Updated 2025
Please note, this Topic Guide should be the starting point of your research. You are encouraged to conduct your own independent research to supplement your argument.
INTRODUCTION
Physician-assisted dying is a term encompassing both assisted suicide and euthanasia. Assisted suicide is the practice of allowing doctors to prescribe life-ending drugs to be administered by individuals who want to die to avoid further suffering. Euthanasia is where someone else – usually a doctor – administers the lethal drug.
The past few decades have seen an international trend of legalising this practice, sometimes for just the terminally ill, sometimes the chronically ill, and sometimes even people whose body is healthy but whose mental illness is so extreme that their suffering is thought to justify the procedure. As this has happened in several liberal societies, many questions have been raised. Can someone ever rationally justify taking their own life, or is it a simple, reasonable choice to make for those who are suffering? What are the wider implications for a society that accepts that sometimes life isn’t worth living? Does the medical profession suffer when the role of the doctor is extended from life-preserver to include life-taker, or is it better that the option to die is put into the hands of professionals?
DEBATE IN CONTEXT
This section provides a summary of the key issues in the debate, set in the context of recent discussions and the competing positions that have been adopted.
Since it was first legalised in Oregon in 1997 [Ref: Guardian], there has been a trend towards legalisation across the liberal world. Since then, other countries, including Belgium, Australia, Switzerland, the Netherlands, Spain and New Zealand [Ref: The Week], have legalised the practice to varying degrees. In Canada, assisted dying now accounts for one in 20 deaths, having increased every year since its introduction in 2016, increasing by 31% year-on-year. [Ref: BBC News]. In November 2024, UK MPs debated on whether to pass a bill similar to the Canadian legislation, which would allow adults in England and Wales the right to have an assisted death. The Terminally Ill Adults (End of Life) Bill will now be further debated in Parliament – a third reading is scheduled for April 2025 – before it could become law [Ref: UK Parliament].
This is not the first attempt at a nationwide legalisation of the practice in the UK. In 2014, Lord Faulkner put forward the Assisted Dying Bill, which passed its first reading in the House of Lords [Ref: BBC] but failed to make it into law. In 2015, a similar bill introduced by MP Rob Maris was defeated in the House of Commons after four hours of debate [Ref: BMJ]. Most recently, in May 2021, Baroness Meacher introduced an Assisted Dying Bill into the House of Lords, but it did not proceed after the end of the session [Ref: House of Lords Library].
There is evidence to show that the UK public now support assisted dying to a greater extent than they once did. Although survey data varies, it is estimated that around 63%-74% of the public think terminally ill adults should be allowed to make that choice [Ref: KCL, YouGov], with one campaign group finding up to 84% of the public are in favour [Ref: Dignity in Dying]. In addition, it is thought that over half of doctors are unopposed to a law change on assisted dying [Ref:BMA], whilst amongst British MPs, 330 of 605 voted in favour of a change in the law in November 2024.
However, concerns have been raised about whether those MPs had sufficient time to scrutinise the proposed law, with Britain’s longest-serving MPs – Labour’s Diane Abbott and the Conservative Sir Edward Leigh – issuing a joint warning in which they argue they have not [Ref: Guardian]. Moreover, a recent poll found that the majority of the public agreed that the Bill had been rushed [Ref: Sky News].
With opinion divided across the country on the issue itself, many have called for a wider, public debate. So, is it time for Assisted Dying to be made legal in the United Kingdom?
Is a life ever not worth living?
The central argument of those in favour of legal assisted dying is that people who are suffering unbearably deserve the choice to shorten their suffering. In many people’s eyes, a life with the guarantee that already-unbearable suffering will get worse is not worth living. For many people, it is humane, therefore, to allow people to choose a time to leave the world, and even that it is degrading to disallow it. Most of these people are going to die soon and to force them to live a little longer is to simply subject them to further torture.
