What do assisted dying, assisted suicide and euthanasia mean and what is the law?

Scotland could become the first UK nation to let terminally-ill people end their lives if a bill that has been introduced in the Holyrood Parliament is approved.

Campaigner Dame Esther Rantzen also wants Westminster MPs to vote on assisted dying, after a report found some evidence that it had led to better end-of-life care in places where it is allowed.

A number of countries have legalised assisted dying, assisted suicide or euthanasia, which are all different.

There is some debate over exactly what the various terms mean.

But assisted dying is generally used to describe a situation where someone who is terminally ill seeks medical help to obtain lethal drugs which they administer themselves.

Assisted suicide is intentionally helping another person to end their life. It can involve people who are not terminally ill.

Providing someone with a lethal dose of sedatives, or helping them go to Switzerland (where assisted suicide is legal), could both be considered assisted suicide.

Euthanasia is the act of deliberately ending a person's life to relieve suffering, in which a lethal drug is administered by a physician.

It is legal in fewer places than assisted dying or assisted suicide, and patients do not necessarily have to be terminal.

There are two types: voluntary euthanasia, where a patient has given consent, and non-voluntary, where they have not been able to, for example if they are in a coma.

The laws throughout the UK prevent people from asking for medical help to die.

More specifically, euthanasia is illegal under English law and is considered manslaughter or murder. The maximum penalty is life imprisonment.

The Suicide Act 1961 also makes it illegal to encourage or assist a suicide in England and Wales. Those found guilty could face up to 14 years in prison.

Similar laws also exist in Northern Ireland.

There is no specific crime of assisting a suicide in Scotland, but it is possible that helping a person to die could lead to prosecution for culpable homicide.

However, a new bill drafted by the Lib Dem MSP Liam McArthur, could see Scotland become the first UK nation to allow assisted suicide.

Mr McArthur expects the bill to be debated in the Scottish Parliament in the autumn.

In March 2024, a report from the Health and Social Care Committee highlighted confusion over the rules governing UK doctors providing medical evidence for people who wanted to go abroad to die.

The British Medical Association (BMA) advises doctors against producing medical reports to facilitate assisted suicide abroad.

UK membership of Dignitas, the Swiss assisted dying association, jumped to 1,900 people in 2023, according to the organisation. That is a 24% rise on the previous year.

It said 40 people from the UK ended their lives at Dignitas in 2023, the highest level since 2019. In total, it has helped 571 Britons die since 1998.

Campaigners have made numerous attempts to alter the law over many years.

Broadcaster Dame Esther Rantzen, who has stage four lung cancer, launched a petition in support of assisted dying in December 2023. It has passed the 100,000-signature threshold needed to trigger a debate in Parliament.

Dame Esther, who has joined Dignitas, welcomed the Health and Social Care Committee's findings that end-of-life care had improved in some places which had legalised assisted dying.

However she said she was "disappointed" that it had not backed her calls for a vote.

The Westminster government says any change is a matter for Parliament.

Proposals on assisted dying were last rejected in July 2022, but the government said it would provide time to debate the subject again. It indicated that MPs would be free to vote as they wished.

Labour leader Sir Keir Starmer says that he is "personally in favour of changing the law" on assisted dying, and is "committed" to holding a vote on the issue if he were elected prime minister.

The current law has also been challenged in the courts, with a number of people with terminal and life-limiting illnesses arguing for their right to die.

Both the BMA and Royal College of Nursing have neutral positions on assisted dying.

Others argue the current legal position around all forms of assisted death should remain the same.

Baroness Grey-Thompson is concerned that vulnerable people could be coerced into pursuing assisted dying, and that it is hard to put adequate safeguards in place.

"We need to make sure people are protected," she told BBC Breakfast, arguing that medical complications can arise once lethal drugs enter the body.

Dr Gordon Macdonald, of anti-assisted dying campaign group Care Not Killing, said he believed there were "many problems" with changing the law.

He is worried that criteria for assisted dying could in time be extended beyond terminally-ill people to include those with disabilities, and conditions such as dementia and depression.

The Dignity in Dying campaign group says more than 200 million people around the world have legal access to some form of assisted dying.

Switzerland has allowed assisted suicide since 1942. Its Dignitas facility began operating in 1998. However all forms of euthanasia are against the law.

Assisted suicide is also legal in neighbouring Austria.

In the US,11 states allow assisted dying. Known as "physician-assisted dying", it permits doctors to prescribe lethal drugs for self-administration.

Physician-assisted dying is legal in Oregon, California, New Mexico, Colorado, Washington, Hawaii, New Jersey, Vermont, Maine and Washington DC.

In Montana, court rulings allow doctors to defend themselves if they assist in a person's suicide.

Voluntary euthanasia is legal in Canada, where it is called medical assistance in dying. It can be provided by a doctor or nurse practitioner, either in in person, or through the prescription of drugs for self-administration.

It is also legal in Spain and Colombia, both of which also permit assisted suicide.

Assisted dying is legal in some parts of Australia, but the law differs across states. It is not permitted in either the Northern or Australian Capital territories, which have separate legal systems.

New Zealand's End of Life Choice Act legalises assisted dying and allows adults in their final months of life to request assistance from a medical professional.

Three countries have laws that allow people who are not terminally ill to receive assistance to die: The Netherlands, Belgium and Luxembourg.

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