This is Prospect’s rolling coverage of the assisted dying debate. This page will be updated with the latest from our correspondent, Mark Mardell. Read the rest of our coverage here
7th January
This could be the year that three of the United Kingdom’s nations make assisted dying legal.
Members of the Scottish parliament are expected to vote on assisted dying around the same time as MPs in London give their final thumbs up or down to Kim Leadbeater’s bill. That’s expected to be sometime in the spring, but Scotland is both ahead and behind Westminster.
Behind, because MPs have already voted in principle for the bill which only applies to England and Wales. Ahead in the sense that in Scotland the committee stage comes before all MSPs get to vote, and that process is already well underway. The Scottish parliament’s brilliant website takes us through the deliberations in detail and so gives some fascinating insights into what the Leadbeater bill committee will be facing this year.
The proposed law in Scotland introduced by Lib Dem MSP Liam McArthur would differ in a few important ways to that in England and Wales.
First, there is no stipulation that the end must be six months or less away—instead it says simply that an applicant must be terminally ill, which it defines as having “an advanced and progressive disease, illness or condition which they cannot recover from, and which is expected to cause their premature death”.
There’s an age difference too—to qualify a person must be 18 in England, 16 in Scotland.
And in Scotland there is no requirement for a judge to sign off the application.
The health and social care committee began its work last summer by calling for people to come forward with their views—both generally and in detailed response to a series of specific questions. The committee makes it clear this is in no way meant to be anything like a reflection of the public mood—those who engaged put themselves forward and many were part of organised campaigns.
But there’s a big difference in the results of the two consultations—the almost 14,000 respondents to the general question on supporting the bill were overwhelmingly in favour (74 per cent), while the just over 7,000 who answered in more detail were heavily against (93 per cent). Which probably says more about the strategy of the 100-plus organisations that engaged with the detailed questions than anything else.
Those opposed put worries about coercion narrowly ahead of a belief in the sanctity of life as the main reason, while those in favour put reducing suffering just ahead of personal dignity. Amid the generalities there were many harrowing personal stories. Here’s one:
“My niece committed suicide because she did not want to die from MS. She was only 40 and in the early stages of her MS, but she had worked with people with MS who could not function, talk or swallow and saw how cruel the condition was. If she had the choice of assisted dying, I believe she would have lived a longer life, knowing she had a plan for her death when she felt scared of her cruel death.”
Some of the detail is interesting, and I suspect mirrors some of the arguments that will be heard in Westminster. In response to the question, “which of the following most closely matches your opinion on the terminal illness criterion for determining eligibility for assisted dying?”, a vast majority of 6,500 said “no one should be eligible”.
The committee goes on to report: “of the other responses, a combined total of 211 wanted some kind of extension to the eligibility, 177 wanted it narrowed and 138 thought it was about right.” Several respondents made suggestions for how eligibility could be extended or changed. These ranged from extending it to those with unbearable suffering to being available to all mentally competent people as a measure of personal choice, a right to die.
One of the more commonly suggested changes was to have a specific reference to life expectancy of six or 12 months, because “The definition is currently too vague and precise so lacks clarity”. It is possible the committee will choose to align with the Leadbeater bill on this.
Again, on the question of age the majority of respondents said no one should be eligible whatever their age. But of those who did engage further many made this point: “There should be no minimum or maximum age, given that terminal illness and suffering do not respect age limits.” But the other most common suggestion was for specific minimum ages other than 16: suggestions ranged from 17, 20 to 25, over 25 and 65.
There was the same pattern again with questions about the coercion of vulnerable people: a huge majority of respondents felt there was no way to completely protect against abuse. “It is impossible to set out an adequate safeguard against such a law being abused, humans are desperately wicked, and there is no way you could ever protect the vulnerable,” one said.
The committee is hearing evidence until February and it will be interesting to see if there is any desire to harmonise the bill with its English counterpart. One writer for the Scotsman frets about the differences: “Why, a patient may ask, do I need the court’s permission if I live in Berwick but not if I live in Banff?”
Indeed, such questions will be asked and differences will be seen as a problem. But a US citizen who lives in Baker City, Oregon probably won’t wonder why she has the right to assisted dying when her sister living across the state line in Boise, Idaho does not. But then most people in the US understand the consequences of a federal system in a way that many in the UK apparently don’t with regard to the logic of devolution, even after 27 years.
6th January
In a few short months we will know if Britain is joining those 13 countries where assisted dying is legal, in some form, in some states. The issue will come to a head with votes around springtime in England & Wales, Scotland and the Isle of Man. Jersey has already voted in favour in principle and a law is being drafted which should go back to the States Assembly by the end of the year. There are no plans to introduce such a law in Northern Ireland.
