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Assisted dying bill: Safeguards against domestic abuse and coercion must be strengthened

One in four women and one in seven men in England and Wales have experienced domestic abuse. Coercive and controlling behaviours are core to domestic abuse. They result in loss of autonomy and independence and are intended to isolate and reduce self-worth. Such behaviours are common but hard for health professionals to detect.

If passed, the Terminally Ill Adults (End of Life) Bill will allow people who are terminally ill and expected to die within six months to request assistance to end their lives. VISION researchers Gene Feder, Elizabeth (Lizzie) Cook and Sally McManus have written an opinion published in The BMJ that calls for safeguards in the bill need to be strengthened to prevent coercion in the context of domestic abuse.

Assisted dying requires a careful consideration of the risks posed by domestic abuse and coercion. The current bill does not fully tackle specific safeguarding concerns for patients experiencing domestic abuse which can include economic, emotional, physical, and other forms of abuse from a partner or other family member. To safeguard against domestic abuse and associated coercion, Gene, Lizzie and Sally propose a set of principles that should be part of the UK bill.

  1. For doctors responding to any request for assisted dying, training must be extensive, specialist, in person, and backed up by referral pathways.  Independent domestic abuse advocates, with expertise in recognising coercive control, could contribute to assessment of assisted dying requests. 
  2. Commitments to confidentiality and data security must not obscure assisted dying decisions and the contexts in which they occur. The bill must ensure transparency.
  3. The bill must establish accountability. Transparent data about each stage of the approval process would also enable monitoring and regular scrutiny of the processes and outcomes of assisted dying legislation.
  4. Lawmakers must resist expansion. Dementia and mental health conditions are now being considered for eligibility. These are conditions prevalent in survivors of domestic abuse. The UK bill should include clauses that limit any expansion of scope to other conditions and situations.

To read the opinion piece: Safeguards against domestic abuse and coercion in the assisted dying bill must be strengthened

To cite: BMJ 2025;390:r1914

For further information, please contact Gene at gene.feder@bristol.ac.uk

VISION responds to Parliamentary, government & non-government consultations

Consultation, evidence and inquiry submissions are an important part of our work at VISION. Responding to Parliamentary, government and non-government organisation consultations ensures that a wide range of opinions and voices are factored into the policy decision making process. As our interdisciplinary research addresses violence and how it cuts across health, crime and justice and the life course, we think it is important to take the time to answer any relevant call and to share our insight and findings to support improved policy and practice. We respond as VISION, the Violence & Society Centre, and sometimes in collaboration with others. Below are the links to our published responses and evidence from June 2022.

  1. UK Parliament – Public Accounts Committee – Inquiry: Tackling Violence against Women and Girls (VAWG). Our submission was published in April 2025.
  2. UK Parliament – Women and Equalities Committee – Inquiry: Community Cohesion. Our submission was published in February 2025.
  3. UK Parliament – Call for evidence on the Terminally Ill Adults (End of Life) Bill. Our submission was published in February 2025.
  4. UK Parliament – Public Accounts Committee – Inquiry: Use of Artificial Intelligence in Government. Our submission was published in January 2025.
  5. UK Parliament – Public Accounts Committee – Inquiry: Tackling Homelessness. Our submission with Dr Natasha Chilman was published in January 2025. See the full report
  6. Home Office – Legislation consultation: Statutory Guidance for the Conduct of Domestic Homicide Reviews. Our submission was published on the VISION website in July 2024.
  7. UK Parliament – Women and Equalities Committee – Inquiry: The rights of older people. Our submission was published in November 2023
  8. UK Parliament  – Women and Equalities Committee – Inquiry: The impact of the rising cost of living on women. Our submission was published in November 2023
  9. UK Parliament – Women and Equalities Committee – Inquiry: The escalation of violence against women and girls. Our submission published in September 2023
  10. Home Office – Legislation consultation: Machetes and other bladed articles: proposed legislation (submitted response 06/06/2023). Government response to consultation and summary of public responses was published in August 2023
  11. Welsh Government – Consultation: National action plan to prevent the abuse of older people. Summary of the responses published in April 2023
  12. Race Disparity Unit (RDU) – Consultation: Standards for Ethnicity Data (submitted response 30/08/2022). Following the consultation, a revised version of the data standards was published in April 2023
  13. UK Parliament – The Home Affairs Committee – Call for evidence: Human Trafficking. Our submission was published in March 2023
  14. UN expert – Call for evidence: Violence, abuse and neglect in older people. Our submission was published in February 2023
  15. UK Parliament – The Justice and Home Affairs Committee – Inquiry: Family migration. Our submission was published in September 2022 and a report was published following the inquiry in February 2023
  16. Home Office – Consultation: Controlling or Coercive behaviour Statutory Guidance. Our submission was published in June 2022

For further information, please contact us at VISION_Management_Team@city.ac.uk

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