Legalise assisted dying with safeguards
Green · what the evidence says
An independent, source-checked look at Green’s policy “Legalise assisted dying with safeguards” — what it would actually do across the things that affect your life. Every claim below quotes the source behind it. How this works.
Personal liberty & free speech — Helps
moderate · moderate confidence
Legalising assisted dying expands bodily autonomy by giving terminally ill people a legal right to choose the timing and manner of their own death, removing a state prohibition that currently forces them to either endure against their wishes or travel abroad. The main caveat is that safeguard design matters: weak safeguards could allow coercion rather than remove it.
The evidence
- The policy would change the law to allow people to choose to end their lives, provided it is their clear and settled will and proper safeguards are in place. — greenparty.org.uk (manifesto) — “allow people to choose to end their lives to avoid prolonging unnecessary suffering, provided it is their clear and settled will and proper safeguards are in place”
- Currently, around 46 Britons travel to Switzerland each year for an assisted death at significant personal cost, meaning the choice is effectively restricted to the wealthy. — dignityindying.org.uk (media) — “Around 46 Britons travel to Switzerland each year for an assisted death, at an average cost of approximately £15,000”
- Up to 650 terminally ill people in the UK reportedly end their own lives annually, suggesting the current prohibition does not eliminate the act but removes legal protection and support. — dignityindying.org.uk (media) — “Up to 650 terminally ill people in the UK reportedly end their own lives annually”
- Common safeguards internationally include multiple independent medical assessments, confirmation of a clear and settled will, informed consent, waiting periods, and reporting to oversight bodies. — mydeath-mydecision.org.uk (media) — “Common safeguards internationally include multiple independent medical assessments, confirmation of a clear and settled will, informed consent, provision of information on alternative options (including palliative care),…”
- Concerns exist that some individuals may cite financial or socioeconomic reasons for requests, with the proportion citing financial reasons rising to 8–10% in Oregon and Washington in recent years. — livinganddyingwell.org.uk (media) — “notable increase in the proportion of applicants citing financial reasons for their request, rising from 2-5% historically to 8.2-10% in recent years in Oregon and Washington”
- There are concerns about potential pressure on vulnerable individuals to end their lives due to societal attitudes towards illness and disability, especially given current shortcomings in social care provision. — kingsfund.org.uk (institutional) — “concerns about potential pressure on vulnerable individuals to end their lives due to societal attitudes towards illness and disability, especially given current shortcomings in social care provision”
- In Oregon, psychiatric evaluations have significantly decreased, with only 1% undergoing assessment in 2022, down from 30% in the first five years, raising questions about whether free choice is adequately verified. — bmjgroup.com (media) — “Psychiatric evaluations for assisted dying in Oregon have significantly decreased, with only 1% undergoing assessment in 2022, down from 30% in the first five years of the law”
Biggest unknown: Whether the required safeguards are robust enough in practice to ensure genuine autonomous choice, or whether vulnerable people face de facto pressure — which would undercut the liberty gain.
Our reading: O10 asks whether people are free from undue state control over their bodies and choices. The current legal prohibition on assisted dying is, by definition, state coercion: it compels terminally ill people to continue living in suffering against their settled wishes, or forces them to act illegally and without medical support, or to travel abroad at prohibitive cost. Evidence shows that today the option exists in practice only for those who can afford roughly £15,000 to travel to Switzerland, meaning the liberty restriction falls disproportionately on those without means. Legalising assisted dying with a 'clear and settled will' requirement directly expands bodily autonomy: it converts a prohibited act into a legally protected personal choice. This is the paradigm case for O10 improvement — removing a state prohibition on a self-regarding act. The counterfactual matters. Absent the policy, up to 650 people annually end their own lives without legal protection or medical supervision. The policy would move that activity into a regulated, safeguarded framework, which enhances rather than reduces autonomous choice. The genuine liberty risk running the other direction is coercion masquerading as consent: if vulnerable people feel socially or financially pressured to choose death, the formal liberty gain is hollowed out. Evidence from Oregon shows financial reasons for requests have risen to 8–10% in recent years, and King's Fund notes concern about social pressure given social care shortcomings. Oregon's near-collapse of psychiatric evaluation (1% in 2022) shows safeguard erosion is a real phenomenon, not merely theoretical. However, the policy text explicitly conditions the change on 'proper safeguards' and 'clear and settled will'. The stated design thus directly addresses the coercion risk. Whether implementation matches the design is a delivery question that cannot yet be answered for a UK law, which is why confidence is moderate rather than high. On balance, the core effect is a moderate expansion of bodily autonomy.
