Is the UK any nearer to making assisted dying legal?
The Isle of Man has come one step closer to legalising assisted dying after the wording of the island's Assisted Dying Bill was debated on Tuesday.
Dr Alex Allinson, who is behind the Bill, said that after extensive debate and evidence taken from expert witnesses, the island's parliament, House of Keys (MHKs), approved "another landmark step in delivering assisted dying".
In the first stage of debate on the clauses stage of the Bill last week, MHKs voted that a person seeking an assisted death should have been resident on the island for five years instead of one, and that the life expectancy criteria be extended from six months to a year.
In Jersey, in the Channel Islands, there have been clashes over the island's proposed assisted dying law.
So, as several parts of the British Isles edge closer to legalising assisted dying, where does the UK stand? And what about the rest of Europe?
What is assisted dying?
The exact definition of assisted dying - sometimes referred to as assisted suicide or voluntary euthanasia - is still debated among medical professionals, and each term has a slightly different meaning, but broadly speaking it is the process of helping a person to end their life.
The NHS describes euthanasia as "the act of deliberately ending a person's life to relieve suffering".
Assisted suicide meanwhile is "the act of deliberately assisting another person to kill themselves".
Is it legal in the UK?
Both euthanasia and assisted suicide are illegal under current English and Welsh law.
Assisted suicide is illegal under the Suicide Act, which came into place in 1961, and it is punishable by up to 14 years in prison.
Depending on the circumstances, euthanasia is regarded as either manslaughter or murder. The maximum penalty is life imprisonment.
In Scotland the Assisted Dying Bill is set to enter its first stage in 2024, after 36 MSPs backed the move.
Could the law change across the UK?
In February the Health and Social Care Committee published a report on assisted dying, but it didn't make any recommendations that the law should be changed.
MPs last debated assisted dying on April 29 after a petition backed by journalist and campaigner Dame Esther Rantzen gained more than 200,000 signatures.
Ms Rantzen, 83, has stage four lung cancer and says that she supports assisted dying in order to protect her family from a "terrible memory".
The issue of legalising assisted dying was last voted on in the House of Commons in 2015, when it was defeated at the second reading stage by 330 votes to 118.
Labour leader Sir Keir Starmer has said that he wants assisted dying to be legalised after the next election.
Speaking in a phone call with Dame Esther in March, Sir Keir said he was "personally committed" to a change in the law.
Who is arguing for and against?
There are strong arguments on both sides of the debate in terms of whether assisted dying should be legalised.
The charity Humanists UK is among the groups that fully support assisted dying, as it explains in a policy on its website:
"We believe that any adult of sound mind who is intolerably suffering from an incurable, physical condition and has a clear and settled wish to die should have the option of an assisted death."
It states that the right to die in the way a person chooses should be "a fundamental human right".
The charity gives the following list of reasons as to why assisted dying should be legalised across the UK:
Assisted dying would give people control at the end of life;
There are tried and tested assisted dying safeguard regimes around the world;
Assisted dying would alleviate unnecessary suffering, indignity and fear;
Assisted dying would allow people to die on their own terms;
Assisted dying with safeguards would give legal clarity to families;
It's what the majority of people want (according to various public polling)
"Families are often forced to make an intolerable choice between either letting their loved ones suffer, or supporting them to travel abroad and risking criminal investigation," the charity says, referring to more than 200 UK citizens who have travelled abroad to end their lives since 2015.
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Meanwhile, there are numerous groups in the UK who have a strong position against legalising assisted dying, including an alliance called Care Not Killing.
The group is made up of disability and human rights groups, healthcare providers and faith-based bodies.
Care Not Killing lists the following arguments as to why assisted dying should not be legalised:
A change in the law would place pressure on vulnerable people to end their lives for fear of being a financial, emotional or care burden upon others; particularly in the case of people who are disabled, elderly, sick or depressed;
Persistent requests for euthanasia are extremely rare if people are properly cared for so the priority must be to ensure that good care addressing people's physical, psychological, social and spiritual needs is accessible to all;
The present law making assisted suicide and euthanasia illegal is clear and right and does not need changing;
The vast majority of UK doctors are opposed to legalising euthanasia along with the Royal College of General Practitioners, the Association for Palliative Medicine and the British Geriatric Society;
Parliament has rightly rejected the legalisation of assisted suicide and euthanasia in Britain four times since 2006 out of concern for public safety
What is the situation in Europe?
Assisted dying has been legal in Switzerland since 1942. Since then nearly 350 British people have ended their lives at the Dignitas centre, which is an organisation that offers physician-assisted suicide.
Switzerland specifies that assisted dying is only legal in that case that the motives are not selfish. Euthanasia in all forms is against the law.
Euthanasia is currently legal in five European countries: Germany, Spain, Belgium, the Netherlands and Luxembourg.
Assisted dying had been legal until 2015 in Germany, but its government ruled that "commercial promotion of assisted dying" was no longer allowed.
That decision was then overturned in February 2020, making assisted dying legal again.
In 2021 Spanish lawmakers legalised euthanasia and assisted dying for people who have serious, incurable or debilitating diseases, and who want to end their lives.
Before the ruling, anybody found to have helped somebody to end their life faced a prison sentence of up to 10 years.
The Netherlands brought its Euthanasia Act into force in 2002, after the national court concluded that the average Dutch physician no longer considered it their duty to prolong a patient's life under all circumstances.
Belgium passed a similar Act in the same year, while Luxembourg followed suit in 2009.
Each country has its own strict conditions under which assisted suicide is considered permissible, such as stringent rules for physicians who help with the procedure.
Meanwhile, in France a 'citizen's convention' concluded that assisted dying should be legalised, and a bill on the issue was introduced by the government in April.
If you have found the topics discussed in this article distressing, you can seek help and advice at the following places:
You can contact Samaritans;
You can call the NHS on 111;
You can text "SHOUT" to 85258 if you would rather not speak to someone over the phone.
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