The United Kingdom is on the brink of tackling one of the most divisive issues in recent times. On November 30, MPs will cast their votes on the Terminally Ill Adults (End of Life) bill — a proposed law that seeks to grant terminally ill adults in England and Wales the right to decide the timing of their own death.

This bill has sparked intense debate, dividing both Parliament and the public. If passed, the law would allow mentally competent, terminally ill adults with six months or less to live to choose medically assisted dying. As lawmakers prepare for this crucial vote, the UK watches closely, aware that the outcome could mark a significant shift in end-of-life rights.

Let’s decode some pressing questions surrounding this debate.

What is assisted dying?

Assisted dying is an umbrella term that includes both euthanasia and assisted death by suicide. Euthanasia involves a physician directly administering a lethal substance to end a patient’s life, while assisted death by suicide means providing the patient with the means to end their life, often through a prescribed drug. The debate centres on whether this should be permitted for those suffering from terminal illnesses or chronic conditions that lead to unbearable suffering.

Which European countries allow assisted dying?

Assisted dying laws vary significantly across Europe, with some countries embracing the practice, while others maintaining stringent prohibitions.

The Netherlands: The Netherlands legalised both euthanasia and assisted death by suicide in 2002, under strict conditions. The law requires the patient to experience “unbearable suffering with no prospect of improvement” and make the request voluntarily and with clear, informed consent. Amendments have expanded these rights to minors over 12 with parental consent and even to patients with advanced dementia who have expressed their wishes while competent.

Belgium: Following the Netherlands, Belgium permitted euthanasia and assisted death by suicide in 2002. Notably, it became the first country to allow terminally ill children to request euthanasia, provided parental approval is given.

Luxembourg: Luxembourg decriminalised euthanasia in 2009, broadening the scope for individuals experiencing intolerable suffering.

Spain and Portugal: Spain passed legislation in 2021 allowing assisted dying for those with serious, incurable illnesses, while Portugal followed suit in 2023. Although Portugal’s law is yet to take effect, it marks a significant step towards wider acceptance in the region.

Switzerland: While euthanasia is prohibited, Switzerland has long permitted assisted suicide, attracting individuals from across Europe seeking to end their lives in a regulated environment.

Austria and Italy: Austria legalised assisted suicide in 2022 after its constitutional court ruled that the prohibition violated fundamental rights. In Italy, the constitutional court allowed an exception in 2019, recognising that aiding someone in unbearable suffering should not be automatically punishable.

Key points in the UK Bill

The Terminally Ill Adults (End of Life) bill, introduced by Labour MP Kim Leadbeater, proposes to allow terminally ill adults in England and Wales to request assistance in ending their lives. This is considered a “matter of conscience,” enabling MPs to vote independently of party lines. The bill follows Prime Minister Keir Starmer’s commitment to put the issue before Parliament during the summer general election campaign.

What does public opinion in the UK say about assisted dying?

A recent YouGov poll indicates strong public support, with 73% of Britons backing the idea of assisted dying, compared to only 13% who say it should not. However, 19% of respondents expressed support for the concept of assisted dying in principle but opposed it in practice, citing concerns that creating strong enough laws to regulate the practice effectively may not be feasible.

How have former Prime Ministers responded to the debate?

The debate is not without dissenters. Former Prime Ministers Gordon Brown, Theresa May, Boris Johnson and Liz Truss have opposed it, while David Cameron has publicly changed his stance and now supports the measure.

What could happen next?

If the bill fails to pass the second reading, it will be defeated, keeping the status quo. Should the bill succeed, it will likely undergo extensive parliamentary debate, which could divert attention from other pressing governmental matters. Additionally, questions remain about which organisation would be tasked with overseeing the assisted dying process. With the National Health Service (NHS) — a comprehensive public-health service under the UK government’s administration — already under significant pressure, this issue adds another layer of complexity to the debate.