Healthcare — Mixed picture
moderate · moderate confidence
Legalising assisted dying could reduce suffering for some terminally ill people who currently have no good options, but international evidence shows real risks: safeguards can weaken over time, palliative care investment may slow, and NHS implementation would need substantial new resources. The net effect on healthcare access and quality is genuinely two-sided.
The evidence
- The policy would allow people to choose to end their lives to avoid prolonging unnecessary suffering, provided it is their clear and settled will and proper safeguards are in place. — greenparty.org.uk (manifesto) — “allow people to choose to end their lives to avoid prolonging unnecessary suffering, provided it is their clear and settled will and proper safeguards are in place”
- Over 100,000 people in the UK currently die annually with unmet palliative care needs. — kingsfund.org.uk (institutional) — “over 100,000 people die annually with unmet palliative care needs”
- Up to 650 terminally ill people in the UK reportedly end their own lives annually, and around 46 Britons travel to Switzerland each year for assisted death at an average cost of £15,000. — dignityindying.org.uk (media) — “Up to 650 terminally ill people in the UK reportedly end their own lives annually”
- Even with comprehensive palliative care, an estimated 6,394 people in the UK each year would still experience no effective pain relief in their final three months. — mydeath-mydecision.org.uk (media) — “even with comprehensive palliative care, 6,394 people in the UK each year would still experience no effective pain relief in their final three months”
- Safe and effective implementation of assisted dying in the UK would require substantial planning, infrastructure, and funding, which are currently scarce in the NHS. — spuc.org.uk (media) — “safe and effective implementation of assisted dying in the UK would require substantial planning, infrastructure, and funding, which are currently scarce in the NHS”
- The emotional and psychological toll on healthcare staff involved in assisted dying is a concern raised by the Nuffield Trust. — spuc.org.uk (media) — “the emotional and psychological toll on healthcare staff involved in assisted dying”
- Countries with assisted dying laws saw slower growth in palliative care services — 8% over 14 years compared to 25% in countries without such laws. — youtube.com (media) — “an 8% increase over 14 years in Western European countries with such laws, compared to 25% in those without”
- In Oregon, psychiatric evaluations for assisted dying have significantly decreased, with only 1% undergoing assessment in 2022, down from 30% in the first five years. — bmjgroup.com (media) — “only 1% undergoing assessment in 2022, down from 30% in the first five years of the law”
- There are concerns about potential pressure on vulnerable individuals to end their lives due to societal attitudes towards illness and disability, especially given current shortcomings in social care provision. — kingsfund.org.uk (institutional) — “concerns about potential pressure on vulnerable individuals to end their lives due to societal attitudes towards illness and disability, especially given current shortcomings in social care provision”
- Projected UK assisted deaths could range from 273 to 1,078 applicants in the first half-year, rising to between 1,737 and 7,598 in year 10. — gov.uk (media) — “total number of applicants could range from 273 to 1,078 in the first half-year (2029-2030), increasing to between 1,737 and 7,598 in year 10 (2038-2039)”
- In Canada, there are concerns about MAID being offered for non-health-related suffering and a failure to explore underlying socioeconomic reasons for requests. — pmc.ncbi.nlm.nih.gov (government) — “concerns about MAID being offered for non-health-related suffering, a failure to explore underlying socioeconomic reasons for requests, and instances where individuals with untreated mental illness have received MAID”
- Common international safeguards include multiple independent medical assessments, confirmation of a clear and settled will, waiting periods, and reporting to oversight bodies. — mydeath-mydecision.org.uk (media) — “Common safeguards internationally include multiple independent medical assessments, confirmation of a clear and settled will, informed consent, provision of information on alternative options (including palliative care),…”
Biggest unknown: Whether the UK would invest adequately in both assisted dying infrastructure and palliative care simultaneously, or whether one would crowd out the other.
