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Islanders will have the legal right to end their lives in certain defined circumstances following a landmark vote in the States yesterday – but how did we get to this point?
Express has broken down the key events in the run-up to the debate when details of proposed legislation were considered by politicians...
Politicians yesterday voted 31 to 15 in favour of setting up an assisted dying service in Jersey for islanders with terminal illnesses and neurodegenerative diseases.
Now, there is expected to be a further 18-month implementation period, meaning the earliest the law could come into effect will be spring or summer 2027.
The service will be open to people with a terminal illness with a life expectancy of six months, or 12 months if they have a neurodegenerative disease (known as Route One).
But someone with an incurable physical condition which might not be terminal but is causing them unbearable suffering (known as Route Two) will not be eligible, after States Members rejected this part of the proposition, with 19 in favour and 27 against.
Health professionals will be able to opt-out, giving them a right to refuse to participate.
There will also be minimum time-frames between the first formal request for an assisted death and the act itself – 14 days.
Video: The vote took place in the States Assembly on Wednesday afternoon, following a debate that opened on Tuesday.
The approved proposal is similar to assisted dying laws in Australia, New Zealand and several US States, where only terminally ill adults deemed to have clear mental capacity are eligible.
Express has compiled a timeline of all the key events in the run-up to the debate...
May 2018: An Express poll showed very strong support for allowing doctors to help terminally ill patients 'die with dignity'. More than 1,000 islanders chose to take part in the poll, with 90.6% (954 islanders) stating that they would support assisted dying proposals in Jersey.
2018: Politicians in Guernsey voted against assisted dying.
March 2021: The Jersey Assisted Dying Citizens' Jury was formed of 23 randomly selected islanders who were demographically representative of the island's population.
April 2021: In a letter to Express penned prior to his time in politics, Health Minister Tom Binet said that "principle of self-determination should lie at the heart of the current debate".
He added: "Following considerable progress in recent years for LGBTQ and other personal rights, let us hope that the current process sees Jersey establish itself as a compassionate, courageous, forward-looking place that understands the need for this long overdue legislation."
Before joining the political fray in June 2022, Deputy Binet campaigned prominently in favour of assisted dying, chairing the lobby group End of Life Choices Jersey.
May 2021: Assisted dying campaigner Alain Du Chemin died aged 50 after a year-and-a-half battle with terminal glioblastoma, a particularly aggressive brain tumour.
Knowing that death from this tumour could be both painful and undignified, Mr Du Chemin booked a place at Dignitas in Switzerland to end his life on his own terms but passed away peacefully at Jersey Hospice.
Before his death, he shared his story with the national and local media to add to the debate about assisted dying, and made a submission to a citizens’ jury in Jersey set up to make a proposal to the States about its possible legalisation in the island.
Mr Du Chemin also wrote an open letter to politicians urging them to “do the right thing” when they consider the jury’s submission.
June 2021: The Citizens' Jury voted by a majority of nearly 80% to recommend that Jersey should permit assisted dying, so long as stringent safeguards were in place.
November 2021: The States Assembly became the first parliament in the British Isles to decide 'in principle' that assisted dying should be allowed and to make arrangements for an assisted dying service.
March-April 2022: Islanders were invited to take part in the first phase of public engagement on assisted dying proposals, where they shared their hopes, thoughts, and concerns through several channels, both online and in-person.
May 2022: A public engagement summary report was published in May 2022. The report found participants focused on the "wider ethical and moral issues", the implications of providing an assisted dying service on the island and personal accounts on the topic of death and assisted dying.
October 2022 to January 2023: The public engagement report identified the key themes from the first phase of engagement, which informed the development of detailed proposals which were the focus of phase two of the public consultation.
The detailed proposals developed after phase one included plans for residency requirements which aim to alleviate fears of Jersey becoming a destination for assisted dying ‘tourism’.
The proposals also suggest that any healthcare professionals who are involved in the assisted dying process must actively ‘opt-in’ and will not be forced to take part.
It also suggested that healthcare professionals should undergo specific training and be offered psychological support.
The survey also focused on gaining insight into islanders' opinions on the nine steps in the assisted dying process, the timeline proposed for them, the appeals process, and the lack of an expiry date.
Almost 1,400 islanders submitted a range of "mixed" opinions on the topic.
28 April 2023: Feedback from the consultation feedback report was published to inform the final set of proposals.
The report, for example, highlighted the challenges perceived by respondents in relation to predicting life expectancy for persons with a terminal illness.
It also found mixed responses to the consultation about the inclusion of "unbearable suffering" in the eligibility criteria.
Islanders were broadly supportive of a multi-agency approach to patient requests for an assisted death.
Many did not believe the role of ‘assisted dying practitioner’ would be suitable for newly-qualified doctors and said that five or 10 years of experience should be required.
The report also read: “Nearly half of the public written responses opposed to assisted dying expressed concern that the eligibility criteria and any safeguards set out in law would ‘erode’ over time.”
7 November 2023: The Assisted Dying in Jersey Ethical Review was published to identify and summarise ethical arguments on key aspects of assisted dying across the Jersey-specific proposals set out in the second phase of the public consultation.
The review said that making assisted dying available to those with incurable conditions causing unbearable suffering “raised significant concerns”, citing an “ableist” judgment about the negative value of the lives of people with disabilities and difficulties around the assessment and definition of suffering.
March 2024: Jersey's progress toward assisted dying legislation was supported by groups in the UK.
Sarah Wootton, CEO of the campaign group Dignity in Dying, praised Jersey for its leadership in this area.
