Assisted Suicide / Euthanasia
False Autonomy and Hobson’s Choice: How ‘Assisted Dying’ Harms the Family
May 14, 2025
Category: Research. This page summarises evidence and outlines alternative interpretations. It sets out method and limitations and links to other perspectives so readers can weigh the evidence and form their own view. For our research process, see here.
Method and limitations: This study reviews comparative data from jurisdictions that have legalised assisted suicide, including trends in eligibility criteria, numbers of deaths, reporting and safeguards. We use published government reports, peer‑reviewed articles and professional body statements, supplemented by stakeholder submissions. The study is a narrative synthesis, not a clinical trial or meta‑analysis. Limitations include variation in definitions, reporting intervals and healthcare systems that may affect comparability.
Other perspectives: Professional bodies, campaign groups and some clinicians argue that assisted dying can be regulated safely and can reduce suffering at end of life. They contend that palliative care and assisted dying can coexist. Readers may wish to review alternative analyses and professional statements before reaching a view.
Executive Summary
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Two Bills currently being considered in UK legislatures – the ‘Leadbeater Bill’ in Westminster, and the ‘McArthur Bill’ in Holyrood – respectively propose systems of assisted suicide (where a physician provides a qualifying person with lethal drugs to end their own life) based on the purported safeguards of eligibility criteria and procedural gatekeeping.
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The eligibility criteria are meant to limit the application of assisted suicide to ‘terminally ill adults’, defined ostensibly in a limited manner but which textual analysis and international analogues show would be far more expansive than has been presented.
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Evidence from Oregon, the assisted suicide model of which both Bill are following, shows that these eligibility criteria have over time led to applications for assisted suicide for normally non-terminal conditions such as anorexia, diabetes, hernias, and arthritis, due to their becoming ‘artificially terminal’ by human action or inaction rather than the inevitable progression of the disease.
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The risk of that occurring in the UK is worsened by the potential for doctor-shopping amongst a minority of doctors who would be providing an assisted suicide service, who would be by definition those with the fewest qualms and least scruples about doing so.
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For more ‘ordinary’ cases, even six-month prognoses are in any case very unreliable, and the danger exists that hundreds if not thousands of people would have their lives ended prematurely, even by a matter of years, if these Bills were passed into law.
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The procedural gatekeeping meanwhile relies on a system whereby the patient seeking to procure an assisted suicide would make two declarations followed by ‘periods of reflection’ (altogether 21 days in one Bill and 7 days or less in the other) and two doctors would assess that they are making an autonomous decision free of duress, in the case of the Leadbeater Bill including an ‘Assisted Dying Review Panel’ to confirm that the procedure has been followed.
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Nothing however establishes how the doctors would know (certainly in 3 weeks or less) how to detect undue pressure or coercion in the patient, even with psychological training. As such, the inclusion of a Panel would only be an added layer of bureaucracy without any ability to safeguard patients.
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The risk of abuses occurring in the UK is obvious from recent medical history (e.g. scandals surrounding Stafford Hospital and the Liverpool Care Pathway), and is worsened by the potential for doctor-shopping amongst a minority of doctors who would be providing assisted suicide – by definition those with the fewest qualms and least scruples about doing so.
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Given the permissive nature of a two-doctor system as demonstrated by the Abortion Act 1967, and given that opposition to the reestablishment of the death penalty exists notwithstanding the forensic nature of the investigation and court process justifying a guilty verdict for a serious crime, this raises the question as to why we would affirm the enabling of patient suicides based on procedural gatekeeping which amounts to nothing more than a box-ticking system which is certainly neither ‘thorough’ nor ‘robust’.
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The Oregon Model has shown many problems over time: amongst others, the removal of safeguards, a failure to protect those with mental illness, expansive application of terminal illness, and a rise in numbers of those opting for assisted suicide over fear of being a ‘burden’.
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Suicide prevention has been demonstrably undermined, and the development of palliative care has also been evidently retarded in those jurisdictions which have legalised assisted suicide or euthanasia. The question of difficult medical resource application in this context also has dehumanising implications.
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The rationale for legalising assisted suicide carries within itself not merely a ‘slippery slope’, but a logical cliff – the precedent to widen the eligibility criteria to all those who would claim a right to ‘choice’, ‘autonomy’ and the ‘right to die’. Evidence from those jurisdictions (Belgium, Canada and the Netherlands) which have followed this logic into euthanasia shows appalling cases of premature death for those who are disabled, mentally ill, or have had hard life experiences.
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The two Bills, like all proposals of assisted suicide and euthanasia, are dangerous and would undermine both the integrity of family relationships and the safeguarding of vulnerable patients.
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Based on the evidence described and its limitations, our interpretation is that the introduction of assisted suicide into British law and medical practice could alter norms around care and may carry risks for families and vulnerable people. Policy options for safeguarding and further research must be developed.