Assisted Dying & Euthanasia in the UK

Euthanasia is the deliberate ending of a patient’s life, usually by a doctor administering medication, to relieve suffering.

This is different from:

Withdrawing treatment
Palliative care
DNACPR decisions

Euthanasia is currently illegal in the UK.

What Is Assisted Dying?

Assisted dying is when a doctor provides a patient with medication to end their life, but the patient performs the final act themselves.

Key distinction:

Euthanasia → doctor administers medication
Assisted dying → patient self-administers medication

Both remain illegal in most parts of the UK at present, although legislation is actively being debated.

Key 2024–2026 UK Update

In November 2024, MPs voted in favour of progressing the Assisted Dying Bill.

The proposed bill would allow:

Terminally ill adults
Expected to die within 6 months
To request medically assisted dying
Under strict legal safeguards

The bill still requires:

Committee review
Further parliamentary votes
House of Lords approval

This makes assisted dying one of the biggest NHS and medical ethics hot topics for medicine interviews.

Difference Between Active and Passive Euthanasia

Active Euthanasia

Direct action intentionally causes death.

Example:

Giving a lethal injection

This is illegal in the UK.

Passive Euthanasia

Stopping or withdrawing life-prolonging treatment.

Examples:

Turning off life support
Withdrawing ventilation
Stopping artificial feeding

This can be legal if:

The patient consents
Treatment is not in the patient’s best interests
The patient lacks brainstem function

Current UK Legal Position

Illegal in the UK

Active euthanasia
Assisted suicide
Doctors directly helping patients end life

Doctors who perform euthanasia could face:

Criminal prosecution
GMC investigation
Imprisonment

Proposed Assisted Dying Bill Safeguards

The proposed legislation includes strict safeguards:

Eligibility

Patients must:

Be over 18
Be terminally ill
Have less than 6 months to live
Have mental capacity
Be making a voluntary decision

Approval Process

Requires:

Two independent doctors
Separate assessments
High Court approval
Waiting periods

Self-Administration

The patient must take the medication themselves.

This is intended to distinguish assisted dying from euthanasia.

Ethical Principles Involved

1. Autonomy

Patients should have control over their own bodies and decisions.

Supporters argue:

Patients should choose how and when they die
Patients should avoid unnecessary suffering

2. Beneficence

Doctors should act in patients’ best interests.

Supporters believe:

Assisted dying can reduce suffering
It may preserve dignity

Opponents argue:

Palliative care is a better solution
Doctors should focus on comfort, not ending life

3. Non-Maleficence

“Do no harm.”

This principle creates major debate:

Is prolonging suffering harmful?
Or is intentionally ending life harmful?

Both sides use this principle differently.

4. Justice

Questions include:

Who qualifies?
Could vulnerable patients be pressured?
Would disabled or elderly people feel like burdens?

Justice and safeguarding are major concerns.

Arguments FOR Assisted Dying

Dignity

Patients may wish to avoid:

Severe pain
Loss of independence
Distressing final stages of illness

Autonomy

Patients should control decisions about their own lives and deaths.

Compassion

Supporters argue allowing suffering patients choice is compassionate.

Safety

Some terminally ill patients currently:

Travel abroad
Attempt suicide alone
Die in traumatic circumstances

Legalisation may create safer regulated processes.

Arguments AGAINST Assisted Dying

Sanctity of Life

Many believe life should never be intentionally ended.

This may be based on:

Religious beliefs
Moral principles
Human rights concerns

Slippery Slope

Concern that criteria may gradually widen.

Examples:

Non-terminal illness
Mental illness
Disability
Chronic suffering

Critics point to debates in countries such as:

Belgium
Canada
Netherlands

Coercion Risk

Vulnerable patients may feel pressure from:

Families
Financial worries
Social isolation
Feeling like a burden

Role of Doctors

Some argue:

Doctors should heal and comfort
Not intentionally end life

This may affect trust in healthcare professionals.

Mental Illness and Assisted Dying

One of the most controversial ethical debates is whether assisted dying should ever apply to psychiatric illness.

Questions include:

Can severe mental illness impair capacity?
Is suffering “terminal”?
Can depression affect decision-making?
Should autonomy still apply?

Countries like Belgium and Canada have debated or expanded access in this area.

This is a strong higher-level discussion point in interviews.

Countries Where Assisted Dying or Euthanasia Is Legal

Euthanasia Legal In:

Belgium
Canada
Netherlands
Luxembourg
Colombia

Assisted Dying Legal In:

Switzerland
Several US states including:
- Oregon
- California
- Washington

Common Medicine Interview Questions

“What is the difference between euthanasia and assisted dying?”

Strong answer:

Define both clearly
Explain who performs the final act
Mention UK legality

“Do you support assisted dying?”

Interview tip:
You do NOT need a strong opinion.

What matters most:

Balanced reasoning
Ethical analysis
Respect for opposing views
Awareness of safeguards

A nuanced answer scores highly.

