The Isle of Man is moving toward potentially becoming the first part of the British Isles to legalise assisted dying, following pivotal parliamentary votes.
Members of the Tynwald, the island’s parliament, are debating whether lethal drugs should be self-administered or administered by doctors to eligible individuals.
Dr. Alex Allinson, both a politician and doctor, introduced the private members’ bill, predicting that fewer than a dozen people annually would choose assisted dying if the legislation passes. The bill, which has passed its second reading, allows terminally ill adults with a clear and settled intention to end their lives to seek assisted dying.
Significant amendments have been made: the residency requirement for eligibility has been increased from one to five years to avoid “death tourism,” and eligibility has been extended to those with less than a year to live, up from the initially proposed six months.
Dr. Allinson emphasised that the law would grant a small number of individuals greater autonomy and control over their deaths. However, some, like MHK Julie Edge, oppose the bill, citing concerns about inadequate safeguards and potential strains on the healthcare system.
The most controversial clauses yet to be debated involve the medical profession’s role in assisted dying, particularly whether doctors should be allowed to administer lethal injections or if patients should self-administer the drugs. The bill stipulates that two doctors must verify eligibility criteria.
After the House of Keys completes its clause-by-clause review, the bill will proceed to the Third Reading, followed by consideration in the Legislative Council, and finally, it will require Royal Assent from the Privy Council in London. If approved, the island’s first assisted death could occur as soon as 2027, following a year-long period to establish the necessary systems.
However, Chief Minister Alfred Cannan has suggested that the bill should be subjected to a public referendum before becoming law. Additionally, a survey by the Isle of Man Medical Society revealed that a third of responding doctors might consider leaving if the law is enacted, echoing concerns about a “slippery slope” and potential pressure on vulnerable individuals.
In contrast, proponents like Sue Biggerstaff argue that the law is necessary to prevent terminally ill individuals from suffering unbearably. She recounted the agonising final months of her husband, Simon, who endured severe pain from motor neurone disease despite extensive palliative care. Similarly, Clare Barber, an MHK and former nurse, supports the bill, having witnessed patients enduring pain while expressing a desire for assisted dying.
Opposition also comes from religious groups, such as Churches Alive in Mann. Reverend Bill Leishman expressed fears about the potential coercion of vulnerable individuals, suggesting that financial pressures could unduly influence decisions toward assisted death.
Parallel debates are occurring elsewhere: Jersey’s parliament will soon vote on assisted dying proposals, Scotland is considering a similar bill, and France is debating a new law supported by President Macron. In contrast, the UK Parliament has previously rejected assisted dying legislation, though a renewed effort is anticipated after the next general election.
The Commons Health and Social Care Committee found that palliative care had improved in several countries following the legalisation of assisted dying, challenging concerns about potential declines in care quality.
