Assisted dying step closer to being legalised in the British Isles following Isle of Man vote

The Isle of Man is now a step closer to become the first part of the British Isles to legalise assisted dying following a further vote in favour by the Isle of Man parliament last week. The Bill will now progresses for further debate on its remaining Clauses before it proceeds to Third Reading on the 11th June and then to the Legislative Council and finally Royal approval.

It is, however, unlikely to become like Switzerland, the preferred destination for seeking to end their suffering. This will not be an option for people currently registered with dignitas as it will only be available be for people who have been resident on the Island for at least a year and even if the bill continues as expected, it is unlikely to be available until 2027.

So far, the Assisted Dying Bill has won over 70% of the votes at each Reading in the Tynwald, the Isle of Man’s Parliament but has strict safeguards. It is proposed only to be an option for terminally ill, mentally competent citizens, who:

• have a life expectancy of less than six months
• have mental capacity and have a clear and settled intention to end their life.
• have reached their decision voluntarily. A psychiatrist can be called if there is any doubt about the person’s capacity to make the decision.

Two registered medical practitioners, working independently, must witness the person’s clear and settled intention and must both be satisfied the person has been informed of palliative and hospice care options.

Assisted dying is different from euthanasia. Assisted dying involves providing assistance such as drugs, to terminally ill individuals who wish to end their own lives, while euthanasia involves a third party directly carrying out deliberate act of ending the individual's life.

According to the Campaign for Dignity in Dying most Britons would prefer to end their lives at home with their families let alone travel to another country and pay over £10,000. Currently, however, under the Suicide Act 1961 in England and Wales, it is a criminal offence to encourage or assist another person’s suicide.

Esther Rantzen and others are campaigning for a change in the law as there is clearly an increasing need. UK membership of Dignitas, the Swiss assisted dying association, jumped to 1,900 people in 2023, according to the organisation. That is a 24% rise on the previous year.

The Isle of Man is a self-governing British Crown with its own parliament, government and laws largely independent from the United Kingdom. The King, who is ‘Lord of Mann’, is the Manx Head of State and is represented on the Island by the Lieutenant Governor.

The Isle of Man’s legislative system was introduced in around 800 AD, making it the oldest parliament in the world with an unbroken existence. Apart from its low taxation it has had some other notable laws unique from the UK. For example, it was the first country in Europe to allow women to vote, and up until 1993 it allowed corporal punishment - "The Birch".

There is no absolute requirement that Manx law has to be ratified by Westminster but new legislation does require Royal Assent. The Ministry of Justice also examines each piece of legislation to ensure there is no conflict with the UK’s international obligations including the (Convention on Human Rights).

If there's no objection from the Crown or Westminster the next stage of the bill will a public announcement by the Isle’s Parliament on the 5th July at the ancient Tynwald Day open-air ceremony. The Lieutenant Governor presides, putting Acts of Tynwald into effect and receiving Petitions for Redress. If accepted assisted dying could be a reality in early 2025.

Scotland could later follow suit as a bill that lets terminally-ill people end their lives was introduced in the Holyrood Parliament was also been approved for further consideration.

In the meantime, according to the Dignity in Dying campaign group, more than 200 million people around the world have legal access to some form of assisted dying. Switzerland's Dignitas facility began operating in 1998. Assisted suicide is also legal in Austria, Spain, The Netherlands, Belgium and Luxembourg.

In the US, 11 states allow assisted dying. Known as "physician-assisted dying", it permits doctors to prescribe lethal drugs for self-administration. In Canada medical assistance in dying is also legal as is the case in Colombia, some parts of Australia, but the law differs across states. New Zealand's End of Life Choice Act legalises assisted dying and allows adults in their final months of life to request assistance from a medical professional.

Obviously helping someone to end their life is a very sad topic but as Esther Rantzen highlights, medical organisations and politicians burying their head in the sand on this issue are just ignoring the wishes of many terminally ill people suffering the indignity of pain and distress.