Book Review: Graham Box and Kenneth Chambaere: Assisted Dying: The Great Legal and Moral Problem of Our Time (Policy Press, 2026, 249 pp, £24.99, paperback / ebook)
This (relatively) short and (relatively) modestly priced book seeks out to “inform debates about the legalisation of assisted dying, wherever they are taking place” (page 4) and, disarmingly, seeks to do so by engaging directly with “you,” as a “a person with a serious interest in assisted dying” (page 22). To this end, it includes reflective questions, as well as a scoring tool to enable you to clarify your perspectives towards the end of the book.
It is a book which has been produced with commendable speed, which manages to include a postscript describing the fate of the Private Members’ Bills in England & Wales and Scotland introduced by Kim Leadbeater MP and Liam McArthur MSP respectively. It also manages to include analysis of the debates in the House of Commons relating to Kim Leadbeater’s Bill, and at least some of the debates relating to Liam McArthur, although the most detailed analysis of Westminster debates relates to earlier Bills. The authors are, though, undoubtedly right to suggest that these debates involve themes with variations, but do not radically alter over time.
The authors somehow manage to pack into the book not only analysis of Westminster debates but also nuanced and interesting discussion of English (and selected overseas) cases,[1] a notably sophisticated analysis of stakeholder views, and an overview of what can be learnt from assisted dying internationally. In respect of that last, it is refreshing – and very important – that the authors make clear both where there is relative security as to the knowledge base, but also where the knowledge base is lacking (and why that might be). Further, as they rightly point out, “even where there is considerable empirical data, much remains in the eye of the beholder.[…] To some degree, the way that you, the reader, align with the interpretation and conclusions of those who use the evidence will tell you something about your own stance” (page 146).
Given that the focus of the book is primarily upon the position in England & Wales (albeit placed in an international context, and undoubtedly written in such a way that international readers will find much of value in it), I do have one regret about it, or, put another way, a wish that there had been one more chapter in the book. It would assist those concerned with the debates at the moment as they heat up again in England & Wales in advance of the second reading of Lauren Edwards’ Bill to have an understanding about how to legalise assisted dying. By this, I do not mean the questions of which criteria to use, or whether it is better that this is done by the courts or the legislature, but (in countries where it is the legislature which is – for whatever reason – in the driving seat) the process by which legislation is taken forward. Even if assisted dying is truly the great moral problem of our time,[2] and moral problems are quintessentially those left to Parliamentarians to determine on a free vote, that is something rather different to saying that it is a problem which can only be addressed by way of a Private Members’ Bill. And if it is also a legal problem, it is a problem which can only be resolved with good law; for the reasons that I develop with my Complex Life and Death Decisions colleagues here, I suggest the Private Members’ Bill process is singularly ill-suited to the production of such good law.
Nonetheless, this is a remarkably useful and good book. It will certainly be added as core reading to the Law at the End of Life course I teach at the Centre of Medical Ethics and Law at KCL, and – before then – I hope will also find its way into the hands of Westminster Parliamentarians who are preparing, again, to consider the problem.
[1] Having been involved in the Conway case with which they opened the book, I must both declare an interest, and also a slight note of regret that they did not trace this story through in more detail in the relevant chapter, given that it represented (on one view) the attempt to remedy the suggestion in the Nicklinson case that arguments of principle were not enough, and that bringing evidence to bear was what was necessary. At all levels up to the Supreme Court, however, that argument did not succeed.
[2] I should perhaps note that the authors are not, necessarily, making the claim that the subtitle of the book suggests that they might: rather, this is a quote from a former Lord Chief Justice, Lord Judge (see pages 4-5 of the book). One area of evidence that the book could perhaps have dug into a little more was as to the extent to which society sees the issue as the great legal and moral problem of our time. Without purporting to carry out analysis at the level of sophistication of the authors, I suggest the the evidence base as to which even those who are supportive of legalising assisted dying see it as a priority is distinctly mixed.