Assisted-dying campaigner and television presenter Esther Rantzen told the BBC: ‘The thing that motivates me greatly is having watched the deaths of loved ones around me and seen how memories of a bad death obliterate happy memories and become very painful for those involved.’ [Ref: BBC News]
Defenders of assisted dying argue this is an extension of the liberal ideal of bodily autonomy. In our society, we value the freedom to choose what we do with our bodies during life, so why should we suddenly lose this freedom when it comes to choosing a better death? Even some religious figures back assisted suicide. The late Archbishop Desmond Tutu argued a change in the law would recognise the right of individuals to have ‘autonomy and dignity’ in death [Ref: Guardian]. And, more recently, George Carey, the former archbishop of Canterbury, urged bishops in the House of Lords to back the latest bill on assisted dying, saying they should ‘be on the side of those who … want a dignified, compassionate end to their lives’. [Ref: Guardian]
However, critics maintain that the growing legalisation of assisted dying is part of a more general trend towards the devaluing of human life. Professor Kevin Yuill argues the case for assisted dying is based on unfounded fears about dying, that it will undermine society’s efforts against suicide, and that it is morally wrong. ‘If we are to place value on even the most wretched of human lives – an important marker of civilisation – neither the death penalty nor assisted suicide can be justified.’ [Ref: Independent]
In criticising the idea of assisted suicide, Katie Breckenridge also argues ‘in a just society, every human being is expected to believe (and it is just a belief) that all others have basic, inherent, and absolutely equal value and worth’ [Ref: Scotsman]. Breckenridge argues that assisted suicide is an attack on this idea and pushes the belief that people who need help to ease their suffering are of less moral worth in our society and should therefore be allowed to die. She argues that justice and equality cannot exist when we hold the view that certain individuals have lives that should be ended.
Impaired judgement and the pressure not to be a burden
Breckenridge’s point leads us onto one of the biggest fears of those against assisted dying: the fear that severely ill individuals will either lack the mental capacity to make a reasoned choice or be pressurised into killing themselves, so as not to inconvenience those immediately around them and wider society in general.
A complicating factor of this is that, while obviously cruel and forthright pressure from relatives can be spotted, the terminally ill with the legal option to die might impose this pressure on themselves. Journalist Giles Fraser, in a recent ‘open letter’ to his mum, outlines why he is against assisted dying, even though his mum wants him to take her to Dignitas. ‘What does it say about our attitude towards the value of human life that we subject it to a cost-benefit analysis in this way… [there] is an assumption that if you are old, or suffering, or mentally distressed or disabled, your life is somehow of lesser value’ [Ref: Mail Online]. Fraser has previously argued that the legislative endorsement of assisted dying puts pressure on people who would have otherwise lived out and made the most of the rest of their lives. [Ref: The Guardian]
But those defending assisted suicide argue that not wanting to put one’s own family and friends through the trauma of witnessing a prolonged, painful and possibly graphic death can be a valid contributing reason in a dying person’s decision to seek assisted suicide [Ref:Express]. They further point out that, in countries where it is legal, there are already many safeguards in place to stop exploitation. Moreover, how do we decide the validity of someone’s private, reasoned decisions? People make sacrifices for their family and friends all the time so it could be argued that it is condescending to object to this particular sacrifice.
Columnist Matthew Parris is explicit in seeing assisted dying as a good thing for society: ‘[H]ow are our economies going to pay for the ruinously expensive overhang that dare not speak its name: old age and infirmity? It may sound brutal, but I don’t apologise for the reductivist tone in which this column treats human beings as units — in deficit or surplus to the collective.’ [Ref: The Times]
In fact, advocates argue, the pain of putting loved ones through this distress can be seen as an addition to the individual’s existing pain. By choosing assisted suicide, someone is not only escaping the pain of their body, but also their mind. As long as safeguards are in place to stop clear external pressure and guilt tripping, many argue there is no reason to ban the practice on the grounds that people will choose it for their own reasons.
The extent to which safeguards are effective is disputed, however. For example, in the Netherlands, one in five of those euthanised (note this is not assisted suicide) have not given explicit consent. In Belgium, involuntary euthanasia is at a rate three times higher than in the Netherlands [Ref: USA National Library of Medicine]. However, defenders of assisted suicide can argue that examples of poor implementation are not an argument against a principle and, even so, these rates are due to the deaths of people in comas and inescapable, near-vegetative states.
Another consideration, argued by both sides of this debate, is how the legalisation of assisted dying might affect palliative care. Those in favour point to evidence that it would enhance palliative care [Ref: Humanists UK], whilst those against argue that if the option to terminate a life is introduced, this will inevitably lead to a decrease in the quality and availability of palliative care options and could lead to a breakdown in the trust between doctors and the public [Ref: BMA].
A slippery slope?
Although perhaps up to 84% of the public think the law should be changed to allow assisted suicide for the terminally ill [Ref: Dignity in Dying], critics of the idea fear it will lead to further relaxation of the law. These people point to the expansion of the practice of assisted dying to the chronically ill and even the depressed, once it has been made legal for the terminally ill [Ref: Al Jazeera].
