Draft Assisted Dying (Jersey) Law 202-

STATES OF JERSEY

DRAFT ASSISTED DYING (JERSEY) LAW 202-

Lodged au Greffe on 2nd September 2025 by the Council of Ministers

Earliest date for debate: 21st October 2025

STATES GREFFE

2025  P.65/2025

DRAFT ASSISTED DYING (JERSEY) LAW 202-

European Convention on Human Rights

In accordance with the provisions of Article 16 of the Human Rights (Jersey) Law 2000, the Minister for Health and Social Services has made the following statement –

In the view of the Minister for Health and Social Services, the provisions of the Draft Assisted Dying (Jersey) Law 202- are compatible with the Convention Rights.

Signed:   Deputy T.J.A. Binet of St. Saviour

Minister for Health and Social Services Dated:  29th August 2025

REPORT

Section 1: Background

This section of the report provides background information, outlines the process for developing the draft law and details planned activity during the lodging period.

Background

1. On 22 May 2024, the States Assembly ("the Assembly") voted for the Council of Ministers' proposition  P.18/2024  requesting  the  Minister  for  Health  and  Social  Services  ("the Minister") to: [1]

1. bring forward primary legislation that permits assisted dying in Jersey for those with a terminal illness and a life expectancy of 6 months, or 12 months for those with a neurodegenerative condition (referred to as Route 1' in P.18/2024)
2. establish  an  assisted  dying  service  in  accordance  with  essential  provisions  and safeguards set out in that proposition

2. In adopting P.18/2024, the Assembly rejected proposals to permit assisted dying for people who have an incurable physical condition but where there is no reasonable expectation of death within a short timeframe (referred to as Route 2' in P.18/2024).
3. Following  the  Assembly's  decision,  work  was  undertaken  to  develop  law  drafting instructions that accords with the detailed proposals set out in P.18/2024. Those instructions were issued by the Minister on 15 November 2024. [2]
4. A health and care professionals working group was established in September 2024 to support the development of the draft law and prepare for the implementation of an assisted dying service. That working group was in addition to the Professional Leads Group who provided senior clinical oversight throughout the development of the P.18/2024 proposals. [3]
5. The working group provides the perspective of professionals who work across the areas of health care practice likely to be impacted by the introduction of an assisted dying service. Members include representatives of non-Government health and care organisations in addition to Health and Care Jersey ("HCJ") staff .[4]
6. During the legislation development phase there has also been ongoing engagement with key stakeholders, including:

1. Jersey Care Commission

2. UK professional regulatory bodies [5]
3. Professional leads working group [6]

7. The UK professional regulatory bodies provided feedback (either via written response or by feedback meeting) on aspects of the draft law that impacts their registrants. These responses included feedback on the provisions related to the right to refuse to participate; the registration of assisted dying practitioners; and the requirement on the Committee to develop operational guidance.
8. Officers have also worked to keep the Assisted Dying Review Panel updated during the law drafting process. [7]
9. In agreeing P.18/2024, the Assembly agreed, in principle, the provisions and effects of the draft  law,  which  were  shaped  by  two  phases  of  extensive  public  and  stakeholder engagement undertaken in 2022 and 2023, in addition to the Assisted Dying Citizens Jury[8] [9] .[10] For this reason, further public engagement has not been undertaken during the law drafting phase. See Appendix 1 for detail on the development of proposals prior to P.18/2024.
10. The draft Law accords with the P.18/2024 proposals agreed by the Assembly, subject to a few minor refinements and updates identified during the law drafting process. These are referenced in the relevant sections of this report and include the following:

End-of-life care

11. P.18/2024 made two key statements in relation to the provision of end-of-life care:

1. consideration will be given to placing a statutory duty on the Minister for Health and Social Services to provide palliative care and end of life care as part of proposed Adult Safeguarding Law that is currently in development
2. the assisted dying should not be brought into force until the Assembly is satisfied that decision taken in the 2023 Government Plan to provide for additional investment in end of life and palliative care is supporting improvements in quality and availability of those services

12. With regard to the statutory duty (as per sub-paragraph a. above), work on the proposed Adults  Safeguarding  Law  has  been  delayed  due  to  competing  priorities.  Hence, consideration has been given to other routes for bringing forward that duty.
13. It was initially proposed that this could be achieved via a regulation making power under the assisted dying law, however, this option creates significant difficulties in that the assisted dying law would effectively be recast as an assisted dying and end-of-life care law. "Co-joining" assisted dying and end-of-life care in a single piece of legislation is not considered appropriate.
14. The Minister, recognising the importance of bringing forward a statutory duty related to end-of-life care, will lodge a separate proposition before end of September 2025, to ask the Assembly to agree that a new end-of-life care law should be presented to Assembly before the assisted dying law, if adopted, comes into force. It is anticipated the assisted dying law will not come into force until around 18-months post adoption of that law (c. late Summer 2027).
15. The Minister is lodging a separate proposition because it is understood that it would be procedurally difficult for the Assembly to determine two separate matters in a single proposition (i.e., the adoption of the assisted dying law alongside the bringing forward of an end-of-life services law).

16. With regard to improvements in end-of-life care (as per sub-paragraph b. above), the Minister will be lodging an addendum to this report and proposition which will include evidence of improvements of quality and availability of palliative and end of life care in Jersey. This accords with Scrutiny recommendations (as described below).

Addendum

17. The Scrutiny Review Panelestablished to examine proposals for assisted dying, as set out in  P.18/2024,  made  several  recommendations  in  their  review  report. [11] These recommendations included placing a requirement of the Minister to publish additional information about the planned implementation of an assisted dying service, and to do so no later than 2 months before the draft law is scheduled for debate.
18. In accordance with the Panel's recommendations, an addendum to this report will shortly be published providing the information requested in response to the following Scrutiny recommendations:

*indicates a key recommendation of the Scrutiny Panel

Lodging period

19. The standard minimum lodging period for a proposition brought forward by the Council of Ministers is 6 weeks. Given the importance and complexity of the draft law, an extended lodging period has been agreed to provide time for the public, health and care professionals, and States Members to engage with the draft law. It is expected that the draft law will be debated before end 2025. The following activities will be undertaken during the lodging period. Further details are provided at gov.je/assisteddying

Lodging period activity

Public

• minimum of 4 public information sessions in different locations

• dedicated sessions for disabled Islanders, working with Enable to ensure specialist communication support is provided, as required

• www.gov.je/assisteddying to be updated to include:

- a summary of the key provisions of draft law

- updated case studies' to illustrate how key safeguards will work

- Q+A section – to be updated to incorporate questions/concerns raised during public sessions

Health and care professionals

• dedicated information sessions for health and care professionals (these will be post- work or evening sessions to best accommodate staff availability)

• meetings with local health and care providers, as requested

States members briefing:

• 3 x States Members briefing sessions

• Fortnightly drop in' sessions, for Members to discuss the draft law on a 1-to-1 basis  

Section 2: Part 1 of draft Law – definitions and criteria

20. Part 1 of the draft law defines key terms used in the law and sets out the eligibility criteria for assisted dying.

Overview of defined roles

21. Amongst other matters, Article 1 defines the roles of professionals who opt in to work for the Assisted Dying Service ("the Service") [see section 4 (paragraphs 285 to 294) for more detail on registration of professionals, and paragraphs 209 to 217 for detail on right to refuse to participate in assisted dying and protections for professionals].
22. Care Navigator - A non-clinical staff member who will support the individual requesting an assisted death and support the Coordinating Doctor to coordinate the process. The initial point of contact for information and enquiries into the Assisted Dying Service. The Care Navigator must complete the mandatory assisted dying training, but they do not need to be registered with the Assisted Dying Service because they are not clinical staff.
23. Certifying Doctor – the doctor who certifies an individual's assisted death. They need to be registered with the Assisted Dying Service and must have undertaken the mandatory assisted dying training.
24. assisted dying practitioner – the general term used to describe any health professional who is registered with the Assisted Dying Service, having met all registration requirements including mandatory training. This includes:

1. assessing doctors (i.e. Coordinating Doctor, Independent Assessment Doctor, Second Opinion Doctor)
2. Administering Practitioners
3. Pharmacy Professionals
4. extended team members.

Involvement in assessment & approval process

25. assessing doctor – the general term used to describe any doctor involved in the assessment process. This could include a Coordinating Doctor, an Independent Assessment Doctor or a Second Opinion Doctor.
26. Coordinating Doctor – the specific term used for the doctor who receives the individual's first and second request (at step 1 and step 4), undertakes the first assessment of the individual (at step 2), coordinates the whole assessment process, and makes the decision to approve or refuse the individual's assisted dying request (at step 5).
27. Independent Assessment Doctor – the specific term used for the doctor who undertakes the independent assessment of the individual (step 3).

28. Second Opinion Doctor - the doctor who may undertake a second opinion assessment if the individual requests a second opinion assessment, whether after the first (step 2) or independent assessment (step 3), and that request is accepted by a "review doctor" – see Articles 32 and 33 of draft law.
29. Extended team member – an extended team member may include, for example, a registered nurse, social worker or any relevant allied health professionals (e.g., a speech and language therapist, physiotherapist or dietician). An extended team will be formed to support the assessment process for individuals who request an assisted death. The purpose of the extended team is to provide check and challenge for the assessing doctors and a multidisciplinary perspective to discussions of eligibility.

Extended  teams  are  commonly  referred  to  as  multidisciplinary  teams  ("MDT")  in healthcare practice. The term MDT was used in P.18/2024.

30. Extended team working practice

a. In accordance with P.18/2024, the draft law does not prescribe matters related to the requirement for an extended team, its membership or practice as these will vary depending on the needs and circumstances of each individual who requests an assisted death. For example, an extended team:

• may not be required where an individual does not meet the residency criteria (although an individual social worker or counsellor may to be required to provide the individual with support to process refusal of their request)

• may not require involvement of speech and language therapist if the individual does not require speech and language support.

b. The draft law does, however, provide that:

• the extended team members are registered assisted dying practitioners who met the required competencies and have undertaken the relevant mandatory assisted dying training

• extended team members may provide professional opinions (Article 31)

• the Committee must bring forward operational guidance on assessing individuals for assisted dying and care planning (Article 62) and the guidance will provide for matters related to the extended team.

c. As set out in P.18/2024, that guidance will state that the extended team meetings will be chaired by the relevant assessing doctor (e.g. the Coordinating Doctor, if convened during the first assessment, or the Independent Assessment Doctor if convened during the independent assessment). The chair will determine the composition of the extended team and frequency of meetings, dependent on the specific circumstances of the individual requesting assisted dying. Details of the meetings will be included in the individual's assisted dying record [see paragraph 260b].

4. In addition to discussion of the individual's eligibility for assisted dying, the extended team meetings may also be used to consider additional support the individual may require, either in relation to their assisted dying request (e.g. access to counselling services or mental health practitioners) or where the person is likely to be assessed as ineligible for an assisted death and may require signposting to other services for support.

Involvement in planning & provision of assisted death

31. Administering Practitioner – the doctor or registered nurse who: supports the individual to develop their assisted dying care plan; supports the individual to either self-administer the approved drugs or who will administer the approved drugs to the individual; who stays with the individual during their death.

The Coordinating Doctor may also act as the Administering Practitioner (if the individual agrees to this) but the Independent Assessment Doctor may not act as the Administering Practitioner  to  help  preserve  the  independent  nature  of  the  Independent Assessment Doctor's role.

32. Pharmacy Professional – the pharmacist or pharmacy technician who will prepare and dispense the approved drugs. To help ensure a clear chain of control over the approved drugs, the draft law provides that the Pharmacy Professional must work for hospital pharmacy. The approved drugs cannot be prepared or dispensed from any other pharmacy.
    33. Survey - health and care professionals' participation in assisted dying survey

P.18/2024 sets out that, post consideration of P.18/2024 by the Assembly, a survey of local health and care professionals would be undertaken to better understand if they may be willing to participate in the Assisted Dying Service.

That survey, which was undertaken in early 2025, indicates that a number of Jersey-based professionals are willing to participate in assisted dying.

This included:

• 19 doctors indicated they would be prepared to act as an assessing doctor

• 51 professionals (doctors and nurses) indicated they would be prepared to act as an Administering Practitioner

• 92 professionals (nurse, social workers, allied health professionals) indicated they would be prepared to be part of an extended team

• 22 professionals indicated they would be prepared to act as Pharmacy Professional.

See Appendix 2 for more information.

Assisted dying eligibility criteria

34. In accordance with P.18/2024, Article 2 of the draft law provides that an individual may be eligible for assisted dying if they meet the following criteria:
    1. health criteria
    2. capacity criterion
    3. decision criteria
    4. age criterion
    5. residency criterion
35. The health criteria are that the individual:

1. has a physical condition that is expected to cause their death within 6 months (or 12 months if the condition is neurodegenerative) i.e., it is a terminal illness; and
2. believes they cannot bear the suffering the condition causes them or is expected to cause them before their death, OR if treatment could extend their life, or make their suffering more bearable, they believe that they could not bear the suffering that the treatment would cause them

36. The draft law provides that the assessing doctor must be satisfied that the individual believes they cannot bear the suffering they are experiencing, or are expected to suffer, but it is for the individual, not the doctor, to determine their own suffering (see Article 25, paragraphs 163-166 for more detail).
37. The capacity criterion is that, when the individual is assessed, they have capacity to decide to end their life by assisted dying. Article 26 sets out the matters that the assessing doctor (or Administering Practitioner at step 6 or 7) must consider in order to be satisfied the individual has capacity. This includes a specific assisted dying capacity test (see paragraphs 167 - 170 for more detail).
38. The decision criteria are that, when the individual is assessed, their request for assisted dying is:
    1. voluntary
    2. clearly expressed
    3. settled (having been maintained consistently since their first request for assisted dying), and
    4. informed.
39. With regard to the voluntary nature of the individual's decision, Article 65 - which sets out matters related to mandatory training for assisted dying practitioners - stipulates that the training must include matters related to domestic abuse and whether someone has been coerced or pressured to do something, including coercive control and financial abuse. This is in line with proposals in the UK Bill (see Appendix 4).

40. In determining whether the individual's decision is informed, Article 28 and 29 (and Schedule 1) set out the general and specific information that the assessing doctors must provide to the individual (See paragraphs 175 - 177).
41. The age criterion is that an individual must be 18 years or older when they make their first request for assisted dying.
42. The residency criterion is that the individual must be ordinarily resident in Jersey for 12 months immediately prior to making their first request for assisted dying and continue to be resident throughout the assisted dying process. Residency is assessed throughout the assisted dying process to ensure adherence to the principle that only people resident in Jersey are eligible for an assisted death in Jersey and to safeguard against any potential cross- jurisdictional risks, for example:

1. a health care professional being involved in the assisted dying process for an individual who is resident in another jurisdiction in which assisted dying is not lawful
2. the individual seeking an assisted death in Jersey whilst resident, even on a short-term basis, in a jurisdiction in which assisted dying is not lawful.

Appendix 3 - case studies

Appendix 3 includes 12 studies that illustrate how the assisted dying eligibility criteria (described in Section 2 above) and the assisted dying process (described in Section 3 below) will work for different individuals depending on their personal circumstances.

Appendix 3 includes case studies focused on individual requesting an assisted death, and health and care professionals involved the assisted dying process or caring for individuals involved in the process.

Section 3: Part 2 of draft Law - Assisted dying process and related matters

43. Part 2 of the draft law:

• sets out matters relating to steps 1 to 8 of the assisted dying process; from first request to review after death

• provides additional detail about the assessment, approval, and provision of assisted dying

Assisted Dying Process (Steps 1 to 8)

44. The draft law sets out the steps for the assisted dying process in accordance with P.18/2024:

Step1: First request for assisted dying (Article 3)

45. As set out in P.18/2024 the first request starts the formal assisted dying process – it signifies a shift from informal consideration of assisted dying to formal intent to initiate an assisted dying process. Prior to making a first request the individual may, over a period time, have had several discussions with the Care Navigator about assisted dying process which may have included being referred by the Care Navigator to other relevant support services.
46. The draft law provides that an individual may be referred into the Assisted Dying Service by another healthcare professional or may self-refer. Self-referral allows people direct access to the service where, for example, their GP, chooses not to refer them on the grounds that they object to assisted dying.

