Proceeding with Caution: Britons' Views on Assisted Dying

  • Research
  • 24 November 2024

Based on in-depth focus groups, and polling of over 15,000 people, our latest report reveals the complexities of public opinion on assisted dying. We assess the strength of the country’s support for reform, but also explore how this support is contingent on strong safeguards and careful parliamentary deliberation.

Read the full report

A clear majority of Britons support legalising assisted dying, but their support is conditional on robust safeguards

Nearly two thirds of Britons (65 per cent) support legalising assisted dying. Only 13 per cent oppose it. 55 per cent of Britons would consider seeking assisted dying if they were diagnosed with a terminal illness.

Support for legalisation spans age, gender, regions and voter groups. Support is also not new: polling shows that as long ago as 1950 Britons' support for assisted dying legalisation outnumber opposition by two to one. 

In only seven British parliamentary constituencies does support for legalising assisted dying drop below 50 per cent. 

Explore support for assisted dying in your local area using our interactive map

That support is however firmly conditional on strong safeguards being put into place: 62 per cent of the public want more robust safeguards, even if it results in restricted eligibility, compared to 29 per cent who favour minimal barriers and safeguards to avoid creating barriers to access.

 

“I think if it's a very restrictive law, then it could possibly work, but it depends on what it's actually stipulating in what you can and can't do.”

Jaspreet, Maidenhead 

Britons' personal experiences of death and illness shape their views on assisted dying

Those with lived experience of illness and bereavement are generally more supportive of legalising assisted dying.

Those who have lost family members in the last five years are 18 points more likely to strongly support assisted dying than those who have not lost their parents. Those who have experience of a relative with a terminal illness are nine points more likely to strongly support legalisation.

However, this stronger support for assisted dying doesn't translate to a desire for more permissive legislation. Those with these experiences also show higher than average support for strict safeguards.

“I am tentatively for it. I recently lost my father to cancer and seeing him go through those stages has sort of painted my view on this. The only thing I would say is that the safeguards in place would have to be very, very tight and very secure.”

John, Oxfordshire

Which arguments do the public find convincing?

Of the arguments in favour assisted dying, the argument that the public find most convincing is one of autonomy: that people who are terminally ill should have the right to choose when and how they die. Roughly three in four Britons find this argument convincing.

A similar number are convinced by the argument that assisted dying can help people to escape insufferable pain.

Both supporters and opponents of assisted dying find the argument that the UK could impose tighter restrictions than exist for those who travel to Switzerland to die convincing.

The most convincing arguments against assisted dying are that the elderly or financially vulnerable may feel pressured to choose assisted dying.

While only 13 per cent of the country oppose assisted dying, 58 per cent are convinced by the concern that elderly people may seek it out because they worry about being a burden or because they are directly pressured. Almost half of the public are convinced by the argument that poorer people may feel financial pressure to pursue assisted dying.

“The concern that I would have is about people who are coerced, so perhaps older people who have got family members that are saying, well, if you weren't here and we had your house, we'd have a much better life (...) And whilst I'm sure that would only be a very small amount of people that would do that, we know that surely there will be some people which would be awful.”

Helen, Oxfordshire

Opponents of assisted dying are particularly convinced by the argument that doctors are trained to save lives, not end them, though this has less resonance among the general public (67 per cent of opponents find this convincing, compared to just 39 per cent of the general public).

The public want clear and tight restrictions on eligibility for assisted dying

58 per cent of the public think that those who are terminally ill with a condition like cancer, should be able to access medical assistance to end their own lives - a further 21 percent think it should depend on the circumstances.

Similar numbers believe those with terminal degenerative conditions should be eligible. However six in ten people oppose making assisted dying available to people on the grounds of severe mental illness. The public are most torn on whether people suffering from dementia should be able to access assisted dying, often balancing their own desire to end their lives in those circumstances with the difficulties of ensuring informed consent. 

“All of my family know that if I was ever diagnosed with something like motor neurone disease or whatever, I will be over to Switzerland getting a plan in place so that when the time came I could just head off over there.”

Helen, Oxfordshire

50 per cent of the public believe that eligibility should be on the basis of a strict set of conditions, while 25 per cent believe it should be on the basis of how long doctors believe a person has left to live.

The public have concerns about the NHS’s ability to deliver assisted dying

Just 26 per cent of the public believe that the NHS is currently in a fit state to provide people with the option of assisted dying compared to 74 per cent who believe it is not.

"You know, we all know the NHS is really struggling as it is, you know, so you add an extra service in that. They've got to facilitate as well. They're not going to manage it. And then it becomes a waiting list game.”

Laura, Maidenhead

While overall the public tend not to think that legalising assisted dying would detract from improving palliative care, a significant minority (44 per cent) do hold this view. This concern is particularly strong among opponents of assisted dying with 73 per cent worried about the impact on palliative care.

Strict safeguards are Britons’ top priority if assisted dying were to be legalised 

72 per cent believe it is essential that there is proof that people are not being pressured into assisted dying. Two thirds believe that assessment by multiple independent doctors is essential and 62 per cent believe there must be formal assessment of a person’s decision making capacity.

“I think the big problem, as often is with almost any law, is how do you protect the vulnerable who get convinced into maybe making decisions before they're ready to make them.”

Simon, Maidenhead

56 per cent of Britons would also want to see some background check against potential financial motivations for family members to pressure relatives into assisted dying. Despite these concerns over safeguarding, a majority (56 per cent) believe that giving people the freedom to end their lives outweighs the risk that people are pressured.

In the face of this complexity, parliamentarians shouldn't avoid the issue altogether: 71 per cent of the public believe it is possible to design a bill that legalises assisted dying while protecting the vulnerable from coercion.

The public want greater consultation, scrutiny and expert input

Three in five Britons say more public consultation is needed before legislation passes through the parliamentary process. However, currently under a third of the public trust politicians to make the right decision on assisted dying, and they are equally split on whether MPs should vote with their conscience or on the basis of what their constituents think.

At the same time, the public do not think there needs to be a trade off between passing legislation in a timely manner and greater consultation. If the Bill receives a second reading, this places a greater premium on parliamentarians using the Bill’s Committee stage to draw in knowledge from medical experts and the lived experiences of people who have suffered from terminal illness or families who have used assisted dying abroad.

Civic institutions and the BBC in particular should be doing more to engage the public with the arguments for and against legalisation.

Proceeding with caution

Given clear support for the principle of assisted dying, public expectations would be best met by giving the Bill a second reading - leaving issues around eligibility, safeguarding and implementation to be more thoroughly explored, along with expert opinion, in later parliamentary stages. 

The Government should allow greater parliamentary time to enable that and to scrutinise the Bill. Specific consideration should be given to whether a tighter eligibility criteria - based on a list of conditions rather than life expectancy alone - should determine eligibility, as well as the feasibility of introducing more stringent checks against motivations for coercion. Throughout subsequent stages of the Bill’s passage MPs and Peers should consider, along with their own views, to what extent they have met the public’s tests and expectations - particularly on safeguarding - before deciding to pass legislation on such an important matter. Regardless of the outcome of Friday’s vote, this will not be the end of the conversation about assisted dying in Britain.

"Don't muck it up. Get it right."

Adrian, Bridgend