What is the Assisted Dying Bill and what does it mean for Wales?

The Assisted Dying Bill is due to have a five-hour debate on Friday (29 November) – the first such debate in the Commons on the issue in almost a decade. After that, MPs are expected to vote on whether it should pass through to be scrutinised by a committee.

Currently, assisting someone's suicide is a crime and those convicted could face up to 14-years in jail. 

If it is made into law, it would mean people would be able to choose to end their lives if they have a terminal illness.

To do so, they'd have to be expected to die naturally within six months, it would have to be clear that they're making the decision without pressure from anyone else, and they would need the consent of two doctors.

• ITV Wales' Gwennan Campbell reports for Sharp End.

What are the arguments for assisted dying?

Some argue that people shouldn't be made to go through unnecessary suffering if they have a terminal illness and wish to end their life.

One of those is Claire O'Shea, who has an incurable gynaecological cancer.

"It’s a rare cancer, so there aren't many treatments available to me, so I’m starting to think about what's next if treatments become ineffective for me. Given my options at the moment, I’d rather be at home," she said.

"Facing a potentially painful, out of control death is something you feel quite anxious about. It takes up more time than you want it to because you do think of those worst case scenarios."

She says assisted dying is something she would consider.

"I could plan for what I wanted. All that anxiety, pain, stress might be something I didn’t have to think about and take a little bit of control back. The best I can hope for at the moment is that I live really well."

Jemma Williams has Multiple Sclerosis. She says: "I don't want to be trapped in a broken body and that thought terrifies me.

"I've had relapses where I've been quite bad, I've been in bed and I've been in terrible pain, and the thought of being like that permanently with no quality of life, and being like that permanently, is really frightening.

"I don't think people should be dictated to about how they should live."

There are other countries where assisted dying is legal. 40 people from the UK travelled from the UK to Dignitas in Switzerland last year to end their own lives.

Jemma says she couldn't afford to go abroad and believes it's unfair that if you have the money, you have the choice.

If people do travel abroad to end their own life, anyone who accompanied them on the journey could be arrested upon their return and could face up to 14-years in jail. 

People like Sue Lawford, who accompanied her friend Sharon to end her own life. When she arrived back in the UK, she was arrested and taken to Cardiff Bay Police Station.

"Five O'clock in the morning there was a loud bang on the door," she said. "My husband called up the stairs and said ,'Sue its the police.'"

"They were here to arrest me. I was put in a cage in the back of a van and taken to the police station.

"It was very scary and not at all what I'd expected to happen."

She spent 19 hours in custody and was investigated by police for six months, but didn't face any charges.

"I never felt that I'd assisted Sharon in any way. The whole application was by her, what I did was chaperone her, accompany her."

She says although it would require a lot of thought, it would be very hard to say no if she was asked to accompany someone again, saying it was a "privilege" to accompany her friend.

What are the arguments against assisted dying?

Concerns about Abuse

Some people have concerns that those with disabilities could be in danger of abuse if the bill is passed.

Former Paralympian and wheelchair user Baroness Tanni Grey-Thompson says disabled people have written to her "in their droves" saying that they are "terrified for their lives".

"There are so many people that could be vulnerable to this," she said.

"In Oregon (where assisted dying has been legal since 1997), their biggest reason for why people request it is not pain, or disease, it's that they're a burden on their family.

"Older people, disabled people, people who's life insurance is about to run out, it just opens the door massively to abuse."

She says that although there are arguments that this bill would give people greater choice, it would take away choice from disabled people.

"Disabled people in our society have a lack of choice- there's discrimination, in education, in work, in transport, and I'm really concerned that if this bill comes into force, disabled people will feel they'll have no choice but to end their lives."

GPs

Some GPs are concerned about the role they'll have if the bill passes. They'd have to give consent for a patient to end their own life.

Dr Rowena Christmas is Chair of the Royal College of GPs. She's not convinced that the NHS has the capacity to be responsible for this.