Our reading: This policy has genuine and evidenced upsides and downsides for healthcare, making a 'mixed' verdict the honest call. On the positive side, the evidence shows a real, unmet need. Over 100,000 people die annually in the UK with unmet palliative care needs, and even with comprehensive palliative care, thousands would still have no effective pain relief in their final months. Up to 650 people end their own lives annually without medical support, and dozens travel abroad at great expense. Legalising assisted dying with safeguards — as the policy proposes — would extend a regulated, medically supervised option to this group, directly addressing suffering the NHS currently cannot alleviate. On the negative side, the international evidence raises three credible concerns for healthcare quality. First, safeguard erosion: Oregon data shows psychiatric evaluation rates collapsed from 30% to 1% over time — the 'proper safeguards' promised by the policy are not self-sustaining. Second, palliative care crowding-out: countries with assisted dying laws saw palliative care services grow at one-third the rate of countries without them; opponents argue this diverts attention and resources. Third, NHS implementation capacity: the Nuffield Trust explicitly flags that safe implementation would need substantial planning, infrastructure, and funding currently scarce in the NHS, and the emotional burden on staff is a real workforce concern given existing NHS pressures. The financial pressure angle (rising proportion of applicants citing financial reasons in Oregon and Washington) and the King's Fund concern about pressure on vulnerable people given social care shortcomings add weight to the downside, particularly given the UK's strained social care context. Both upsides and downsides are well-evidenced, making this a genuine 'mixed' verdict. The magnitude is moderate — the projected case numbers are relatively small compared to overall NHS demand, but the systemic effects on palliative care investment and staff culture could be more significant over the long term.
Security in later life — Mixed picture
moderate · moderate confidence
Legalising assisted dying could give terminally ill older people a real choice over how they die, relieving suffering that palliative care cannot always address — but there are credible concerns that vulnerable people, especially those worried about being a burden, could feel pressured, and that the policy may not improve the broader care infrastructure they depend on.
The evidence
- The policy supports legalising assisted dying for those with a clear and settled will and proper safeguards. — greenparty.org.uk (manifesto) — “Support changing the law on assisted dying to allow people to choose to end their lives to avoid prolonging unnecessary suffering, provided it is their clear and settled will and proper safeguards are in place.”
- Over 100,000 people in the UK die annually with unmet palliative care needs. — kingsfund.org.uk (institutional) — “over 100,000 people die annually with unmet palliative care needs”
- Up to 650 terminally ill people in the UK reportedly end their own lives annually, and around 46 travel to Switzerland at an average cost of £15,000. — dignityindying.org.uk (media) — “Around 46 Britons travel to Switzerland each year for an assisted death, at an average cost of approximately £15,000.”
- Loss of autonomy, loss of dignity, and inability to engage in enjoyable activities are the primary reasons people cite for seeking assisted dying. — cdn.dignityindying.org.uk (media) — “Key concerns cited are loss of autonomy (90.9-92%), decreased ability to engage in enjoyable activities (89.5-88%), and loss of dignity (75.7-64%).”
