The legalisation of assisted suicide carries a far greater cost, both emotionally and financially, than its supporters in the UK are prepared to admit. That fact becomes inescapable when the evidence presented in a major new report is taken into account. Although the authors of the report insist that they are neutral on the principle, their detailed examination of assisted dying laws across Europe, North America, New Zealand and Australia reveals the profound impact such laws have had on the healthcare systems across 15 jurisdictions.
Based on a mixed-methods study conducted between October 2024 and July 2025, the 120-page report “Assisted dying in practice,” published by the Nuffield Trust, highlights the deeply conflicted responses of doctors and nurses responsible for the premature death of their patients. While most healthcare personnel actively involved in the practice claim to feel professional satisfaction, a significant number of them admit to negative experiences.
- Nurses often described sadness and despair. In Austria, 14.5% of nurses experienced mental health deterioration.
- Providers of Medical Assistance in Dying in rural Canada said they faced elevated emotional costs and the risk of social ostracisation. While 85.5% of Canadian social workers experienced “medium to high emotional charge” and 62.4% required “processing breaks”.
- In the Netherlands, doctors reported experiencing “long-term psychological consequences from crossing personal boundaries”.
- In New Zealand, providers required time off for “self-care and reflection”.
The report acknowledges that only a minority of the medical profession wishes to take part in the practice, meaning a relatively small number of clinicians are involved in a high proportion of assisted deaths. In Western Australia, for example, just five doctors oversaw 43% of cases.
The real-world experience of other jurisdictions shows that the kind of specialised training needed is far more extensive than that envisioned by the UK Government in its analysis of the Terminally Ill Adults (End of Life) Bill (TIA Bill). The authors conclude:
“Estimates of funding within the government’s impact assessment for the TIA Bill in England and Wales are limited to direct costs (for example, for staff directly involved) – but international evidence demonstrates that wider costs need to be considered, including to develop the infrastructure to support implementation of assisted dying services.”[1]
The authors acknowledge that the additional cost of the appropriate level of training — including support for the emotional burden experienced by those running the assisted suicide scheme — means there will have to be trade-offs that will divert funding from existing services. This bears out the repeated warnings that the cost of assisted suicide risks further erosion of the UK’s already underfunded palliative care services.
The report also points out that training needs also evolve over time, particularly when there are changes to legal frameworks. This is a tacit acknowledgement that the practice of assisted dying has a profound effect on public attitudes towards suicide and the preservation of life. In none of the 15 jurisdictions listed in the report have assisted dying laws been restricted. Instead, the tendency is to remove safeguards and to expand eligibility to more and more groups, including the disabled, the mentally ill and eventually even the poor.
These are just some of the factors that Members of the House of Lords need to consider before the Second Reading of Kim Leadbeater’s Bill on 12 September. For those who haven’t yet written to the members of the House of Lords, information on what to say and how to contact them can be found here.