Adding to this, some worry about the expansion of assisted suicide to children, a group not given the right to make such big personal decisions in other areas of the law. Belgium and the Netherlands are often cited as evidence of this, with the Netherlands planning to legalise euthanasia for children under 12 [Ref: BBC] and Belgium having controversially allowed depressed but physically healthy people to access assisted suicide [Ref: Daily Mail]. Canada has announced plans to allow assisted dying for people suffering only from mental illness from March 2024 [Ref: BBC], although the introduction has been put back to 2027 [Ref: BBC News].
Rather than calling it a slippery slope, Professor Yuill thinks of assisted suicide as a ‘moral Rubicon’ [Ref: The Independent]. From his perspective, the moral line has already been crossed when we allow assisted suicide at all. He argues that once any form of assisted dying is considered as medical treatment for unbearable suffering, it is difficult to deny it to others who suffer unbearably from other causes. Sociologist Ashley Frawley argues this is a deliberate ‘foot in the door’ strategy by activists, who start by getting agreement for limited use of assisted dying, then push for its expansion. [Ref: X.com]
But defenders of physician-assisted suicide push back against this. Journalist and Parkinson’s sufferer, Mark Meecher, argues that those making the ‘slippery slope’ argument ‘are skating downhill on thin ice – for most it is an excuse to shelter behind, while keeping their real, religious, objections hidden’. [Ref: Prospect Magazine]
In the House of Lords
This section of the topic guide has been produced with the support of the House of Lords communications team in conjunction with Debating Matters at the House of Lords. All students may find the material useful.
The subject of assisted dying has been debated multiple times in the House of Lords, with the first mention in Hansard being a 1936 Private Member’s Bill by Lord Ponsonby of Shulbrede. It was last debated at a second reading of a bill put forward by Baroness Meacher in October 2021, with a speakers list of 140 members.
The Private Member’s Bill (PMB) in the name of Kim Leadbeater MP, which passed its second reading stage in the Commons last month, will come to the Lords should it complete its journey through the Commons.
It is worth noting that the first broadcast from the House of Lords chamber on 23 January 1985 included a debate on euthanasia.
Please see the House of Lords section below for examples of when Assisted Dying has been discussed in the chamber, as well as a selection of committee reports.
So, bearing in mind the arguments for and against, would legalising assisted dying fundamentally change the way in which society views death and dying, and does this have negative repercussions for vulnerable groups such as the elderly and disabled? Or is it an important step in recognising the autonomy of the individual, because: ‘any meaningful right to life entails the right to choose how we die’? [Ref: Guardian]
ESSENTIAL READING
It is crucial for debaters to have read the articles in this section, which provide essential information and arguments for and against the debate motion. Students will be expected to have additional evidence and examples derived from independent research, but they can expect to be criticised if they lack a basic familiarity with the issues raised in the essential reading.
FOR
‘My diagnosis has changed my mind on assisted dying’
Kate Berry & Kirsty Jones BBC 1 February 2025
Former archbishop of Canterbury urges C of E bishops in Lords to back assisted dying bill
Harriet Sherwood The Guardian 18 October 2024
David Cameron: Why I’m now backing assisted dying
David Cameron The Times 27 November 2024
Assisted dying: ‘I don’t have quality of life anymore’ Man with terminal cancer calls for law change
ITV 6 March 2023
Today, 17 people will likely die in unimaginable pain. Here’s how you can help stop that
Polly Toynbee The Guardian 19 January 2023
AGAINST
I’m disabled. Here’s why I am scared of the assisted dying bill
Merry Cross Open Democracy 20 November 2024
‘We’re not the national death service’: Inside NHS concerns over assisted dying
Eleanor Langford & Paul Gallagher iNews 28 November 2024
UK’s longest-serving MPs issue joint plea for Commons to reject assisted dying bill
Jessica Elgot and Peter Walker The Guardian 20 November 2024
‘Assisted dying’: why we need to kill the bill
Kevin Yuill Spiked 30 December 2024
The Committee to scrutinise the Assisted Dying Bill seems bent on avoiding real scrutiny
Nikki da Costa Conservative Home 23 January 2025
IN THE NEWS
Assisted Dying would be free and provided by the NHS, supporters say
Hanna Geissler Express 4 March 2025
Legalising assisted dying in England and Wales ‘may hamper suicide prevention work’
Jessica Elgot The Guardian 21 February 2025
Assisted dying: what (the hell) is going on in Parliament?