- A notable and rising proportion of applicants in Oregon and Washington cite financial reasons for their request. — livinganddyingwell.org.uk (media) — “notable increase in the proportion of applicants citing financial reasons for their request, rising from 2-5% historically to 8.2-10% in recent years in Oregon and Washington”
- The Nuffield Trust concluded that safe implementation in the UK would require substantial planning, infrastructure, and funding currently scarce in the NHS. — spuc.org.uk (media) — “safe and effective implementation of assisted dying in the UK would require substantial planning, infrastructure, and funding, which are currently scarce in the NHS”
- The King's Fund raises concern that vulnerable individuals may feel pressure to end their lives given current shortcomings in social care. — kingsfund.org.uk (institutional) — “concerns about potential pressure on vulnerable individuals to end their lives due to societal attitudes towards illness and disability, especially given current shortcomings in social care provision”
- Countries with assisted dying laws have seen slower palliative care growth than those without. — youtube.com (media) — “Some studies suggest a slower growth of palliative care services in countries with assisted dying laws (an 8% increase over 14 years in Western European countries with such laws, compared to 25% in those without)”
- An estimated 6,394 people in the UK each year would still have no effective pain relief in their final three months even with comprehensive palliative care. — mydeath-mydecision.org.uk (media) — “even with comprehensive palliative care, 6,394 people in the UK each year would still experience no effective pain relief in their final three months”
- Psychiatric evaluations for assisted dying in Oregon have dropped sharply, with only 1% undergoing assessment in 2022. — bmjgroup.com (media) — “Psychiatric evaluations for assisted dying in Oregon have significantly decreased, with only 1% undergoing assessment in 2022, down from 30% in the first five years of the law”
Biggest unknown: Whether robust safeguards would prevent 'burden' motivations from driving requests among people who lack adequate social care support, and whether implementation would crowd out or complement palliative care investment.
Our reading: This policy touches O8 in two distinct, competing ways: autonomy and relief of suffering at end of life on one side, and risk to the security and dignity of vulnerable older people on the other. On the positive side, the evidence shows a clear unmet need. Over 100,000 people die annually in the UK with unmet palliative care needs, and even comprehensive palliative care would leave thousands without effective pain relief. People currently travel to Switzerland at significant personal cost. The primary motivations for assisted dying — loss of autonomy and dignity — are directly relevant to what O8 cares about. Legalisation with safeguards would give terminally ill people a genuine option that currently only the wealthy can access abroad. On the negative side, the evidence from comparable jurisdictions raises material concerns specific to later life. The rising share of applicants citing financial reasons (from 2-5% historically to 8-10% in Oregon/Washington) suggests that inadequate social care and financial precarity — both endemic in the UK — could drive requests. The King's Fund explicitly links this risk to 'current shortcomings in social care provision.' If people are choosing assisted dying because they cannot afford care rather than because of irreversible suffering, the policy worsens rather than protects security in later life. Safeguard erosion over time is also evidenced: psychiatric assessments in Oregon fell from 30% to 1%. The Nuffield Trust warns UK implementation would demand substantial infrastructure currently lacking. The slower growth of palliative care in jurisdictions with assisted dying laws raises concern about whether the policy complements or crowds out improvements to care that would benefit the much larger population of older people. The policy text itself is aspirational — it supports 'changing the law' with 'proper safeguards' but commits to no specific mechanism. The verdict is 'mixed' because the evidence supports both genuine benefit (relief of unmet suffering, autonomy) and genuine risk (coercion via inadequate care, safeguard drift, palliative care stagnation) at population scale.
Equal treatment & democratic rights — Mixed picture
moderate · moderate confidence
Legalising assisted dying with safeguards would extend an equal right to end-of-life choice to terminally ill people who currently cannot access it fairly — wealthier people can travel abroad while others cannot. But evidence from comparable jurisdictions shows real risks that safeguards erode over time and that vulnerable groups face disproportionate pressure, which could undermine the equal and due-process protections O9 requires.
