Assisted dying is to become legal on the Isle of Man after the island's landmark legislation received Royal Assent, capping a legislative journey of more than two years and making the island the second part of the British Isles to take the step.

The announcement was made at the start of Tuesday's sitting of Tynwald by its president, Juan Watterson, and confirmed in BBC reporting. The move was immediately described by campaigners as "historic" — though the island's doctors remain firmly opposed, and no assisted death will take place until the health service is ready.

A first for a British parliament

Tynwald passed the Assisted Dying Bill in March 2025, making it the first parliament in the United Kingdom or the Crown Dependencies to approve such legislation. But the bill then spent more than 18 months in constitutional limbo after the UK's Ministry of Justice said it could not recommend the proposals for Royal Assent, citing concerns over safeguards, monitoring and the island's capacity to deliver the service safely.

That intervention forced the bill's mover, former Ramsey MHK Alex Allinson, back to the drawing board. He brought forward a series of changes designed to address the concerns, tightening eligibility and oversight provisions until the objections were resolved. The Isle of Man government and Tynwald have published the evolving drafts throughout the process.

The delay frustrated supporters but, its backers argue, ultimately produced a more robust law. Dr Allinson said the announcement of Royal Assent "marks an important step forward for our Island," while stressing that "there is considerable further work to be done to draw up codes of practice and guidelines with healthcare professionals and provide holistic education and support for all those involved."

Douglas promenade, Isle of Man

Image: Peter Beaven via Wikimedia Commons (CC BY-SA 2.0)

Who will be eligible

The Act sets some of the strictest eligibility criteria seen in assisted dying legislation anywhere in the world. To qualify, a person must be an adult who has been resident on the Isle of Man for five or more years — a provision designed to prevent the island becoming a destination for so-called "suicide tourism."

They must also have a terminal illness and be expected to die within 12 months, and must demonstrate a clear and settled intention to end their own life. The process involves strict assessments, medical oversight and an independent review after death.

Crucially, the service will not begin the moment the law takes effect. Dr Allinson and the island's health authorities have been explicit: assisted dying will only be offered once the island is ready, with capacity legislation expected by April 2028. Before then, codes of practice must be drawn up with clinicians, and education and support put in place for everyone involved — doctors, nurses, pharmacists and families.

Dr Allinson also used his statement to underline that choice at the end of life must sit alongside better care: "Key to improving choice and dignity for those facing a terminal illness is investment in palliative care and expanding the choices available for the people of our Island and their families."

Celebration — and fierce opposition

The reaction, captured by Manx Radio, split sharply between jubilation and alarm. Sarah Wootton, chief executive of the UK charity Dignity in Dying, called it "a historic and deeply emotional day for the Isle of Man and above all for the families who made it happen," adding: "Dying Manx people now have the reassurance that, if their suffering becomes unbearable, they will not be abandoned to pain, fear or desperate alternatives."

Campaigner Sue Biggerstaff, who has spoken publicly about watching her husband Simon die of motor neurone disease, said he would have been eligible under the new law: "It's too late for him, but it isn't too late for the next family. Knowing that no one else on this island will be forced to go through what Simon went through means everything to me."

On the other side, the Isle of Man Medical Society maintained what it called its "firm and steadfast position regarding the profound risks this legislation poses to healthcare, vulnerable patients, and the medical profession across the Island." The society said 74 percent of doctors on the island oppose assisted dying, and vowed to continue advocating for "compassionate, life-affirming care."

The division mirrors the fierce debate seen at Westminster, where a landmark bid to legalise assisted dying in England and Wales was halted by a parliamentary vote in September — leaving people in England and Wales, for now, with no legal choice at the end of life. The ethical fault lines are familiar from other end-of-life controversies, including the German case that shocked Europe, and they run through questions of trust, vulnerability and the proper limits of medicine.

What happens across the British Isles now

With Royal Assent granted, the Isle of Man becomes the second part of the British Isles to pass assisted dying legislation, after Jersey's bill gained Royal Assent earlier this year (Jersey's government has published its own implementation timetable). The contrast with the rest of the UK is now stark: Scotland's parliament is still considering its own bill, while Westminster's attempt collapsed last month.

For supporters, the Manx law is a working model — proof that a small jurisdiction can design rigorous safeguards and get them past constitutional scrutiny. For opponents, the 74 percent of Manx doctors in opposition is a warning that legislation imposed over the objections of the medical profession risks damaging trust in healthcare itself.

The next milestones are practical rather than political: the codes of practice, the training of staff, the capacity legislation due by April 2028. Only then will the first terminally ill Manx resident be able to make the choice the Act now promises. As Verity's politics desk has noted throughout this saga, the hardest part of assisted dying law is not passing it — it is building a system the public, patients and doctors can all trust.

More on this developing story at veritynewspaper.com and in our news section.