47. An individual must meet face-to-face with a Coordinating Doctor to make their first request. This will be captured on a first request form. As set out in P.18/2024, during that meeting the Coordinating Doctor will talk to them about assisted dying, and the assisted dying process.
48. The draft law provides that, at this first step in the process, the Coordinating Doctor must explain to the individual that they can choose whether to permit the Assisted Dying Service to share information about the individual with others (for example, with other health care professionals, friends or family members) and, whilst the individual may choose not to permit information sharing, this may impact on the assessing doctors' or Administering Practitioner's ability to determine if the individual meets the eligibility criteria.
49. The Coordinating Doctor must also determine matters related to age and residency at Step
    1. In doing so they may seek relevant opinions of others (see Article 31 and paragraphs 180 - 188).
50. If the individual makes their first request (and both they and the Coordinating Doctor sign a form confirming the individual has made a first request), and the Coordinating Doctor is satisfied the individual meets the age and residency criteria, the individual may then request to proceed to the next step (step 2). As per paragraph 128, they may request to proceed to the next step at the same time as making a first request or a later date – this is because they are in control of the speed of the process.
51. The draft law provides that the Coordinating Doctor cannot accept the request to proceed to step 2, unless they reasonably believe that the request is voluntary and clearly expressed (see Article 17 and paragraph 130). At step 2 matters related to the other criteria are assessed and determined.
52. If the Coordinating Doctor is not satisfied the individual meets the age and residency requirements, or that their request is voluntary and clearly expressed, they must tell the individual and explain the reasons for their refusal. The assisted dying process then stops unless overridden by an appeal (see Article 42 and paragraphs 232 - 243).
53. In accordance with P.18/2024, the draft law permits an individual to make a new first request if an earlier assisted dying process ended, but it also provides that the Coordinating Doctor can refuse to start the process again if:

1. the Coordinating Doctor believes the new process would end for the same reason as the previous process, or
2. the individual withdrew from the first process before the process completed but the Coordinating Doctor reasonably believes that, in any event, the first process would have ended for another reason (e.g. they would have been found to be ineligible).

54. The above provisions allow for individuals whose circumstances change (i.e., their life expectancy was previously more than 6 months but is now six months or less) whilst avoiding necessary distress to individuals who make repeated requests but are clearly not eligible for assisted dying under the law – including those who withdraw from previous processes.

Step 2: First assessment (Article 4)

55. If the individual completes step 1, including requesting to proceed to the next step, the Coordinating Doctor will undertake a first assessment. Depending on the circumstances of the individual, the assessment may be completed during one meeting or may require multiple meetings. Article 18 sets matters related to the location of meetings, for example Jersey and UK, and the format of meeting, for example, in-person or electronic (see paragraphs 138 - 146).
56. During the first assessment the Coordinating Doctor:

1. must decide whether they are satisfied that the individual meets all the criteria (Articles 25 to 30 provides for how the Coordinating Doctor determines the criteria - see paragraphs 161 -179)
2. may decide the individual has a life expectancy of 14 days or less, in which case they may override the 14-day minimum timeframe. See note on minimum timeframes,

paragraph 64.

57. In making those determinations  the Coordinating Doctor may or must seek relevant opinions of other professionals or connected persons. A connected person is someone who has a personal relationship with the individual (e.g.: a family member, friend, neighbour, or colleague).
58. The Coordinating Doctor – and all other assessing doctors- may seek a relevant opinion when it will be helpful to them to understanding a matter (for example, they may speak to family members to better understand why the individual is refusing treatment). They must seek a relevant opinion when the opinion is necessary to help them decide a matter (for example, they must get an expert in capacity to undertake an assessment if they are unable to determine whether the individual has capacity). Article 31 provides information on relevant opinions - see paragraphs 180 - 188.
59. If the Coordinating Doctor determines that the individual does not meet one of the criteria, they are not required to assess all the criteria. For example, if they are not satisfied that the individual's condition is terminal - and hence the individual could not be found to meet all the eligibility criteria - the Coordinating Doctor is not required to assess the whether the individual meets the capacity or decision criteria. Criteria that have not been assessed in these circumstances are referred to as unassessed criteria (See Article 24). Unassessed criteria can be considered as part of a second opinion assessment if a second opinion assessment is undertaken (See paragraph 200)
60. If the Coordinating Doctor is not satisfied that the individual meets the criteria, they must tell the individual and provide written confirmation that they do not meet the criteria, which criteria they do not meet and why, and which, if any, are criteria are unassessed. The process then stops unless overridden by a second opinion assessment (see Articles 32/33 and paragraphs 189 - 201) or an appeal (see Article 42 and paragraphs 232 - 243).

61. If the Coordinating Doctor is satisfied that the individual meets the criteria they must, when meeting with the individual, sign a form stating this.
62. If the individual then wishes to request to proceed to the next step of the process they may do so, but the Coordinating Doctor may only accept this request if they reasonably believe the individual's request is voluntary and clearly expressed (see Article 17).  
63. Note: If the Coordinating Doctor did not decide to override the 14-day minimum timeframe during the first assessment (because at the time of the first assessment the individual's life expectancy was more than 14 days) the Coordinating  Doctor – or another doctor if permitted by the draft law – may make this decision at any time after the first assessment if the individual's health has deteriorated.
    64. Note: Minimum timeframes

1. In accordance with P.18/2024, Article 9 of draft law provides that an individual's assisted death must be at least 14 days after the day on which the individual has made their first request and completed Step 1.
2. 14 days is considered sufficient time for assisted dying process to be completed, and for the assessing doctors to be confident that an individual's request for an assisted death is settled (in accordance with the eligibility criteria), whilst not unduly extending any suffering and uncertainty. This is in line with some other jurisdictions that permit assisted dying.
3. The draft law also provides that the minimum timeframe may be overridden if, in the opinion of the Coordinating Doctor and the Independent Assessment Doctor, the individual is likely to die in less than 14 days from the date on which they made their first request. In the cases there will be no minimum timeframe.
4. Overriding the 14 days minimum timeframe automatically includes removal of requirement for at least 2 working days period between approval of an assisted death (at Step 5) and the administration of the approved drugs (at Step 7). The 2 working days period is to allow for appeals from a person with a special interest in the care and treatment of the individual. The minimum timeframe is provided for in Article 9. Appeals are provided for in Article 42.
5. There is no maximum timeframe for an assisted death (i.e., the draft law does not stipulate that the process must take no more than a given number of months). This is because an individual must be able to dictate the pace at which they move through the process – except for where the minimum timeframes apply.

Step 3: Independent assessment (Article 5)

65. If the individual completes step 2, including making a request to proceed to step 3, then the Independent Assessment Doctor will undertake a second assessment to decide whether the individual meets the health criteria, the capacity criteria, the decision criteria and the residency criteria. They do not need to determine the age criteria as the fact that the individual is aged 18 or over has already been determined at step 1.
66. The independent assessment process mirrors the first assessment process – as described in paragraphs 55 -63 above - except that the draft law provides that Independent Assessment Doctor may review the Coordinating Doctor's first assessment form and any relevant opinions that have already been sought.
67. This provision differs from P.18/2024, which set out that the Independent Assessment Doctor may consult the Coordinating Doctor and review relevant opinions but may not review the Coordinating Doctor's first assessment form. The restriction has been removed in response to stakeholder feedback (including from the health and care professionals working group) on the basis that permitting the Independent Assessment Doctor to consult the Coordinating Doctor (as agreed in P.18/2024) but then restricting access to the first assessment form is perverse, on the basis that the Coordinating Doctor can just tell the Independent Assessment Doctor the information captured on the first assessment form.
68. The draft law does, however, introduce new provisions that work to ensure the independence of the Independent Assessment Doctor by requiring the Independent Assessment Doctor to disclose any interests vis-à-vis their relationship to the Coordinating Doctor (see Articles 20 & 22 and paragraphs 152 - 155). These disclosure provisions are over and above the safeguards provided for in P.18/2024.

Step 4: Second request (Article 6)

69. If the individual completes step 3, including making a request to proceed to step 4, they may then make their second assisted dying request.
70. The second request process broadly mirrors the first request process except that the draft law provides that the signing of the second request form must be witnessed by a person aged 18 or over who knows the individual well enough to be able form a belief as to whether the individual's request for an assisted death is voluntary; clearly expressed; settled and informed but who:

1. is not a close relative of the individual
2. is not an assisted dying practitioner involved in their assisted dying process
3. does not benefit or believe they may benefit, financially or in any significant way, from the individual's death

71. The requirements for the witness, which are set out in Article 17 of the draft law, accord with P.18/2024. A witness is not required at step 1 as the primary purpose of the first request is to start the formal assessment process, whereas the second request has more significant implications as it signifies continued intent to have an assisted death.
72. As set out P.18/2024, it is envisaged that second request form, to be prescribed by Order, will include a form of declaration, for example: I declare that I am making a second request for an assisted death. I make this request voluntarily and without coercion. My decision to have an assisted death is clear, settled and informed. My wish is made in full knowledge of alternative options for my ongoing care and treatment. I fully understand the nature and effect of this decision.
73. Having made their second request, the individual can then request to proceed to the next step (step 5) when they are ready to so do. As set out in Article 17 (paragraphs 127 - 138) the Coordinating Doctor may only accept the individual's request to proceed to Step 5 if they reasonably believe that:
    1. the individual has capacity to request to end their life by assisted dying and
    2. their request is voluntary, clearly expressed, settled and informed.
74. If the Coordinating Doctor cannot accept the second request or the request to proceed to the next step, they must inform the individual in-person and in writing, stating the reasons for this decision. The process the stops unless overridden by an appeal (see Article 42 and paragraphs 232 - 243).

Step 5: review and decision on request for assisted dying (Article 7)

75. At Step 5 the Coordinating Doctor must decide whether to approve an individual's request for assisted dying. They must approve the request if they are satisfied that the individual has completed steps 1 to 4 in accordance with the law or, if not satisfied they must refuse the request.
76. In accordance with  P.18/2024, the Coordinating Doctor must review the individual's records and ensure all steps have been completed before they make their decision. If any steps have not been completed, they must try to ensure they are completed, for example by requiring the step to be completed.
77. The Coordinator Doctor may, at this stage, also decide to override the minimum 14-day time frame if they and the Independent Assessment Doctor (or another doctor registered with the Assisted Dying Service) are satisfied, or have previously determined they are satisfied, that the individual's condition is likely to cause their death in 14 days or less (see paragraph 64).
78. The individual's request for an assisted death may be approved if the Coordinating Doctor is satisfied the assessment process accords with the law.

79. As set out in P.18/2024, the draft law provides there will be no expiry date on an assisted dying request approval. The decision not to include an expiry date is a safeguard, so that pressure is not placed on the individual to end their life through an assisted death when they are not yet ready to do so, simply because their approval is close to expiry.
80. It is known that an approval for an assisted death can have a palliative effect, providing the individual with a sense of control over the end of their life. Evidence from other jurisdictions suggests that, in some cases, the knowledge that a person has the option to end their suffering brings such comfort that they choose not to proceed to an assisted death. For example, in Western Australia in 2022 around 28% of people who were approved for an assisted death, did not go on to have an assisted death.
81. The individual may, at a time of their choosing, request to proceed to the next step (Step
    6. The Coordinating Doctor must accept the request to proceed, if the Coordinating Doctor reasonably believes the request is voluntary and clearly expressed (as per Article 17).
82. If the Coordinating Doctor decides to refuse the request, they must meet with the individual and tell them in person and in writing the reasons why the request is not approved. The process then stops unless overridden by an appeal (see Article 42 and paragraphs 232 - 243).

Step 6: Care planning (Article 8)

83. If an individual is approved for an assisted death they may proceed to the care planning phase (Step 6), At this step, the Administering Practitioner takes on coordination of the process. As set out above, the Coordinating Doctor may also act as the Administering Practitioner (see paragraph 31).
84. During the care planning stage, the draft law requires the Administering Practitioner to inform the individual:
    1. that they may withdraw their request for assisted dying at any time before the drugs are administered
    2. that they are expected to die if the drugs are administered
    3. about the approved drugs
    4. about options for administration of the approved drugs (such as swallowing or intravenous injection) and options for who administers the drugs (the individual may wish to self-administer or wish the Administering Practitioner to administer the drugs) and any risks associated with the options
    5. about options for family and friends to be present or involved in the assisted death, and any associated risks
    6. about options for where the assisted death may take place (see paragraph 93 below)
85. The Administering Practitioner must also provide information about the implications of the following choices which the individual may decide to make at Step 6. These include the choice to:

1. provide consent to the continued carrying out of an assisted death at Step 7 (see paragraph 94)
2. waive the requirement for future capacity at Step 6. If the individual does waive the requirement for future capacity, they must also make their final request to end their life at Step 6 as opposed to at Step 7 (see paragraph 95)
3. make an advanced decision to refuse treatment (see paragraph 96) if an advance decision is not already in place.

86. The information set out above will have been previously discussed with the individual as part of Steps 1 to 4 - in accordance with the assessment process operational guidance (as required under Article 62) - but at step 6 there is an explicit legal requirement to ensure all the information is reiterated.
87. During step 6, the Administering Practitioner and individual must agree on a care plan which must record the individual's preference for their assisted death, including:

1. time and place of their assisted death
2. who will administer the drugs (self-administration or practitioner administered) and how they will be administered (for example, orally or by IV)
3. their choices with regard to providing consent to the continued carrying out of an assisted death and / or waiving the requirement for future capacity and / or advance decisions to refuse treatment.

88. Where the individual wishes the Administering Practitioner to administer the approved drugs, the care plan must set out the Administering Practitioner's agreement to do so. As set out in Article 36, an Administering Practitioner has the right to refuse to administer the approved drugs to an individual and may opt to only support self-administration (unless medical complications arise after the individual has self-administered the approved drugs and the Administering Practitioner needs to intervene).
    89. Self-administration / practitioner administration

1. This draft law permits an Administering Practitioner to opt-out of administering the approved drugs to the individual, as opposed to supporting the individual to self- administer the approved drugs because it is recognised that some health care professionals only support assisted dying when the individual brings about their own death through self-administration of the approved drugs. (The rationale being that, if assisted dying is about personal choice and autonomy, the person must take the final step to end their life by self-administering the assisted dying substance)
2. In accordance with P.18/2024, the draft law provides for both self-administration and practitioner administration on the basis that restricting assisted dying to self- administration can significantly limit options for some individuals. This dual provision differentiates the draft law from the UK Bill which only permits self-administration (see Appendix 4) but accords with the Ethical Review Panel who note that there are reasonable arguments in favour of, and against, both self-administration and practitioner-administration.

