The practice of allowing doctors to prescribe a fatal medication to terminally ill patients who request it. Also known as assisted suicide or medical aid in dying.
Oregon became the first state to legalise assisted dying in 1994, establishing a model that has since been widely replicated. By the end of 2025 twelve states plus Washington, DC had legal assisted-dying laws, after Delaware and Illinois approved legislation that year. New York is expected to follow, with Governor Kathy Hochul expected to sign the state's bill into law.
The Oregon model consistently requires patients to have six months or less to live, with the diagnosis confirmed by two doctors. Patients must be mentally competent, must themselves request the medication, and must be able to take it themselves rather than having a doctor administer it. Relatively few people are eligible, and since some hospitals and doctors refuse to participate on moral grounds, assisted dying remains rare: in states where it is legal it accounts for less than 1% of deaths.
New York's legislation adds further guardrails beyond the Oregon model. The patient's mental fitness must be confirmed by a psychologist or psychiatrist, rather than by just any doctor. The patient's request to die must be filmed, as well as being witnessed by two people. These additional elements were added during negotiations between legislators and Hochul, a Catholic who sought the toughest safeguards in the country.
Religious groups have opposed assisted-dying legislation in Delaware, Illinois and New York. Pope Leo XIV unsuccessfully lobbied J.B. Pritzker, Illinois's governor, to exercise his veto. Some disability-rights groups have objected for fear that people will face pressure to choose death to relieve others of the burden of caring for them.
Assisted dying is legal in more than 30 jurisdictions worldwide, and the British Crown dependency of Jersey has passed a similar law. In Britain, majority support for assisted dying goes back to at least the 1930s; the House of Lords first formally debated an assisted-dying bill in 1936, years before any other country. An effort to legalise it has been made almost every decade since the 1960s. Four-fifths of Britons say it should be allowed for a terminally ill person with a painful illness. Keir Starmer, the prime minister, personally supports it.
In June 2025 MPs passed a bill introduced by Kim Leadbeater, a Labour backbencher—the fifth parliamentarian to propose such a bill since 2003—that would allow mentally competent adults with fewer than six months to live to be prescribed a lethal drug. It was arguably the strictest such bill in the world. However, rather than backing a government bill (as David Cameron did with gay marriage in 2013), Sir Keir chose to keep the government neutral and use the weaker private-member's bill route.
The bill was blocked in the House of Lords by a handful of peers who tabled almost 1,300 amendments (23 per page, a record at that stage). Nearly two-thirds came from just seven peers who oppose the principle of assisted dying. The proposed changes ranged from closing loopholes for anorexia patients to requiring all applicants to take a pregnancy test. Lady Finlay was among the seven blocking peers. The bill was certain not to become law before its final scheduled day of April 24th 2026.
In Scotland, members of parliament voted down a similar bill introduced by Liam McArthur in March 2026, citing inadequate safeguards. Protections allowing medical staff to opt out on moral grounds could not be included because the powers of Scotland's devolved Parliament do not extend to employment law, which turned many health-care professionals against it. Mr McArthur's bill spent two years in the Scottish Parliament; 81% of Scottish adults supported assisted dying in case of terminal illness.
Research by Anne Rasmussen at the University of Copenhagen found that policy in Britain aligned with majority opinion only 55% of the time, compared with an average of 63% across 31 European countries. The salience of an issue was a strong predictor of alignment; British voters generally rank moral issues far below the cost of living, immigration and the NHS.
The safeguards in America tend to be stricter than in some other Western countries. Canada and the Netherlands, for example, allow assisted dying in cases where patients suffer from incurable pain but are not terminally ill. American campaigners tend to rule out assisted dying for patients who are not terminally sick, and even fewer support it for those whose only illness is mental. Death with Dignity, an advocacy group, expects assisted-dying bills to be considered in 13 states in 2026, with Virginia, Maryland and Massachusetts judged most likely to pass them. More than 30% of Americans live in states where assisted dying is legal.
Either I'm dead or my watch has stopped.