How does assisted dying uptake vary globally?published at 14:23 BST 11 September

14:23 BST 11 September

By Anthony Reuben

Speaking during the debate earlier, Conservative MP Sir Edward Leigh said: “I believe that in 10 years time we will be in a situation like Canada and very large numbers of people will be choosing assisted dying.”

I’ve been looking at the countries where assisted dying is legal and have examined their most recent annual reports containing the number of people who have had an assisted death. There is a wide range in the levels of take-up.

In Canada, in 2024 the rate was 5%, external, which means that of all the deaths in the country that year, one in 20 was assisted. In the Netherlands, external it was higher than that in 2025 at 6%.

At the other end of the scale, Spain, external, Austria, external and Colombia, external have rates of about 0.1%, which means one death in 1,000 is assisted.

The debate over the Terminally Ill Adults (End of Life) Bill has now ended after hours of back and forth in the House of Commons.

MPs are now voting on if the debate should be brought to a close - if this vote passes, they will vote on the bill itself.

Image source, House of Commons

Minsiter for Health Alison McGovern says assisted dying has been subject to "detailed consideration" over a number of years, inside and outside of parliament.

She reiterates that the government is neutral on assisted dying and on the passage of the bill.

"It is right that this is a matter for parliament and not government to decide whether this bill should become law," she adds.

But she says the government has a duty to the statute books and to make sure the bill is "workable and effective".

McGovern makes the point that the government is working to improve both social care and palliative care.

"This is a deeply challenging issue" she says, becoming emotional, and says MPs must listen and understand one another during this time.

Image source, UK Parliament

Labour MP for Stroud Dr Simon Opher says this assisted dying bill is the "safest... in the world" because it has got so many safeguards - more than bills in other countries, including Australia, he says.

Opher says in 2010, the UK system of palliative care was levelled the best in the world, "and yet still people went to Dignitas, still 600 people who were suffering from terminal diagnoses killed themselves".

Turning to mental health, he says studies in California show that even for people with terminal illness who were treated with depression, it made no difference to their choice around assisted dying.

"It's not a choice between life and death; it's death from natural causes, or death under your control ," he adds.

Harry Farley
Political correspondent

Janet Daby, the Labour MP for Lewisham East, announced she has changed her mind.

She told the Commons she had “nightmares about dying and death” after she voted in favour of the bill.

“I had to wrestle with myself, knowing that I was not entirely comfortable with the decision I had made, and my conscience was not at peace, and I cannot again, in good conscience, vote for the Bill,” she said.

She pointed to the government’s equality impact assessment and her concerns about the risks of coercion, particularly for those of ethnic minority backgrounds.

There haven’t been many MPs in this debate openly switching their position. There may be evidence of more changers when we get to the vote.

Image source, UK Parliament

Siân Berry, Green Party MP for Brighton Pavilion, says she has heard from many of her constituents about "losing people under the worst circumstances because the status quo did not allow them another choice".

She says one constituent, Julia, described losing her mother, Jane, after she was diagnosed with a "progressive, terminal neurological condition" aged 92.

Jane chose to end her life in a "very distressing way", Berry tells MPs, and made sure her friend and carer would find her instead of her daughter.

Jane said: "She has left me with positive memories of her rather than the gradual eroding of herself that she and I to be honest were both dreading."

Berry says people have "demonstrably been harmed by the law as it stands" and rebuts alarms other MPs have raised about this bill opening people up to the risk of harm.

"I believe we can see real safeguards in the bill before us, they are very very strict," she adds.

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Hugh Pym
Health editor

Image source, Getty Images

Some palliative and end of life care is provided by charities which have to raise most of their funding from the public.

Hospices receive only up to about a third of their income from the NHS with the rest coming from high street charity shops, donations and fundraising.

The sector has been struggling with rising employer costs, other bills and the NHS funding not keeping pace.

Some have announced redundancies and cuts to services. There can be wide variation over what financial support local NHS care boards will provide.

Hospices offer residential care and community services to allow patients to spend their final days at home if they wish. They argue that busy and noisy hospitals, sometimes without specialist palliative care, are not the best place for end of life patients.

Hospice leaders are calling for the system to be stabilised and properly funded so people can have a genuine choice over their options in the event of assisted dying becoming legal.

Image source, House of Commons

Former Work and Pensions Secretary Liz Kendall says the ability to live or die as one chooses "shouldn't only be the privilege of those with money, knowledge or resources".

The Labour MP for Leicester West focuses on the "principle of choice" in discussing this bill.

She says the bill is "deeply important to the people and families who have suffered unbearable deaths and who are worried about unbearable deaths, whether or not they use that choice".

