Assisted Dying: Proposals, their Pitfalls, and Legal Alternatives

Assisted dying is a complex and divisive subject due to the ethical, religious, moral, and legal dimensions of end-of-life decisions.

In recent times, the topic has surged to the forefront of public discourse following the launch of Dame Esther Rantzen’s campaign in support of the legalisation of assisted dying.

This has reignited impassioned debates amongst policymakers, healthcare professionals and the public. 

Below, our Wills, Trusts, and Probate team explore the various proposals, their potential pitfalls, and the legal alternatives available to individuals facing terminal illnesses.

Proposals for assisted dying often concern the legalisation of euthanasia or physician-assisted dying.

Broadly, euthanasia involves a physician administering a lethal dose of medication to end a patient’s life, while physician-assisted dying occurs when a terminally ill patient self-administers such medication prescribed by a doctor.

At present, in the UK, euthanasia and assisted suicide are illegal.

Depending on the circumstances, euthanasia is regarded as either manslaughter or murder, with the maximum penalty being life imprisonment.

Assisted suicide is illegal, contrary to the Suicide Act 1961, and is punishable by up to 14 years’ imprisonment. 

Proponents of the legalisation of assisted dying often argue that this offers terminally ill people the option to choose a painless, dignified death on their own terms.

The opinion that it could improve end-of-life care is often posited by advocates, which was found to be the case in some of the countries where it is allowed by the Health and Social Care Committee. 

The Dignity in Dying campaign group states that more than 200 million people worldwide have legal access to some form of assisted dying. 

Countries such as the Netherlands, Belgium, Luxembourg, Canada, Spain, Colombia, Austria and some states in America have implemented various forms of assisted dying legislation.

To balance the need to ensure patient autonomy and mitigate the risk of abuse, each jurisdiction has its own safeguards, including, for example, strict eligibility criteria, numerous and thorough medical assessments, and mandatory waiting periods.

Dame Esther’s petition, launched in December 2023, triggered a debate in parliament which took place on Monday 29 April 2024.

The last parliamentary debate around this topic was in July 2022 when it was rejected. 

Prior to that, a bill was introduced and later defeated in 2015, under which people in England and Wales with less than six months to live could be prescribed a lethal dose of drugs, which they would have to self-administer. 

Amidst the fervent calls for legislative change in the UK by groups such as Dignity in Dying and Humanists UK, many concerns and pitfalls have been raised, highlighting the intricate nature of this contentious topic. 

Opponents often cite concerns about potential abuse, coercion, and the devaluation of human life.

There is particular concern about the impact on more vulnerable people, who may be unduly influenced or pressured into choosing assisted dying.

Anti-assisted dying campaign group Care Not Killing has expressed fears that eligibility criteria could, in time, be extended beyond the terminally ill to include those with disabilities.

This concern is echoed by paralympic medallist Baroness Tanni Grey-Thompson, who warned that legalised assisted dying would be a “chilling prospect” for people with disabilities. 

Baroness Grey-Thompson and other opponents refer to the significant logistical hurdles involved in implementing assisted dying legislation.

Determining eligibility criteria, establishing procedures to assess capacity, and ensuring access to medical resources are among the complex considerations that would need to be addressed should the law change. 

The outcome of the campaigns on either side of the assisted dying debate remains to be seen.

However, in the meantime, individuals in the UK still have legal alternatives to assert their medical and end-of-life preferences and maintain control over their healthcare decisions.

Two key documents include the Lasting Power of Attorney (LPA) for health and welfare decisions and the Advance Decision document.

LPAs for Health and Welfare

An LPA for health and welfare allows an individual (“donor”) to appoint one or more trusted people (“attorneys”) to make decisions about their healthcare and personal welfare (within the current legal framework) if they become unable to do so themselves. 

This includes decisions about medical treatment, care preferences, and end-of-life care.

If the donor chooses, this can include life-sustaining treatment decisions.

By appointing a trusted attorney and making their preferences known in advance, individuals can ensure that their wishes are respected should they ever lose mental capacity.

Making a health and welfare LPA is a proactive step an individual can take towards maintaining a degree of control and autonomy over healthcare decisions, ensuring their voice is heard and preferences are respected even if they become unable to advocate for themselves at the time. 

Advance Decision Document

An Advance Decision document (often referred to as an “Advance Directive” or “Living Will”) enables individuals to outline their preferences for medical treatment and end-of-life care in advance.

This document is legally binding, subject to certain conditions being met, and allows individuals to refuse specific treatments or interventions if they lose capacity and are unable to communicate their wishes.  

Whilst this document cannot be used to request assisted dying in jurisdictions where this is not legal, it provides an opportunity to express preferences regarding medical interventions to ensure that they are complied with during times of vulnerability.

It is important to distinguish between assisted dying and the legal alternatives set out above.

Whilst assisted dying involves active medical intervention to end someone’s life, LPAs for health and welfare and Advance Decision documents focus on ensuring that an individual’s wishes regarding medical treatment and end-of-life care are respected within the confines of current UK legislation. 

Assisted dying remains a contentious issue, which polarises opinions due to its ethical, moral and legal implications. 

Whilst proposals for legalisation continue to be debated, Myerson’s Wills, Trusts and Probate team are adept at assisting individuals explore legal alternatives to assert their end-of-life preferences and maintain control over decisions concerning their welfare.