The assisted dying bill – officially called the Terminally Ill Adults (End of life) Bill – is being examined and debated by politicians. This would apply in England and Wales. Here’s what nursing staff need to know.
What does the bill propose?
It's a bill to allow adults who are terminally ill, subject to safeguards and protections, to request and be provided with assistance to end their own life. The bill, if passed, would apply to people over 18, who live in England or Wales and have been registered with a GP for at least 12 months. They must be expected to die within 6 months. The bill sets out strict conditions that would relate to mental capacity and expressing a clear, settled and informed wish, free from coercion or pressure.
Two separate declarations, witnessed and signed, would have to be made by the individual about their wish to die. Two independent doctors must be satisfied the individual is eligible.
The individual who has expressed their wish to die would take the substance being used to end their life themselves, but a doctor would prepare it.
Find out more about the Terminally Ill Adults (End of life) Bill on the UK Parliament website.
Is the assisted dying bill now law?
No. The bill has had its first and second reading in the House of Commons and is currently in the committee stage. The committee review the bill line by line, and amendments are considered. The bill will then progress to the third reading where it’ll be voted on again.
If the vote is in favour, it will then go through the same process in the House of Lords and amendments considered, before Royal Assent is able to be given. This is when the bill will become an act.
What’s the RCN position?
We’ve had a neutral position on assisted dying for people who have a terminal illness since 2009. This position allows us to represent and support all nursing staff, regardless of their personal or professional stance on assisted dying, while focusing on practical measures to ensure patient safety, workforce protection and the effective delivery of end-of-life care.
At RCN Congress in 2024, members debated a resolution to "support the principles of assisted dying". The indicative vote that followed saw the Congress voting in favour of the resolution. While this vote did not change our neutral stance, it demonstrated the range of perspectives among nursing staff and highlighted the importance of their voices in this debate.
Work is currently under way to provide resources to support members on the issue.
What’s the RCN doing?
While we have a neutral position on the bill, we believe it's important that the bill is practical in delivery and is safe for nursing staff to be involved in.
We’re seeking key changes in the bill. RCN General Secretary and Chief Executive Professor Nicola Ranger has given evidence in person to the Bill Committee. We've also submitted written evidence.
While we take no position on whether the bill should become law, we’re committed to ensuring that, should assisted dying be introduced, the framework is robust, equitable, and workable for all involved. We believe this is essential to maintaining public trust and confidence in both the health care profession and end-of-life care.
What changes to the bill do we want to see?
We’re recommending:
- strengthening protections for nursing staff to ensure they are safeguarded from detriment regardless of their stance, including indirect involvement
- embedding nursing leadership in governance and oversight roles to ensure the practical realities of end-of-life care inform the framework
- including explicit provisions for robust training and emotional support programmes for health care professionals beyond registered medical professionals, with specific reference to the needs of nursing staff
- the bill include provisions to establish clear and formal processes for stakeholder engagement
- ensuring transparency and accountability through independent oversight and regular publication of anonymised data.
What are we specifically saying about emotional support?
We believe there should be a requirement for mandatory training on assisted dying for nursing staff. There is currently no provision for this in the bill.
Emotional support should be developed in collaboration with regulators and professional bodies, including the Nursing and Midwifery Council (NMC) and the RCN. In addition, emotional support services, such as counselling and peer networks, should also be provided to address the significant impact this work can have on professionals.
What about nurse leadership?
There’s currently no role for nursing leadership in the bill. We want to see a formal role for nursing leadership in the bill’s oversight and governance structures, ensuring the perspectives of nursing staff inform policy development and implementation. We also recommend there should be clear provisions for ongoing consultation with nursing staff during the creation and evaluation of guidance, codes of practice and regulations.
What about end-of-life care?
Regardless of any legislative changes related to assisted dying, the profession's commitment to improving end-of-life care remains essential to maintaining public trust and delivering compassionate, dignified care for all.
While most of the formal responsibilities rest with medical practitioners, the contribution of nursing staff is vital to ensuring end-of-life care is delivered with professionalism and compassion. This is a critical point and highlights why the voice of nursing should be centred in these discussions, alongside other professional groups, as well as patients.
What do we expect of politicians?
We’re encouraging politicians to consider an amendment to ensure nursing expertise is explicitly included in the governance of this legislation, reflecting the vital role of nursing in end-of-life care.
Does the assisted dying bill apply across the UK?
No. The bill currently passing through the UK parliament will be effective across England and Wales only.
In Scotland, the Assisted Dying for Terminally Ill Adults (Scotland) Bill is currently being considered by the Scottish Parliament. We're engaged in the parliamentary process at Holyrood to ensure that the bill contains the necessary safeguards to protect nursing staff and nursing practice.
We are working to protect nurses who may wish to participate in assisting a death under the framework established by the bill, and those who may not wish to participate if the legislation progresses. Find out more.
In Northern Ireland, assisting someone to die is a crime, and there is no proposed legislation to change this.
And elsewhere?
In May 2024 the States Assembly approved detailed proposals for assisted dying in Jersey, and requested the Minister for Health and Care Jersey to bring forward primary legislation that permits assisted dying in Jersey for those with a terminal illness. Details of the proposals differ from those proposed in England. Read more.
On the Isle of Man, proposed laws that would give terminally ill people the right to choose to end their lives have reached the final stages. Get the latest information.
What are other health care organisations saying?
The NMC and the British Medical Association also have neutral positions.
Will the RCN position change if the law changes?
Should there be any changes to current legislation, members will be informed, and meaningful engagement will be undertaken in any RCN decision-making process. This may also include discussion on the right to object in the participation of assisted dying.
We’ll also work with members and the NMC to ensure the rights of nursing staff are protected, specifically on issues related to conscientious objection.