She rebuts the argument that the country needs better palliative and social care before introducing legislation to legalise assisted dying, saying that both are needed because better social care "will not relieve unbearable suffering for some people".

It is important to allow people to die a "good death", Kendall says, which includes being able to choose "where death occurs, who is present, who shares the end".

She adds that it is is "not right" that a "tiny minority" in the House of Lords should be able to "talk the bill out with hundreds and hundreds of amendments for the sole purpose of scuppering this bill".

Image source, House of Commons

Carla Lockhart, the DUP's MP for Upper Bann, says what she describes as the "soft language" of assisted dying is misleading the public - saying it "obscures the dark reality of what is actually being proposed".

"We should have the courage to call things what they are," she tells MPs, saying the bill would allow doctors to provide lethal drugs for a patient to end their life.

Lockhart says this goes against NHS principles and would ultimately be a form of "state-sponsored suicide".

She refers to world suicide prevention day, which took place yesterday, and says this "irony" should not be lost on MPs.

The bill "weakens the principles that underpin our suicide prevention strategies," Lockhart says, adding that she also has "grave concerns" about people who may be pressured into choosing assisted dying.

"The bill presumes the best, rather than legislates for the worst," she says, adding that the answer is to make care more available, not making "death more available".

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Campaigners have been protesting both for and against the passing of the bill at Parliament Square, close to where MPs are currently debating the proposed legislation in the House of Commons.

One says it's "too dangerous", while another hopes desperately it is passed. You can watch more above.

Image source, House of Commons

Abena Oppong-Asare, Labour MP and patron at the Community Hospice in Abbey Wood, says she has personally seen "dignity, comfort and compassion" provided to those at end of life - and how much that means to people.

She says providing dignity at the end of life is possible and that it is MPs' responsibility to make it available for everyone.

Oppong-Asare says that when considering this bill, MPs must consider the uncertainty of prognosis and diagnosis provided to patients towards the end of life.

She also says she can't separate the debate from her own experiences and that members of her family have suffered discrimination in healthcare settings, adding: "Trust, access and outcomes in healthcare are not always experienced equally by everyone."

"They do not disappear when people become terminally ill," she adds.

Oppong-Asare concludes by saying that access to death should never be easier than dignity in life, and that until Parliament is able to implement proper measures that tackle inequality and safeguarding, the bill should not pass.

Much of today's debate has included conversations over end of life care, and improving it so people have access to a dignified death.

Toby Porter, the chief executive of Hospice UK says the bill in its current wording could lead to an "unintended negative impact" for hospices, potentially leaving them in financial and legal difficulties.

He earlier told BBC Radio 4's Today programme that the charity has asked for an amendment to the bill to allow hospice boards and leadership teams to take their own decisions on how to engage with a potential change in law.

Meanwhile, Dr Sam Royston from the Marie Curie charity says the "crisis" in palliative care must be fixed regardless of what happens with the law.

Steve Smith, speaking on behalf of St Christopher's hospice in south London, says current hospice funding is "not sustainable" and calls for fair funding before more services are "forced to close or cut back".

"Whatever MPs decide on assisted dying, investment in hospices must be treated as an urgent priority in the new Modern Service Framework for palliative care," he says.

The organisations above remain officially neutral on the topic of the law changing on assisted dying.

Conservative MP Martin Vickers says the "crucial" relationship between doctor and patient could be "compromised" if the patient was "anything other than 100 per cent certain that the doctor was striving to maintain life".

He says they cannot produce legislation for every single circumstance, and instead need to look at sufficient safeguards, which the bill does not have.

When people are old and well, people need "compassion and support", he adds, not the worry over whether everything possible is being done to "preserve ones life".

Image source, UK Parliament

Hilary Benn of Labour says the bill addresses a "very difficult" moral and practical question.

The MP tells the Commons that the "biggest contradiction" for those arguing against it lies with the matter of terminally ill individuals already travelling abroad to end their lives in places where assisted dying is legal.

He describes it as "a gaping hole" in the argument, adding that it has left the Crown Prosecution Service with the "terrible dilemma" of considering whether to prosecute loved ones escorting terminally ill individuals to destinations such as Switzerland.

He says figures show the vast majority have not been prosecuted for this.

Therefore, Benn says: "If we have in effect legalised assisted dying for British citizens who have the money and the means to do it abroad... then why are we not prepared to provide the same means to people to bring their lives to an end who are terminally ill here in the United Kingdom?"

Erica Witherington
Disability affairs reporter

Image source, Reuters

Crossbench peer Baroness Campbell tells me disabled people are tired of explaining why they fear assisted dying.

The veteran disability rights campaigner and founder of Not Dead Yet UK has spent decades opposing attempts to change the law.

She says she understands the desire for control at the end of life.

