Assisted dying is moving closer to becoming legal in parts of the UK – with bills moving through parliament in England, Wales, and Scotland.
They could mean terminally ill people from all three nations are able to end their lives “on their own terms”, providing they have a life expectancy of six months or less.
Other safeguards include the patient being able to take the fatal drugs themselves and the approval of two doctors.
The Terminally Ill Adults (End of Life) Bill passed with a majority of 55 in November, and Scotland’s Assisted Dying for Terminally Ill Adults (Scotland Bill) was voted in with a majority of 14 on 13 May.
If written into law, the original bill would have jurisdiction in England and Wales, with the newer one applying to Scotland. Northern Ireland has not brought forward any similar legislation.
While it received support from 330 MPs, the Terminally Ill Adults Bill has garnered huge controversy, with 150 amendments made for it to pass the first stage.
Both the vote and its proposed implementation date have also been pushed back, throwing the entire debate into doubt.
Here Sky News looks at why assisted dying is so contentious – and where in the world it is already legal.
Why is assisted dying controversial?
A key concern is the so-called “slippery slope” argument.
Opponents argue a law might initially have strict criteria – for example, restricting it to terminal illness and excluding mental health conditions – but that over time these could be eased.
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Read more:
Five stories that bring the assisted dying debate home
Two terminally ill patients give opposing views on assisted dying
Kim Leadbeater, the backbench Labour MP who brought forward the bill, says this hasn’t happened in countries that have brought in assisted dying laws.
“Where there are countries where the law is broader, that was always how it started,” she told Sky News in October. “So I think there is a perception around the slippery slope concept, which actually isn’t reality.”
But there is one example of this: Canada has changed its laws.
It no longer requires the presence of a terminal illness – only a chronic physical condition. It was also due to expand the laws to mentally ill people in March, but that move has been delayed until 2027.
Other frequently cited worries are that people could be pressured to end their life, potentially by a relative who would benefit financially, that people might act because they don’t want to ‘burden’ others, or that they could make an irrational decision while depressed.
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The Royal College of Psychiatrists announced they were withdrawing their support for the bill in May, arguing it may undermine suicide prevention.
Some opponents say it’s against their religious beliefs or is unethical for doctors. Ms Leadbeater has given assurances that clinicians who do not wish to be involved in the process can refuse.
But those on the ‘against’ side argue the focus should be on improving palliative care to ease suffering – not ending that care prematurely.
Those who support a law change, such as the campaign group Dignity in Dying, insist “everybody has the right to a good death” – rather than suffering for months or years with a very poor quality of life.
The group says it should be an option for terminally ill adults who are mentally competent. It claims more than eight in 10 people favour changing the law and that currently some people are forced to choose “a lonely and perhaps violent death”.
How close is it to being legal in England and Wales?
Having passed its first and second reading last year, Ms Leadbeater’s bill was scrutinised further at the committee stage, where 150 amendments were made.
It will return to the Commons for the report stage on 16 May, when MPs will vote on it again, along with any further amendments. It would then move to the House of Lords, where Peers have their own readings, committee, and report stages, before it can be given royal assent and written into law.
At the end of March, Ms Leadbeater also revealed the scrutiny committee had agreed to delay implementation of the law from 2027 to 2029.
Originally there was a two-year “backstop” between the legislation being passed and put into practice.
But Ms Leadbeater said she believes it “more important to do this properly than to do it quickly” and extended it to four years.
This means assisted dying will not happen in England or Wales until at least 2029 – the year by which the next general election is required to take place.
What changes were made?
The most significant and controversial amendment to the England and Wales bill so far has been swapping final sign-off from a High Court judge for a panel of experts.
Originally, once an assisted dying decision was cleared by two doctors, it would have been referred to a High Court judge for final approval.
Now the final decision would be made by an expert panel comprising a “voluntary assisted dying commissioner”, a psychiatrist, and a social worker.
Ms Leadbeater argues the change gives the bill “additional patient-centred safeguards” by providing a “range of expertise” through the three-member panel, describing it as a “strength, not a weakness”.
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But opponents of assisted dying disagree, claiming that removing the High Court judge requirement “fundamentally weakens protections for the vulnerable and shows just how haphazard this whole process has become”.
The move has seen both the Royal College of Physicians and the Royal College of Psychiatrists remove their support for the bill.
In a statement after the amendment was adopted, 26 Labour MPs who previously voted against it said: “It does not increase judicial safeguards but instead creates an unaccountable quango and to claim otherwise misrepresents what is being proposed.”
Other amendments include the establishment of independent advocates for people with learning disabilities, autism or mental health conditions and setting up a disability advisory board to advise on legal implementation and impact on disabled people.
Scotland’s bill
A separate bill for Scotland passed the first stage on the road to becoming law on 13 May.
