Briefing: Terminally Ill Adults (End of life) Bill, Second Reading, House of Lords – 12.09.25

Assisted dying is a complex, sensitive, and ethically-charged issue. While opinion polls and surveys can measure levels of support or opposition, they often lack the depth needed to understand the complex trade-offs and relevant complexities.

The Citizens’ Jury closes this gap. It brought together 30 people from all walks of life, selected by a process of sortition*, and broadly represented the demographics and existing attitudes towards assisted dying of the English population.

Jury members explored three key questions: whether the law should be changed to permit assisted dying; what such a law should include or exclude if it is changed; and what, if any, policy recommendations should be made if the law remains unchanged.

Over eight weeks, participants engaged in a structured process of learning and deliberation, hearing expert testimony and examining a wide range of evidence and opinion. They then worked together to produce detailed recommendations, answering the overarching questions.

Alongside the Jury, the NCOB commissioned two nationally representative surveys, each with 2,000 respondents. The respondents were selected and weighted to reflect the demographic makeup of the English population. Together, the Jury’s recommendations and the survey findings offer robust and nuanced insights into public attitudes on assisted dying.

Further information on the research methodology and the full analysis of the findings can be found in the final report.

*Sortition: Citizens’ Jury members were recruited to take part using a process called ‘sortition’ or ‘civic lottery’, which was conducted by the Sortition Foundation. Sortition ensures that people are selected to take part in a way that is broadly representative of the wider population. It is recognised internationally as the gold standard model for recruitment to deliberative processes. Further information on the recruitment process can be found in the report.

While a majority of both Jury members and survey respondents supported changing the law to permit assisted dying, views and perspectives varied across demographic groups.

In Survey 1, those in the older age groups, whose ethnicity is White, and those with no religion were more likely to agree with the view that assisted dying should be legalised in England. Those from ethnic minorities, younger age groups, those of Muslim faith, and those working in end-of-life care were less likely to agree. The findings for Survey 2 were broadly similar, with variation across demographics.

If the law in England is changed to permit assisted dying, the majority of Jury members thought people who have a terminal condition should be eligible. There was less support for non-terminal physical conditions which cause intolerable suffering being eligible.

The reasons Jury members gave for restricting the law to terminal conditions include:

• Challenges in defining and measuring ‘intolerable suffering’, given that it is a subjective experience.
• A perception that there will be greater support for assisted dying if it is limited to terminal conditions.
• Concern that if it is not restricted to terminal conditions, there will be widespread access to assisted dying and it could lead to a “slippery slope”.

The Jury believed that if the law is changed to permit assisted dying, it is important that patients accessing an assisted death have a choice over how they end their life. This is in terms of who administers the lethal drugs (self-administered by the patient or administered by a physician), the method of how the medication is administered (injection, intravenous or oral), and where the assisted death take place.

The Jury agreed that patients should have a choice of where an assisted death can take place, enabling them to choose somewhere they feel comfortable and safe and can be with loved ones.  While 68% of survey respondents said that patients should have a choice in location (e.g. at home or in a regulated clinic).

Safeguarding people in more vulnerable situations was a significant issue in Jury member considerations, whether they were in favour of the law being changed or not. Coercion and pressure to pursue assisted death on elderly people, disabled people, or those with other vulnerabilities – whether social, familial, or political – was a key concern.

If the law is changed to permit assisted dying, both survey respondents and Jury members called for effective, robust legislation, governance and monitoring of assisted dying services to ensure high-quality care and protect vulnerable people.

The Jury members called for a safeguarding framework to be developed before any legislation is introduced, with the involvement of a range of experts.

Within the current Bill, the provision of assisted dying will be overseen by an Assisted Dying Commissioner.

Jury members considered that if the law is changed, having an independent regulatory and/or governing body would be essential. The purpose would be to:

• Ensure that assisted dying is tightly regulated and monitored, and high standards and quality of care are maintained, and to protect the intention of the law.
• Prevent misuse or abuse of the system, and ensure safeguarding measures are adhered to.
• Ensure transparency in relation to standards and safeguarding to ensure open scrutiny of the process.
• Establish a clear record of assisted deaths, including drugs used and complications.
• Ensure that mistakes are recorded, and investigations undertaken, while also providing opportunities for learning.
• Build public trust and reassurance in assisted dying processes and procedures.
• Ensure that decisions are unbiased, and processes are followed, so patients have equal opportunities and can appeal or complain about a decision.
• Ensure safe management and disposal of drugs.
• Ensure there is continual learning.
• Keep a record of medical practitioners who are trained and allowed to conduct an assisted death.

A few Jury members argued that the regulatory body would have a key role in controlling the commercialisation of assisted dying, in the event that private companies are allowed to provide assisted dying services to patients.