Assisted Dying & Euthanasia in the UK - NHS Medicine Hot Topics & Interview Questions in 2024
Updated: 5 days ago
You will need to provide some examples of hot topics you can apply during your medical school interviews. Here you will learn everything you need to know about euthanasia and assisted dying in the UK.
This is a particularly relevant hot topic as the bill only went through parliament in November 2024 - which was hotly contested. This article has been recently updated to include information on the assisted dying bill debate in the UK in 2024.
This includes the ethical implications and some example medicine interview questions and model answers. Combine your reading here with medicine interview tutoring to boost your answers and delivery.
Summary of Euthanasia and Assisted Dying in the UK for Medical Interviews
Euthanasia is when a doctor intentionally ends the life of a patient, usually with medication, to relieve them of their suffering
Assisted dying is when a doctor provides a patient with the means and instructions to end their own life, but the patient performs the final act
Both euthanasia and assisted dying are currently illegal in the UK, though a bill is to be considered by the Scottish Parliament and English government that, if passed, would legalise assisted suicide for terminally ill adults
You should be prepared to answer questions about the arguments for and against euthanasia, as well as key ethical issues with the topic such as who would be eligible and more
Key Update 29/11/2024
Update on the Assisted Dying Bill 2024
On November 29th, 2024, MPs voted in favour of the Assisted Dying Bill 2024, a significant milestone in the debate surrounding end-of-life care in the UK. The bill, introduced by Labour MP Kim Leadbeater, aims to legalise assisted dying for terminally ill adults expected to die within six months, under strict safeguards.
The vote passed by 330 to 275, with MPs sharing emotional and deeply personal stories during the debate. Proponents highlighted the importance of autonomy and compassion, arguing that current laws force individuals to endure unnecessary suffering or seek assistance abroad. Opponents, however, raised concerns about the potential for coercion and the risk of a slippery slope leading to broader applications beyond terminal illness.
Public reaction has been mixed. Advocacy groups like Dignity in Dying celebrated the decision as a step toward greater choice and dignity for patients, while critics, including disability rights campaigners, expressed fears about protecting vulnerable individuals.
The bill now moves to the committee stage, where MPs will scrutinise it line by line. Additional votes and amendments will follow before it progresses to the House of Lords. Even if the bill becomes law, implementation is expected to take up to two years to ensure robust safeguards are in place.
This development marks a pivotal moment in the UK’s approach to assisted dying, and it remains a topic of intense ethical and legal debate.
Key Ethical and Social Issues Related to Euthanasia and Assisted Dying in the UK
What is the difference between euthanasia and assisted dying?
Euthanasia is when a doctor administers medications with the intent of ending a patient’s life. In most places around the world where this is legal, it is performed exclusively on terminally ill patients with little time left to live - often estimated at less than 6 months.
Euthanasia is usually carried out using a class of drugs known as barbiturates. These drugs slow down the brain and nervous system, so are often used in smaller doses to treat patients with seizures or insomnia, or as anaesthesia.
Assisted dying, on the other hand, is when a doctor provides these medications to a patient to administer to themselves. There is much debate as to the ethical distinction between the two concepts. Some argue that both are essentially identical, whilst others believe that it is different when the doctor is not performing the final act. There are also practical considerations, such as patients who are physically incapable of performing assisted suicide but may wish for euthanasia.
Euthanasia or assisted dying is legal in many places around the world - including the Netherlands, Switzerland, Australia, some parts of the USA, and more.
Both of these terms are different from what is known as passive euthanasia, the withdrawal of life-prolonging treatment such as a ventilator. This is legal with the consent of the patient, or in cases where a patient is brainstem-dead.
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What is the difference between active and passive euthanasia?
Active euthanasia involves the deliberate act of ending a person's life, such as administering a lethal dose of medication or injection, with the intention of relieving the person's suffering.
Passive euthanasia, on the other hand, involves withholding or withdrawing life-sustaining treatments, such as ventilators, feeding tubes, or medication, with the intention of allowing the person to die naturally.
The key difference between active and passive euthanasia is that active euthanasia involves a positive act to end a person's life, while passive euthanasia involves a decision to refrain from continuing medical treatment or support that is keeping the person alive.
Both active and passive euthanasia are controversial and raise ethical and moral concerns. Many people argue that active euthanasia is morally unacceptable because it involves intentionally taking a life, while others believe that it can be justified in certain situations, such as when a person is suffering from unbearable pain and has no hope of recovery.
Passive euthanasia is often seen as more acceptable because it allows a person to die naturally and peacefully, without the need for aggressive medical interventions that may cause unnecessary suffering.
However, some people argue that withholding or withdrawing medical treatment can also be morally problematic, particularly if the person is not able to make their own decisions about their care.