The evidence
- The policy requires that assisted dying be available only where it is the person's clear and settled will and proper safeguards are in place. — greenparty.org.uk (manifesto) — “provided it is their clear and settled will and proper safeguards are in place”
- Currently around 46 Britons travel to Switzerland each year for assisted dying at an average cost of around £15,000, creating an inequality of access by wealth. — dignityindying.org.uk (media) — “Around 46 Britons travel to Switzerland each year for an assisted death, at an average cost of approximately £15,000”
- Common safeguards used internationally include multiple independent medical assessments, confirmation of a clear and settled will, informed consent, information on alternatives, waiting periods, and reporting to oversight bodies. — mydeath-mydecision.org.uk (media) — “Common safeguards internationally include multiple independent medical assessments, confirmation of a clear and settled will, informed consent, provision of information on alternative options (including palliative care),…”
- The King's Fund raises concern about potential pressure on vulnerable individuals to end their lives due to societal attitudes towards illness and disability, especially given shortcomings in social care. — kingsfund.org.uk (institutional) — “concerns about potential pressure on vulnerable individuals to end their lives due to societal attitudes towards illness and disability, especially given current shortcomings in social care provision”
- In Oregon, the proportion of those citing financial reasons for requesting assisted dying has risen from 2–5% historically to 8.2–10% in recent years, suggesting possible coercion by economic circumstance. — livinganddyingwell.org.uk (media) — “a notable increase in the proportion of applicants citing financial reasons for their request, rising from 2-5% historically to 8.2-10% in recent years in Oregon and Washington”
- In Canada, concerns have been raised about MAID being offered for non-health-related suffering, failure to explore underlying socioeconomic reasons, and instances where people with untreated mental illness received MAID. — pmc.ncbi.nlm.nih.gov (government) — “concerns about MAID being offered for non-health-related suffering, a failure to explore underlying socioeconomic reasons for requests, and instances where individuals with untreated mental illness have received MAID”
- In Oregon, psychiatric evaluations before assisted dying fell from 30% in the law's first five years to just 1% in 2022, suggesting a weakening of a key due-process safeguard over time. — bmjgroup.com (media) — “Psychiatric evaluations for assisted dying in Oregon have significantly decreased, with only 1% undergoing assessment in 2022, down from 30% in the first five years of the law”
- Support for assisted dying among the British public is lower among minority ethnic groups and religious individuals than the general average. — natcen.ac.uk (academic) — “Support is generally consistent across political parties, regions, and among disabled people and people of faith, although it is less positive among minority ethnic groups and religious individuals”
- For some marginalised groups, discussions around assisted dying are described as a 'luxury worry' compared to their unmet basic needs. — rsm.ac.uk (academic) — “for some marginalized groups, discussions around assisted dying are a "luxury worry" compared to their unmet basic needs”
Biggest unknown: Whether the stated safeguards ('clear and settled will', 'proper safeguards') would be maintained in practice, or whether — as in Canada and Oregon — scope expands and oversight weakens, disproportionately affecting marginalised groups.
Our reading: On the equal-treatment dimension of O9, this policy cuts both ways with real evidential weight on each side — genuinely mixed, not manufactured balance. On the improving side: the current situation creates a stark inequality by wealth and geography. Terminally ill people in the UK who wish an assisted death must either bear costs of ~£15,000 to travel to Switzerland or go without. Legalising with safeguards would equalise access to this option and give terminally ill people formal legal standing — a due-process gain. On the worsening side: evidence from comparable jurisdictions shows consistent patterns of safeguard erosion and differential pressure on vulnerable groups. Psychiatric assessments in Oregon fell from 30% to 1%; Canada has documented cases of MAID offered for socioeconomic rather than medical reasons; the proportion citing financial motivation has grown to nearly 10%. The King's Fund and the Royal Society of Medicine flag that marginalised groups — those with unmet social care needs, those in poverty, minority ethnic communities — are at heightened risk of coercion by circumstance rather than exercising a genuinely free choice. This is not a theoretical risk: the financial-motivation data in Oregon is measurable and the Canadian coercion concerns are documented. The policy's stated safeguards ('clear and settled will', 'proper safeguards') point in the right direction, but the international record shows these provisions tend to weaken with time and scale. The equal-treatment verdict therefore depends heavily on whether the UK maintains safeguards more robustly than comparable jurisdictions — which is unknown at enactment. Both the equality gain and the vulnerability risk are evidenced, making this genuinely mixed at moderate magnitude over the long term.