“Should assisted dying be allowed for mental illness?”

Good discussion points:

Capacity
Autonomy
Vulnerability
Recovery possibility
Safeguards
Risk of coercion

“How should assisted dying be regulated?”

Discuss:

Multiple doctor approval
Mental capacity assessment
Waiting periods
Judicial oversight
Voluntary decision-making
Protection for vulnerable groups

Thirteen Questions and Answers

1. What is assisted dying?

Model answer:

Assisted dying refers to providing a person with the means to end their own life, usually at their voluntary request, often in the context of terminal illness. In the UK, it is currently illegal, although it is legally permitted in some countries under strict safeguards.

2. What is the difference between euthanasia and assisted dying?

Model answer:

Euthanasia is when a clinician directly administers medication to end a patient’s life. Assisted dying is when the patient self-administers prescribed medication to end their life. Both are illegal in the UK under current law.

3. What is your view on assisted dying?

Model answer (balanced):

I can understand why assisted dying is a deeply complex and emotionally charged issue. On one hand, arguments in favour include patient autonomy, relief of suffering, and dignity at the end of life. On the other hand, concerns include protecting vulnerable patients, potential coercion, and the ethical role of doctors as healers.
While it is currently illegal in the UK, I believe it is important to approach patients with empathy, ensure effective palliative care, and respect existing legal and ethical frameworks.

4. A patient asks you for assisted dying. What do you do?

Model answer:

I would first listen carefully and explore their concerns with empathy.
“Can you tell me more about what is making you feel this way?”
I would assess for underlying issues such as uncontrolled pain, depression, or fear. I would reassure the patient that I am there to support them, not to judge them.
I would explain that assisted dying is currently illegal in the UK, but I would ensure they receive appropriate palliative care, psychological support, and involve senior colleagues or specialist teams.

5. What ethical principles are involved in assisted dying?

Model answer:

The key ethical principles include:
Autonomy: respecting a patient’s right to choose
Beneficence: acting in the patient’s best interests
Non-maleficence: avoiding harm, including intentionally ending life
Justice: ensuring fair protection for vulnerable populations
The debate often centres on balancing autonomy against non-maleficence.

6. What are arguments in favour of assisted dying?

Model answer:

Arguments in favour include:
Respect for patient autonomy
Relief of unbearable suffering
Preservation of dignity at end of life
Control over timing and manner of death
Avoidance of prolonged invasive treatments

7. What are arguments against assisted dying?

Model answer:

Arguments against include:
Risk of coercion or pressure on vulnerable patients
Difficulty in assessing mental capacity in distressed patients
Ethical duty of doctors to preserve life
Potential for misuse or slippery slope effects
Availability and improvement of palliative care as an alternative

8. How would you respond to a distressed patient requesting assisted dying?

Model answer:

I would respond with empathy and openness:
“I’m really sorry you are feeling this way. Can you help me understand what is troubling you most right now?”
I would explore physical symptoms, psychological distress, and social concerns. I would ensure appropriate symptom control and involve palliative care and mental health support.

9. What would you do if a colleague offered to assist a patient in dying?

Model answer:

I would recognise this as a serious professional and legal concern. I would prioritise patient safety and escalate immediately to a senior clinician or safeguarding lead.
In the UK, assisting in dying is illegal, so I would ensure appropriate reporting through governance channels.

10. Should assisted dying be legalised?

Model answer (balanced MMI approach):

This is a complex societal and ethical issue. While I understand arguments for legalisation based on autonomy and relief of suffering, I also recognise significant risks regarding vulnerable patients and ethical responsibilities in medicine.
As a medical student, I would focus on providing compassionate care within the current legal framework and supporting high-quality palliative care.

11. Key MMI phrases to use (high scoring)

“I would approach this with empathy and without judgement.”
“I would explore underlying concerns such as pain or depression.”
“I would ensure patient safety and escalate appropriately.”
“I would act within current UK legal and ethical frameworks.”
“I would focus on palliative care and symptom relief.”

12. Simple structure for any assisted dying station (VERY useful)

E-A-S-P

E – Empathy and explore reasons
A – Assess symptoms / mental health
S – Support and reassure
P – Palliative care + senior escalation

13 “What are the ethical arguments surrounding assisted dying?”

Answer:

“Assisted dying is ethically complex because it involves balancing patient autonomy with the duty to protect life. Supporters argue that terminally ill patients should have the right to choose a dignified death and avoid prolonged suffering, especially when palliative care may not fully relieve symptoms. This aligns with autonomy and compassion.

However, opponents argue that intentionally ending life conflicts with the sanctity of life and the principle of non-maleficence. There are also concerns about coercion and whether vulnerable patients may feel pressure to choose assisted dying.

Another important issue is the slippery slope argument, where eligibility criteria may gradually expand over time. Overall, I think it’s important to approach the issue respectfully, acknowledge both sides, and ensure any legislation includes strict safeguards to protect patients.”