King's College London

Around two-thirds (63%) of people in England and Wales say they want the current Parliament to make assisted dying legal for terminally ill adults in the next five years, according to a new study.

20% say they do not want this to happen, while a further 17% do not take a side or have an opinion.

The research, by the Policy Institute and the Complex Life and Death Decisions Group at King’s College London, also finds that support is virtually the same when the public are told key details of Lord Falconer’s assisted dying bill, which are likely to be very similar to a parallel bill being introduced in the House of Commons this week by MP Kim Leadbeater. 66% back the Lords bill when they know its core provisions.

However, the findings also reveal much of the public still have reservations about the risks of assisted dying, even if they are broadly supportive of its legalisation.

Three in five (61%) say they would be concerned about some people being pressured to have an assisted death if the law were changed, including a majority (53%) of those who want the current Parliament to legalise.

And among supporters of legal assisted dying, 55% say they’d be likely to change their mind and become opponents of the policy, if it turned out someone had been pressured into choosing this option.

Just under half (48%) of supporters also say they are likely to rethink their position if someone’s choice of an assisted death was motivated by a lack of access to other care.

Further, 83% of those who support assisted dying cite poor palliative care as an important factor in their support, including 47% who say it’s very important.

The research – which is based on a nationally representative survey of 2,063 adults in England and Wales conducted by Focaldata – also looks at what motivates people’s views on assisted dying, how it should work in practice, including the role of the NHS and private sector in its provision, as well as who should pay and the potential risks involved.

Despite the desire to see Parliament legalise assisted dying, a considerable minority want to respect MPs’ personal views

While two-thirds (63%) of the public say they want assisted dying to be legalised in this Parliament, although under half (45%) say they want their MP to vote for the law, with 29% saying they’d rather their MP followed their own conscience in any vote on the issue.

Supporters of assisted dying prioritise pain relief and dignity, while opponents worry most about risks to the vulnerable

85% of supporters say the fact that assisted dying could give people a less painful or distressing death is a very important reason for their support.

A similar share (83%) say giving people more dignity at the end of their life is very important for them, while 72% say the same about people being able to choose how and when they die.

On the other side, 72% of opponents say a very important reason for their position is that vulnerable people could be pressured into an assisted death, and 69% feel this strongly about health professionals saving lives, not assisting in taking them – the top two answers given.

Most of the public want assisted dying to be available on the NHS…

Three in five (59%) people say assisted dying should be available on the NHS, if it is legalised, compared with one in five (18%) who think it should not.

Support for NHS provision rises even higher, to 80%, among those who want to see assisted dying legalised within this Parliament.

Seven in 10 (68%) of the public overall trust the NHS to provide assisted dying – although most of this group only trust the health service a fair amount (42%) on this issue.

…despite being relatively split on the financial impact

By 32% to 25%, the public are somewhat more likely to believe overall costs to the health service would decrease rather than increase if assisted dying was provided by the NHS.

But there is no clear consensus, with 25% also thinking costs would stay about the same, and 18% saying they don’t know.

However, 35% of the public say they’d be more likely to support legalising assisted dying if it reduced overall costs to the NHS. This compares with 23% who say they’d be less likely to support it if it increased costs to the health service.

A fifth (18%) of supporters of legalisation within this Parliament say they’d be more likely to change their mind if assisted dying led to higher NHS costs, and a fifth (19%) of opponents say they’d do the same if costs decreased.

But the public are most likely to say patients should not have to pay for assisted dying themselves

44% say that, if assisted dying were made legal, those seeking an assisted death should not have to pay for it themselves – almost double the 23% who think patients should have to cover their own costs.

Support for the view that patients should not have to pay rises with age, with those aged 65+ (53%) the only age group where a majority hold this opinion.

59% of those who support legalisation within this Parliament feel assisted dying should be free to the patient, compared with 19% who oppose it.

Yet a majority also see a role for the private sector

55% of the public support private healthcare companies also providing assisted deaths – almost double the share (24%) who oppose them doing so.

But people are more sceptical of such companies receiving public money for these services from the government’s healthcare budget, with 37% against this, compared with 28% in favour. Around a third (35%) do not take a side or say they don’t know.

People with mental health conditions are perceived to be most at risk from legal assisted dying

43% of the public say people with mental health conditions are most at risk of being pressured to have an assisted death, if the law were changed, with older people (34%), those with disabilities (33%), chronic pain or long-term health conditions (33%), or a cognitive impairment (30%) perceived to be next most at risk.

Many measures are seen as essential by majorities of the public, in order to minimise risks to patients, including the need to inform them of other care options (67%) and the risks associated with the assisted dying process (64%), as well as asking them twice if they want to proceed (66%).

By contrast, only around a quarter (23%) feel it is essential for a court or tribunal to approve the decision in each case – a requirement which is currently stipulated in the House of Lords bill.

Age and ethnicity are key dividing lines in public opinion on assisted dying

Younger people are notably less likely to back assisted dying, either in principle or practice. For example, 50% of 18- to 34-year-olds support its legalisation within this Parliament, compared with 68% of those aged 35 and above.

This may reflect the greater salience of this issue for those at a more advanced stage of life, as well as their higher likelihood of having experienced the death of loved ones.

Similarly, people belonging to ethnic minorities are less likely than white people to support legalisation within the current Parliament (46% vs 666%), as well as less likely to feel assisted dying should be available on the NHS (41% vs 62%) and that it should be free to those who want such a death (28% vs 47%).

Professor Katherine Sleeman said:

“While two thirds of people say they would want assisted dying legalised this parliament, 61% of the public are concerned about people being pressured into having an assisted death, and 83% of assisted dying supporters say poor palliative care is a reason for their support. With a Parliamentary vote on assisted dying imminent, it is critical that the debate on assisted dying considers the complexities involved in implementing this kind of reform. This includes the implications of legalising assisted dying in a context where many dying people struggle to access the care they need.”

Professor Bobby Duffy said:

“With two-thirds of the public in our study saying they want assisted dying to be made legal within this parliament, it seems right that a bill should be introduced and debated by MPs and peers. Supporters cite many strong reasons why they’d like to see assisted dying legalised, from reducing pain and distress in death, giving people more dignity and control over when and how they die, and avoiding the need to travel to other countries like Switzerland.

However, the study also shows how difficult and complex a decision this will be for politicians. While minorities of the public have very strong views in support or opposition, the majority are somewhat in the middle, either not having any opinion or only tending to support or oppose – views could shift quickly. We can also see that in some of the results, where over half of supporters of assisted dying say they would change their view to opposition if it turns out someone was pressured into an assisted death by people close to them, and nearly half say the same if it turned out someone had chosen an assisted death because they couldn’t access the care they needed.”

Professor Gareth Owen said:

“Whether one holds strong views about assisted dying or not, this data on the public’s views about the choice the Westminster parliament now faces deserves sympathy, respect and the attention of MPs and Peers. Two thirds of the public look ready for a change in the law but preferences may be unstable in light of moral complexities and imperfect access to care”