Exploring public views on assisted dying

Who is running and funding the project?

The Exploring public views on assisted dying project is being run by the Nuffield Council on Bioethics (NCOB). The NCOB has commissioned the social research agency Hopkins Van Mil (HVM) to design, organise, and facilitate a series of quantitative surveys and a Citizens’ Jury for the project. HVM will also be partnering with:

The Sortition Foundation is a not-for-profit organisation whose mission is to promote and institute sortition (random selection) in empowered citizens’ assemblies and juries. They are responsible for recruiting people to take part in the Jury and aim to ensure the Jury is broadly representative of the English population.

M.E.L Research is a specialist independent market, social and behavioural research and insights consultancy. They are responsible for delivering the two surveys.

The project is being funded by a grant from the AB Charitable Trust. The AB Charitable Trust will receive regular updates on the progress of the project but will not be involved in how the project is designed and delivered, or its outputs. 

Why are we looking at assisted dying?    

There is a gap in qualitative evidence about public views on assisted dying in England and the reasons the public considers important in forming their views.

Most available data about public perspectives on assisted dying in England are based on opinion polls which often do not explore or capture the relevant complexities involved in the debate. When we engaged with experts across the UK Government and the health policy sector, we heard that nuanced and robust evidence on public opinion on the topic would be a welcome contribution to informing the debate on assisted dying.

Will we be making any recommendations about the law on assisted dying?

No, we will not be publishing a Nuffield Council on Bioethics (NCOB) opinion on assisted dying, or the ethics of assisted dying, as part of this project. Our focus is on supporting an informed public conversation on the topic, and publishing the findings from our public engagement and survey work.

Why are we using the term ‘assisted dying’ (not ‘assisted suicide’, for example?)

There is no universally agreed terminology when discussing the debate on assisted dying. A range of terms are used internationally, and different people have preferences for different terminology. We refer to the definitions described in this Parliamentary Office of Science and Technology briefing note on assisted dying, which uses assisted dying as an umbrella term for “the involvement of healthcare professionals in the provision of lethal drugs intended to end a patient’s life at their voluntary request, subject to eligibility criteria and safeguards. It includes healthcare professionals prescribing lethal drugs for the patient to self-administer (‘physician-assisted suicide’) and healthcare professionals administering lethal drugs (‘euthanasia’).”

The terms used throughout our project, and in associated publications, are not intended to endorse or reflect any particular NCOB stance on the law on assisted dying.

When will the findings be published?

In September 2024 we published an interim report including the recommendations from the Citizens’ Jury. This report includes the results of the voting process and the summary findings from jurors. We have also published the briefing materials and tools that were used to inform the deliberations at the Citizens’ Jury and the surveys.

These will be followed by a final report in early 2025 that captures the survey and Citizens’ Jury findings in depth. This will include an analysis of why jurors think as they do and the reasons and values that underpin their views. The report will also include the overarching project methodology, participant demographics, a summary of the evidence and speakers, and notes on the process through which the Jury reached their recommendations.

What methodologies are you using?

We appointed Hopkins Van Mil who are partnering with M.E.L Research and the Sortition Foundation to design, organise, and facilitate a three-stage process of survey activities and a Citizens’ Jury:

1. Conducting a nationally representative quantitative survey of the English population to explore and capture current attitudes towards assisted dying. We will use these initial survey results to inform the recruitment stratification criteria for the Citizens’ Jury;

2. Facilitating a Citizens’ Jury to explore the views and deliberations of an informed ‘mini-public’ regarding:

3. Conducting a second nationally representative quantitative survey of the English population to gather views on the recommendations and findings made by the Citizens’ Jury.

Why does the project only focus on England not Wales or Scotland?

The funding we have received for this project is best suited to running a series of surveys and a Citizens’ Jury in England. This is the first Citizen’s Jury looking at the English population's views on assisted dying.

How will you ensure that the surveys are representative of a diverse group of people in England?

We appointed deliberative specialists Hopkins Van Mil, who are partnering with M.E.L Research and the Sortition Foundation, to design and facilitate the public engagement and survey activities. The delivery partners are responsible for designing and running a survey to provide statistical confidence that the findings broadly represent the views of the English population.

