Assisted dying: balancing safety with access

The UK parliament is due to debate MP Kim Leadbeater’s bill on medically assisted dying for terminally ill adults in England and Wales in November 2024.1 Scotland and Ireland are considering similar bills. Over 300 million people across the world already have access to the option. Leadbeater’s bill has yet to be published, but decades of international experience can inform UK law making and how the bill might be implemented to optimise safety and access for local context, and including concerns such as eligibility, safeguards, conscientious objection, oversight, and reporting.2

In terms of eligibility, all jurisdictions that permit assisted dying require that the requesting patient is capable and fully informed, and most restrict access to adults with terminal illness (eg, the US and Australian states that permit assisted dying and New Zealand). Some jurisdictions restrict the option to patients within six or 12 months of death while others such as Canada, Belgium, and the Netherlands do not specify a timeframe to death. Some jurisdictions also permit assisted dying for non-terminal conditions, but such deaths are rare34; most assisted deaths globally (70-80%) are in people with advanced cancer or neurodegenerative disease.5 In practice the eligibility criteria have little effect on who actually receives an assisted death.5

Common safeguards include independent assessment of eligibility and a pause between the request and …