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Assisted dying, vulnerability, and the potential value of prospective legal authorization

Alexandra Mullock and Jonathan Lewis

Medical Law Review, 2025, vol. 33, issue 2, 11.

Abstract: Concern for vulnerable people is a crucial issue when considering the legalization of assisted dying (AD), but the meaning and normative significance of vulnerability in this context is under-explored. We examine vulnerability and the protective obligation through the lens of vulnerability theory to improve understanding of vulnerability in the context of AD. By appealing to a more nuanced account of vulnerability, we argue that the current ban on AD in England and Wales is a blunt tool that lacks compassion and fails to recognize the importance of personal autonomy, as well as the relationship between vulnerability and autonomy. Recently, some emerging lawful models of AD purport to better protect the vulnerable via prospective legal authorization. This is also a feature of recent English Assisted Dying bills, with proposals for judicial or quasi-judicial authorization, and so we consider the potential value of prospective legal authorization. Although this approach risks being burdensome for applicants, we suggest that it could, in principle, not only safeguard vulnerable individuals, but also enhance end-of-life autonomy thereby offering support for a restrictive approach to lawful AD.

Date: 2025
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