As the law stands, there are very narrow circumstances which allow an adult, who is either terminally ill or intolerably suffering, voluntarily to end their life with medical oversight. In England and Wales, the law treats people who have mental capacity and people who lack mental capacity differently. It also presumes that people are of sound mind, unless it can be proven otherwise.


If someone aged 18 or above has mental capacity then they have an absolute right to refuse ongoing medical treatment, even if that decision will ultimately result in death. For example, if someone is dependent upon an artificial ventilator and they wanted to end their life, they could not be forced (even if a doctor or judge disagreed with their reasons) to continue receiving the treatment. In cases where someone is not dependent upon medical treatments to stay alive, the only way they can legally end their life with medical oversight is by refusing food or water. 

It is also legal, in certain circumstances, for medical staff to ease any distress which might be caused by choosing to refuse or withdraw medical treatment or by voluntarily stopping eating and drinking. 


If someone aged 18 or above does not have mental capacity, then it is also lawful for them to stop receiving ongoing medical treatment even if that will eventually result in death. For example, someone in a permanent vegetative state can have life-sustaining treatment withdrawn, but only if their doctor judges it is in their ‘best interests’ to do so. 

The notion of someone’s best interests is elusive, but it is well established that extending life is not always in someone’s best possible interests. To assist doctors, the Mental Capacity Act 2005 outlines the factors a doctor should consider when deciding someone’s best interests. These include: someone’s wishes and feelings both expressed at the time and before capacity was lost, the views of carers, family, or those with an interest in the person’s welfare, and other factors the person would likely consider themselves if they were able.


In order to avoid a circumstance where you might lose mental capacity and receive medical treatment that you’d don’t want, there are two legally binding options available: 

  • An Advance Decision
  • A Lasting Power of Attorney (Health and Welfare).

Beyond this, it is also possible to state anything which would be important to your healthcare through a non-binding document, called an ‘Advance Statement’; as well as indicate if you would not like to receive cardiopulmonary resuscitation (CPR) through something called a ‘Do Not Attempt Resuscitate Decision’.