Blog13th September 2024

In conversation with members of England’s first Citizens’ Jury on assisted dying

Molly Gray

Three Citizens’ Jury members – Ashok, Helen and Daniel – share their reflections on the deliberative process with Project Manager Molly Gray.

Assisted dying

In September 2024, the Nuffield Council on Bioethics (NCOB) published an interim report from our project designed to explore public views on assisted dying in England. This showed that the majority of the Jury voted in favour of legalising assisted dying for people with a terminal illness and capacity to make their own decisions. They also said that being able to access both physician-assisted suicide and (voluntary) euthanasia was important. But what was it really like to participate in a Citizens’ Jury exploring assisted dying in England? We asked three of the Jury members to share their reflections on the deliberative process.

Why did you decide to participate in the Citizens’ Jury?

Ashok: This was a very personal decision. Having worked in palliative care, I have noticed how the quality of life for some goes down when they were waiting for their life to end. One woman I cared for had terminal cancer and although she wanted to end her life, the UK law did not permit this. It was painful to observe her suffer on a daily basis. Additionally, I lost my mother to colon cancer. My learning from this was that life should be about having a better quality as opposed to quantity.

Daniel: My decision to participate in the Citizens’ Jury was motivated by my personal interest in the topic. As a person with multiple disabilities, I’ve often contemplated this issue, questioning whether it would be ethical for society to offer assisted dying. My concern, which I feel was substantiated by some of the information presented to me throughout the Jury process, is that if assisted dying is permitted in the UK, the original set of legal parameters put in place could erode. And this, in my view, could lead to many non-terminally ill people opting to end their lives.

Helen: Initially, I decided to participate in the Jury because I was interested in learning more about assisted dying. However, after some consideration, I realised I was being given the opportunity to provide my perspective on this topic that is of national debate. I wanted to bring emphasis on protecting vulnerable people and make a difference as a young person so, this became an added motivation.

What did you find most valuable about participating in the Citizens’ Jury?

Ashok: The most valuable aspect of participating in the Citizen’s Jury was the opportunity to explore a wide range of perspectives on assisted dying. Besides learning a good theoretical underpinning on assisted dying, it opened up lateral thinking and an eclectic approach towards this sensitive and much debated topic. I came into the Jury with a pre-conceived mindset. Following the in-person sessions, my fellow Jury members were able to provide different dimensions. The face-to-face workshop brought out the best in me and meant I could see the topic in a new critical perspective. It also helped me to analyse the pros and cons associated with assisted dying.

Daniel: Prior to the Jury, my understanding of the assisted dying process was largely optimistic. However, evidence I was presented with challenged this view and one of the most significant outcomes for me has been confronting the possibility that assisted dying can be a far cry from the often-idealized portrayal. Hearing expert testimony about distressing experiences some people have had, was deeply unsettling and it became clear to me that assisted dying is not the guaranteed peaceful end that many hope for.

Helen: Being invited and able to have a say on the topic was the most valuable thing to me. We heard real life case studies and heard both information from sides of the argument which I found to be important. I wanted to have the topic be presented in an unbiased way, and it was. Being able to discuss the topic with the other Jury members was very valuable as there were a multitude of backgrounds and experiences.

Which of the recommendations the Jury agreed on most resonated with you?

Ashok: I voted in favour of legalising assisted dying in England. The deliberation helped my fellow Jury members, and I chalk out the eligibility criteria for this quite clearly. We wanted to empower individuals to give them the freedom to decide, but adequate and appropriate considerations were given to safeguarding individuals. Due consideration was given also to the Mental Capacity Act 2005 in terms of both clinical and legal perspectives.”

Daniel: I was in a minority view, voting against the legalisation of assisted dying. However, I do agree with my fellow Jurors’ that were assisted dying to become a reality in England, it should be reserved exclusively for the terminally ill. To me, the key question when considering assisted dying must always be, “Does this person have quality of life mobility?” and if the answer is yes, it should not be an option.

Helen: For me, the discussions we had as a Jury on how to best protect vulnerable people were some of the most important. I wasn’t convinced at the start of the Jury that it was possible to mitigate the process so that vulnerable people could not be exploited, however, after hearing information about the proposed plans for an assisted dying service in Jersey and personal reflections from disability perspectives I felt satisfied it is possible and so voted in favour of changing the law.

You can read the interim report of the Jury’s key findings and voting here. A second, more in-depth report, providing further detail on the Jury’s deliberations and how they reached their decisions, will be published in early 2025.