3. In providing for both modes of administration, the draft law nevertheless provides that Administrating Practitioners can decide if they opt out of practitioner administration (as can the administration witness – see paragraphs 99 - 103)

90. The draft law provides that the care plan agreed at step 6 may be amended, prior to the assisted death taking place, but any amendments must be signed by both the individual and the Administering Practitioner.
91. In addition to agreeing the care plan, the Administering Practitioner must confirm that arrangements have be made for a Certifying Doctor to attend the individual within 14 days prior to their death (if they have not already done so). This is because, under the Marriage and  Civil  Status  Law,  a  Certifying  Doctor  is  only  qualified  to  complete  a  Medical Certificate of Fact and Cause of Death if they attended the person within 14 days prior to their death. (See paragraphs 115 - 116).
92. Note: whilst the Administering Practitioner must confirm the arrangement relating the Certifying Doctor at step 6, in some instances the Certifying Doctor may have already attended the individual, particularly if they have a life expectancy of 14 days or less.
    93. Place of assisted death

a. The draft law does not restrict the places where an assisted death may be carried out (for example, it could be a private home; care and nursing facilities owned by GoJ or managed by GoJ; care and nursing facilities not owned by GoJ; hospital facilities) but Article 9 of the draft law provides that:

• the place must be approved by the Administering Practitioner, and

• the Administering Practitioner must be satisfied that an assisted death can be safely carried out in that place, having considered any risks that may make it unsuitable, and the views of others who live there.

b. The draft law also provides that:

• where the place is a care home that is not provided by Health and Care Jersey, the provider or manager must have agreed that the assisted death may be carried out there

• operational guidance on matters related to approved places must be developed.

c. As set out in P.18/2024, the operational guidance will set out factors that must be considered in approving a place. For example:

• if the assisted death is to take place in a care facility, there will need to be consideration of other individuals that may be present or close by during the assisted death (for example, persons and staff in the same hospital ward, even if the assisted death takes place in a private room)

• if the person wishes to die at home but lives in shared accommodation the Administering Practitioner will need to consider whether this may result in disruption and / or distress and / or potential harm.

Note: The Minister, in response[12] to Scrutiny's review[13] of P.18/2024 proposals has committed to provide details of to timeline and stakeholders to be involved in discussions on matters related to the use of Jersey General Hospital as a place of last resort for assisted deaths. This information will be provided in an addendum to be this report to be lodged before debate (See paragraph 10).

94. Consent to continued carrying out of an assisted death

1. Consent to continued carrying out of an assisted death was referred to as Consent to proceed in P.18/2024. Where the individual provides consent, the Administering Practitioner may take appropriate action at Step 7 to bring about the individual's death if compliance with the care plan does not result in their death and the individual has lost the capacity to consent to that action (for example, they are unconscious). Appropriate actions may be required if, for example, the time to death is protracted post-administration of the approved drugs in which case the Administering Practitioner may:

• administer different approved drugs or more approved drugs

• administer approved drugs themselves, as opposed to the individual self- administering the drugs

• administer the approved drugs in a different way (for example, by injection rather than swallowing).

2. Examples of the medical complications that may require non-compliance with the care plan include regurgitation and vomiting, or seizure; delayed effectiveness of oral medication (for example, where the person has not died within 60 minutes of taking the substance orally); loss of consciousness before all the oral medication has been taken.

95. Waiver of requirement for future capacity

1. The draft law provides that, at step 6, the individual may choose to waive the requirement for them to have future capacity.
2. The waiver allows the individual to decide in advance that, if they lose decision- making capacity AFTER their request for an assisted death has been approved (Step 5) but BEFORE they are due to confirm their consent during the final review (at Step 7),

the assisted death can still take place. The rationale for the waiver is ensure that a person whose capacity deteriorates rapidly is not prevented from having their request fulfilled in accordance with previously agreed arrangements.

3. Provisions relating to the waiver of requirement for future capacity accord with those set out in P.18/2024 except that P.18/2024 referred to a waiver of final confirmation of consent. The draft law also clarifies how the waiver will operate in practice. These clarifications include:

• if the individual chooses to waive the requirement for future capacity at Step 6, they must also make their final request to end their life at Step 6, as opposed to at Step 7. The effect being that, at Step 6 the individual is saying "I want an assisted death, and I consent to the administration of the approved drugs on the date set out in my care plan even if, on that date, I no longer have capacity"

• the Administering Practitioner can only confirm the request to waive requirement for future capacity if, at Step 6, they are satisfied that the individual has the capacity to make their final request for an assisted death and they reasonably believe the final request is voluntary

4. The waiver of requirement for future capacity relates to both the requirement for capacity at step 7 (as per P.18/2024) and the requirement for capacity to request to proceed from Step 6 to Step 7. The proposals presented in P.18/2024 did not include matters related to the request to proceed from Step 6 to Step 7, which could have unintended consequences for an individual who waived the capacity requirement at Step 7 but who had lost capacity before requesting to proceed to Step 7.  
5. As set out in P.18/2024, Article 9 of the draft law provides that the Administering Practitioner may not continue with the administration of the substance if the individual demonstrates a refusal or resistance to the administration by words, sounds or gestures (for clarity, reflexes and other types of involuntary movements, such as response to touch or the insertion of a needle, would not constitute refusal).
6. As set out in paragraph 10, the addendum to be published by Minister for Health and Social Services will include details and processes for establishing refusal or resistance to an assisted death by a person who has lost decision-making capacity.

96. Advanced decision to refuse treatment

1. Advance Decisions to Refuse Treatment (ADRT) are permitted under the draft law as in any other end of life circumstances in Jersey.[14] ADRTs – which can include a do not attempt cardiopulmonary resuscitation - provide clear instruction to health care

providers about when a patient does not want to be provided life sustaining measures in the event of a medical emergency.

2. Many individuals requesting an assisted death will already have ADRT's in place. However, in the highly unlikely event that an ADRT is not in place, and the individual declines to make an ADRT, this may have implications in the period AFTER the assisted death being approved but BEFORE the approved drugs are administered.
3. For example, if the individual were to have to have a medical emergency health care professionals would need to consider whether to attempt life sustaining measures because there is no ADRT to instruct them not to.
4. In practice, if they knew about the assisted dying request, it is unlikely that they would proceed to resuscitation as this would seemingly contradict the assisted dying request (and therefore not be considered in the person's best interests) but the lack of the ADRT creates a degree of uncertainty for health professionals. Furthermore, if the health care professional does not know about the assisted dying request, this could result in resuscitation of an individual who wants an assisted death.
5. Article 10 of the draft law provides that AFTER the approved drugs have been administered, a person need not act to preserve the individual's life if the individual has not requested that.

Step 7: Final review and carrying out of assisted death (Articles 9 - 12)

97. The draft law provides that, on the agreed day of the assisted death, the Administering Practitioner must undertake a final review to determine that the individual still has capacity to proceed (unless the individual waived the requirement for future capacity at step 6) and their wish to proceed is still voluntary.
98. The Administering  Practitioner  must  also  be  satisfied  that:  any  appeals  have  been determined or withdrawn; that the Certifying Doctor has attended the individual within the last 14 days; and that the assisted death will accord with the minimum timeframes set out in the draft law.

Administration witness (Article 9)

99. In accordance with P.18/2024, a witness must be present at the carrying out of the assisted death to watch preparation for, and the administration of, the approved drugs.

100.  The witness must be a nurse, a doctor or another assisted dying practitioner. P.18/2024 had proposed that the witness could only be another assisted dying practitioner (if the assisted

death is to take place in a private residence) or another doctor or nurse if the assisted death is  to  take  place  in  Jersey  General  Hospital.  However,  following  feedback  from stakeholders, the draft law also permits doctors and nurses working in other locations to act as witnesses (for example a nurse working for a home care provider) – although in practice it is anticipated that witness will most usually be another assisted dying practitioner.

101.  Any professional can refuse to act as a witness for an assisted death or refuse to act as

witness if the Administering Practitioner is administering the approved drugs, as distinct from the individual self-administering the drugs (see Article 36 and paragraph 211).

102.  As noted in P.18/2024, the administration witness may also undertake additional tasks such

as providing practical and emotional support to the individual or any family who are present, or providing clinical support under the direction of the Administering Practitioner (for example, setting up IV tubes and preparing the substance if they are a registered nurse or a doctor) but there is no statutory requirement to undertake these additional tasks because placing any additional statutory requirement on them may distract from their core duty to witness the preparation and administration of the approved drugs.

103.  The requirement for a witness provides an important safeguard as it ensures that there is no

lone practitioner.

Carrying out the assisted death (Article 10)

104.  The assisted death must, as far as is practicable, accord with the care plan agreed at step 6

105.  If the individual has chosen for the Administering Practitioner to administer the drugs, the

Administering Practitioner must administer the drug and remain nearby until the individual dies.

106.  If the individual has chosen to self-administer the drugs, the Administering Practitioner

must give them the drugs, tell them and their helper (if they have a helper) how to take the drugs, watch whilst this happens, and then remain nearby until the individual dies.

107.  In accordance with P.18/2024, the draft law provides that where the individual has chosen

to self-administer the approved drugs, they may be helped by a family member or friend (for example supporting the person to bring the cup to their lips). This would likely be an extension of the care and support that loved ones have been providing over the previous days and weeks. Matters relating the involvement of a helper will be discussed and agreed as part of the care plan (Step 6).

108.  In the event that compliance with the care plan does not result in the individual's death, the

administration practitioner may take a number of actions - including administering more approved drugs or different approved drugs, or administering the drugs in a different way. This includes where the individual still has capacity to consent, where the individual provided  consent to the  continued  carrying out of an assisted  death  and where the individual does not have capacity, but they waived the requirement for future capacity.

109.  The draft law provides that a person need not act to preserve the individual's life once the

approved drugs have been administered, if the individual has not requested this (see paragraph 96).

Delaying or stopping assisted death (Article 11)

110.  The draft law provides that the Administering Practitioner:

1. may delay an assisted death if the individual does not have capacity to give final consent at that point in time (and there is no wavier for future capacity in place) but Administering Practitioner believes this may be due to waiving capacity as a result of their conditions or their medications – for example, on a different day, the individual may be in less pain and less heavily medicated and able to give final consent. If Administering Practitioner does delay, they must decide a new date (in consultation with the individual, if possible) on which to reassess the individual and determine their capacity
2. may stop an assisted death if they decide the individual does not have capacity (and there is no wavier for future capacity in place), or their request is not voluntary. The decision to stop may be overturned by appeal.

Disposal of approved drugs (Article 12)

111.  The Administering Practitioner must dispose of any remaining approved drugs as soon as

possible after the assisted death has been carried out (or after the decision to delay or not carry out the assisted death). Disposal must be accordance with relevant legislation that governs the control of drugs.

Step 8: Review after death (Article 13)

112.  In accordance with P.18/2024, the draft law provides that as soon as reasonably practicable

after the assisted death:

1. the Administering Practitioner must complete and sign a form specifying details of the assisted death (for example, the time of the administration of the drugs; the time of death; dosage and drugs used; details of the administration process; details of any complications that may have arisen relating to the administration of the drugs), and
2. the step 7 witness must also sign that form confirming it has been accurately completed.

113.  In this context, as soon as reasonably practical means where at all possible, this takes place

within the hour or so immediately following the death.

114.  Within 2 working days of the assisted death, the Administering Practitioner must:

1. provide a copy of the signed form specifying the details of the assisted death to the Review Panel (see Article 94 and paragraphs 296 - 303), and
2. provide a copy of both the form specify the details for assisted death (as signed as Step 8 and the form completed after the Administering Practitioner's review (as signed at step 7) to the certifying doctor.

115.  The Certifying Doctor must then view the individual's body and complete the Medical Certificate of Fact and Cause of Death ("MCFCD") in accordance with the requirements

of the Marriage and Civil Status (Jersey) Law 2001. The MCFCD must be provided to the relevant registrar within the period of 5 days following the death. A relevant registrar can be either a Parish Registrar or the Superintendent Registrar, dependent upon if the parish has a registrar in post at the time of the assisted death.

116.  As set out in above, in order to be qualified to complete the MCFCD the Certifying Doctor

must have attended the individual within the 14 days prior to their death. The draft law requires the Administering Practitioner to arrange for this to happen at Step 6 if it has not already happened.

117.  As set out in P.18/2024, an assisted death will be recorded in the same way as all other

deaths in Jersey. This means that the MCFCD will record the disease or condition leading to the death and any antecedent causes (amongst other matters). In the case of an assisted death this would mean that MCFCD would state, for example, that the condition leading to the death was cardiorespiratory arrest which was caused by administration of approved drugs. As each entry into the register of death is publicly available an individual's assisted death would be a matter of public record.

118.  As noted in Assisted Dying Phase 2 public consultation [15]in some jurisdictions (for example

Western Australia) the death certification process does not record the death as an assisted death; the cause of death is instead recorded as the underlying illness which the person had which made them eligible for an assisted death. This is intended to protect the privacy of the person. However, in other jurisdictions the law and associated guidance strives for transparency and acceptance around the assisted dying process (for example, in New Zealand) where the death is recorded as an assisted death. In Jersey the proposed approached, as provided for in the draft law, it to promote transparency and, by so doing to help remove stigma associated with end-of-life choices.

119.  For the purposes of clarity, assisted deaths will not be recorded as suicide because they are

not suicide (as provided for in Article 43 of the draft law). This is the case in all other jurisdictions where assisted dying is legal.

Matters relating to the Assisted Dying Process

120.  Part 2 of the draft law also sets out additional matters related to the assessment, approval

and provision of an assisted death.  

Consent to sharing the individual's information (Article 14)

121.  In accordance with P.18/2024, the draft law provides that the individual must give consent

for an assisted dying practitioner to share information about that individual with another person, for example a family member or health and care professional. Consent, and any changes to the consent must be recorded in the individual's records.

122.  Disclosing information without consent may be an offence under the law. See Article 41

(paragraph 225 - 231) and Article 52 (paragraphs 247 - 251).

Withdrawing request or pausing the process (Article 15)

123.  The draft law provides that the individual may withdraw their request for an assisted death

at any point in the process by telling any assisted dying practitioner involved in their assisted dying process that they are withdrawing. The practitioner must tell the Coordinating Doctor (if the individual did not tell the Coordinating Doctor in the first instance). The Coordinating Doctor will confirm with the individual that they wish to withdraw and record the withdrawal on a written notice.

124.  As set out in paragraph 53, the draft law permits an individual to make a new first request

having previously withdrawn a request, but the Coordinating Doctor can refuse to start the process again if the conditions set out in Article 1 are met. As set out in P.18/2024, where an individual has withdrawn a previous request but then started the process again from the beginning, the operational guidance will provide that the assessing doctors must consider whether the previous request withdrawal indicates that their wish for an assisted death is not a settled wish.

125.  The individual may pause the process at any point by choosing not to request to proceed to

the next step.

Another person may sign forms (Article 16)

126.  Where the individual is physically unable to sign any assisted dying form, another person

may sign it on their behalf. That person must be aged 18 or over, must be together with the individual when the form is signed, and cannot be:

1. an assisted dying practitioner or involved in the individual's assisted dying process
2. the witness to the individual's second request (Step 4).

Request to proceed to next step (Article 17)

127.  The requirement to request to proceed to the next step is detailed in the assisted dying

process described above in paragraphs 35 to 68. The request to proceed provisions accord with P.18/2024 except P.18/2024 referred to a step transition process. Step transition is renamed request to proceed to more accurately the intent and outcome of these provisions.

128.  It is anticipated that the individual will, in many cases, request to proceed to next step during the same meeting at which they are told the outcome of the previous step (for example, at during the same meeting at which they are told the outcome of their first assessment, they will request to proceed to their second assessment) however it is imperative that the individual must be in control of the assisted dying process and must be

able to choose whether to proceed to the next step, and be able to do so at their own pace. The request to proceed process provides for this. It is an essential safeguard that allows for:

1. an individual to pause the process between steps for as long as they wish
2. an individual to restart' the process when / if they are ready to do so by requesting to proceed

3. the Coordinating Doctor (or the Administering Practitioner at Step 6) to decide key matters related to nature of the individual's request to proceed to the next step – particularly if there has been a protracted period of between the different steps.

129.  A request to proceed to the next step must be made at the end of previous step if the

individual is to complete the previous step (for example, the individual only completes Step 2 if they have also requested to proceed to Step 3). The exception being at the end of Step 7 as the individual will be deceased.