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What is the current legal status of medically assisted dying in the UK?
Euthanasia is currently illegal across the UK, and doctors who performed the procedure would be prosecuted and potentially sentenced to prison. Assisted suicide is also illegal in England, Wales, and Northern Ireland, and whilst there is no specific law against it in Scotland, other laws make it de facto illegal and it is not performed.
Additionally, it is illegal for doctors to provide patients with information about other ways to access euthanasia or assisted dying, such as travelling to countries where it is legal.
Liam McArthur, an MSP (member of the Scottish parliament), has won the right to introduce a bill known as the Proposed Assisted Dying for Terminally Ill Adults (Scotland) Bill. It would legalise assisted dying for terminally ill patients who are deemed by at least two doctors to be of sound mind and to have at most approximately 6 months of life expectancy.
Charities such as Friends at the End advocate for assisted dying and are involved in pushing forward this bill in Scotland. Similar bills have been proposed and rejected by the parliament before, and it is expected that regardless of the result this bill will be the subject of a very close battle.
If the bill were to be passed, it is likely that only a small handful of doctors would be licensed to assist a patient in dying.
Assisted Dying Bill 2024: What You Need to Know
In 2024, the Assisted Dying Bill was introduced in the UK Parliament, sparking intense debate about the future of end-of-life care. The proposed legislation seeks to legalise assisted dying for terminally ill adults in England and Wales, granting patients greater autonomy over their final moments while including stringent safeguards to address ethical concerns.
What Does the Bill Propose?
The Assisted Dying Bill, introduced by Labour MP Kim Leadbeater, would allow terminally ill adults who are expected to die within six months to legally end their lives.
Key conditions include:
Eligibility: Patients must be over 18, residents of England or Wales for at least a year, and registered with a GP.
Mental Capacity: Patients must demonstrate a clear, informed, and voluntary wish to die, free from coercion or external pressure.
Approval Process: Two independent doctors must confirm eligibility, with a seven-day gap between assessments. A High Court judge must also approve the request after reviewing evidence and potentially questioning the patient.
Administration: Patients would self-administer the prescribed medication, ensuring that no doctor or other individual directly ends their life.
The process is designed to balance patient autonomy with robust protections, ensuring that only those who meet strict criteria can access assisted dying.
Why Is This Bill Being Proposed?
Advocates for the bill argue that current laws force some terminally ill individuals to endure prolonged suffering.
Leadbeater emphasised that even the best palliative care cannot alleviate all pain and that offering patients the choice to die with dignity is a compassionate solution.
Campaigners point to cases where individuals have travelled abroad to access assisted dying services, often in distressing and expensive circumstances, as evidence of the need for change.
What Are the Safeguards?
The proposed law includes some of the strictest safeguards in the world.
It would be a criminal offence, punishable by up to 14 years in prison, to pressure or coerce someone into choosing assisted dying.
Healthcare professionals who object to participating in the process would not be compelled to do so, reflecting a neutral stance from organisations like the British Medical Association and the Royal College of Nursing.
Public and Professional Reactions
The bill has divided opinion among the public, politicians, and healthcare professionals. Supporters, including groups like Dignity in Dying, argue that the proposal prioritises compassion, autonomy, and safety.
Critics, such as disability-rights advocates and campaigners like Paralympian Baroness Tanni Grey-Thompson, warn that legalising assisted dying could expose vulnerable people to coercion and undermine efforts to improve palliative care.
Comparisons with International Laws
The proposed legislation resembles laws in Oregon, USA, where assisted dying has been legal since 1997 for terminally ill adults with a life expectancy of six months or less. However, it is more restrictive than laws in countries like the Netherlands and Belgium, which allow euthanasia for individuals experiencing unbearable suffering, including non-terminal conditions.
Assisted Dying Bill 2024
On November 29th, 2024, MPs voted 330 to 275 in favour of the Assisted Dying Bill, marking a significant step toward legalising assisted dying for terminally ill adults in England and Wales.
The debate saw emotional contributions from both sides, with supporters emphasising autonomy and compassion and critics warning of risks to vulnerable individuals.
The bill now moves to the committee stage for further scrutiny, with additional debates and votes required before it can become law.
This historic vote reflects growing public and political engagement with end-of-life care and the ethical complexities surrounding it.
What’s Next?
Following the recent Commons vote, the Assisted Dying Bill will now proceed to the committee stage, where MPs will carefully examine its provisions and propose potential amendments. After this, the bill will return to the Commons for a final reading before moving to the House of Lords for further debate and voting.
Each stage offers opportunities for scrutiny, and any amendments made in the Lords will require agreement in the Commons. Given the complexity and sensitivity of the issue, this process is expected to take several months, with final decisions potentially extending into late 2025.