What is a Citizens’ Jury?

A Citizens’ Jury is a form of deliberative ‘mini-public’ and is a tool for engaging citizens on a wide range of policy issues. Citizens’ Juries consist of a representative group of citizens randomly selected to deliberate on a particular issue and provide recommendations to inform public policy. They place members of the public at the heart of processes. They emphasise the importance of consensus, collective decision-making, and deliberation.

Inherent to the process is providing a robust and balanced range of perspectives and information and structured deliberations on specific questions, so that jurors are fully informed and base their recommendations on the evidence and reasoning they have heard. As a result, they can prove especially effective when addressing contentious issues, such as assisted dying, where knowledge is disputed and there are significant ethical and social implications.

Citizens’ Juries help to address the gap between public opinion (captured through polling and surveys) and public judgment (a carefully considered view that citizens come to after engaging with a subject and hearing an overall balance of expert evidence). Citizens’ Juries can be a helpful tool to explore and consolidate public judgment and means that the recommendations they propose can help inform decision-makers.

Why is voting used in a Citizens' Jury?

Citizens’ Juries use voting as an integral part of the final stage of the recommendation development process. Voting is used to sense check where jurors are in their thinking, to understand how near or far they are from reaching a consensus, and to understand where there is clear agreement or disagreement on a topic.

Expert facilitation and support are key to running a voting process that helps to explore creative dissent, address conflict resolution, and facilitate consensus building, without the voice of the minority being silenced. Facilitators also bring critical skills for ensuring that the Jury group functions well and that the deliberative space is used to its full potential.

What questions did the Jury consider?

The overarching questions the Jury considered were:

1. Should the law in England be changed to permit assisted dying?

• What are the most important reasons in favour of permitting assisted dying?
• What are the most important reasons against permitting assisted dying?

2. If the law is changed to permit assisted dying in England, what should it include? What should it exclude?

3. If the law is not changed to permit assisted dying in England, are there any recommendations or changes to assisted dying policy that should be made?

Who ran the Jury?

The Citizens’ Jury was designed, organised, and facilitated by Hopkins Van Mil, a social research agency specialising in deliberative methods.

How were people chosen to take part in the Citizens’ Jury?

We commissioned social research agency Hopkins Van Mil, to design, organise, and facilitate the Citizens’ Jury. They partnered with the Sortition Foundation to design and run the recruitment process for the Jury. The Sortition Foundation is a not-for-profit company dedicated to promoting fair, transparent, inclusive, and effective deliberative processes. They used a democratic lottery algorithm to give everyone in the population of interest an equal chance of taking part.

In February 2024, a random sample of 7,000 households across England received an invitation inviting anyone aged 18 or over living in that household to register their interest - by either completing a simple online form or using a freephone number. From those who registered their interest, the Sortition Foundation used a lottery to select 30 people who represent a ‘mini-public’ of the English population to participate in the Jury. The selection criteria included attitudes towards assisted dying.

How accessible was the Citizens’ Jury?

We wanted the Citizens’ Jury to be accessible for all people and we provided additional support to enable those selected to take part. All members of the Jury are receiving £440 in recognition of their commitment and a thank you for taking part. Internet-enabled digital devices and an internet connection were available to those who did not have access to a suitable device or internet connection. Hopkins Van Mil provided support on IT skills, including one-to-one phone calls and online introductory sessions. The in-person Jury sessions were held at an accessible venue with disabled parking available. Food and accommodation was provided, and travel expenses covered. All members of the Jury had access to a prayer room or quiet space during the day. A specialist mental health professional was available to offer support to participants during the project period. Additional support - for example translation or childcare - was also provided.

What will happen after the surveys and Citizens’ Jury?

An interim report providing the top findings and recommendations from the Citizens’ Jury has been published. The main report will be published later in the project, in early 2025. This will capture the survey findings and the recommendations from the Jury. It will also provide an explanation of the process.

The recommendations and findings will be presented at a workshop to a range of policy and decision-makers. We will host a series of events to present the findings of the project and embed these with key decision-makers. We aim for the findings to inform future national conversations on the topic.