130.  At the end of Steps 1 to 6 the Coordinating Doctor (or the Administering Practitioner at

Step 6) must reasonably believe the individual's request to proceed is voluntary and clearly expressed (i.e., the individual is not being coerced or pressured by a third party to proceed to the next step).

131.  At the end of step 4 (Second request for assisted dying), the Coordinating Doctor must also

reasonably believe that the individual's request to proceed is:

1. settled – because they have maintained this wish since making their first request for an assisted death at step 1
2. informed – because the assessing doctors have informed them of the general and specific information about assisted dying (as set out at Article 28 and 29) and the assessing doctors are satisfied that the individual understood the information (see paragraphs 175 - 177).

132.  Furthermore, at the end of step 4 (Second request), in order to accept an individual's request

to proceed to step 5, the Coordinating Doctor must reasonably believe that the individual has capacity to request to end their life by assisted dying. Reasonable belief of capacity is not required at:

1. at the end Step 1 (First Request) to proceed to Step 2 (first assessment) as no assessment of capacity is undertaken until Step 2
2. at the end of Step 2 (First assessment) to proceed to Step 3 (independent assessment) because during both those steps the assessing doctor must assess the individual's capacity
3. at the end Step 3 (independent assessment) to proceed to Step 4 (second request) because capacity has been determined during Step 3
4. at the end of Step 5 (review and decision on request) to proceed to Step 6 (care planning) as Step 5 is a wholly administrative process

133.  At the end of Step 6 (care planning) to proceed to Step 7 (final review and carrying out of

an assisted death), the Administering Practitioner must also reasonably believe that the individual has capacity to request to end their life by assisted dying unless, at Step 6, the individual waived the requirement to future capacity (see paragraph 95).

134.  These arrangements provide an additional series of anti-coercion' safeguards, requiring the assessing doctors to consider the possibility of coercion not just during step 1 to 7, but

also as the individual transitions between steps. This is important because, if an individual

delays transition to the next step, there may be underlying hesitancy that needs examination.

135.  The Coordinating Doctor or Administering Practitioner's reasonable belief must be based

on their meetings with the individual and may also be based on the relevant opinions of others (see Article 29 and paragraphs 180 - 188).

136.  If the Coordinating Doctor or Administering Practitioner do not reasonably believe any of

the matters they are required to believe as part of the request to proceed process, they must tell the individual in person and in writing, and the explain the reasons for their decision.

137.  The individual may ask them to reconsider their decision. The doctor or Administering

Practitioner may reconsider their decision, if they think doing so might change that decision but they are not obliged to (for example, if they are of the view that individual no longer has capacity or is being subject to coercion). In reconsidering any decision made under Article 17, the doctor or Administering Practitioner may take into account any additional information provided by the individual.

138.  Whilst the draft law provides for reconsideration of a reasonable belief as part of process

of proceeding to the next step, this does not apply to decisions which require the assessing doctor or administrating practitioner to be satisfied of a matter (for example during the first or second assessment, where they have assessed the individual and are satisfied the individual meets the capacity criteria). Where the individual – or a person with a special interest – disputes an assessing doctor's or administrating practitioner's decision that they are satisfied of a matter, they must appeal this decision under Article 42.

Location/format of meetings (Article 18)

139.  Article 18 provides that all the meetings required under the draft law must take place in

Jersey (i.e., the individual and / or the assisted dying practitioners must be in Jersey) unless any person is permitted or required, by Order, to be elsewhere.

140.  Article 18 then provides that the persons must meet in person, unless the meeting is an

additional meeting (an additional meeting being for example, a phone call that takes place after an in-person assessment during which the assisted dying practitioner is following up on a specific matter, such as providing additional information about pain relief). However, unless provided for by Order, the meeting participants must still be in Jersey (i.e., the individual at home in Jersey on a phone call with the Coordinating Doctor who is also in Jersey). The operational guidance on assessing individuals for assisted dying will set out matters and protocols related to electronic meetings.

141.  P.18/2024 had stated that UK-based professionals may provide relevant opinions whilst in the UK (for example, a London-based oncologist could provide an opinion on the individual's prognosis to an assessing doctor from their London office). However, since the P.18/2024 debate there has been further engagement with the General Medical Council (GMC), the British Medical Association (BMA) and the UK Ministry of Justice (MOJ) who

have confirmed that the current legal position for health professionals practising in the UK

is unclear and that, a professional who provides a relevant opinion in relation to an individual's request for assisted dying in Jersey, may contravene Section 2 of UK Suicide Act 1961 and commit the offence of encouraging or assisting the suicide or attempted suicide of another individual' if they are in the UK at the time of providing that opinion.

142.  Hence the BMA currently recommends that their members should not write medical

reports specifically to facilitate assisted suicide abroad'[16] which means that, as matters currently stand, a UK-based  professional giving a relevant opinion under the Jersey Assisted Dying Law must travel to Jersey to do so. However, given the evolving position in the UK, with the Terminally Ill Adults (End of Life) Bill due to have its second reading in the House of Lords in September, this position may change in the very near future.

143.  For this reason, the draft law sets out that all meetings must be held in Jersey but provides

for an Order-making power so that if the UK position changes, the law can provide for meetings to be held in the UK. Note: as an additional safeguard, the draft law also places a requirement on an assessing doctor or administrating practitioner, when requesting a relevant opinion, to advise the professional providing the opinion (if they are not in Jersey) to consider their local legalisation to ensure they do not unintentionally act outside of that legislation.

144.  The Order-making power also provides future flexibility should the delivery of healthcare

change in the coming years and electronic meetings become more commonplace due to improved digital information sharing and assessment techniques.

145.  The Order-making power does not, however, allow for meetings where a witness is required

to place in an electronic format. These meeting must be in person as they provide an important safeguard.

146.  Note: in the event a UK based professional travels to Jersey to undertake an assisted dying

assessment or provide a relevant opinion under Jersey Law, they will not be committing an offence under UK law.

Disclosure of interests in relation to individuals (Article 19 & 21)

147.  A professional involved in an individual's assisted dying request must disclose any interests

they may have in relation to that individual – both at the start of their involvement or, during the process, if they become aware any emerging interests. This includes:

1. any assisted dying practitioner involved in the process, Care Navigator or certifying doctor
2. a professional providing a relevant opinion
3. a person who provides communication support (unless they are family member etc) or independent advocacy.

148.  If an interest is disclosed, this must be reviewed by the interests review officer to determine

if it is problematic / potentially problematic for example, if the professional:

1. is a close relative of the individual
2. may benefit financially or in any significant way from the individual's death
3. has an interest that may be seen to conflict with the individual's assisted dying process to such an extent that the review officer is of the opinion they should not be involved (for example, the individual previously made a complaint about the professional, even if that complaint was not upheld)

149.  The interests review officer is the HCJ Medical Director or someone appointed by the

Medical Director as they are relevant lead professional (for example, the Chief Pharmacist may review any interests declared by a Pharmacy Professional) .

150.  If the review officer decides the professional's involvement is a problem, that professional

must not be involved in the process, and if they have already been involved, any step completed only because of their involvement must be repeated.

151.  The provisions above are in addition to the requirement for all professionals to declare any

potential interests on registration as an assisted dying practitioner (see paragraph 288).

Disclosure of interest in relation to independent assessment (Article 20 and 22)

152.  The draft law provided that the Independent Assessment Doctor, in addition to disclosing

their interests in relation to the individual, must disclose any interests they may have in relation to the Coordinating Doctor prior to undertaking an independent assessment.

153.  If an interest is disclosed, this must be reviewed by the interests review officer to determine

if it is problematic / potentially problematic for example, if the Independent Assessment Doctor:

1. is a close relative of the Coordinating Doctor
2. has a personal relationship with the Coordinating Doctor (such as a family member, friend, neighbour)
3. has a work-based or financial relationship (e.g.: are business partners) with the Coordinating Doctor which conflicts, or is seen to conflict, with the independence of their assessment (for example, they have direct or supervisory line to Coordinating Doctor.

154.  If the review officer decides the Independent Assessment Doctor's relationship with the

Coordinating Doctor is a problem, they must not be involved in the process, and if they have already been involved, any step completed only because of their involvement must be repeated.

155.  These provisions, which were not set out in the P.18/2024 proposals, were introduced following feedback from stakeholders with a view to ensure the independence of the Independent Assessment Doctor through an examination of any hierarchical connection', whilst recognising the challenge establishing total independence and professional

separation in a small island jurisdiction. An additional element has been added to the draft law that did not feature in P.18/2024 proposals.

Independent advocacy and communication support during the assisted dying process (Article 23) 156.  The draft law places a requirement on assisted dying practitioners to:

1. determine whether the individual requires independent advocacy or communication support to receive, understand or convey information about their assisted dying request, and
2. try to arrange this independent advocacy or communications support (note: the financial and resource information, as set out in paragraphs 335 & 343, includes monies associated with the provision of advocacy and communications support)

157.  In deciding whether independent advocacy or communications support is required, the

practitioner may seek the relevant opinions of others.

158.  P.18/2024 did set out that advocacy support should be made available, but following

feedback from stakeholders, the Minister has determined the Assembly should, by Regulation, make detailed provision in relation to independent advocates. It is envisaged this detailed provision will broadly mirror the provisions made in other Jersey laws, such as the Children and Young People (Jersey) Law 2022; Mental Health (Jersey) Law 2016 and Capacity and Self-Determination (Jersey) Law 2016.

159.  As set out in paragraphs 309 & 313, it is intended that the Minister will bring forward the

independent advocacy regulations before the assisted dying law comes fully in force.

160.  Note: the ability to provide for independent advocates by Regulations mirrors the draft UK

Assisted Dying Bill (see Appendix 4).

Additional requirements for assessments and determining eligibility

161.  The requirements for assessing an individual's eligibility for assisted dying are set out in

Articles 25 to 30 of the draft law, which also provides that the Committee must arrange for the development of operational guidance specifically focused on the assessment process (see Article 62 and paragraph 260).

Life expectancy (Article 25)

162.  An assessing doctor, when predicting an individual's life expectancy (6 months, 12 months

in relation to a neurodegenerative condition, or within 14 days or less if overriding the minimum timeframe), must predict the matter based on their medical knowledge and their assessment of the individual. They may also base their prediction on a relevant opinion (for example, where they have sought the opinion of a professional who has expertise in the individual's condition).

Suffering and treatment (Article 25)

163.  When assessing whether an individual can bear the suffering (or anticipated suffering) caused by their condition or the treatment for the condition, the assessing doctor need only

satisfy themselves that the individual believes they cannot bear the suffering, or would not be able to bear the expected suffering - irrespective of what the assessing doctor personally believes about the suffering / expected suffering.

164.  This is because, as set out on P.18/2024 suffering is a subjective experience, as is fear of

anticipated suffering. Different people experience suffering or fear of suffering in different ways, and hence it is only the individual who can determine whether they believe they can bear the suffering - the doctor cannot do this for them.  

165.  That said, whilst the assessing doctor must set aside their own beliefs as to whether the

individual can bear the suffering, Article 29 nevertheless requires the assessing doctor to tell the individual if they, the assessing doctor, disagrees with the individual's belief that they would not be able to bear expected suffering.  

166.  This requirement for the assessing doctor to tell the individual that the assessing doctor

thinks the individual's belief is wrong was not set out in P.18/2024. It has been added further to stakeholder feedback.  

Capacity (Article 26)

167.  In order to be eligible for an assisted death, the individual must have capacity to decide to

end their life by assisted dying. Article 26 sets out a specific assisted dying capacity test, which focuses on all relevant decision-making factors, rather than relying on the more general capacity test set out in the Capacity and Self-Determination (Jersey) Law 2016 ("CSDL"). The assisted dying capacity test states that the doctor must be satisfied that the individual has the capacity to:

1. receive the information given to them
2. understand the information and all matters relevant to their decision, including the effect of their decision - i.e., that it will result in their death
3. retain the information for long enough to make their decision
4. use or weigh the information in making their decision or request
5. convey their decision.

168.  The draft law, like the CSDL, requires any decision that the person lacks capacity to be

based on evidence that they lack capacity, as this is critical to ensuring proper respect for personal autonomy. This is known as a presumption of capacity'  – i.e., capacity is presumed unless there is evidence of lack of capacity, as distinct from "capacity has to be evidenced". This accords with assisted dying laws in other jurisdictions.

169.  However, the presumption of capacity in the assisted dying law is different to the CSDL, in that under the assisted dying law the doctor must be satisfied that the person meets the capacity test, and they only assume the person has capacity (i.e., the capacity to weigh up

and use information to make an assisted dying decision as per the capacity test) if, in working to satisfy themselves, they cannot evidence the person does not have that capacity – i.e., they cannot assume capacity at the outset on the basis that there is no evidence of lack of capacity.

170.  Note: the CSDL is also different from the assisted dying law in that, under the CSDL law

if it is determined a person does not have capacity, a best interests decision' may be made on their behalf – i.e. a doctor may decide the person should be given a treatment they have refused. Under the assisted dying law, no-one may decide that an individual may have an assisted death, except that individual.

Individual's decision or request is voluntary, clearly expressed and settled (Article 27)

171.  During the first and independent assessments (Step 2 and 3), care planning (Step 6) and final request and review (Step 7), the assessing doctors and administrating practitioners

must be satisfied that the individual's decision to end their life by assisted dying is voluntary, clearly expressed and settled. They must also believe the individual's request is:

1. voluntary and clearly expressed whenever the individual requests to proceed to the next step of the process
2. settled when the individual requests to moves from Step 4 to Step 5 of the process (i.e. that their wish for an assisted death has been maintained from the point at which they made their first request to the point at which the Coordinating Doctor approves that requests)

172.  In determining the voluntary nature, the doctor must talk to the individual about:

1. why they wish to end their life by assisted dying
2. whether anyone has asked, coerced or pressured them, or they have felt coerced or pressured, to request assisted dying.

173.  In determining whether the decision or request is clearly expressed and settled the doctor

must talk to the individual about:

1. why they wish to end their life by assisted dying
2. how long they have had that wish
3. whether their wish is consistent or changing.

174.  They may seek relevant opinions of others – for example a social worker from the extended

team.

Individual's decision or request is informed (Article 28 and 29/ Schedule 1)

175.  The draft law requires an individual's decision to have an assisted death to be an informed

decision, and sets out the information that must be provided to the individual. This includes both:

1. the general information set out in Schedule 1 which includes information about:

• the criteria for assisted dying

• each step of the assisted dying process (this will include information on minimum timeframes - see paragraph 64)

• the Service

• the right to appeal certain decisions under this Law

• how they or their family and friends may obtain support (such as counselling)

• how someone may complain about service

• matters that an individual may want to consider before their death (such as life insurance or other personal administrative or financial matters)

2. the specific information set out in Article 29 which includes information as it relates to their personal circumstances. This includes information about:

• the physical condition that is expected to cause their death; the expected course of the condition; options for care and treatment and the likely outcomes

• options for the administration of the approved drugs and any associated risks (including whether it is self-administration or practitioner administration, and the method of administration – oral, IV etc)

• options for the place of their assisted death

• the involvement of family or friends in the carrying out of the assisted death, and the risk to those people (for example, any distress they may experience as a result of supporting, or not supporting, self-administration)

• the individual's choice to do any of the following, and the implications of each choice: consent to the continued carrying out of the assisted death; waive the requirement for future capacity; or to decide in advance to refuse treatment (see paragraphs 94 - 96)

• the individual being able to withdraw their request for assisted dying during the process

• on the requirement for the individual to request to proceed to taking the next step in the process

• matters that the individual must decide including, talking to their family members or friends about their request for assisted dying (unless the assessing doctor believes that it is not reasonable to do so, after discussing the individual's circumstances with them) and whether they want other practitioners to know about their request (for example, their domiciliary care provider).

176.  Critically, the individual must also be informed, and must understand, that they are

expected to die if approved drugs are administered.