As the debate continues, the focus will remain on balancing safeguards to protect vulnerable individuals with the autonomy and dignity of terminally ill patients.
What are the ethical arguments in support of euthanasia and medically assisted dying?
There are numerous arguments in favour of medically assisted dying, and one article does not have enough space to cover all of them. However, some of the main ones are:
Dignity: It would allow patients who are suffering to have a say in when they die and avoid the pain that often comes at the end of terminal illnesses such as cancer and end-stage organ failure.
Autonomy: Patients have a right to decide what happens to their own bodies and in their own lives, including when that life should end. Doctors are there to facilitate a patient’s wishes.
Safety: Some patients, in places such as the UK where assisted dying, is illegal, may commit unassisted suicide which can be more traumatic and dangerous for them (if the attempt leaves them more disabled) and anyone who finds them. Assisted suicide would prevent this.
What are the ethical arguments against euthanasia and medically assisted dying?
Similarly, there are plenty of arguments against medically assisted dying. Here are some of the main ones:
Sanctity of life: Many people believe life to be sacred, either for religious or non-religious reasons. Therefore, life should never be intentionally ended.
Slippery slope: It could be hard to determine who can and can’t get euthanasia, which means that some people could be euthanised when it is not in their best interests even if they want it.
Doctors playing God: Doctors are there to help and heal, not to kill. Some people believe that these laws would give doctors far too much power.
Summary
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Who would be eligible for euthanasia, and what about patients with mental illnesses?
One of the key aspects of euthanasia to consider is who would be eligible for it. In particular, aspects to consider include:
How many doctors should have to agree that this is in the patient’s best interests, they are of sound mind, and that they are terminally ill with a low life expectancy?
Should this be limited to patients who are terminally ill?
What about patients who write advance directives about wishing for assisted death, even if they do not have the capacity to consent later on?
Should this be limited to patients with physical illnesses, or also be allowed for patients with mental illness?
The latter question is becoming increasingly relevant in ethical discussions surrounding assisted death.
Of the 2656 people who died from physician-assisted suicide last year in Belgium, 57 gave their primary reason as mental rather than physical illness. Canada has also sparked debate with its decision to allow the procedure for people with psychiatric disorders. The BBC published an article about a woman named Aurelia Brouwers who received assisted suicide after a long battle with mental illness.
Some people believe that people with these illnesses also deserve the autonomy to decide to end their life, especially after trying all possible treatment options. Others think that the lack of terminality of these illnesses, combined with murky waters surrounding patients’ capacity to consent, means that this should not be allowed.
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Where in the world is euthanasia legal?
Euthanasia is legal in the following countries:
Belgium
Canada
Colombia
Luxembourg
The Netherlands
Switzerland
In addition, assisted dying is legal in the following US states:
California
Colorado
Hawaii
Maine
Montana (through a court ruling)
New Jersey
Oregon
Vermont
Washington
It is important to note that the laws and regulations surrounding euthanasia and assisted dying can vary greatly between different countries and regions, and they may be subject to change over time.
Top tips for Medicine Interview Questions on Euthanasia
You could get questions about any of the above topics, or dying more generally, in your medical school interviews. Some top tips to consider are:
Be aware of the current law and show off your knowledge about how it is changing, especially in Scotland.
Think about weaving multiple topics together. If you are asked about the capacity to consent, for instance, you may also want to consider how this links to questions surrounding assisted dying for patients with mental illnesses.
Show both sides of the argument. This is a topic where a lot of people have strong views on both sides, and it’s important to be respectful of that. Bear in mind that the British Medical Association is neutral on euthanasia.
👉🏻 Read more: MMI Medicine Interview Tips Guide
Example Medicine Interview Questions and Answers on Euthanasia
Q: Do you support the proposed bill that would legalise assisted dying in Scotland?
Answer 1 (Yes): Ultimately, the question of assisted death is incredibly complex and there are very valid arguments on both sides. Personally, I would support this bill.
I believe that the purpose of medicine is to allow people autonomy over their own lives and to facilitate their ability to live as they wish. This, for me, includes control over dying. In particular, I think that the choice to end your life with dignity, avoiding suffering, is valid and something that we should assist with. It would also prevent patients from feeling as though they have to take their own lives instead, which can be riskier, more traumatic, and less dignified.
I understand concerns that the bill could lead to patients being assisted to die who do not really need this, however, I believe that this can be safeguarded against. For instance, we could have firm rules on which patients are eligible and ensure that multiple doctors have to agree before the procedure takes place.
This is definitely a tough ethical issue and something that I’d like to read more about, but I do support the proposed bill to legalise assisted death in Scotland.
