The Royal College of Physicians (RCP) has published a summary of its work on the Terminally Ill Adults (End of Life) Bill as it reaches the conclusion of the parliamentary process.
The Terminally Ill Adults (End of Life) Bill, introduced by Kim Leadbeater MP, is approaching the end of its parliamentary process.
The Royal College of Physicians (RCP) adopted a neutral position on assisted dying in 2019 following an online survey of its members, reflecting the range of views throughout the 30 plus medical specialties. This means that the RCP neither supports nor opposes a change in the law.
While the ultimate decision on assisted dying rests with society through parliament, professional and clinical issues are integral to legislation, regulation, guidance and safe and effective implementation on this matter.
What has the RCP said about the Terminally Ill Adults (End of Life) Bill?
This RCP has maintained its neutral position as the Terminally Ill Adults (End of Life) Bill has made its way through parliament. The RCP neither supports nor opposes a change in the law.
After second reading in the House of Commons, RCP Council established a short-term working group to consider the practical implications of the bill on physicians and patients were it to become law.
The group developed a position statement, approved by RCP Council and published in May 2025, identifying areas of the bill that would need to be protected in the legislation if the bill were to pass. These factors included:
- Patients being enabled to have an equitable choice of services as they approach the end of their lives
- Doctors having the option to absent themselves from any aspects of assisted dying
- Decisions around a patient’s prognosis being informed by expert clinical professionals including those who know the patient
- Prognostic uncertainty being understood and accepted by the patient and professionals involved in decisions and oversight
- That prognostic uncertainty for people approaching the end of their lives for six months or fewer is very high. This may prevent people who have a deteriorating illness from accessing assisted dying.
- Equally the bill definition of terminal illness may influence assessing doctors to make this prognosis, despite its inaccuracy
- Decisions on capacity, and safeguards around coercion being informed by face-to-face assessments of relevant and appropriately skilled health and care professionals including those trained in mental health to assess the patient for any remediable suicidal risk factors
- Services that may deliver assisted dying being closely regulated and monitored for assisted dying
- Medicines prescribed and administered in assisted dying being regulated for safety and efficacy for this use
- Assisted dying services not diverting resources from other end of life care which must be available for all patients, or disadvantage provision of end of life and other services
- That patients would not have equitable choice of services because of the inequity of availability, and under-provision of end of life care and palliative care in England and Wales, and that some patients may choose assisted dying because they fear their needs would not be met by palliative care services that are currently not adequate
- That inequality of access may be created if a large proportion of primary care and hospital doctors would not be prepared to be involved in assisted dying
- That the current bill describes the coordinating doctor and independent doctors as working alone in making decisions around prognosis, available treatments, mental capacity, and ensuring that patients have not been coerced. These decisions would not be made by doctors alone in any other aspect of clinical practice
- The bill does not prescribe a multidisciplinary discussion and decision making. Face to face assessments by a clinician trained in mental health and social worker would be important.
How has the RCP worked with parliamentarians during the passage of the bill?
The RCP submitted evidence to the UK parliament public bill committee on 14 February 2025.
The RCP sent its position statement to all MPs after it was published, ahead of third reading in the House of Commons. The RCP also shared its joint statement with the Royal College of Psychiatrists (RCPsych) with all MPs in June 2025.
The joint RCP and RCPsych statement expressed shared concerns, including:
- The way that doctors and health professionals would be expected to work, reiterating the joint view that complex clinical decisions must be made as part of the multidisciplinary team and through face to face assessments
- That the Mental Capacity Act does not provide a framework for assessing a person’s capacity to decide to end their own life
- That vulnerable patients (particularly those with remediable mental health or other unmet needs) are not adequately protected by the current bill
- That the NHS workforce does not currently have the resource required to meet these additional demands.
The RCP’s position statement was shared with all Peers ahead of second reading in the House of Lords. On 22 October 2025, RCP president Professor Mumtaz Patel gave evidence to the House of Lords Select Committee on the bill. Professor Patel outlined the factors that the RCP believes would need to be protected within the legislation from its position statement and agreed in principle that assisted dying would need to be a separate service, with separate pathways, and adequate resources for delivery.
The RCP also submitted our position statement to the Senedd Legislative Consent Motion Committee in Wales.
How will the RCP engage with the bill from here?
The matter of whether the Terminally Adults (End of Life) bill passes or not rests with parliamentarians. The RCP will continue to remain neutral on a change in the law.
The bill is currently in the House of Lords. Peers must debate all proposed amendments before the bill can return to the House of Commons for further consideration and final votes on whether it will progress to Royal Assent to become law. As a private members’ bill, it must pass through the full parliamentary process by the end of the parliamentary session, which we expect to be in May.
RCP Council will discuss the Terminally Ill Adults (End of Life) Bill in March 2026 to inform the RCP’s activities if the bill does not complete its process by May but is brought back in the next session.
However, should the bill pass, the RCP stands ready to engage with the government on the likely statutory guidance that will be required, including:
- Training, qualifications and experience required to be a coordinating doctor
- Regulation of medicines or substances to be prescribed and administered
- Regulation of any provider delivering assisted dying service
- Code of professional practice for those participating
- Operation of the act, and provision of services.
For further information, please contact policy@rcp.ac.uk.