177.  In addition to the draft law requiring the provision of the information set out above, the

assessing doctors must be satisfied that the individual has understood the information.

Residency (Article 30)

178.  As set out in paragraph 42, the individual must be ordinarily resident in Jersey for 12

months immediately prior to making their first request for assisted dying and continue to be resident throughout the assisted dying process. Hence residency is assessed throughout the assisted dying process.

179.  Article 30 provides however, that once the Coordinating Doctor has determined the

individual meets the residency criterion at Step 1, an assessing doctor or Administering Practitioner can, at all other steps, be satisfied that the individual is resident providing the individual confirms they continue to be resident and there is no evidence to the contrary.

Relevant opinions of others (Article 31)

180.  Article 31 accords with the proposals set out in P.18/2024, albeit relevant opinions were

referred to in P.18/2024 as supporting opinions or assessments. Article 31 provides for matters related to the relevant opinions that an assessing doctor or administrating practitioner must seek, if necessary to deciding a matter (for example, they must seek relevant opinion from social worker if determining matters related to potential coercion) or may seek if helpful to understanding a matter (for example, opinion from a family member about the individual's suffering).

181.  Relevant opinions may be required when determining an individual's eligibility for assisted

dying or when considering other matters such as the requirement for communication support or advocacy support.

182.  The draft law allows for relevant opinions because, at set out in P.18/2024, it must be

recognised that assessing doctors may not have expertise on all conditions (and associated treatments) so must be able to seek that expertise as required.

183.  The draft law provides that the assessing doctor or an Administering Practitioner may seek

the opinion of persons whom the doctor or practitioner thinks will help them decide or form their belief about a matter. This may include:

1. connected persons - a person who has a personal relationship with an individual, such as a family member, friend, neighbour or colleague, or
2. professionals who have the required expertise or experience. This may include professionals who are not assisted dying practitioners or extended team members.

184.  A relevant opinion may not be sought unless the individual has given their permission for

information to be shared at Article 14.

185.  A professional providing a relevant opinion:

1. may have previously seen the individual in a professional capacity (for example, their palliative care consultant) or may not have any previous knowledge of the individual (for example, a mental health practitioner may be asked by an assessing doctor to assess or examine the individual and advise on their capacity)
2. may be asked to examine or assess the individual or may be asked to provide general information about life expectancy, prognosis or treatments associated with specific conditions in which they have expertise.

186.  The assessing doctor / Administering Practitioner must tell the professional that their

opinion relates to a request for assisted dying and the professional may exercise their right to refuse (Article 36).

187.  As set out in P.18/2024, where a professional opinion is sought, the doctor or Administering Practitioner must have regard to the opinion but they are not required by law to agree with

the opinion or base their decision on that opinion. It is the assessing doctor or Administering Practitioner who is responsible for the determination of eligibility, and they must rely on their own determination (whether or not informed by the relevant opinion). It is common practice for doctors, who are trained to use their professional judgement, to make determinations that do not accord with the opinions or determinations of all other professionals. However, the operational guidance will state that where they do not adopt the relevant opinion, they must have clear and robust reasons for doing so and this must be documented in the relevant forms.

188.  For the purposes of clarity, the professional providing the relevant opinion will not be

making an explicit determination of eligibility for assisted dying. They will instead be providing their opinion on matters which they are qualified to assess, determine or advice on (for example, disease progression or treatment) for the assessing doctor or Administering Practitioner to determine the matter at hand.

Second opinion request (Article 32)

189.  As set out in P.18/2024, an individual may request a second opinion assessment if they are

found not to meet any of the main criteria either during the first assessment or independent assessment. Whilst P.18/2024 indicated this would be a matter for guidance, the main criteria include the health, capacity and decision-making criteria but does not include the age or residency criteria, although age and residency may be subject to appeal (Article 42– see paragraphs 232 -243).

190.  A second opinion may only be requested by the individual. A third party (for example, a

family member, an attending practitioner or carer) cannot request a second opinion if they are in disagreement with the assessing doctor's determination that the individual does, or does not, meet the criteria.

191.  Where a third party has a concern about an assessing doctors' determination, they may raise

that concern through the complaints process. (Note: the Committee is required at Article 61 to arrange for the development of procedures for investigating and resolving complaints). It is anticipated that the complaints process will set out that, in the first instance, the third party should raise their concerns with the Coordinating Doctor, who must give the matter their consideration, unless the complaint is about that doctor, in which case it will escalate in accordance with the complaints policy. This is a minor variation on P.18/2024 which proposed that the draft law would place a duty of the Coordinating Doctor to consider complaints. On further consideration, and in discussion with stakeholders, it has been determined that a statutory duty should not be placed on the Coordinating Doctor because the complaint which may be about that doctor's decisions.

192.  As noted in P.18/2024, an individual should not be provided an automatic right to a second

opinion because of the potential for second opinions assessment to result in a vexatious use of resource if an individual, who is clearly not eligible for an assisted death, requests multiple second opinions. The draft law addresses this be providing that, whilst an individual may request a second opinion, that request must be reviewed by a review doctor' who must determine whether to accept or reject the second opinion request.

193.  The review doctor is an assisted dying practitioner who is registered with the Service and

who has not previously been involved in the individual's assisted dying process.

194.  In deciding whether to accept the second opinion request, the review doctor:

1. must review the forms from the original assessment/s
2. may review the relevant opinions of others (if any)
3. may discuss the matter with the individual, the assessing doctor or any individual who provided a relevant opinion.

195.  The review doctor must accept the second opinion request if they consider it reasonable to

think that the results of the original and second opinion assessments may differ. If not, they must refuse the second opinion request. If they refuse the request, the individual must be told the reasons why, in person and in writing. If they accept the request, a second opinion assessment will be arranged.

196.  A person may request a second opinion at both the first and second assessment, because

there may be valid reasons for requesting a second opinion at each stage of the process.

Second opinion assessment (Article 33)

197.  The Second Opinion Doctor must be an assisted dying practitioner but cannot be the

individual's Coordinating Doctor or Independent Assessment Doctor.

198.  The Second Opinion Doctor:

1. must review the assessing doctor's form from the original assessment and the relevant opinions of others (if any) and,
2. may themselves assess the individual.

199.  Whilst the draft law does not prevent the Second Opinion Doctor from determining that the

eligibility criteria are not met based on a review of the assessing doctor's forms and any relevant opinions, it does require the Second Opinion Doctor to meet with the individual and undertake their own assessment to satisfy themselves that eligibility criteria are met. This provision allows for the Second Opinion Doctor to reasonably and appropriately exercise their clinical judgement based on an evidence review when determining criteria are not met but provides for additional safeguards are when determining that the criteria are met.

200.  The Second Opinion Doctor may determine any unassessed criteria from the original

assessment (see paragraph 59) in addition to unmet criteria from the original assessment.

201.  Having undertaken their assessment, the Second Opinion Doctor must notify the Coordinating Doctor of their findings, who must inform the individual that the Second

Opinion Doctor:

• is satisfied that the individual meets the criteria and may proceed to the next step; or

• is not satisfied that the individual meets the criteria, specifying which criteria are met, unmet or unassessed and the associated reasons.

Prescribing, preparing and dispensing approved drugs (Article 34)

202.  As described in P.18/2024, it is important to ensure a clear chain of control over the

approved drugs. For this reason, the draft law provides that the approved drugs may only be prescribed by the individual's Administering Practitioner or another assisted dying practitioner who is acting for the individual's Administering Practitioner.

203.  This is in addition to the approved drugs only being prepared and dispensed by a Pharmacy

Professional at the Jersey General Hospital and may only be dispensed to the Administering Practitioner or another assisted dying practitioner at their request.

204.  Article  62  provides  that  the  Committee  must  produce  operational  guidance  on  the

prescribing and dispensing of approved drugs.

Change of practitioners (Article 35)

205.  As set out in P.18/2024, the draft law provides that any assisted dying practitioner (for

example, a Coordinating Doctor or a certifying doctor) may be replaced at any time in the process if required. For example:

1. if a Coordinating Doctor makes a declaration of interest that the review officer determines would impact on their ability to perform the role
2. if a Second Opinion Assessment determines that the person has met the eligibility criteria, in which case the Coordinating Doctor may not wish to continue in the role and the Second Opinion Doctor may agree to assume the role of Coordinating Doctor
3. if an unforeseen circumstance occurs, such as long-term sickness or unplanned absence, which means the practitioner cannot continue in role.

206.  Any  practitioner  would  be  replaced  by  an  equivalent  practitioner  (for  example,  a

Coordinating Doctor would be replaced by another Coordinating Doctor).

207.  The draft law requires the practitioner or doctor who is being replaced must tell the

individual about the change as soon as reasonably practicable.

208.  Safeguards

The provisions set out in Part 2 of the draft law (as described above) and the governance and oversight arrangements set out in Part 3 of the draft law (as described below) provide a robust framework of controls which support compliance with the following five key safeguarding objectives:

1. only those who meet the eligibility criteria are approved for an assisted death
2. all islanders are protected and supported throughout the assisted dying process, including:

• Islanders who may be coerced or pressured into requesting assisted dying

• people with mental health conditions and / or those who do not have decision-making capacity

• family members and loved ones of the individual requesting an assisted death

• continuing ongoing support, care and treatment for individual whilst requesting an assisted death and on the assisted dying process

3. assisted dying practitioners act in accordance with guidance and law
4. professionals are supported and protected when acting in accordance with guidance and law, regardless of their position on assisted dying
5. The Assisted Dying Service is safe and of high quality.

Appendix 5 provides details of safeguarding associated with the five safeguarding objectives.

Section  4:  Part  3  of  the  draft  Law  -  right  to  refuse,  protections, challenging decisions, offences, committee, service and review panel

209.  Part 3 of the draft law sets out matters relating to:

1. right to refuse, safe access zones, disclosure of information and appeals
2. protection and offences
3. Assisted Dying Assurance and Delivery Committee
4. the Assisted Dying Service
5. Review Panel.

Right to refuse to participate and associated protections (Articles 36 – 39)

210.  In accordance with P.18/2024 the draft law provides all persons with a right to refuse to

participate in assisted dying for any reason. For example:

1. on moral, ethical or religious grounds (conscientious objection)  
2. because  of  professional's  concern  about  the  potential  emotional  impact  on themselves of participating in an assisted death
3. for practical or business reasons (concern that their participation may create concerns amongst other clients or patients).

211.  There are a few limited exceptions to the right to refuse to participate:

1. an assisted dying practitioner, a Certifying Doctor and a Care Navigator cannot refuse to participate on the basis that they have opted-in to be an assisted dying practitioner
2. an administrating practitioner cannot refuse to administer the approved drugs to the individual (as  distinct  from  supporting the  individual  to self-administer)  if  the Administering Practitioner previously agreed to do so - but they may refuse to agree to do so in the first instance (see paragraph 88). This is to avoid undue distress to an individual if an Administering Practitioner were to unexpectedly exercise their right to refuse in the hours and minutes immediately preceding death

3. a witness to the administration of the drugs (at Step 7) cannot refuse to witness the administrating practitioner administer the approved drugs to the individual if the witness previously agreed to do so. As above this is to avoid undue distress in the hours and minutes immediately preceding death.

212.  In accordance with the Panel's amendment to P.18/2024 (as adopted) the draft law does

not limit the right to refuse to direct participation in assisted dying, as distinct from indirect participation, but in common with other Assisted Dying Laws (Victoria and Western Australia[17],)[18] it does set out activities that:

1. constitute participation, so may be refused (for example, giving patients information about  assisted  dying;  giving  a  relevant  opinion  to  support  an  assisted  dying assessment; being present at the administration of the approved drugs)
2. do not constitute participation, so may not be refused (for example, caring for the individual's body after death; reserving an appointment time for them; providing usual care and treatment; cleaning the Services offices).

213.  Exercising right to refuse

The right to refuse includes the right not to give someone information about assisted dying if they have asked for it, or if they are being given information about how their condition may be treated. However, in exercising that right a health care professional, the draft law sets out that must tell the person

• they are exercising the right to refuse

• that the Service may be able to help the person

• how the person may find the Service's contact details.

The requirements set out above mirror those set out in professional regulatory standards, such as the GMC's guidance on ethical objections.

The draft law sets out there must be operational guidance to support all professionals to operate within the right to refuse provisions set out in the draft law (Article 62), plus the appropriate conversations training to be developed by the Committee must also address the right to refuse (See paragraph 260)

In addition, as set out in P.18/2024, it is anticipated that the Service will provide all health care professionals with information leaflets that they may hand to patients who have raised the subject of assisted dying. The monies required for this have been factored into the resource requirements set out in Section 6 of this report.

214.  In accordance with feedback from the BMA, and in common with legislation in New

Zealand [19]and the Isle of Man,[20] the draft law protects employees and business partners (for example, partners in a GP Practice) who exercise their right to refuse, from employment detriments, such as being sacked, overlooked for employment, promotion etc. Equally, it also protects employees and business partners who do participate in assisted dying.

215.  Article 96 enables the Assembly, by Regulations, to provide for civil remedies where an

employee or business partner has suffered an employment detriment because they refused to participate or did participate in assisted dying. It is anticipated that the Minister will present these Regulations to the Assembly before the law comes fully into force (see paragraph 309 & 312).

216.  Article 39 also protects tenants who refuse to participate, or conversely do participate, in

an assisted death. This includes tenants:

1. whose housing is related to their employment
2. tenants whose landlord holds a position on assisted dying (for example, a faith based housing association)
3. tenants who wish for their assisted death to take place at home, where that home is rented.

217.  P.18/2024 proposed that a landlord could not prevent a tenant from having an assisted death

in home but, following discussion with stakeholders, the provisions set out in the draft law have been cast wider so as to include other categories of tenants (such as those referenced in the above paragraph).

218.  Discussion of assisted dying with patients

In accordance with P.18/2024, the draft law is silent' on health care professionals discussing assisted dying with their patients (except where the health care professional is exercising their right to refuse). That is to say, the law will neither:

1. require health and care professionals to raise the subject of assisted dying with a patient whom the professional thinks may be eligible for an assisted death, nor
2. prohibit health and care professionals from talking to their patient about assisted dying, in the context of the patient's care and treatment options, even where the patient did not raise the subject in the first instance.

Whilst assisted dying should never be recommended', health and care professionals do need to be able to engage in open and informed conversations about end-of-life options which may, in some cases, include assisted dying. There is a balance to be struck between:

1. the risk that a patient may feel that assisted dying is being suggested to them as a preferred option
2. the risk that a patient is unable to have an informed discussion with a trusted professional about their end-of-life options, and
3. the risk that access to information is inequitable.

The draft law sets out there must be operational guidance to support all professionals – not just assisted dying practitioners - to have appropriate conversations with patients about assisted dying (Article 62) and associated training (Article 66). In providing this training, the draft law is clear that there is no compulsion for other professionals to attend, for example, if they object to assisted dying.

Safe access zones (Article 40)

219.  A safe access zone is a designated area in which protests, demonstrations and other

activities are expressly prohibited. They are intended to protect professionals and service users from potential harassment and/or abuse. Safe access zones are provided for in abortion in the UK and other jurisdictions.

220.  The draft law provides that certain activities will be banned in safe access zones and that

the Assembly may, by regulations, specify what activities are banned, in addition to designating the associated safe access zone boundaries and time periods.

221.  It will be an offence for a person to undertake an activity that is banned by Regulations (for

example, physically obstructing someone's access to the Service, or harassing them).

222.  The UK Supreme Court [21]held that safe zones around abortion clinics are compatible with

the Human Rights Convention, with much of the associated reasoning being applicable to assisted dying safe zones. Whilst safe access zones do place some narrow restrictions on rights related to freedom of expression (to protect individuals from harassment) they do not breach the Convention because they do not fundamentally undermine the right to freedom of expression.

