What next for the Isle of Man Assisted Dying Bill?

When the Isle of Man became the first place in British Isles to agree to legalise assisted dying the decision made by the parliament was hailed as "historic".

After months of debate, the Assisted Dying Bill 2023 completed its passage through the House of Keys and the Legislative Council on Tuesday.

But there are still many steps to take before it can become law, including receiving Royal Assent and the creation of secondary legislation and the codes of practice.

If the legislative process is successful, the bill's mover Alex Allinson MHK said he hoped an assisted dying service could be in place by 2027.

Under the measures in the proposed legislation, those eligible must be terminally ill and "reasonably expected" to die within 12 months, be over the age of 18, and have been resident on the island for five years.

The person must also have the legal capacity to make the decision, have the decision verified by two independent doctors, and be registered with an Isle of Man GP.

All legislation must be approved by the Head of State before it becomes law under a process known as Royal Assent.

As the bill has been agreed by both branches of the parliament, a Royal Assent copy can now be sent to the UK Ministry of Justice.

Once authorisation has been received by the Clerk of Tynwald, it would then be circulated for signing during a sitting of Tynwald, when it needs to be signed by least five members of the council and 13 MHKs in Tynwald.

At that point it would be sent to be officially signed off by the island's Lieutenant Governor, at which stage it will become an act.

The bill must then be promulgated on Tynwald Hill, which involves it being read out in Manx and English, within 18 months of receiving Royal Assent or it ceases to have effect.​

But the law would not be able to come into operation until Manx politicians have decided how the law would work in practice.

That would involve the creation secondary legislation, including codes of practice for medical professionals involved in the process and details on the implementation of the much debated safeguards within the legislation.

All that would involve further scrutiny by Tynwald members and consultations with those working in healthcare and other island residents have been promised as pat of that process.

The bill has been polarising. Public opinion was narrowly divided in 2023 when more than 3,000 people shared their views in a consultation exercise on the subject.

Supporters have said the proposed law change would give people a choice and prevent prolonged suffering, while opponents have raised concerns over coercion, additional pressure on the health service, and a potential exodus of medical professionals.

An Isle of Man Medical Society poll found a third of doctors who responded would consider leaving the island if the legislation was introduced.

Reacting to the latest step forward, Gordon Macdonald from campaign group Care Not Killing described the move as "very sad day for islanders".

He said he believed the proposed law had been "pushed through by for a small vocal minority" and was "in danger of jeopardising healthcare for everybody in the Isle of Man".

In its position statement on the issues, Hospice Isle of Man said it would "respect the freedom of choice of each and every individual" but it "would not see itself taking part in any process directly linked to an assisted death".

However, those in support of the bill, including campaign group Dignity in Dying, said Tuesday's milestone was a "historic moment for compassion" in the Isle of Man and the wider British Isles.

Chief executive Sarah Wootton said the bill's progression was Sue Biggerstaff's husband Simon and Millie Blenkinsop-French's son James "who died without choice over their deaths".

The campaigners had "led the charge for choice" in the island, which would mean "no one will be forced to suffer at the end", she said.

"Change is coming across the British Isles and the Isle of Man has led the way", she added.

While it remains illegal in most countries, more than 300 million people now live in countries which have legalised assisted dying.

Canada, Australia, New Zealand, Spain and Austria have all introduced assisted dying laws since 2015.

In Westminster Kim Leadbeater's bill is being scrutinised by a committee after MPs backed proposals covering England and Wales in November.

In Scotland, Liam McArthur MSP's bill is expecting its first vote by 23 May and in Jersey, politicians have voted to introduce an assisted dying bill with draft legislation to be debated by the end of 2025.

While Allinson said he was "hopeful" an Isle of Man assisted dying service could be in place by 2027, many stages of the parliamentary process must still be cleared before a resident who meets the specific Manx criteria would be able to ask for an assisted death.

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