A bill to legalise assisted dying for people who are terminally ill passed its second reading in the UK parliament on 29 November 2024. Scotland, Jersey and the Isle of Man have also actively debated assisted dying. Deliberation about assisted dying takes place at a time of fundamental challenges with the provision of end of life care in the UK.
A number of other countries allow assisted dying but implementation varies: there is limited high-quality evidence about the impact of legislation on end of life care services.
About this project
We are undertaking this project to study the effects of legalised assisted dying on end of life care policy and service delivery in different countries, so that if assisted dying becomes legal in the UK, we can anticipate impacts on end of life care.
Clarifying our organisational position on assisted dying
The Nuffield Trust is an independent health think tank. We are neutral on the ethical question of whether or not assisted dying should be legalised, but we are committed to providing evidence on the implications for end of life care services of legislation. The focus of this proposal is on the impact of legal change on end of life care policy and service delivery including for the NHS and social care services and the workforce.
What we’ll do
We have divided the project into two complementary phases, so that publication of outputs can be timely in response to relevant legislative developments.
In this first phase we will undertake a scoping review of evidence and identify potential implications for end of life care policy and service delivery across a number of areas, including the impact on individuals and families, staff and how services used by people at the end of life are organised. We will conduct interviews with UK stakeholders to understand stakeholders’ perspectives on the impacts, positive and negative, of assisted dying legislation on end of life care. We will undertake a survey to understand the international landscape with respect to end of life care and assisted dying legislation and implementation.
Our research questions are:
What aspects of end of life care policy and service delivery might be impacted by assisted dying being legalised? What are the concerns of UK stakeholders about the impact of legislation on end of life care?
What is the evidence specifically of the impact on (a) patients/service users and their families, (b) the health and care workforce, (c) organisation of services (for example, funding, regulation)?
How have international jurisdictions outside the UK planned for the impact of legislation on end of life care services?
What lessons do international jurisdictions have for the UK (based on salient contextual similarities, for example, in terms of approach to end of life care services, and the scope and aims of assisted dying legislation)?
The scope of the second phase, which will look in more depth in some countries, will be reviewed after phase 1.
Project funding and outputs
The research is funded by the Nuffield Trust from our endowment. Findings from the research will be published on the Nuffield Trust website.
Timelines
Phase 1 of the project began in October 2024 and will run until June 2025.
Project team
The project team includes Sarah Scobie, Miranda Davies, Rachel Hutchings, Stephanie Kumpunen and Sarah Reed.
The project is being supported by an advisory group. The advisory group is chaired by Professor Graham Martin, and brings together a broad range of expertise and experience including people with lived experience of end of life care, health and social care provision, academia and people from different clinical backgrounds.
Please contact sarah.scobie@nuffieldtrust.org.uk for further information.