👉🏻 Read more: Answering Medicine Ethics Questions
Answer 2 (No): Ultimately, the question of assisted dying is incredibly complex and there are very valid arguments on both sides. Personally, however, I would not support this bill.
I believe that medicine should be about improving patients’ lives - both increasing the amount and quality of time that they have. Given this, I don’t think that assisted dying is ever the answer - instead, it’s important to focus on palliative care and pain relief. Even if there are some cases where these options may not be successful, this is worth it to stop the cases of unnecessary patient death that would arise.
I do understand arguments that this is necessary for patients to maintain dignity and practice autonomy, but there are plenty of procedures that we don’t offer to patients because we deem them not to be in their best interests. This is just one more case like that.
This is definitely a tough ethical issue and something that I’d like to read more about, but I do not support the proposed bill to legalise assisted dying in Scotland.
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Medical Interview Euthanasia and Assisted Dying Questions
What is the difference in definition between euthanasia and assisted dying?
What do you understand about the debate surrounding the assisted dying bill?
Do you think it is right that doctors are not allowed to give patients information about how to travel to countries where euthanasia is legal?
Should euthanasia be allowed for patients with mental illnesses?
If euthanasia were legalised, how should it be implemented?
What happened with the Assisted Dying Bill vote in 2024? What was its significance?
What are the pros and cons of assisted dying in the UK?
What types of patients, if any, do you think should be eligible for euthanasia?
Imagine that you are a GP and a patient comes to you requesting euthanasia. They are suffering from terminal metastatic lung cancer and are expected to only have a few months left to live. How would you respond to this?
If euthanasia were to be legalised, which types of doctors should perform it?
👉🏻 Read more: 280 Common Medicine Interview Questions
Conclusion
Overall, euthanasia and assisted dying questions can provide a valuable opportunity to reflect on the ethical challenges that can arise in medicine and to demonstrate your ability to think critically about these issues.
FAQs: Understanding Euthanasia and Assisted Dying in the UK
What is euthanasia?
Euthanasia refers to the practice of intentionally ending a person's life to relieve suffering, typically through medical intervention. It differs from assisted dying, where a patient self-administers life-ending medication. Both practices are often debated in the context of medical ethics and patient rights.
Is euthanasia legal in the UK?
Euthanasia is not legal in the UK. However, the Assisted Dying Bill 2024 is currently under discussion and could legalise assisted dying for terminally ill adults in England and Wales. This would allow patients expected to die within six months to make a legally supported choice about ending their lives.
What is the difference between euthanasia and assisted dying?
The main difference lies in who performs the final act. In euthanasia, a doctor administers the life-ending medication. In assisted dying, the doctor prescribes the medication, but the patient administers it themselves. The UK does not currently allow either practice.
What are the main arguments for euthanasia?
Supporters of euthanasia argue that it provides dignity and choice for terminally ill patients, allowing them to avoid prolonged suffering. It is also seen as respecting patient autonomy and preventing unsafe or traumatic attempts at ending life in places where it is not legally supported.
What are the arguments against euthanasia?
Opponents highlight concerns such as the sanctity of life, the potential for coercion, and fears of a "slippery slope" where legalisation could expand to less restrictive cases. Many also believe that palliative care should be the primary focus, rather than allowing assisted dying.
What is the legal status of euthanasia globally?
Euthanasia is legal in countries like Belgium, the Netherlands, and Canada, while assisted dying is allowed in Switzerland and several US states, including Oregon and California. These laws often include strict safeguards, such as requiring multiple medical assessments.
What are the ethical concerns surrounding euthanasia and assisted dying?
Ethical debates often centre on patient autonomy versus the sanctity of life. Critics argue that allowing euthanasia could undermine trust in healthcare and lead to potential abuse, while supporters see it as a compassionate response to unbearable suffering.
Are there examples of euthanasia cases in the UK?
Although euthanasia is illegal in the UK, cases of terminally ill patients travelling to countries like Switzerland for assisted dying are well-documented. These stories often fuel the debate around changing UK laws and highlight the emotional and ethical complexities involved.
What is the Assisted Dying Bill 2024?
The Assisted Dying Bill 2024 proposes allowing terminally ill adults in England and Wales to legally end their lives. It includes strict safeguards, such as requiring two independent doctors to confirm eligibility and a High Court judge to approve each case. The bill has sparked significant public and political debate.
How does active euthanasia differ from passive euthanasia?
Active euthanasia involves deliberately administering medication to cause death, while passive euthanasia refers to withholding or withdrawing treatments that prolong life, allowing the patient to die naturally. Passive euthanasia, such as turning off life support with consent, is legal in the UK under specific circumstances.
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