daniel Micallef | Assisted Dying: Needs and realities of people will prevail

In November 2022, Prime Minister Robert Abela insisted that the debate should eventually lead to a decision and should not "just be a discussion that goes nowhere." The Nationalist Party has stated its opposition to euthanasia. The only organisation actively campaigning for a bill regulating assisted dying is the Malta Humanist Association, while the Catholic Church, in line with its teachings, opposes it.

Andrew Azzopardi | Assisted Dying: It’s a Pandora’s box, but we are late to the debate

During a ceremonial mass, shortly before President Myriam Spiteri Debono took her Oath of Office, Archbishop Charles J. Scicluna used his homily to advise the new president to, “defend all life from the beginning of its existence until its natural end”. 

A recent poll by Esprimi revealed that 62% of Maltese people believe that doctors should be allowed to assist terminally ill patients end their life, an increase from the 53% recorded in a 2016 MaltaToday survey.

Editorial | It’s time for a mature debate on euthanasia