She said: "Jersey should be applauded for its leadership on assisted dying; for listening to its citizens and to dying people and their loved ones and taking steps towards a law to be proud of."
Broadcaster Esther Rantzen, who has also been a prominent campaigner for the rights of individuals to end their lives and is a regular visitor to the island, also commended Jersey's progress on the issue.
This came after she revealed her decision to join the Swiss assisted-dying organisation Dignitas following her stage four lung cancer diagnosis.
18 April 2024: In a column for Express, family doctor and former chair of the island's Primary Care Body, Dr Nigel Minihanhe criticised some individuals within the medical profession for perpetuating what he described as "misconceptions".
10 May 2024: A group of healthcare workers called Our Duty of Care Jersey sent an open letter to the Health Minister signed by 84 medical professionals.
Here, the group expressed "grave concerns" about the proposed law and what they described as "serious consequences".
The letter, composed by Dr Andreas Melchior and Dr Helen Thomas, said there hadn't been enough consultation with long-term care professionals. The letter also expressed concerns about a potential lack of safeguards and robust governance systems.
15 May 2024: Members of a Scrutiny panel reviewing the proposals to introduce assisted dying in Jersey expressed concerns about some elements of the plans.
The Assisted Dying Review Panel, chaired by Deputy Louise Doublet, called for the Health Minister to provide more details in a report.
Scrutineers also called for a palliative care plan and training to prevent instances of coercion in the report.
It also called on the Health Minister to "ensure that the Jersey Assisted Dying Service is not headquartered within the Jersey General Hospital".
9 May 2024: An additional consultation with 38 people from the public and disability charities recommended by the Jersey Ethical Review was published.
Respondents were largely in support of assisted dying for those with unbearable suffering who were terminally ill.
However, they were divided equally on whether it should also be available to those with incurable conditions.
Those opposed were concerned about the subjective nature of suffering in cases where a person was not nearing the end of their life, the perceived risk of coercion, the possible adverse impact on medical professionals and the fostering of negative attitudes to disability.
May 2024: Jersey Hospice Care CEO Mike Palfreman confirmed to Express that the charity would support Hospice patients who might choose the assisted dying route, but wouldn’t be delivering it on-site.
“If the legislation is passed, we will continue to offer that palliative care even to those who may choose assisted dying," he said.
"But what we will not be doing it is delivering it within Hospice."
20 May 2024: Local polling company Island Global Research revealed the results of a poll commissioned by Dignity in Dying, which found 61% of islanders supported legalising assisted dying.
A total of 51% of respondents strongly supported reform and 10% somewhat supported reform after being asked their views on changing the law to allow mentally competent and terminally ill adult residents the option of assisted dying
21 May 2024: Scheduled date for debate on assisted dying proposals by the States Assembly.
22 May 2024: The debate on assisted dying proposals opened with a lengthy discussion in which the stories of numerous islanders with terminal and life-limiting conditions were shared.
Politicians eventually voted in favour of setting up an assisted dying service in Jersey for islanders with terminal illnesses and neurodegenerative diseases, following a landmark vote in the States Assembly.
However, politicians did not approve making those with incurable conditions causing them "unbearable suffering" eligible to choose when to end their lives.
The vote was split into five separate parts:
1. Establishing an assisted dying service for adult residents who have made a voluntary and informed decision to die: 31 votes pour, 15 contre, 0 abstentions.
2. Limiting eligibility to people with a terminal illness with a life expectancy of six months, or 12 months if they have a neurodegenerative disease (known as Route One): 32 pour, 14 contre, 0 abstentions.
3. The service being open to someone with an incurable physical condition which might not be terminal but is causing them unbearable suffering (known as Route Two): 19 pour, 27 contre.
4. An opt-out for health professionals, giving them a right to refuse to participate in assisted dying: 45 pour, 1 contre (Constable of St Ouen, Richard Honeycombe).
5. Minimum timeframes between the first formal request for an assisted death and the act itself – 14 days for route one and 90 days under Route Two: 44 pour, 1 contre (Deputy Barbara Ward), 1 abstention (Deputy Raluca Kovacs).
Summer 2027: The earliest date the law would come into effect.
It is expected the process for drafting a law could take around 18 months, with a debate then taking place by the end of 2025.
If a law is approved, it is expected a further 18-month implementation period will then begin, meaning the earliest for it to come into effect would be summer 2027.
During this time, some of the specifics of how the service would operate would need to be worked out – and this includes where it would operate from.
Deputy Binet has agreed with Scrutiny politicians that the General Hospital should be a "last resort" for assisted dying, but declined to fully rule out the idea of it being an Assisted Dying Service headquarters.
Jersey Hospice has also been clear that it would not provide such a service on-site.
EXPLAINED: Everything you need to know about the big assisted dying debate (May 2024)
FOCUS: "People have a reluctance to talk about death – no matter how that takes place" (May 2024)
Scrutineers share concerns ahead of assisted dying debate (May 2024)
Split views on assisted dying for those with unbearable suffering (May 2024)
Campaign group steps up lobbying ahead of assisted dying debate (April 2024)
Concern that doctors are propagating "misconceptions" about assisted dying (April 2024)
UK select committee focuses on Jersey's assisted dying move (March 2024)
Assisted dying proposals vote scheduled for May (February 2024)
Assisted dying proposals delayed to avoid end-of-year rush (October 2023)
Health Minister pledges to put forward assisted dying plan by end of year (April 2023)
Gov needs more time to consider public feedback on assisted dying (February 2023)
EXPLAINED: How assisted dying is proposed to work in Jersey (January 2023)
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