Her first husband, Graham, contracted HIV through contaminated NHS blood products, and she describes his death as “about as hard as it gets”.

But Baroness Campbell says her own fight to get the support she needs has also shaped her views.

“Choice is only genuine when a real alternative exists,” she says.

She argues many disabled people still can’t get the adequate social care, accessible housing or palliative care they need to live a “good life.”

Families can be exhausted, while people may spend years fighting for basic support.

“Nobody needs to tell a disabled person they should die for them to feel like a burden,” she says.

“Autonomy without support is not freedom. It can be abandonment dressed up as choice.”

Image source, House of Commons

Sadik Al-Hassan, Labour MP for Somerset North, says that when considering whether to support the bill, he had to consider his views as a Muslim.

"I've concluded that while I personally may not choose to make use of this provision, my faith guides my own life. It is not my place to let it dictate someone else's final chapter," he tells MPs.

Al-Hassan says the debate is about whether people "have the right to choose" and that choice is central to faith.

"If I were to use religion as a basis for stripping others, it would turn faith against one of its own foundations," he says, adding that the right to choose "should not be denied any one of our beliefs".

He adds that as a former pharmacist, he's seen the faces "behind this debate", and watched people collect prescriptions "that offer nothing more than a sticking plaster over the terminal illness".

"Pain managed but suffering not ended."

A safe, legal route at the end of life wouldn't replace palliative care but "sit alongside it, offering the small mercy of choice," he adds.

Image source, House of Commons

Lib Dem MP Monica Harding says there has been "no assurance" that government time will be allocated to amendments for today's bill.

She says the question isn't over the principle of assisted dying but if they are content with this bill as they no longer have the prospect of the second chamber making the bill "any safer", alluding to the House of Lords stalling in their consideration of the bill earlier this year.

She says the warning that resonated the most with her was from the Royal College of Psychiatrics when they stated "somebody could proceed to an assisted death where they may have made a different decision had those needs been met".

Harding says during the passage of this bill, two of her siblings who both suffered poor mental health throughout their lives have died. While they suffered with cancer, she witnessed their mental health worsen when staff couldn't get the medication right.

This was due to poor handover practices and difficulties in assessing the mental health of palliative patients, she says, adding neither of these factors will be resolved by today's bill.

"It is our duty to design the systems and processes which are safe for people like my brother and sister," she says, adding they haven't done so here.

The MP adds: "There will be no amendments to protect my brother and sister. I would have wanted them protected."

"The bill is not safe."

Image source, PA Media

Prime Minister Andy Burnham has said he will not vote on the bill on Friday, noting he has his "own personal views on the issue" but it was "a matter for Parliament to decide".

He has also stressed the government would officially remain neutral on the bill.

In July, Burnham said the funding of palliative and social care should be "fixed" before assisted dying is considered in England and Wales.

It was the first time he set out his position on the issue after becoming PM.

In 2024, when he was the mayor of Greater Manchester, Burnham told BBC Manchester he would "probably vote in favour" of the bill if he was in Parliament.

But in June he suggested it would be challenging to implement before social and palliative care were improved.

Burnham has also told ministers they can vote as they wish but he told them they "should avoid being part of the public debate and should not express views about the implications of the bill for their department's responsibilities".

Image source, House of Commons

Tory MP Alicia Kearns says it is a "fallacy" to suggest that the assisted dying bill should wait until the state of palliative care is fixed.

In fact, she says it provides an opportunity to fix palliative care.

Kearns says palliative care can't always deal with the pain people are in, adding: "We are asking for people to die in pain for something that cannot be given."

She acknowledges that some peers in the House of Lords used tactics to delay the bill, but says others provided legitimate amendments, including on eating disorders.

Kearns say she is not asking MPs to accept the bill as it is and says she will be providing her own amendments.

She concludes: "I will be voting for this bill because living in a perpetual state of torture cannot be right and we cannot allow people to wait for longer."

Susan, 77, from Sidcup gets in touch to say that "palliative care is ideal but not realistic anytime soon".

"I have three to six months to live and had a few spells in hospital this year. I have witnessed challenging patients and frustrated nurses.

"So this ideal palliative requires funds that are simply not available, staff that are perfect and they don't exist. I would like to have choice between suffering and ending my life."

Meanwhile, Tina in Brighton says: "Assisted suicide needs to be legalised as there is a lack of care in available especially in many nursing homes."

Morgan, from Kidderminster, says it "really is not for a government to legislate a bill that allows suicide, the role of government and MPs is always to preserve the life of their constituents".

"Improving palliative and end of life care fundamentally would be a better use of resources," he adds.

"I am very concerned about the assisted dying bill and the effects on the vulnerable," says John in Salford.

MPs continue to debate the bill, which you can watch live at the top of the page.