What do assisted dying, assisted suicide and euthanasia mean and what is the law?

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Older woman looking out the windowImage source, Getty Images

Scotland, Jersey and the Isle of Man are all considering changing the law to let terminally ill people end their lives.

Campaigner Dame Esther Rantzen also wants Westminster MPs to vote on assisted dying after a report found some evidence that it had led to better end-of-life care in places where it is allowed.

A number of countries have legalised assisted dying, assisted suicide or euthanasia, which are all different.

What is assisted dying?

There is some debate over exactly what the various terms mean, external.

But assisted dying is generally used to describe a situation where someone who is terminally ill seeks medical help to obtain lethal drugs which they administer themselves.

What is assisted suicide?

Assisted suicide is intentionally helping another person to end their life, external. It can involve people who are not terminally ill, external.

Providing someone with a lethal dose of sedatives or helping them go to Switzerland (where assisted suicide is legal) could both be considered assisted suicide.

What is euthanasia?

Euthanasia is the act of deliberately ending a person's life, external to relieve suffering in which a lethal drug is administered by a physician, external.

It is legal in fewer places than assisted dying or assisted suicide and patients do not necessarily have to be terminally ill, external.

There are two types: voluntary euthanasia, external, where a patient has given consent, and non-voluntary, external, where they have not been able to, for example if they are in a coma.

The laws throughout the UK prevent people from asking for medical help to die.

More specifically, euthanasia is illegal under English law and is considered manslaughter or murder. The maximum penalty is life imprisonment.

The Suicide Act 1961 also makes it illegal to encourage or assist a suicide in England and Wales. Those found guilty could face up to 14 years in prison.

Similar laws also exist in Northern Ireland.

There is no specific crime of assisting a suicide in Scotland but it is possible that helping a person to die could lead to prosecution for culpable homicide.

However, a new bill drafted by the Lib Dem MSP Liam McArthur could see Scotland become the first UK nation to allow assisted suicide.

Mr McArthur expects the bill to be debated in the Scottish Parliament in the autumn.

In March 2024, a report from the Health and Social Care Committee highlighted confusion over the rules governing UK doctors providing medical evidence for people who wanted to go abroad to die, external.

The British Medical Association (BMA) advises doctors against producing medical reports to facilitate assisted suicide abroad.

UK membership of Dignitas, the Swiss assisted dying association, jumped to 1,900 people in 2023, according to the organisation. That is a 24% rise on the previous year.

It said 40 people from the UK ended their lives at Dignitas in 2023, the highest level since 2019. Between 1998 and 2023 it helped 571 Britons to die, external.

What is the situation in the Isle of Man and Jersey?

Jersey and the Isle of Man are part of the British Isles but set their own laws. Both islands are considering proposals to allow assisted dying.

Politicians in the Isle of Man parliament have been debating the Assisted Dying Bill, which was introduced by Dr Alex Allinson who serves as an independent member of the House of Keys, roughly equivalent to the House of Commons at Westminster.

If the legislation is passed, it would only apply to those who have been resident on the Isle of Man for five years, to discourage so-called "death tourism".

The bill will be discussed again on 11 June.

Jersey's politicians approved the principle of legalising assisted dying in 2021.

On 21 May, Jersey's States Assembly will vote on specific proposals detailing how an assisted dying service could work.

Who is calling for a change in the law in the UK?

Campaigners have made numerous attempts to alter the law over many years.

Broadcaster Dame Esther Rantzen, who has stage four lung cancer and has joined Dignitas, launched a petition in support of assisted dying in December 2023.

It received more than 200,000 signatures, well above the 100,000 threshold needed to trigger a debate in Parliament.

That took place on 29 April and Dame Esther urged MPs to attend, despite the lack of a binding vote.

In February, she welcomed the Health and Social Care Committee's findings that end-of-life care had improved in some places which had legalised assisted dying.

She added, however, that she was "disappointed" that the committee had not called for a formal vote.

Image source, PA Media
Image caption,

Dame Esther Rantzen, who has stage four lung cancer, says she has joined Dignitas in Switzerland

The Westminster government says any change is a matter for Parliament.

Proposals on assisted dying were last rejected in July 2022 but the government said it would provide time to debate the subject again, external. It indicated that MPs would be free to vote as they wished.

Labour leader Sir Keir Starmer says that he is "personally in favour of changing the law" on assisted dying and is "committed" to holding a vote on the issue if elected prime minister.

The current law has also been challenged in the courts with a number of people with terminal and life-limiting illnesses arguing for their right to die.

Who opposes euthanasia or assisted dying?

Both the BMA and Royal College of Nursing have neutral positions on assisted dying.

Others argue the current legal position around all forms of assisted death should remain the same.

Baroness Tanni Grey-Thompson is concerned that vulnerable people could be coerced into pursuing assisted dying and that it is hard to put adequate safeguards in place.

"We need to make sure people are protected," she told BBC Breakfast, arguing that medical complications can arise once lethal drugs enter the body.

Dr Gordon Macdonald, of anti-assisted dying campaign group Care Not Killing, believes there are "many problems" with changing the law.

He is worried that criteria for assisted dying could, in time, be extended beyond terminally ill people to include those with disabilities and conditions such as dementia and depression.

Actor and disability rights campaigner Liz Carr shares that concern, which she explored in a BBC documentary Better off Dead?

She fears a world in which the poor, disabled or mentally ill may eventually feel compelled to have an assisted death, a prospect she calls "terrifying".

The Dignity in Dying campaign group says more than 200 million people around the world have legal access to some form of assisted dying, external.

Switzerland has allowed assisted suicide since 1942. Its Dignitas facility began operating in 1998. However, all forms of euthanasia are against the law.

Assisted suicide is also legal in neighbouring Austria.

In the US,11 states allow assisted dying. Known as "physician-assisted dying", it permits doctors to prescribe lethal drugs for self-administration.

Physician-assisted dying is legal in Oregon, California, New Mexico, Colorado, Washington, Hawaii, New Jersey, Vermont, Maine and Washington DC.

In Montana, court rulings allow doctors to defend themselves if they assist in a person's suicide.

Voluntary euthanasia is legal in Canada where it is called medical assistance in dying. It can be provided by a doctor or nurse practitioner, either in person or through the prescription of drugs for self-administration.

It is also legal in Spain and Colombia, both of which also permit assisted suicide.

Assisted dying is legal in some parts of Australia but the law differs across states. It is not permitted in either the Northern or Australian Capital territories which have separate legal systems.

New Zealand's End of Life Choice Act legalises assisted dying and allows adults in their final months of life to request assistance from a medical professional.

Three countries have laws that allow people who are not terminally ill to receive assistance to die: The Netherlands, Belgium and Luxembourg.