Assisted Dying: How We Got to Where We Are Today

It is thought that the ancient Greeks and Romans believed it was better to voluntarily end a life than endure prolonged suffering.

Later, many religions viewed life as a divine gift, which led to limited acceptance of euthanasia.

Although euthanasia (ending another person’s life believing it is in their best interests) differs from assisted dying (where the individual remains in control and another person only assists), attitudes toward both have shifted dramatically over time.

This article is the first in a two‑part series exploring the legal history of assisted dying in the UK. Here, we trace the key cases that have challenged the UK’s position, shaped domestic law, and divided public and parliamentary opinion.

The Law on Euthanasia and Assisted Dying

Under the Suicide Act 1961, it is a criminal offence to “encourage or assist the suicide or attempted suicide of another person,” even if the person consents and is suffering from a terminal or debilitating condition.

A conviction can lead to up to 14 years’ imprisonment, though prosecutions are not automatic. The Director of Public Prosecutions (DPP) applies public‑interest guidelines, for example, whether the assister pressured or coerced the individual.

Article 8 of the European Convention on Human Rights (ECHR), incorporated into UK law through the Human Rights Act 1998, protects the right to private and family life. Several assisted‑dying cases have argued that choosing the manner of one’s death falls within this right.

However, the ECHR allows states to restrict rights to prevent crime and protect vulnerable people, meaning no country is obliged to legalise assisted dying.

Some ECHR states, Switzerland, the Netherlands, Belgium and Luxembourg, have legalised forms of euthanasia or assisted dying. UK citizens may travel to these countries to end their lives.

However, anyone who assists could face prosecution if the individual:

• is frail
• cannot travel independently
• cannot end their life without direct help

Key Legal Challenges

Pretty v UK (2002): Article 2 and Article 8 ECHR

Diane Pretty had Motor Neurone Disease, leaving her mentally capable but paralysed from the neck down. She wished to end her life with her husband’s help but could not do so alone. She asked the DPP to guarantee he would not be prosecuted; the DPP refused.

Pretty argued that her rights under Article 2 (right to life) and Article 8 (private life) were breached. After losing in the High Court and House of Lords, she appealed to the European Court of Human Rights (ECtHR).

Outcome

The ECtHR accepted that Article 8 covers personal autonomy and the desire to avoid a painful, undignified death. However, it ruled that states may restrict assisted suicide to protect vulnerable people. Pretty’s request was dismissed, and she died shortly after the ruling.

R (Purdy) v DPP [2009]: Clarifying the Suicide Act

Debbie Purdy, who had Multiple Sclerosis, wished to travel abroad to end her life with her husband’s assistance. She argued the Suicide Act lacked clarity on when someone would be prosecuted for assisting suicide overseas.

She also claimed a breach of Article 8, as uncertainty meant she might have to travel alone prematurely.

After losing in the Court of Appeal, she appealed to the House of Lords.

Outcome

The Law Lords ruled in Purdy’s favour, finding the DPP’s policy unclear and incompatible with her Article 8 rights. They ordered the DPP to publish a clear prosecution policy, which remains in use today.

R (Nicklinson) v Ministry of Justice [2014]: Article 8 Becomes Politicised

Tony Nicklinson had locked‑in syndrome after a stroke, leaving him paralysed from the neck down. He described his life as a “living nightmare.” He sought either:

• a declaration allowing a doctor to assist his suicide legally, or
• a ruling that the Suicide Act was incompatible with Article 8

The High Court dismissed both. Nicklinson refused food and died slowly. His wife continued the case to the Court of Appeal and then the Supreme Court.

Outcome

The Supreme Court acknowledged that Article 8 is relevant to assisted dying and that the Court could declare the Suicide Act incompatible.

However, it declined to do so, emphasising Parliamentary Sovereignty and stating that elected MPs should decide whether to change the law. Nicklinson’s wife appealed to the ECtHR, which dismissed the case.

“Martin”: Clarifying Assistance by Non‑Family Members

“Martin,” who had suffered a stroke, wished to travel abroad to end his life. After Purdy, the DPP had clarified prosecution criteria for family members, but Martin wanted clarity for non‑family members who might assist him.

Outcome

The Court of Appeal held that the DPP’s policy was unclear regarding non‑family members. In 2014, the DPP updated the policy, stating that medical professionals or those directly involved in care would be more likely to face prosecution.

R (Conway) v Secretary of State for Justice [2018]: A New Policy Proposal

Noel Conway had Motor Neurone Disease and only months to live. He wished to end his life with medical assistance.

He argued the Suicide Act breached Article 8 and proposed a new system: a High Court judge could approve assisted dying for patients with a prognosis of six months.

After losing in the High Court, he appealed.

Outcome

The Court of Appeal accepted it was not strictly bound by previous cases but raised concerns:

• medical prognoses are uncertain
• doctor‑patient relationships could be affected
• vulnerable patients might feel pressured

The Court held that Parliament, not the judiciary, should change the law. Conway sought to appeal to the Supreme Court, but permission was refused.