Government admits disabled people may face ‘subtle pressure’ to choose an assisted death, if bill passes

A new government assessment has admitted that disabled people – and particularly older disabled people – could face subtle pressure to choose an assisted death, if a bill described as “unsafe” and “weak” by campaigners is approved by parliament.

The impact assessment was published by the Department of Health and Social Care (DHSC) and the Ministry of Justice (MoJ) last Thursday.

The terminally ill adults (end of life) bill will be debated and voted on by MPs next Friday.

The assessment’s publication came on the same day that prime minister Andy Burnham wrote to Labour MPs to say he would not vote on the bill on 11 September because he did not want to “unduly influence the debate as prime minister”.

He had already told the media that he believed the funding crisis in palliative and social care should be fixed before there is any debate about legalising assisted dying.

And he has now also told ministers that as the government will remain neutral on the bill, they should “avoid being part of the public debate, and should not express views” about the implications of the bill for their own departments.

The bill was first introduced to parliament in autumn 2024, but it ran out of time to complete its progress through the Lords at the end of the last parliamentary session in April.

Now the same private members’ bill that was narrowly approved by MPs in June 2025 is set to begin its progress through the Commons, in a fresh attempt at legalisation, this time led by Labour MP Lauren Edwards.

But a vote against the bill next Friday will see this latest bid to open the door to assisted suicide in England and Wales defeated.

On Thursday (28 August), DHSC and MoJ published three key documents that assess the “potential impacts” of the bill.

Their equality impact assessment of the bill accepts that disabled people “may be more susceptible to feeling as though they are a burden on those around them”, a key concern raised by campaigners opposed to legalisation.

The impact assessment says that this pressure “is not necessarily felt or applied by other people” but that disabled people “may feel subtle pressure due to attitudinal barriers or a lack of alternative appropriate services and support”, such as with the lack of access to palliative care.

It says these feelings of being a burden could also be caused by “structural pressures such as neglect, poverty and difficult living conditions”, while disabled people are twice as likely as non-disabled people to be victims of domestic abuse such as coercive behaviour.

And the equality impact assessment warns that factors such as high rates of poverty, poorer access to healthcare, lower quality care, and disproportionate levels of domestic abuse of black and Asian women could cause disproportionate numbers of minority ethnic people to choose an assisted death “to avoid financial hardship or escape abuse”.

It also highlights how older people, who are likely to be the main recipients of assisted dying, are “often dependent on those who care for them”, which puts them at increased risk of abuse and pressure to choose an assisted death.

And the assessment reports findings by the UN in 2021 that older people “may feel subtly pressured to end their lives prematurely”.

Those findings saw UN human rights experts express “alarm at a growing trend to enact legislation enabling access to medically assisted dying based largely on having a disability or disabling conditions, including in old age”.

Those experts also found that, even when access to assisted dying was restricted to those at the end of life or with a terminal illness, disabled people, older people, and particularly older disabled people, “may feel subtly pressured to end their lives prematurely due to attitudinal barriers as well as the lack of appropriate services and support”.

Despite fears that extreme poverty could increase pressure on people to seek an assisted death, as has happened in Canada, the government’s equality impact assessment instead concludes that the bill “may have a positive impact on those from lower socioeconomic backgrounds by making assisted dying available without incurring cost”.

A second document attempts to analyse whether the bill will be compatible with the European Convention on Human Rights (ECHR).

It concludes that it is, and that the safeguards provided by the bill – despite repeated concerns raised by disabled people opposing the bill – are “sufficient to ensure that an individual’s decision to end his or her life is taken freely and with full understanding of what is involved”, and to prevent a breach of their right to life under ECHR.

In the third document, an impact assessment, the two government departments conclude that, if the bill becomes law, it is likely to lead to between 298 and 2,766 assisted deaths in the first year of its introduction, rising to between 1,367 and 6,257 assisted deaths in year 10.

But the disabled people’s organisation BuDS Disability Service believes the impact of legalisation would be much more significant.

It has looked at countries with similar healthcare systems to the UK that have introduced assisted dying – in Belgium, the Netherlands, Canada, and Australia – and has estimated that as many as 21,600 people could die annually from an assisted suicide by the 10th year of its introduction, if it is legalised in England and Wales.

BuDS has urged opponents of the bill to share its figures with MPs.

Phil Friend (pictured), from Not Dead Yet UK (NDY UK), which leads disabled people’s opposition to legalisation in the UK, said: “The government has published an impact assessment on the assisted dying bill and declared it ECHR-compliant. We disagree.

“Their own figures project 6,257 assisted suicides a year.

“What those figures cannot tell us is how many of those people will have made a genuinely free choice — and how many will have felt they had no other option, because the care and palliative support they needed simply wasn’t there.

“We will never know. And that is precisely why this bill is unsafe.”

Disabled people who oppose the bill are to gather outside parliament on 11 September from 8am so MPs can hear their voices “loud and clear”.

NDY UK says it might need to persuade as few as 12 MPs to change their minds on legalisation to defeat the bill.

It does not believe the bill’s safeguards “adequately protect disabled people from coercion, abuse or the pressures created by inadequate health, palliative and social care”.

Friend said: “Not Dead Yet UK will be in Parliament Square on 11 September, the day of the second reading.

“We’ll be making the case to MPs to vote against this bill, and we hope as many supporters as possible will join us.”

Sophia Kleanthous, policy and campaigns officer for Disability Rights UK (DR UK), said the bill “should not have been brought back”.

She said: “It got through the House of Commons by a narrow margin, and its flaws were laid bare by the House of Lords.

“Absolutely nothing has changed, except the evidence of its weaknesses are now greater.

“The equality impact assessment highlights our ongoing concerns that disabled people could be at more risk of coercion from feeling like a burden, or as a result of living in poverty or other services failing.

“We live in a country where thousands of disabled people aren’t given the support to live with dignity and independence, where one in three people die without their need for palliative care being met, yet this bill proposes we are given the right to die.

“In a society where people aren’t able to make genuine choices at the end of life and including inequitable access to care, and where the risks of ableism and coercion are high, passing this bill is a step we can’t afford to take.”

Today (Thursday), members of the Crisis in Care Coalition – which includes DR UK – are due to meet MPs in parliament to try to persuade them not to support the bill but to focus instead on the care funding crisis.

The coalition is calling on the prime minister to “take urgent action and address the deepening crisis in palliative and end-of-life care and end the spiralling non-consensual use of Do Not Attempt Resuscitation Orders”.

It is encouraging disabled people to write to their MPs before the second reading to try to persuade them to oppose the bill, as is NDY UK.