The Terminally Ill Adults (End of Life) Bill 2025 has been passed by the House of Commons with a narrow majority, and is now at the second reading stage in the House of Lords. If enacted, it will mark a major shift in the landscape for end-of-life decisions in England and Wales: legalising assisted dying for competent adults with a terminal prognosis of six months or less.
If the Bill becomes law, it will allow terminally ill adults with a clear, settled and informed wish to end their own lives to request assistance, provided they meet specific criteria, including being ordinarily resident in England and Wales for at least one year, and being registered as a patient with a general medical practice here. Critically, the individual must have mental capacity to make the decision in accordance with the Mental Capacity Act 2005.
The Bill sets out in detail the process to be followed, beginning with the individual's signed "first declaration" which must be witnessed by the co-ordinating doctor and another person.
This article does not attempt to explore the moral and ethical implications of the Bill, but instead looks at the legal framework surrounding end-of-life and related decisions, for which the legislation carries important implications, particularly in relation to Lasting Powers of Attorney (LPAs), Advance Decisions to Refuse Treatment (ADRTs), and Wills.
Lasting Powers of Attorney: Health & Welfare
The Bill requires that an individual, having the requisite mental capacity, personally initiates the assisted dying process, meaning that an attorney under a Health & Welfare LPA (who can only act once the donor has lost capacity) cannot make or authorise the request on the donor's behalf. It is important that anyone considering assisted dying appreciates that this decision cannot be delegated to anyone else.
Individuals considering assisted dying may still be advised to put in place a Health & Welfare LPA to enable an attorney to make decisions about their ongoing care and medical treatment in the event that they lose mental capacity and are unable to proceed under the assisted dying route.
As has always been the case, it will be helpful if donors of LPAs for Health & Welfare can provide as much supporting guidance about their wishes and preferences as possible, whether in the LPA itself or separately.
Advance Decisions to Refuse Treatment (ADRTs)
An ADRT cannot function as a request for assisted dying. However, it might provide useful context and support an individual's broader approach to end-of-life autonomy, by demonstrating a consistent refusal of burdensome or life-prolonging interventions. Importantly, it might offer a fallback framework should it not be possible to complete assisted dying procedures.
Existing ADRTs should be reviewed if the Bill becomes law.
Wills
Individuals considering assisted dying should ideally review their Wills well before commencing the process.
Given the potential vulnerability of terminally ill individuals, changes made at around the same time as an assisted dying request may come under heightened scrutiny. More so than ever, individuals can expect their solicitors to insist on rigorous capacity assessments and on documenting instructions meticulously, with a view to guarding against potential challenges to the Will in due course.
Conclusion
The new legal framework presents a raft of ethical, safeguarding and practical challenges in the context of end-of-life decisions.
Advisers will need to become well-versed in the legislation and prepare for a potentially increased demand for assistance with ADRTs, Wills, and LPAs, as well as for advice in handling contentious estates.
The Bill reinforces the importance of integrated end-of-life planning and terminally ill clients will be advised to contact their advisers well ahead of any possible assisted dying request, seeking a comprehensive review to ensure that their legal documents support both personal autonomy and procedural compliance under the new regime.
After the Bill's passage through the House of Commons completed in June 2025, its second reading in the House of Lords is due to take place on 12 September 2025. A third one will be needed before it reaches the final stages.
Depending on how long the House of Lords takes to pass the Bill (if at all) it is likely to take some time from enactment, for the Bill to be implemented.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
