Patients face ‘considerable’ wait for assisted dying in British Isles

A Whitehall process to get assisted dying on the Isle of Man’s statute book has taken almost four times longer than other bills, Press Association analysis shows.

The island’s Tynwald became the first parliament in the British Isles to agree a framework for assisted dying last year, but after 337 days, the UK Ministry of Justice is yet to process the legislation for royal assent.

Jersey’s parliament, the States Assembly, is also in the process of deciding whether to make assisted dying available for terminally ill adults.

Its members voted in May 2024 in favour of drawing up laws for an assisted dying service in the Crown Dependency, with a final vote expected as soon as Wednesday.

Amid concerns around delays to the Isle of Man Bill, Jersey’s attorney general Matthew Jowitt said he would be “astonished” if the assisted dying law was not given royal assent should it clear his island’s parliament.

He told the States Assembly: “If it didn’t, we would be facing a constitutional difficulty of some magnitude.”

He described the “constitutional relationship” Jersey has as a Crown Dependency as “something of a ballet, and it requires all of us to avoid stepping on each other’s toes”.

A freedom of information (FOI) request by PA showed that since the start of 2020, the Ministry of Justice took an average 88 days to process Isle of Man legislation.

After the Assisted Dying Bill, the next-slowest scrutiny process was in 2021, when the Lord Chancellor received the Climate Change Bill 194 days before clearing it.

Alex Allinson, who steered the legislation through the Tynwald, said “a lot of work” will be needed once the Bill becomes law, including setting up support systems for patients, families and medical staff on the island.

A UK Government spokesperson said the length of processing time “depends on the complexities and sensitivities of a bill, as well as any legal and constitutional issues”.

There is no set deadline or target time for Whitehall to process legislation approved in Douglas.

The lack of deadline is “interesting”, Dr Allinson told PA.

He said: “I think there is the impetus really to complete the full passage of this Bill so we can start with some of the implementation of it, which will take a considerable amount of time because there were various amendments and clauses brought into the Bill in terms of the implementation, in terms of secondary legislation that has to go through the next Tynwald.”

Dr Allinson, a GP and independent member of the House of Keys (MHK), later added: “It will take quite a lot of time to do the right consultation with our medical, nursing and pharmaceutical professions to get the code of practice, the various legislation that needs to be put in in terms of what substances we use, what medications we use, the backup, the training that’s necessary, and also the support for patients, their families and the staff involved.

“So, there is a lot of work to be done, however, across the world, numerous jurisdictions make available assisted dying to their populations.”

The Bill, passed on March 25 last year, would make assisted dying available to terminally ill adults who are “reasonably expected to die” within 12 months.

They must have lived on the Isle of Man for at least five years.

“We’ve had two separate approaches now from the Ministry of Justice regarding some of the operational issues of the legislation,” Dr Allinson said.

“These don’t interfere with our constitutional relationship with the United Kingdom.

“It’s quite clear that the Assisted Dying Bill for the Isle of Man is only for Isle of Man residents who have been resident here for at least five years.

“So, it really is a matter of royal assent being granted so that we can get on with the significant amount of additional consultation we will need to do to bring it into implementation.”

Whitehall did not raise questions “fundamental to the principles behind the Bill”, the MHK added.

Responsibility for processing legislation from the Crown Dependencies lies with the Lord Chancellor, a post which Deputy Prime Minister David Lammy holds.

“The length of time taken to pass Crown Dependency legislation depends on the complexities and sensitivities of a bill, as well as any legal and constitutional issues,” a UK Government spokesperson said.

“This makes sure legislation is properly considered, in line with our good governance responsibilities.”

An Isle of Man Government spokesperson said: “The Isle of Man Government notes that the Assisted Dying Bill is currently progressing through the royal assent process.

“We are not able to comment on the timelines of that process, which are a matter for the UK Ministry of Justice.

“Should royal assent be granted, the act will not be commenced until all required secondary legislation and the code of practice have been developed, consulted upon and approved by Tynwald.”

It is thought that the implementation period for an assisted dying service could be up to two years after royal assent.

Nathan Stilwell, who chairs the Assisted Dying Coalition, has previously said Whitehall “should not delay the democratic will” of the Tynwald.

“Every month they stall, more dying people are forced to endure needless suffering or travel abroad to die,” he added.

Politicians in several parliaments are considering assisted dying legislation, including in Westminster, where MPs backed the Terminally Ill Adults (End of Life) Bill 314 votes to 291, majority 23, last June.

Welsh lawmakers in the Senedd on Tuesday gave their legislative consent for the UK Parliament to pass the Bill, which faces further scrutiny in the Lords before it can become law.

Debates are also taking place in the Scottish Parliament.