A new report from the health policy think tank, which takes no position for or against legalisation draws on evidence from 15 countries where assisted dying is already legal, including Australia, Belgium, Canada and New Zealand. It finds that policymakers consistently underestimate both the resources needed to establish services and the long-term costs of keeping them sustainable.
The report comes as Parliament continues to debate proposals on assisted dying, with the care sector closely monitoring the potential impact on services and workforce planning.
Among its findings, the research highlights:
- Demand grows over time: In Oregon, assisted deaths rose from 0.2% of all deaths in 2010 to 0.86% in 2023, even without changes to eligibility rules.
- Capacity is easily stretched: In Victoria, Australia, just 10 doctors were involved in more than half of all cases in 2023–24.
- Inequalities in access: Barriers linked to deprivation, ethnicity and geography are already visible in end-of-life care and are likely to be repeated.
- Hidden costs: Countries have had to create new oversight bodies, data systems, public guidance, pharmacy services and training schemes costs that go far beyond direct clinical care.
The analysis also reveals that the majority of people who seek assisted dying are already terminally ill, often with cancer, and most are receiving palliative care. The median age of people choosing the practice internationally is between 69 and 80.
Sarah Scobie, deputy director of research at the Nuffield Trust, said:
“With assisted dying remaining a contested issue, and our health and care systems struggling under immense pressure, implementing a new service won’t be straightforward. Other countries provide valuable lessons which can help policymakers make good choices as the Bills continue their parliamentary journeys.”
She added: “Debate in the UK has often focused on avoiding a ‘slippery slope’, but international evidence shows the bigger risk may be people who are eligible but still face barriers to access. Parliament will need to get the balance right.”
The think tank recommends that the UK government and devolved administrations develop robust implementation plans, ensure fair access across regions, and set aside funding that goes beyond frontline costs to cover regulation, training and oversight.