223.  It is intended that safe access zone Regulations will be brought to the Assembly before the

draft Law is fully enacted, following a period of public consultation.

224.  Note: is it also envisaged that safe access zones will also be provided for in the amended

termination of pregnancy law to be lodged in December 2025.

Disclosure of information about people (Article 41)

225.  The draft law prohibits people from disclosing information that allows for the identification

of an individual who is having an assisted death or a professional who is involved in an individual's assisted death. It further prohibits disclosure of information about an individual's assisted death.

226.  There are exceptions to these prohibitions, for example, the individual having the assisted

death or their family members may talk about it, do media interviews etc providing they do not disclose information about the professionals involved (unless those professionals give their permission).

227.  Information may also be disclosed to protect a person's safety (for example,

whistleblowing) or to support an investigation into a professional's practice.

228.  Article 52 provides that it will be an offence to disclose this information in a manner which

does not accord with the law.

229.  In prohibiting the disclosure of information about an individual, it is nevertheless the case

that, as set out in P.18/2024, Medical Certificate of Fact and Cause of Death [22]and the register of deaths – which is a public document - will include details of antecedent causes of death, amongst other matters. Hence, the names of people who have had an assisted death will be a matter of public record post death (see paragraph 117).

Disclosure of information about the approved drugs (Article 41)

230.  The draft law similarly prohibits people from disclosing information about the approved

drugs, except that the Administering Practitioner may tell the individual about the approved drugs to be used for their assisted death. Information about the approved drugs will not be published due to the sensitivity of the information.

231.  Article 41 provides that it will be an offence to disclose information about the approved

drugs in manner which does not accord with the law.

Appeals (Article 42)

232.  In accordance with P.18/2024, the draft law provides for appeals to the Royal Court. Whilst

most jurisdictions do not provide for appeals within their assisted dying legislation (an exception being some Australian states), the Assembly previously determined that a right of appeal was important to support public confidence in the assisted dying process.

233.  Appeals will be made to the Royal Court, which will sit as the Inferior Number - this will consist of the Bailiff , Deputy Bailiff or a Royal Court Commissioner sitting with two Jurats.

As opposed to the Superior Number which consists of the Bailiff , the Deputy Bailiff or a Royal Court Commissioner and a minimum of five Jurats.

234.  The draft law provides that an appeal against a decision must be made within 28 days of

that decision being made by the assisted dying practitioner.

235.  An individual may appeal a decision that their request for assisted dying is rejected, at any

step in the process, on the basis that:

1. (in respect of the health criteria), the decision was irrational or not made in accordance with the law; or
2. (for any other decision), the decision was unreasonable, or not made in accordance with the law;

236.  A person with a special interest in the care and treatment of the individual requesting an

assisted death may only appeal the Coordinating Doctor's decision to approve the individual's assisted dying request at Step 5, on the basis that:

1. (in respect of the health criteria), the decision was irrational or not made in accordance with the law; or
2. (for any other criteria), the decision was unreasonable, or not made in accordance with the law.

237.  It is for the Court to be satisfied whether a person has a special interest. This may be, for

example, a family member or a professional involved in the individual's assisted dying process. It does not include an unconnected third party (such as a representative of a lobby group) who is appealing a decision of the Coordinating Doctor on the basis that they do not support assisted dying.

238.  P.18/2024 set out that the grounds for appeal would not include matters relating to health

criteria (i.e., the individual's diagnosis and prognosis or their beliefs related to their suffering / anticipated suffering). In discussion with law officers this position has been amended. The draft law now provides that the individual / person with a special interest may appeal a decision on the health criteria decision but only if that decision is irrational (i.e. a decision that is flawed or so unreasonable that it could not be sensibly reached) or not made in accordance with the law.

239.  A health criteria decision cannot be appealed on the grounds of difference of opinion alone,

where the opinion is reasonable and made in accordance with the law. For example, if an assessing doctor is of the opinion that the individual's life expectancy is 8 months, and that opinion is supported by medical literature and by other medical professionals who have examined the individual, the individual cannot appeal on the grounds that they think their life expectancy is 5 months.

240.  The draft law (Article 9) sets out that minimum timeframe between assisted death being

approved at Step 5 and taking place at Step 7, must be at least 2 working days. This 2 working day period allows for an appeal by person with a special interest.

241.  It is acknowledged that 2 working days is a limited period, but it strikes a balance between

giving time for appeals, whilst not significantly impeding the assisted dying process where the individual wishes to proceed.

242.  It is further acknowledged that a person with a special interest can only appeal if they are

aware of the individual's assisted dying request in the first instance. This may not always be the case, despite the draft law providing that the assessing doctors must advise the individual to speak with family and friends about their assisted dying request (Article 29).

243.  The 2 working day minimum timeframe may be overridden but only an assessing doctor

(or another doctor, as permitted by the draft law) is satisfied that the individual's life expectancy is 14 days or less (Article 7).

Protections and offences

Protections (Article 43)

244.  The draft law states that assisted dying is not suicide. This accords with the principles set

out in P.18/2024 and provides that a person who is lawfully engaged in supporting an individual's assisted dying process in Jersey is not aiding or abetting suicide.

245.  The draft law then provides that a person who is authorised by the assisted dying law to

perform an assisted dying function, does not commit an offence under another law if they perform the function in good faith and in a way they reasonably believe to be in accordance with the draft law and cannot be held liable in a civil court or disciplinary proceedings if they also do so with reasonable skill and care. The effect of this provision is that, for example:

1. an administrating practitioner is not committing the offence of homicide if they administer the approved drugs to bring about an individual's death, providing they are a registered Administering Practitioner and providing all provisions of the law are accorded with
2. any other person who administers the approved drugs to an individual is committing an offence even if the individual wanted the other person to assist in ending their life.

246.  Clarification of matters related to suicide

As noted in P.18/2024, there is currently some lack of clarity as to the legal provisions associated with suicide and assisting suicide in Jersey law. Suicide was historically treated as a crime in Jersey under customary law, but practice has evolved and the Courts have ceased treating suicide as a crime.

Whilst the Homicide (Jersey) Law 1986 refers to the "offence" of "aiding, abetting, counselling or procuring a person's suicide," it is doubtful whether that wording serves to create an offence, and whether there can be an offence of "aiding, abetting" etc. if suicide itself is no longer an offence.

This has been addressed via consequential amendments to the draft law which clarifies that:

1. suicide (taking one's own life) is not an offence.
2. an act that is capable of encouraging or assisting the suicide or attempted suicide of another person is an offence, if the act was intended to encourage or assist suicide or an attempt at suicide (such an offence would be broadly in-line with section 2 of the UK's Suicide Act 1961).

Offences (Articles 45 – 53)

247.  In jurisdictions where assisted dying is permitted, there are two broad approaches to

offences under the law:

Approach 1: assisted dying is treated in law as an exception to existing criminal offences such as homicide, i.e., a medical practitioner who supports a person's assisted death would not be committing the offence of homicide if the assisted death complied with the assisted dying law. This is the approach in the Netherlands, Belgium and Luxembourg.

Approach 2:  this similarly treats assisted dying as an exception to existing criminal offences but also creates new offences to protect against the wider public. This is the approach used in most other jurisdictions (Canada, New Zealand, all Australian states) and is the approach taken in the draft law.

248.  The draft law provides the following offences in accordance with P.18/2024. It is an

offence:

1. to unlawfully administer, or assist in the administration or self-administration of, the approved drugs unless in accordance with the law
2. to coercively or dishonestly induce a person to request an assisted death, or decide to end their life by assisting dying, or conversely to withdraw their request for an assisted death
3. to give a false or misleading statement or forge a document, which would include the individual, their friends or family giving false information to an assisted dying practitioner or assisted dying practitioner giving false information, including as part of the assisted dying registration process

4. not to tell the Service about significant registration matters i.e., an assisted dying practitioner commits an offence if they do not tell the Service, for example, if their professional registration as a doctor (whether in Jersey or the UK) has been cancelled, suspended, or had conditions imposed
5. to disclose information that they are prohibited from disclosing, for example, information that allows for identification of an individual, the assisted dying practitioners involved in an individual's assisted dying process, or the approved drugs (see paragraphs 225 - 231).

249.  In addition, the draft law also provides that it is an offence to:

a. purport to act as an assisted dying practitioner, Certifying Doctor, or Care Navigator

– i.e., to undertake the duties for one of these professionals when not registered to undertake the roles

b. purport to be an assisted dying practitioner, Certifying Doctor or Care Navigator – i.e. to falsely pretend to hold one of these roles or allow another person to state they hold that role

c. purport to be the Assisted Dying Service or to provide assisted dying - i.e., an organisation or person cannot state they are the Assisted Dying Service or that they provide assisted dying when they are not the Assisted Dying Service, or allow another person to state they are the Service

d. promote or advertise assisted dying with the intention of persuading or encouraging anyone to have an assisted death although this offence does not prevent people from giving information about assisted dying for legitimate purpose, such as the Government of Jersey website providing information about the Service, or a GP telling people they are also an assisted dying practitioner.

250.  The offences above are introduced to safeguard against people being misled or scammed

by third parties seeking to generate income (for example by offering a paid for assisted dying pre-assessment process) or for other such purposes.

251.  In addition, as set out in paragraphs 219 - 224, it is an offence to do banned activity in a

safe access zone and in accordance with Regulations made by the Assembly.

Assisted Dying Assurance and Delivery Committee (the "Committee")

Committee members (Article 54)

252.  The draft law provides that the Minister must establish and maintain an Assisted Dying

Assurance and Delivery Committee ("the Committee") to undertake the functions and obligations set out below. Committee members will include:

1. the Chair – a person who has experience of supervising and assuring the provision of health and care services to patients and is neither an employee or governor / trustee of an organisation that provides palliative or end-of-life care in Jersey or directly affiliated with a group that campaigns for, or against, assisted dying
2. regular members – who may be:

• representatives of palliative or end-of-life care services providers in Jersey (excluding HCJ employees)

• people with significant experience in supervising and assuring provision of health and care services (excluding HCJ employees)

• people who represent patients and who have experience of palliative or end- of-life care in Jersey themselves or as provided to a family member or friend

• experts in medical ethics

• any other person who has experience that the Minister considers to be relevant

3. professional lead members – senior HCJ professionals who have responsibility for other professionals and expertise in governance, professional practice and standards, for example, the Chief Officer, the Chief Nurse, the Medical Director.

253.  The Minister will appoint:

1. the Chair having consulted the Jersey Appointments Commission.
2. the regular members, having consulted the Chair and the Jersey Appointments Commission, if the Minister deems it appropriate to consult the Jersey Appointments Commission.

254.  There is no absolute duty to consult the Jersey Appointments Commission when appointing

regular members on the basis that the number of potential candidates is limited and that the Chair, who must be consulted by the Minister, can provide appropriate advice and guidance.

255.  The Chair may appoint the professional lead members.

256.  The Minister may choose to remunerate members (except professional lead members) and

must repay reasonable expenses (see Article 56).

257.  The draft law does not provide the periods of appointment, which will accord with the

policies of the Jersey Appointments Commission, nor does it provide for grounds of dismissal of the Chair and regular members. These will be provided for in the Committee's terms of reference and associated contracts for service.

Terms of reference (Article 55)

258.  The Committee must work in accordance with its terms of reference, which must be

approved by the Minister. The terms of reference will set out the Committees procedures for performing its functions and obligations, for example, matters related to the holding for Committee meetings, resolution of conflicts of interest, etc.

Functions and obligations (Article 57 to 70, Article 76 and Article 91)

259.  The Committee must ensure that the Service operates in accordance with the assisted dying

law and the Regulation of Care (Jersey) Law 2014, and has regard to the assisted dying operational guidance (Article 57).

260.  The Committee must arrange for the development, maintenance, and approval of the

following policies, systems, procedures, guidance, and support services. This includes determining whether they should be published (under Article 68) or only made available to relevant people such as regulators or professionals (under Article 69). In arranging for their development, the Committee must ensure that any consultation requirements set out in the draft law are complied with. The policies, systems, procedures, guidance, and support services include:

1. the schedule of approved drugs (Article 58)
2. the assisted dying individual's record system and associated retention schedules. The individual's record system which holds all records, forms and details related to an individual who has request an assisted death, whether or not they had an assisted death (Article 59 and Article 61). Assisted dying practitioners and care coordinators working for the Service will ensure all records and forms are held in the system, with the Service permitting access to the record in accordance with Article 79 of the draft law (for example, providing records to the Review Panel)
3. the register of assisted dying practitioners and certifying doctors which records each person who is an assisted dying practitioner and the assisted dying role they may undertake. In accordance with P.18/2024 that register will not be a public register to protect the privacy of practitioners in a small jurisdiction. This decision was taken in consultation with the UK professional regulatory bodies (Article 60). The Committee must also ensure that the Service registers professionals in accordance with the requirements of the draft law (see paragraphs 285 - 292)
4. the general information about the assisted dying process as set out in Schedule 1 of the draft law. This includes information about the criteria; the process; the Service; appeals; access to support services for the individual, family and friends, and professionals; complaints and matters that an individual may want to consider before their assisted death, such as life insurance or other personal administrative or financial matters (Article 61 and Schedule 1).

An assessing doctor must be satisfied that an individual's decision, or request, to have assisted death is informed, hence Article 28 of the draft law places a duty on the assessing doctor to ensure the individual has been provided the general information, and to be satisfied that the individual has understood the general information.

5. Assisted Dying Service standards and procedures for investigating and resolving complaints
6. the operational guidance which sets out how a professional must comply with the draft law or provides details as to how they carry out a particular function. Non- compliance with operational guidance is not a breach of the law, but it may be used as evidence in prosecution or disciplinary proceedings. Operational guidance must include:

• the right to refuse to participate in assisted dying

• having appropriate conversations with patients about assisted dying

• holding, indexing, and giving access to individuals' records

• registration of assisted dying practitioners

• places of assisted deaths

• independent advocacy, communication support, and support for interpretation of languages and advocacy

• assessing individuals for assisted dying

• care planning

• prescribing and dispensing approved drugs

• administering approved drugs, including protocols for medical complications

• disclosing interests and deciding whether they conflict

• disclosing information about health professionals to regulatory bodies

• donating organs - as set out in P.18/2024, the draft law does not prohibit post- assisted death organ donation, but it is intended that guidance will be developed in consultation with the NHS Blood and Transplant Authority. In many cases, the physical conditions that make a person eligible for an assisted death rule out the possibility of donation in any event as the organs are no

longer viable (for example, cancer)

7. general guidance for people who are not health and care professional. The family and carers guidance (required under Article 63) will set out easy to understand information on matters such as how to support a family member who is requesting assisted dying; how to access support services; how to notify the Service if a loved one wants to withdraw their request; how to appeal or raise a complaint
8. the professional competencies required to be an assessing doctor, Administering Practitioner, Pharmacy Professional, extended team member, or certifying doctor. (Article 80 provides that a professional cannot be registered with the Service unless they meet the competencies). The competencies, which will be developed in consultation with relevant UK professional bodies, must consider the following:

• capabilities, including professional skills (for example, practical, communication and clinical skills), professional knowledge and professional values and behaviours (for example, professional and ethical responsibilities and safeguarding vulnerable patients)

• training, in addition to the mandatory assisted dying training

• professional qualifications

• requirements to be professionally registered (for example, requirements of an assessing doctor to be registered with the Jersey Care Commission and the GMC, including the minimum period for which they must have been registered).