Mo Lovatt Academy of Ideas Substack 13 February 2025
MP who proposed assisted dying bill defends changing who gives final approval
Sky News 11 February 2025
Cross-party MPs in move to allow assisted dying at 12 months left for those with neurodegenerative illnesses
Humanists UK 6 February 2025
Assisted dying now accounts for one in 20 Canada deaths
Nadine Yousif BBC 12 December 2024
Questions of life and death are complex and messy. Let’s admit the assisted dying debate is too
Frances Ryan The Guardian 29 November 2024
Assisted Dying: where next for the UK?
Patricia Haitink & Emily Jackson LSE Blogs 13 September 2024
I’m glad the debate on assisted dying is forging ahead. But few understand why it frightens so many
Frances Ryan The Guardian 29 February 2024
‘I’ll take you to Dignitas as you wish but I still fear assisted dying could open up a Pandora’s box of nastiness’: A heartfelt open letter by Moral Maze panellist the Rev GILES FRASER
Reverend Giles Fraser Mail Online 28 January 2024
If every human life is of equal value, why promote assisted suicide?
Katie Breckenridge The Scotsman 9 March 2023
How euthanasia has revived the death penalty
Kevin Yuill spiked 8 March 2023
IN DEPTH
Assisted dying: two-thirds of public back legalisation within this Parliament, study finds
King’s College London 11 October 2024
Physician-assisted dying survey
BMA 18 September 2024
The Assisted Dying Bill: A guide to the Private Member’s Bill processMatthew England & Dr Ruth Fox Hansard Society 27 November 2024
Assisted dying/assisted suicide Inquiry
UK Parliament
The Assisted Dying Inquiry Report | Everything you need to know
Humanists UK 7 March 2024
Assisted dying inquiry must lead to Government action says poll
Dignity in Dying 19 January 2023
The liberal, humanist case against assisted dying
Kevin Yuill spiked 25 March 2022
Humanists UK calls for a compassionate assisted dying law across the UK and Crown Dependencies
Humanists UK 6 February 2023
WATCH/LISTEN
Assisted dying on the NHS?
Battle of Ideas Festival 2024
Better off dead?
Liz Carr BBC/YouTube 14 May 2024
How should we talk about suicide?
BBC Moral Maze 24 May 2023
Prue and Danny’s Death Road Trip
Channel 4 16 February 2023
The expansion of assisted suicide in Canada
Al Jazeera 30 November 2022
Exploring the moral quandaries of Canada’s assisted dying law
CNN 27 February 2023
IN THE HOUSE OF LORDS
Voluntary Euthanasia (Legalisation) Bill Hl
Hansard report on euthanasia 1 December 1936
Voluntary Euthanasia Bill Hl
Hansard report on euthanasia 25 March 1969
Euthanasia – Hansard – UK Parliament
Hansard report – first broadcast from the House 23 January 1985
Euthanasia
Hansard report on euthanasia 6 May 1998
Assisted Dying Bill [HL] – House of Lords Library
Library briefing ahead of the second reading of Baroness Meacher’s bill 8 October 21
The Terminally Ill Adults (End of Life) Bill 2024-25 – House of Commons Library
Research Briefing 22 November 2024
The law on assisted suicide – House of Commons Library
Research Briefing 25 April 2024
Assisted Dying for Terminally Ill Adults Bill [HL] – Parliamentary Bills – UK Parliament
Private Members’ Bill 21 October 2024
OLDER ARTICLES
Slippery Slope or Wise Demise? The pros and cons Of Medically Assisted Dying
Avivah Wittenberg-Cox Forbes 1 November 2022
An evidence-based approach to Assisted Dying
Stephen Matthews King’s College London 11 May 2022
20 years of euthanasia in Belgium
ADF International 25 May 2022
Genevieve Lhermitte: Belgian mother who killed her five children euthanised
Jeremy Gahagan BBC News 3 March 2023
Dying for a change? How a 23-year-old Belgian woman’s decision to end her own life… triggered a scandal in global assisted suicide capital
Sue Reid Daily Mail 17 October 2022
Netherlands backs euthanasia for terminally ill children under-12
BBC News 14 October 2020
One in four Canadians supports euthanasia on grounds of poverty
James Billot UnHerd 9 May 2023