"As anyone who's tried to get an appointment with their GP recently knows, it's really difficult to get an appointment. We're really hard stretched with a lack of workforce and incredibly high workloads, so we need to have capacity to be able to have these quite complex, quite challenging conversations, these aren't going to be quick consultations and we need the capacity to have them.

"One of the things we feel is very important is that GPs have the opportunity to opt out, with no detriment to themselves or importantly no detriment to their patients either."

The Church

For some members of the Clergy, the issue is also troubling. Reverend Dean Roberts visits hospitals and hospices to spend time with people in their final moments.

"I completely sympathise with people who are terminally ill who feel that way," he said.

"I think one of the things that I would say is none of us truly know whether that would be what we would want until there's no turning back.

"I think as well, from my experience, a lot of terminally ill people go through periods of complete despair. They're going through their own bereavement. That anticipatory grief, that bereavement about the life that they used to enjoy that they can no longer enjoy to the same extent. But then there are moments of peace. There are moments of happiness, there are moments of celebration. 

"The people that we don't often think about in this debate, and that is the people who are left behind, the family members, the loved ones, the children who may grow up not knowing why dad or mum decided to end their own lives prematurely and dealing with that emotional and psychological burden for the rest of their lives."

In a statement released by the Archbishop and the six Bishops in Wales, the church leaders say there should be "no limits on compassion".

It reads: "This is an extremely difficult issue over which different people, including Christians, will have arrived at differing views with the best of intentions.

"Nonetheless, the protection of the most vulnerable people in our society from the risks inherent in this measure must be the paramount issue, and for that reason, we cannot in good conscience support the proposed legislation.

"There is abundant evidence from those jurisdictions where this measure has been enacted that good intentions can swiftly lead to bad and unintended outcomes, and to the devaluing of all human life.

"Our Christian faith has always been rooted in the reality of pain and mortality, but also in the incalculable value of each human person, irrespective of their social standing, their access to resources, or their physical or mental ability.

"In that spirit, shown to us in the person of Jesus, we give our heartfelt support to the extension of the best possible palliative care to all who require it, so that no limits are put on the compassion which we show as individuals and as a society.”

Palliative care

Some people, including former prime minister Gordon Brown, have argued that instead, the focus should be on better end-of-life care.

An amendment revealed on Tuesday, backed by six cross-party MPs, raised concerns about the level of debate and scrutiny before any vote on Friday, and called for an “independent assessment” of the provision of palliative care.

The amendment would “decline” to give a second reading to the Bill but whether or not it is voted on would depend on whether it is selected by the Speaker.

Professor Mark Taubert has worked in Palliative care for 18 years- he says there are misconceptions around what assisted dying looks like.

"A lot of people will envisage that it's maybe one or two pills, you know, washed down, maybe with a nice drink sitting in their back garden.

"I've heard stories where they've had to ingest up to 100 tablets for assisted suicide. This doesn't sound like a better death to me

"I think what I would prefer to see is well funded palliative care. I want to see well funded community services, hospital services before we take this seismic step."

What would it mean for Wales?

Last month, Senedd members, including First Minister Eluned Morgan and Health Secretary Jeremy Miles, voted against assisted dying.

In total, 19 Senedd members voted in favour, with 26 against and nine abstentions.

The power to pass laws that affect both England and Wales lies with politicians in Westminster, and not in Cardiff Bay, meaning the Senedd vote was mostly symbolic.

But while the law isn't devolved, running the NHS in Wales is, and as it would be Welsh NHS GPs who would have to give consent and prescribe medication for someone to end their own life, the Senedd may have some say.

Although the Senedd couldn't stop the law being passed, they may have to decide if the law is applied differently in Wales than it is in England, or not at all.

However as it is not a devolved issue, the decision on whether or not to legalise assisted dying is entirely in the hands of MPs at Westminster.

However, last month's vote against the bill in principle means it is uncertain what will happen in Wales if the bill is passed.

How will my MP vote?

You can find out how your local MP will vote, if they have declared their intention, here.

Most MPs representing Welsh constituencies are either undecided or have not public declared how they intend to vote.

Watch the full Wales This Week: Death by design? Programme on ITV1 Wales, tonight at 8:30pm.