9. training for assisted dying professionals which must be completed by all assisted dying practitioners, Certifying Doctor and Care Navigators. This includes initial training that is required before registration with the Service, and continuing training at intervals set by the Committee. (see Article 65)

The training must be relevant for each assisted dying role and must include:

• all elements of the law, including the assisted dying process and assessment requirements

• operational guidance

• risk

• domestic abuse and whether someone has been coerced or pressured to do something, including coercive control and financial abuse

• the safety and well-being of professionals

• the technical knowledge required to perform each role (e.g.: administration of approved drugs by an Administering Practitioner; certification of an individual's assisted death by a certifying doctor)

10. other training which may be completed by anyone who provides health and care services in Jersey (if they wish to complete the training), and which must include training on appropriate conversations (Article 66)
11. support for individuals, family and professionals (such as counselling) to help the person deal with any negative effects of their involvement in the assisted dying process or their bereavement (Article 70).

261.  In addition to above, Articles 71 and 72 provide that the Committee may investigate the practice or performance of assisted dying practitioners, certifying doctors or care navigators

in accordance with Regulations made under the Law. The purpose of these investigations is to consider whether disciplinary proceedings may be required by an employer or regulatory body, or in enforcement or prosecution purposes. Any disciplinary proceedings could result in suspension or cancellation of the professional's assisted dying registration.

262.  The Committee must, in accordance with Article 91, develop the terms of reference for the

Assisted Dying Review Panel ("the Panel") for approval by the Minister. The terms of reference will set out how the Panel will perform its functions (for example, how the Panel makes decisions and resolves conflict). See paragraph 296

263.  In relation to assuring compliance with the law and operational guidance, the Committee must (in accordance Article 76) consider the decisions, findings and recommendations

made by the Assisted Dying Review Panel under Article 94 or 95 (see paragraphs 296 - 303 below). The Committee may accept and act on a Review Panel recommendation or may reject a recommendation and take a different course of action. In all cases, it must send a copy of the Panel's report to the Care Commission with details of any action the Committee proposes to take.

264.  As described in paragraph 301 below, the Review Panel must undertake review of every

assisted death in Jersey ("post-death review"). The Committee may, however, request that the Panel also review an assisted dying process that ended before an individual's assisted death (for example, the individual withdraw their request; the request was not approved; the person died of natural causes). If the Committee requests a review of an incomplete assisted dying process, the Panel must undertake that review.

Reports of the Committee (Article 73 to 76)

265.  The draft law provides that the Committee must collect and analyse information to:

1. identify any trends or issues with assisted dying, for example, whether requests for assisted dying by individuals with similar conditions indicates a problem with treatment or care for the condition
2. assure the quality and safety of the Assisted Dying Service.

266.  This must include information about:

1. individuals who request assisted dying and the outcome of their assisted dying process
2. the Service's compliance with the law, operational guidance and service standards
3. the investigation and resolution of complaints.

267.  The Committee must report the following information to the Minister and to the Jersey

Care Commission on an annual basis:

a. the numbers of:

• first requests

• individuals whose requests is approved

• individuals who withdrew their request and at which step in the process

• individuals who died from an assisted death, including how the approved drugs were administered and whether they were administered by the practitioner or the individual

• assessments for each individual at each step in the process, including second opinions and relevant opinions from professionals

• appeals, the grounds for appeals, and the outcomes

b. for each individual to whom approved drugs were administered:

• the period between the approval of their request for assisted dying and their assisted death

• any medical complications during or after administration of the drugs

3. personal details about all individuals who made a first request, whose requests were approved, who withdrew their request, who died from an assisted death, including:

• age

• gender

• physical condition expected to cause their death

• use of palliative or end-of-life care

• main language and any additional languages used

• use of communication support and advocacy support

• a protected characteristic under the Discrimination (Jersey) Law 2013.

268.  The Minister must consult the Medical Officer of Health to determine what information in

the report should be published. As set out in P.18/2024, the combination of a small population size - coupled with the fact that the names of people who have had an assisted death will be recorded in the public register of deaths - is likely to require some details not being published to protect anonymity and privacy.

269.  In addition to the annual reporting requirements, the Committee:

1. may report to the Minister any assisted dying matters it deems relevant
2. must report to the Minister on any assisted dying matters that the Minister requests.

270.  Note:  P.18/2024  did  not  reference  reporting  requirements  related  to  protected

characteristics under the Discrimination (Jersey) Law 2013, but this has been included in response to feedback from the Assisted Dying Scrutiny Panel.

Independent inspection and regulation

271.  As described in P.18/2024, appropriate structures and systems are required to ensure

the safety, quality and effective delivery of the service, and to provide public assurance of these matters. These include:

1. the Assisted Dying Assurance and Delivery Committee (as described above)
2. Review Panel which must undertake a post-death review of every assisted death, in addition to reviewing assisted dying processes that do not end in an assisted death, when required by the Committee to do so
3. independent oversight by the Jersey Care Commission ("JCC").

272.  The draft law, as described in paragraph 323, amends the Regulation of Care (Jersey)

Law 2014 and Regulation of Care (Standards and Requirements) (Jersey) Regulations 2018 to allow for the registration and regulation of the Service by the JCC.

273.  In the event JCC finds that the Service is failing to meet any of the requirements set out

in this law, or under the 2018 Regulations, the JCC will be able to take action in accordance with the JCC's existing escalation and enforcement policy which, in the first instance, is likely result in the JCC issuing the Service with an improvement notice. If the Service contravenes a JCC requirement or fails to comply with an improvement notice, the JCC may refer information to the Attorney General, for the Attorney General to decide whether to prosecute.

274.  The ultimate sanction against services regulated by the JCC is the cancellation of a

service provider's registration with the JCC – the effect of which is to shut the service down. However, this shut down' power does not apply to essential services provided by the Minister (i.e. a service for which a Minister is the sole provider). As the Assisted Dying Service would meet the definition of an essential service, the JCC could not cancel its registration, and could not shut it down.

275.  Hence, in accordance with P.18/2024, the 2014 Law is further amended to provide that

the Assisted Dying Service is not an essential service, and in the case of serious failings, its registration may be cancelled by the JCC, effectively shutting it down. However, these amendments provide that, if Service's registration is cancelled, an individual whose assisted death has been approved at Step 5 – but whose assisted death has not yet been carried out – may still have an assisted death providing the cancellation of registration by the JCC does not relate to one of the assessing doctors involved in that individual's assisted dying process.

Assisted Dying Service ("the Service")

Minister to establish the service (Article 77)

276.  In accordance with P.18/2024, it is the responsibility of the Minister to establish and

maintain the Service, regardless of their views on assisted dying, or the views of others (i.e., a Minister who is opposed to assisting dying on the grounds of conscience cannot shut the Service down). However, there may be circumstances which prevent the Minister from establishing or maintaining the Service, for example, if the numbers of professionals willing to work in the Service is not sufficient to deliver a safe service.

277.  The draft law provides that, if the Minister cannot establish and maintain the Service, they

must present a report to the Assembly stating why the Service cannot be established or maintained; what they have done and intend to do to resolve the issue and what, if anything, the Assembly may decide to do to help the Minister establish and maintain the Service.  

278.  Accountability

For the purposes of clarity, the draft law sets out that the Service is provided by HCJ, acting for the Minister – i.e., the Minister is accountable for the Service.

The Committee is not an independent entity and it not accountable for the Service, but the Committee has functions and obligations that work to ensure the quality and safety of the Service for which the Minister is accountable.

For the purposes of clarity, if the Service provider is changed, the Minister nevertheless remains accountable for ensuring that the new provider delivers the service, which the Minister will achieve through the contractual arrangement with the new service provider (i.e., the draft law provides that a Minister, who is opposed to assisted dying, cannot arrange for third party to provide the Service and then accept non-provision by that third party).

Service provider / change of provider (Article 77)

279.  The draft law provides that the Assisted Dying Service should be provide by Health and

Care Jersey. This accords with most other jurisdictions where assisted dying services are also delivered as part of the public health system - Switzerland and Germany being the exceptions.

280.  However, the draft law also provides that the Service may, if required by Regulations, be

provided by another entity. This regulation making power (provided for in Article 96) accords with P.18/2024 and works to ensure that the Minister is not precluded from making arrangements for a different entity to provide the Service if, at some point in the future, the Assembly were satisfied that another entity was better placed to manage and deliver the Service.

281.  Article 96 also provides regulation-making powers to facilitate any future change of

providers. This includes powers to:

1. transfer employees, equipment, facilities, individuals' records, and responsibility for individuals to a new provider, and
2. amend various provisions of draft law as necessitated by the change of provider (for example, amendments to the governance and oversight arrangements) except that this cannot affect whether an individual is eligible for an assisted death (i.e., the eligibility criteria cannot be amended as set out in paragraphs 34 - 42)

Exclusive functions (Article 78)

282.  The draft law provides that the Service must arrange the services of assisted dying

practitioners  and  associated  support  services  (including  counselling,  communications support, and advocacy support).

283.  This function is exclusive to the Service. No other person may provide, or purport to

provide, assisted dying (i.e., a business may not suggest that it provides assisted dying). Furthermore, as set out above it is an offence to advertise or promote assisted dying or the Service with the intention of persuading or encouraging anyone to have an assisted death - although this should not prevent people from giving information about assisted dying for a legitimate purpose.

Fees (Article 78)

284.  The draft law provides the Service must not charge a fee for any part of the Service. This accords with P.18/2024. However, Article 94 of the draft law provides that in future, the Assembly may, by Regulation, require the payment of fees (which was proposed via P.18/2024) as a result of third-party service provision, wider fee reform across HCJ, or

other system changes that may impact the  Service. The regulation-making power is

provided to enable the levying of fees, in the event the Assembly was satisfied that charging for the Assisted Dying Service is consistent with any future approach to health service fees and charges i.e. in the event that service user charges are introduced, as standard, for Government delivered health and care services.

Registration of assisted dying practitioners and certifying doctors, renewal and information on the register (Articles 80, 81 and 83)

285.  As set out above, the Committee must arrange for the development and maintenance for

the register of assisted dying practitioners and certifying doctors, and the Service must register those professionals.  

286.  Registration provides critical safeguards:

1. no person may act as an assisted dying practitioner or certifying doctor unless they are registered. If they do, they will be committing an offence
2. no professional can be forced to register; it is their choice alone. The draft law provides a right to refuse to apply to be registered and protects professionals who do not register (or who register) from any action by their employer
3. a  professional cannot be registered unless they have  undertaken the necessary training and have the necessary competencies
4. a professional must be professionally registered to be eligible to register with the Service (for example, a nurse with the NCM and JCC; a doctor with the GMC and JCC, etc) ensuring they have met the required standards of education, competency, and conduct to practice their profession
5. a professional can be deregistered (and therefore unable to practice assisted dying) in response to concerns about their assisted dying practice or their professional practice more generally.

287.  People may apply to be registered as a Certifying Doctor, or one or more of the following

types of assisted dying practitioner:  

• a Coordinating Doctor

• an assessing doctor who is not a Coordinating Doctor (for example, a person may register only as an Independent Assessment Doctor or as a Second Opinion Doctor)

• an Administering Practitioner

• a Pharmacy Professional

• an extended team member.

288.  Having received an application, the Service must register a person if satisfied that:

1. it has the necessary information
2. the person has the required competencies (see paragraph 260h) - i.e., they have the skills, knowledge, character, and health to practice
3. the person has completed the mandatory assisted dying training for the role (see paragraph 260i)
4. the person has disclosed any conflicts of interests
5. the person has a responsible officer if required – i.e., a doctor requires a responsible officer for the purposes of GMC revalidation. The doctor must have a responsible officer at the point of registration, they cannot be between' responsible officers.

289.  A registered assisted dying practitioner must renew their registration on an annual basis

(this does not include a certifying doctor). The draft law provides that they must apply to renew within 3 months of the annual renewal date, i.e. there is a grace period during which a professional can continue to be registered as an assisted dying practitioner before they are removed from the register. This allows for accidental failure to renew in a timely fashion.

290.  The Service may renew the registration if satisfied of the matters set out above. If the

assisted dying practitioner has not renewed their registration, their registration ends after 18 months, and they are no longer an assisted dying practitioner.

291.  The draft law sets out the information that the Service will record on the register. This

includes:

1. the registrant's name and roles; their professional registration bodies names and numbers (for example, their JCC and NMC registration numbers)
2. whether they have a contract of employment or service with the Service
3. any disclosed interests
4. date of initial registration and renewal dates / dates of completion of initial and continuation training
5. date on which their registration ended and the reason (if applicable).

292.  As set out in paragraph 260c, the register is not a public to protect the privacy of

practitioners in a small jurisdiction. The draft law prohibits the Service from sharing information on the register unless to the Committee or others for purposes related to governance and investigations (Article 87).

Registration changes, suspension and cancellation (Article 84 to 86)

293.  The draft law provides that a registered professional must tell the Service if their

professional registration is suspended (for example, suspended by the JCC or NMC); cancelled (whether by them or by the registration body); has conditions imposed (for example, they must be supervised by another professional when undertaking specific tasks) or anything else happens which may affect the registration (for example, their registration body is going to investigate their practice)

294.  The Service must suspend a professional's assisted dying registration if their professional

registration is suspended and cancel their assisted dying registration if they are no longer professionally registered. Furthermore, the Service may suspend or cancel a professional's assisted dying registration in response to an investigation into their practice (in accordance with Regulations made under Article 96).

Development and publication of document and training (Article 88)

295.  The Service must develop documents, information, guidance, and training in accordance

with requirements established by the Committee.

Review Panel (Articles 90 to 95)

296.  The draft law provides that the Minister must establish and maintain an Assisted Dying

Review Panel (the "Panel") and appoint its members.

297.  The primary purpose of the Panel is to undertake post-death review to determine whether,

in each case, there was proper adherence to the legislation and guidance, and to identify any process matters that may require improvement / change. Post-death review also supports immediate identification of suspected malpractice and, as such, are critical to safeguarding people.

298.  The number of members, the appointment process, and members' required knowledge and

expertise will be prescribed by Order.

299.  As described in P.18/2024, members are likely to include experts from a range of

disciplines including legal; end-of-life care specialists; medical ethicists; social care practitioners; medical practitioners with expertise in the types of physical medical conditions that give rise to assisted dying requests; people with expertise in clinical service governance and safety. The draft law provides that there may be remuneration.

300.  The Minister may only appoint members in accordance with the Order and as

recommended by the Committee. This may include employees of HCJ, but the Committee must be satisfied that the interests of any person recommended for appointment do not conflict with the interests of individuals in the assisted dying process.

301.  The Panel must follow the procedures set out in the terms of reference developed by the

Committee, and deliver the functions and obligations set out in the draft law. These functions and obligations include:

1. reviewing every assisted death that is carried out - in reviewing an assisted death, the Panel must review all parts of the individual's assisted dying patient record. They may also request that additional information is provided to them. As set out in P.18/2024 this may include asking assisted dying practitioners, or others, to attend a review panel meeting. Having undertaken the post-death review, the Panel must then decide if the assisted dying process being reviewed accorded with the law and the operational guidance approved under the law. The Panel must report its decisions and findings to the Committee
2. analysing assisted death reviews – the Panel must, having undertaken 2 or more post- death reviews, consider whether it should recommend to the Committee potential changes or improvements to the assisted dying process, or the requirement for investigation into a professional's practice or performance. The Panel must provide reasons for its recommendations.

302.  In addition to the above, if the Committee requests that the Panel undertake a review of an

assisted dying process that ended before an individual's assisted death (for example, the individual withdraw their request; the request was not approved; the person died of natural causes) the Panel must undertake that review.

303.  All reviews must be undertaken in the timeframes prescribed by Order.

Section 5: Part 4 of draft Law - secondary legislation, forms and final matters

304.  Part 4 of the draft law provides for Regulations, Orders, forms, commencement, and other

related matters.

Regulations (Article 96) and Orders (Article 97)

305.  Article 96 sets out the Regulation-making powers associated with the draft law. This

includes powers to amend some provisions of the draft to ensure its continued and ongoing currency (for example, powers to amend some offences; restrictions on disclosure of information; functions of the Committee; functions of the Review Panel; matters related to the assisted dying process which the Review Panel determines should be improved).