Brought forward by Liberal Democrat MSP Liam McArthur, it is the third time the Scottish Parliament has voted on assisted dying, with previous attempts to change the law defeated in both 2010 and 2015.
First Minister John Swinney has said that the proposals from Mr McArthur are a “much better bill” than previous attempts, though he stressed he would not be supporting the legislation.
Like in the UK parliament, MSPs have a free vote on the issue and are therefore not whipped to tow their party’s line.
After the vote ended in 70 in favour and 56 against, the bill will now progress to the committee stage before it can become law, which won’t happen until next year at the earliest.
The proposed legislation for Scotland has “strict eligibility criteria” with two doctors needed to independently certify that someone is both terminally ill and has the mental capacity to request an assisted death.
There would also be two weeks between the request being made and the necessary medication being given, which the patient would have to be capable of taking themselves.
The criteria also includes living in Scotland for at least 12 months and being registered with a GP there.
As it stands, the bill would allow anyone over the age of 16 to request an assisted death – but Mr McArthur has said he plans to increase this to 18.
Assisted dying on Isle of Man pushing ahead
The Isle of Man is set to become the first place in the UK where assisted dying is legal, after a bill cleared the last parliamentary hurdle before royal assent earlier in the year.
Its legislation would give terminally ill people “autonomy and choice” at the end of their life, according to Dr Alex Allinson, the GP and politician who introduced the bill in 2022.
Members of the island’s legislative council approved a final reading of the Assisted Dying Bill on 25 March, meaning it will become law as soon as it is given royal assent, with Dr Allinson hopeful that will happen this year – and assisted deaths be made available by 2027.
Only people who have been living on the island for at least five years, have a terminal illness, and a life expectancy of no more than 12 months would be eligible. They must also have a settled intention to end their life.
Where else is assisted dying legal?
It has been legal to help someone die in Switzerland since 1942 – provided the motive is not “selfish”.
The country’s Dignitas group has become well-known as it allows non-Swiss people to use its clinics.
New Zealand brought in a law for terminally ill people with fewer than six months to live following a 2020 referendum.
Every state in Australia also has some kind of assisted dying law. Victoria was the first to pass such legislation in 2017.
The Australian laws allow a person to self-administer life-ending drugs, or get a doctor to do it if they aren’t physically able.
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The Netherlands, Spain, Luxembourg and Belgium have similar rules allowing doctors to prescribe the drugs as well as administer them in some cases.
In Austria since 2022, two doctors need to approve requests for life-ending drugs. The patient must have a serious long-term condition and wait 12 weeks to reflect on their choice in case they change their mind, with minors and people with mental health conditions excluded.
A handful of US states, including California, Oregon, New Jersey and Colorado, have also taken action on assisted dying.
A doctor can only prescribe the drugs, meaning the patient must be physically able to take the fatal medication themselves.
Canada became the first Commonwealth country to legalise assisted dying. It passed a law in 2016 allowing doctors to both prescribe life-ending drugs and to administer them.
Who’s for and against assisted dying?
November’s five-hour debate in the House of Commons drew emotional opinions on both sides.
Prime Minister Sir Keir Starmer backed the proposal, as did Chancellor Rachel Reeves.
But other cabinet members including Health Secretary Wes Streeting and Justice Secretary Shabana Mahmood voted against the bill, having previously warned about vulnerable people being coerced and of a “slippery slope of death on demand”.
Liberal Democrat leader Sir Ed Davey also expressed caution.
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He told Sky News he was “sceptical” about the case for assisted dying due to “quite personal” concerns that stemmed from his mother’s battle with bone cancer when he was a child.
Sir Ed said that through nursing and palliative care “she was able to enjoy life and be with us”.
The Royal College of Psychiatrists’ decision to withdraw support centred around the lack of provision for unmet needs, the specific role of psychiatrists on expert panels, and the strain that might put on the profession. They were also unsure whether assisted dying would become a sanctioned ‘treatment’.
In their statement, the Royal College of Physicians said: “Whilst the bill has undergone a number of changes during the public bill committee phase, there currently remain deficiencies that would need addressing to achieve adequate protection of patients and professionals. This is a growing movement of medical opposition to this particular bill – it is simply not fit for purpose”
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The issue has also gained attention as a result of campaigning by Dame Esther Rantzen, best known for setting up counselling service Childline.
The 84-year-old has stage-four lung cancer and revealed last year that she had joined Dignitas.
Other well-known supporters include Great British Bake Off judge Prue Leith, broadcaster Jonathan Dimbleby – whose brother had motor neurone disease – and actor Sir Patrick Stewart.
Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email [email protected] in the UK.
In the US, call the Samaritans branch in your area or 1 (800) 273-TALK
