Assisted Dying Bill: Health minister writes to MHKs as Ministry of Justice holds legislation under review

Ministry of Justice requests clarity on post-death reviews and capacity protections

The Health and Social Care Minister has written to all Members of the House of Keys outlining progress on discussions with the UK Ministry of Justice over the Isle of Man’s Assisted Dying Bill, including further detail on safeguards, oversight, and human rights compliance required before Royal Assent can be granted.

Health Minister Claire Christian has written to all Members of the House of Keys setting out the latest position following discussion between the Manx government and UK’s Ministry of Justice, after the Bill was submitted for policy assurance as part of the Royal Assent process.

In her letter, Ms Christian explains that the Ministry of Justice sought additional reassurance on two human rights issues: the operation of post-death reviews in assisted dying cases, and the robustness of safeguards against coercion.

These requests were made with reference to the European Court of Human Rights judgment in Mortier v Belgium, which examined deficiencies in oversight arrangements where no pre-death review exists.

The Department of Health and Social Care confirmed that a compulsory review would be required in every assisted death. While the detailed procedures are not set out on the face of the Bill, the minister says this was intentional, allowing time after Royal Assent for consultation and development of independent review mechanisms before the Act is brought into force.

The letter states that independence could be secured through statutory mechanisms, including but not limited to those available under the Safeguarding Act 2018. Reviews would examine statutory declarations, medical records, and compliance with all safeguards. Monitoring arrangements would include annual reporting to Tynwald, corrective action where failures are identified, and sanctions for non-compliance, potentially including regulatory referral or criminal liability.

Furthermore, DHSC outlined plans to strengthen the Capacity Act and related clinical protections.

Proposed measures include clearer statutory rules on capacity assessments in assisted dying cases, structured assessments to identify coercion or undue influence, and mandatory training for professionals involved in the process.

Drafting of amendments and regulations would begin only after Royal Assent, with no commencement order made until all safeguards are in place.

The minister also clarified that earlier correspondence may have been misinterpreted as committing to the Safeguarding Board as the sole oversight body. She says this was not the intention, and that a range of potential models remain under consideration, including the possible creation of a new independent body through legislation.

According to the letter, the Department has since written again to the Ministry of Justice to clarify this point, and has also discussed the issue with the mover of the Bill to ensure alignment.

Ms Christian stresses that, should Royal Assent be granted, the Act will not be commenced until all secondary legislation and the Code of Practice have been developed, consulted upon, and approved by Tynwald. She notes that DHSC is legally obliged under section six of the Human Rights Act 2001 to ensure compatibility with Convention rights, including Articles 2, 3, 6, 8 and 14.

Minister Christian says the next step is for the Ministry of Justice to finalise its submission to the Lord Chancellor.

Once that advice is issued, the Isle of Man Government expects to receive an indication of when the Lord Chancellor’s advice to His Excellency will conclude this stage of the Royal Assent process.

Chief Minister Alfred Cannan claimed the fundamental concerns raised by the MoJ related to human rights issues, but insists the UK body cannot alter Manx legislation, and does not believe it to be connected to the UK's assisted dying legislation "in any way".

Mover of the Bill - Ramsey MHK Alex Allinson - told the House it is not uncommon for the Ministry of Justice to request additional clarification. However, other backbenchers questioned whether it was usual for it to take this long.