Updated 2026
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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 now there are even efforts to extend this to people whose body is healthy but whose mental health is so distressed that they wish to end their life. As the increased legalisation 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? What does the legalisation of assisted dying tell us about how we view and value palliative care today?
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 others, such as Germany, it has been decriminalised. In Canada, assisted dying now accounts for one in 20 deaths, having increased every year since its introduction in 2016, increasing by 31 per cent 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 was not passed before the end of the parliamentary session and it remains to be seen whether it comes back in the next one. [Ref: UK Parliament].
In Germany, the federal constitutional court decriminalised assisted dying in 2020 [Ref: The Spectator]. The court ruled that an individual’s autonomy is the overriding concern when deciding whether someone should be able to end their lives. However, in the past six years there have been several cases where patients’ free will in this decision has been contested, highlighting the difficulty of drawing the line between assisted dying and euthanasia. Debates around euthanasia remain particularly sensitive in Germany due to the murder 300,000 people with mental and physical disabilities under the Nazi regime [Ref: BBC News].
Assisted dying has been legal in Belgium since 2002, and allowed in Switzerland since 1942 [Ref: Dignity in Dying], so some argue that Germans have always had access to medically assisted death through ‘assisted dying tourism’. Between 2001 and 2020, an average of 68 Germans went to Switzerland for assisted dying each year. With this in mind, is it better that the German government allows those seeking the procedure to have it closer to home?
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 simply to 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. George Carey, the former Archbishop of Canterbury (the spiritual leader of the Church of England) 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. Philosopher Kathleen Stock argues that the acceptance of assisted dying comes from the loss of Christian values, as we move towards an increasingly secular society we don’t only lose the idea that life is sacred, but also that life is special. [Ref: YouTube]. 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.’
Noelia Castillo Ramos, a 25-year-old Spanish woman, died by euthanasia in the spring of 2026, which was granted due to her paraplegic disability, but ultimately due to her poor mental health [Ref: Spiked]. After suffering from a fractured family and being subjected to a horrific gang rape in 2022, many see her death not caused by her ‘chronic pain’ but by the poor care and mental anguish that she experienced. Her proposition, rooted in her belief that she had the right to a painless death, and her autonomy in ending her life, didn’t convince many of the Spanish public. But with the legalisation of assisted death, there were no institutional safeguards to protect her [Ref: European Conservative].
Impaired judgement and the pressure not to be a burden
One of the biggest fears of those against assisted dying is that severely ill individuals will either lack the mental capacity to make a reasoned choice or be pressured into killing themselves, so as not to inconvenience those immediately around them or 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 and Anglican priest 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?’ [Ref: The Times] And as we are heading towards a demographic crisis across Europe, with countries having to rely on fewer workers to support an increasing elderly population, the cost of old-age care is likely to carry on rising [ref: bruegel].
In fact, advocates argue that 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, they can therefore escape both the pain in their body and their mind. As long as safeguards are in place to stop clear external pressure and guilt tripping, advocates see no reason to ban the practice on the grounds that people will choose it for their own reasons, despite the potential external pressure.
The extent to which these safeguards are effective is disputed. 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 as it gives patients compassion and choice at the end of their lives [Ref: Humanists UK]. Those against argue that if the option to terminate a life is introduced, it 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]. This is particularly concerning as across the EU, palliative care is increasingly strained, evidenced by the case of a German palliative care nurse who was jailed in November 2025 after killing 10 patients in an effort to reduce his workload. [Ref:The Telegraph]
A slippery slope?
Although perhaps up to 84 per cent of the British public think the law should be changed to allow assisted suicide for the terminally ill [Ref: Dignity in Dying], critics fear that there will be an inevitable expansion of assisted dying once the principle is established, beyond the terminally ill to those who are disabled or chronically ill but are not expected to die in the near future. It could even be expanded to include the severely depressed [Ref: Al Jazeera].
There are further concerns that assisted suicide could quickly be extended to children, a group who are still limited in their rights to make such big decisions in other areas of the law (such as marriage or voting). 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]. In March 2026, Dutch doctors euthanised a teen with autism, as his condition led him to be ‘oversensitive to stimuli’ and to find his life ‘joyless’. Yet despite his evident cognitive struggles, doctors decided that he had the capacity to rationally decide to end his own life. Thus, in the end, the doctors were able to euthanise a child with a neurodevelopmental condition without any consequence or question [Ref: National Post].
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 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. A 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]
READINGS
FOR
‘My diagnosis has changed my mind on assisted dying’
Kate Berry & Kirsty Jones BBC 1 February 2025
Public support for legal change towards assisted dying
Chujan Sivathasan NatCen 18 March 2025
Europe’s slow but ‘inevitable’ march to allow assisted dying
Claudia Chiappa and Lucia Mackenzie Politico EU 29 December 2024
Esther Rantzen: I’d consider going to Dignitas if my cancer does not improve Blathnaid Corless Telegraph 19 December 2023
Today, 17 people will likely die in unimaginable pain. Here’s how you can help stop that
Polly Toynbee 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
UK’s longest-serving MPs issue joint plea for Commons to reject assisted dying bill
Jessica Elgot and Peter Walker Guardian 20 November 2024
What Germany can teach the UK about assisted dyingMark Taubert Spectator 24 November 2026
Give Me Liberty and Give Me DeathMegan Dent The Dispatch 31 March 2026
IN THE NEWS
Autistic teenager with mental health struggles euthanized in the NetherlandsCassy Cooke Live Action 4 April 2026
Awakened by Euthanasia?Jorge González-Gallarza European Conservative 15 April 2026
Spain is euthanising rape victims nowGeorgina Mumford spiked 27 March 2026
Assisted Suicide Isn’t Care: How the UK Abandons the Chronically Mentally Ill Rose Denham European Conservative 20 December 2025
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 Guardian 21 February 2025
Assisted dying: what (the hell) is going on in Parliament?
Mo Lovatt Academy of Ideas Substack 13 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 Guardian 29 November 2024
I’m glad the debate on assisted dying is forging ahead. But few understand why it frightens so many
Frances Ryan 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 Scotsman 9 March 2023
How euthanasia has revived the death penalty
Kevin Yuill spiked 8 March 2023
German court repeals ban on assisted suicide services
Reuters Guardian 26 February 2020
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 process
Matthew 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
Reasons for Wanting Assisted Suicide: A Retrospective Evaluation of Telephone Inquiries
Deutsches Ärzteblatt 2023
Assisted dying inquiry must lead to Government action says poll
Dignity in Dying 19 January 2023
Humanists UK calls for a compassionate assisted dying law across the UK and Crown Dependencies
Humanists UK 6 February 2023
WATCH/LISTEN
Bookshop Barnie with Kathleen Stock on “Do Not Go Gentle”
Austin Williams (YouTube) 21 April 2026
Assisted dying: Is there a right to die?Battle of Ideas Festival 2025
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
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
OLDER ARTICLES
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
One in four Canadians supports euthanasia on grounds of poverty
James Billot UnHerd 9 May 2023