306.  The draft law provides extensive detail about how a function is undertaken, as opposed to

simply providing that a function must be undertaken and, given that the Assisted Dying Service is entirely new, it must be recognised that this detail may require amendment once tested through practical application – providing all essential safeguards are maintained.

307.  Article 96 also provides for Regulations to change the provider to the Service.

308.  However, in accordance with P.18/2024, the draft law does not allow the assisted dying

eligibility criteria to amended by Regulation. Any future change to the eligibility criteria must be via a primary law change which would require Privy Council consideration and Royal Assent. This safeguard is intended to ensure that Privy Council, as well as the States Assembly, are sighted on any changes and to provide a counter to the slippery slope' concerns raised in phase 1 and phase 2 public consultations in 2022 and 2023.

Regulations to be made prior to commencement of the Assisted Dying Service

309.  Article 96 of the draft law will come into force 7 days after the law is registered, allowing

for the Minister to present the following regulation to the Assembly before the law comes fully in force:

1. Regulations to provide for safe access zones
2. Regulations related to the investigation of professionals
3. Regulations related to civil remedy
4. Regulations related to independent advocacy.

310.  Regulations to provide for safe access zones including specifying:

• activities that are prohibited in a safe access zone (see Article 38), such as doing anything intentionally or recklessly – (i) to obstruct someone's involvement in the assisted dying process; or (ii) to harass someone for their involvement in, or contact with someone involved in, the assisted dying process

• the periods during which those activities may be prohibited

• the places that are safe access zones, whether being defined as places at which: the assisted dying process is carried out; the Service operates; assisted dying practitioners are employed; by boundaries around a place (for example, the area within 100 metres of the boundary of any private property at which an individual's assisted death is to be carried out)

311.  Regulations that provide for the investigation of professionals:

1. Article 71 of the draft law provides that the Committee may investigate the practice of an assisted dying practitioner or a certifying doctor, or the performance of a care navigator, so far as it relates to assisted dying and further to that investigation, may suspend or cancel their assisted dying registration. Suspension or cancellation of assisted dying registration will prevent the person from practicing assisted dying.
2. The investigation must be done in accordance with Regulations made under the draft law.
3. The draft law does not provide the Committee powers to investigate the practice of those professionals more widely (i.e. they may investigate an assessing doctor when they are acting as an assessing doctor, but they may not investigate an assessing doctor when that assessing doctor is acting as a GP). Powers of investigation into wider professional practice are matters for the employer and / or the professional registration body (e.g.: the GMC)
4. Developing the regulations requires extensive consultation with the Jersey Care Commission and UK professional regulatory bodies but, subject to that consultation, it is envisaged that the Regulations will provide for matters including:

• protocols for notifying professional regulatory bodies and information sharing

• powers of investigation

• reports following an investigation

• removal from the assisted dying register or refusal to renew assisted dying registration following an investigation and associated appeals.

312.  Regulations that provide for civil remedy in relation to an employee or partner who suffers detriment because of their decision to participate, or to refuse to participate, in assisted dying (in accordance with Article 38). These Regulations may provide for matters such as:

1. conferring jurisdiction on a court or tribunal to consider the matter
2. making of awards of compensation and the recovery thereof
3. setting of maximum amounts
4. appeals, offences, exemptions, etc.

313.  Regulations to provide for independent advocacy:

1. As set out in paragraph 158, the Minister has determined the Assembly should, by Regulation, make provisions in relation to independent advocates who support people who have requested an assisted death. This will align with the draft UK Bill and will mirror similar independent advocates provisions in other Jersey laws.

2. Subject to consultation, it is envisaged that the independent advocacy regulations may make provisions as to –

• the training and/or qualifications required to be appointed as an independent advocate

• the procedure for appointment of independent advocates

• provision for payments

• criteria for a qualifying person' who may be supported by an independent advocate and the steps to be taken to ensure that a "qualifying person" who has requested assisted dying is aware of the availability of the services of independent advocates

• matters in which independent advocates may help a qualifying person, in relation to an assisted dying request or the assisted dying process and the functions they may undertake when giving such help.

Orders (Article 97)

314.  Article 97 provides for matters that the Minister may specify by Order, including where a

meeting under this law may be held and whether it may be held electronically (as per paragraphs 139 – 146. This may be subject to change in the future, depending on changes to UK provisions related to assisted dying and offences related to suicide)

315.  A number of these Orders must be made prior to commencement of the Assisted Dying

Service, including those relating to the membership of the Committee and Review Panel, and the information that must be contained in all the forms to be completed under the draft law.

Commencement / transitional provisions (Articles 100 and 102 / Schedule 2)

316.  As set out in Article 102, key Articles will come into force 7 days after the draft law comes

into force. These Articles enable the Service to be established (for example, the Committee may be stood up, the competencies, training and operation guidance may be developed, and assisted dying practitioners may be registered) but not provide for the Service to commence delivery. For the avoidance of doubt, Schedule 2 clearly states that assisted dying cannot be provided until the entirety of the law comes into force.

317.  It is anticipated the rest of the law will come into force around 18-months post adoption of

the law (c. late summer 2027).

Amendments to other legislation (Article 101 / Schedule 3)

318.  The Cremation (Jersey) Regulations 1961 currently prohibits a cremation where it appears

that the death has, or might have, resulted from poison. The Regulations are amended to disapply this prohibition in the case of an assisted death.  

319.  The Regulations are further amended to clarify the existing requirements regarding who

may not be a confirming practitioner. The amended Regulations also provide additional requirements where the death is an assisted death, so that an attending practitioner cannot be related to, or a partner of, an Administering Practitioner or the individual's certifying doctor.

320.  In accordance with P.18/2024, the Homicide (Jersey) Law 1986 is amended to explicitly

clarify that suicide is not an offence in Jersey and to create a new offence of encouraging or assisting suicide, in line with Section 2 of the UK Suicide Act 1961. Encouraging or assisting suicide would include, for example, buying lethal drugs for a person with the intention that they will take them to end their life. This is an area of potential increased risk given the availability of some lethal drugs on-line and the associated prosecutions relating to supply of lethal drugs in jurisdictions such as Canada.

321.  The Inquests and Post-Mortem Examinations (Jersey) law 1995 provides that a person who

believes that another person, who is under the care of medical practitioner, has died from causes other than natural causes, will notify the police, who will then notify the Viscount. This is amended to provide that notification to the Viscount is not required in the case of an assisted death, although the amendment does not prevent action by the Viscount where there are concerns about the manner of the assisted death.

322.  The Marriage and Civil status (Jersey) Law 2001 is similarly amended to provide that there

is no duty on the relevant registrar to notify the Viscount about an assisted death.

323.  The Regulation of Care (Jersey) Law 2014 and Regulation of Care (Standards and

Requirements) (Jersey) Regulations 2018 are amended to provide for the registration and regulation of an Assisted Dying Service by the JCC. The amendments to the 2014 Law and 2018 Regulations, which accord with P.18/2024 (see paragraphs 271 - 275) collectively work to provide that:

1. the Assisted Dying Service is a defined regulated activity
2. the Service is required to discharge its statutory functions in accordance with the assisted dying law, enabling the JCC to regulate the Service fully, ensuring that it is compliant with all its statutory responsibilities under the assisted dying law, as well as the general requirements placed on all services under the Regulation of Care Law
3. the Assisted Dying Service is not an essential service, enabling the JCC to cancel its registration in the event of serious service failings, thereby effectively shutting the Service down. Except that, an individual whose assisted death has already been approved may proceed to have an assisted death, providing the reasons for cancellation of registration do not relate to one of the assessing doctors involved in that individual's assisted dying process.

Section 6: Resources and financial implications

324.  The 2026 Government Budget includes monies associated with the establishment and

ongoing delivery of the Assisted Dying Service. This accords with P.18/2024, which clearly stated that resources currently allocated for palliative care or other health and care services in Jersey would not be used to funded assisted dying, and that new monies were required.

325.  The anticipated costs associated with the implementation and ongoing provision of the

Assisted Dying Service are set out below. Note: these costs have been updated since the publication of P.18/2024.

326.  Whilst considerable care has been taken in developing the estimated costs, it must be

recognised that there is an inevitable degree of uncertainty as to their accuracy.

327.  Implementation costs include, for example: developing a bespoke training package for

assisted dying practitioners. Given that there is no existing equivalent training package in the UK, the development costs can only be based on those associated with training packages for existing health care services.

328.  Ongoing delivery costs which will fluctuate on an annual basis dependent on factors such

as:

• numbers  of  requests  for  assisted  dying  in  Jersey,  and  associated  complexity  of

assessments

• uptake and requirement for counselling, wellbeing and bereavement support

• uptake and requirement for interpreting, communication support, and advocacy

• regulatory action and appeal.

Estimated number of assisted deaths per year

329.  The costs set about below are based on an estimated 28 people having a first assessment in

2029, with 24 of those people going on to have a second assessment, and 14 of those people going on to have an assisted death. With fewer assisted deaths during the first two years, as has been the case in other jurisdictions where assisted dying has been implemented:

330.  The number of assisted deaths - as a % of all deaths - in jurisdictions where assisted dying

is permitted ranges from 0.86% (in Oregon) to 4.7% in Canada. This variation is based on multiple factors, including the differences in eligibility criteria and assessment process.

331.  The jurisdiction that is most similar to Jersey, in terms of eligibility criteria and assessment is Western Australia, hence the estimated number of assisted deaths in Jersey is based on figures provided in the Western Australian Voluntary Assisted Dying Board 2024 annual

report. [23] However, these figures should be taken with a degree of caution given the variations in geography, societal make-up and health service delivery between the two jurisdictions.

Estimated staffing hours per assisted death

332.  As set out below, based on discussion with Jersey based health and care providers, it is

assumed than each assisted death will require an average of 85.5 hours of staff time, although  this  is  likely  to  vary  significantly  dependent  on  the  circumstances  of  the individual. 85.5 hours is more than the estimated 60 hours per assisted death reported in some Australian jurisdictions - and more than the 32 hours set out in the UK impact assessment - but, in developing the assisted dying costs – given the known, unknowns - officers have erred on higher end of estimates.

UK impact assessment

333.  The  impact assessment published as part of the  recent UK parliamentary debate on

Terminally Ill Adults (End of Life) Bill set out both the potential costs and the potential cost savings associated with assisted dying. [24]The estimated UK costs differ considerably to those set out in the report, due to two key factors:

1. UK estimates on number of assisted deaths - in calculating the estimated number of assisted deaths, the UK impact assessment is based on the Oregon death rate (0.86% of all deaths in 2023), whereas - as noted above – the Jersey's estimate is based on Western Australia assisted death rate figure (1.67% of all deaths in 2023). This is because the draft UK bill only permits assisted dying for people with 6 months life expectancy (as per Oregon), where the Jersey draft law permits assisted dying for people with 6 months life expectancy or 12 months where the person has a neurodegenerative condition (as per Western Australia)

2. Differences in the proposed assessment process etc - the UK proposals do not provide for the functions - or costs – associated with the role of the Care Navigator, the Committee, or the Review Panel (all of which have been factored in the Jersey proposals). Further to this, the UK proposals do not take account of costs such as the provision of wellbeing and bereavement support.

Costs

334.  Total estimated one-off and recurring costs associated with the establishment and on-going

delivery of the Service (as per Government Budget 2026-2029)

335.  Total estimate costs by category:  

336.  Implementation costs include, for example, provision of a programme manager to oversee

the establishment of the new service and associated workstreams, such as the development of operational guidance and the assisted dying person record.

337.  Training costs include developing the training package for assisted dying practitioners and

certifying doctors; developing the general assisted dying training module for on-island health and care professionals; and recurring costs associated with the delivery of the training, including the cost of staffing time when completing the training.

338.  Information management costs include the development and ongoing maintenance of an

assisted dying practitioner register and the assisted dying person record.

339.  Public information costs include one-off costs associated with the development of a

dedicated webpage for the Service on gov.je and the production of leaflets to inform the public of the contact details for the Assisted Dying Service (where a health care professional chooses not to refer them to the Service).

340.  Recruitment costs include one-off costs associated with recruiting Assisted Dying Service

staff, the independent chair and external Committee members, and members of the Review Panel.

341.  Staffing costs include recurring costs for Assisted Dying Service practitioners, Care

Navigators, and administrative staff.

342.  Facilities/ equipment/ supplies costs include costs associated with the administration of the

service – such as IT and office equipment, and recurring costs related to the provision of assisted dying, including the approved drugs.

343.  Wellbeing & support services costs include recurring costs for support for Assisted Dying

Service staff (such as access to counselling) and wellbeing support for individuals requesting assisted dying and their families (including bereavement support), plus costs of interpretation and independent advocacy for individuals requesting assisted dying.

344.  Assurance & Delivery committee costs include recurring expenditure such as the

remuneration of the independent committee members,  administrative  costs  and costs associated with the production of an annual report on assisted dying in Jersey.

345.  Regulation & oversight costs include both one-off and recurring costs associated with

inspection and regulation of the  Service  by the  Jersey Care  Commission; and costs associated with the Review Panel.

346.  Note: these costs do not include insurance costs, for example, any additional medical

indemnity insurance protection, if required. Such cost projections cannot be determined prior to the adoption of the law.

Children's Rights Impact Assessment

A Children's Rights Impact Assessment (CRIA) has been prepared in relation to this proposition and is available to read on the States Assembly website.

Human Rights Notes

The notes on the human rights aspects of the draft Law in Appendix 6 have been prepared by the Law Officers' Department and are included for the information of States Members. They are not, and should not be taken as, legal advice.

APPENDIX 1 TO REPORT Background to P.18/2024: Previous debates, consultation and engagement

1. The  proposals  outlined  in  P.18/2024  were  developed  following  several  phases  of consultation with the public and with professional stakeholder organisations.

Citizens' Jury and States Assembly in-principle' debate

2. In November 2021, the States Assembly ("the Assembly") agreed, in principle, that assisted dying should be permitted in Jersey (P95/2021) [25]but that, prior to the preparation of  the  law  drafting  instructions,  detailed  proposals  should  be  brought  back  to  the Assembly for debate.
3. P.95/2021 was informed by the key recommendations of the Jersey Citizens' Jury on Assisted Dying which took place between March and May 2021, with the final Citizen's Jury report being published on 16 September 2021.[26]
4. The Jersey Citizens' Jury on Assisted Dying was commissioned by the previous Minister for Health and Community Services, Deputy Richard Renouf , following community interest in the introduction of assisted dying in 2018.[27]
5. A citizens' jury is a form of deliberative democracy, where a small group of people, representative of wider demographics of a given area, come together to carefully consider a complex issue. The Jersey Citizens' Jury on Assisted Dying consisted of 23 Jersey residents who were broadly representative of the Island's population in terms of age, gender, location, socio-economic status, place of birth and attitude towards assisted dying. The jury members came together over 10 online sessions to examine evidence, hear from expert witnesses and consider the central question "Should assisted dying be permitted in Jersey and if so, under what circumstances?".
6. At the end of the jury process, 78% of jury members agreed that assisted dying should be permitted in Jersey.[28]

Note: Citizen's deliberation processes

The use of citizen's deliberation processes, such as a jury, was relatively new to Jersey and, as such, some Assembly members raised questions about the process during the P.95/2021 debate. The Public Accounts Committee subsequently reviewed the use and effectiveness of such processes and concluded that the Jersey Citizens' Jury on Assisted Dying should be utilised as the model of best practice when establishing future deliberative bodies. [29]

Following Jersey's Citizen's Jury on assisted dying, a Citizen's Assembly on end-of-life matters, including assisted dying was held in France in 2022/23 [30]and a Citizen's Jury on assisted dying took place in England in 2024. [31]