According to very similar stories in the Observer and Sunday Telegraph, up to 30 MPs could withdraw support unless Kim Leadbeater’s Commons bill is changed to stop doctors raising the subject with patients. That would still give a majority, not kill the bill, and I suspect there might be just as much traffic in the other direction. My prediction is that after many alarums and excursions the bill will become law this year,
If so, Britain will become part of a trend; whether it is progressive or pernicious will be much debated. The Catholic Church has been one of the main opponents and the Pope reiterated this opposition, fairly mildly, in his New Year message, saying: “I also ask for a firm commitment to respect… the dignity of human life, from conception to natural death.” However, there’s no doubt all over the world the debate is gathering momentum. But why now?
The debate itself is hardly new: the organisation campaigning for a change in the law. Dignity in Dying, was set up in 1935 as the Voluntary Euthanasia Legalisation Society.
In 1942 Switzerland became the first country in the world to state in law that assisting suicide was not a crime if done for altruistic reasons.
In 1995, the Northern Territory of Australia passed the first law explicitly legalising euthanasia—although the law’s effect was nullified two years later by the federal parliament. In 1997, the US state of Oregon legalised medically aided euthanasia.
But this is really a phenomenon of our new century—the Netherlands proudly claims to be the first country to adopt such a law, on 1st April 2002. Belgium followed a month later. Luxembourg took until 2008 to join them—the same year that Washington became the second US state to adopt it. Vermont became the third in 2013.
Legal assisted dying stayed in those fairly low-profile jurisdictions until 2016, when Canada became the first non-European nation to change its laws. Canada was swiftly joined by America’s most political city, Washington DC, and the large and politically important states of California and Colorado. The following year Victoria became the first Australian state to adopt a Voluntary Assisted Dying Act.
Momentum really began to build when a slew of US states followed suit: Hawaii in 2018, New Jersey in 2019, Maine in 2019 and New Mexico in 2021—and Western Australia, Queensland, New Zealand and Spain joined the club that same year. With Tasmania doing the same the following year and then South Australia and New South Wales in 2023, almost all of Australia now has an assisted dying law in place—20 years after it was first legalised in part of the country.
Another significant moment came in 2022 when judges in Colombia ruled in favour of assisted dying. Ecuador followed suit in 2024. So far these are the only two countries outside Europe or the Anglosphere to have made it legal. Chile’s lower house has approved legalisation but, despite a presidential promise last summer, the bill hasn’t yet reached the Senate.
As far as I can see, there still has been little discussion of assisted dying in large parts of the world—the Middle East, Africa and much of Asia. But in Europe the progress of bills has been disrupted only by electoral turmoil in Iceland, Ireland, France and Portugal, while in Germany and Italy the courts have effectively leapfrogged the politicians and given a green light to the practice.
The trend may continue in the US, with the American Conservative tellingly asking, like us, in its headline: “Is 2025 the Year of Assisted Suicide?”
So why now? Why in this millennium?
The deep context, of course, is the long arm of the Enlightenment, which is only now delivering its powerful punch. The fall-off in personal faith goes hand in hand with a growing disregard for the dictates of the church, and indeed the state, when it comes to individual rights: personal choice is all. That means public opinion appears to be on the side of changing the law.
More directly, you can’t underestimate the political power of momentum. The more places adopt these laws, the less daunting they seem. What once appeared strange, even weird, now feels almost ordinary. It might sound odd to use the term “fashion” for something so serious, but politics does have its trends.
Beyond these generalities, in many places, from Canada to Oregon, the ball was set rolling by a court case bought by an individual arguing it was a breach of their rights to deny them the chance to have medical help to kill themselves. Even in the UK, which doesn’t have a written constitution for such claims to be measured against, Kim Leadbeater’s bill was given a fair wind by the prime minister, informed by his time as director of public prosecutions and a feeling that the current legal situation was incoherent.
It’s probably also significant that the US, even with its broken and dysfunctional political system, is particularly well-suited to acting as pathfinder for the rest of us. Its federal system pushes individual states to plough their own furrows, at slightly different depths, using slightly different tools.
This allows people to observe the effects of these variations—the impact of tinkering in one place versus another. It creates a sense of openness to new possibilities. We who come after can learn from these pioneers—it is already clear that there is a tendency to loosen the criteria over time, and if that is anathema then laws have to be drawn very tightly. Even if you believe calamity waits around the corner, forewarned is forearmed.
Whatever the reasons, it seems likely medically assisted dying will be made legal in more jurisdictions in 2025. I’ll be following the debate closely here, and over the next few days will be looking more closely at Scotland and Malta.
