Legality of VSED in the UK
The UK legal situation,
an overview of statements from medical professional bodies, and other legalities
This information was updated by us in September 2026 to summarise the legal situation and publicise the position statements from medical professional organisations.
It is intended as information for people with an interest in VSED in the UK, including individuals considering this choice for themselves and the people close to them. We also intend it to be used as a resource to be shared with GPs and other healthcare professionals who are supporting or considering supporting someone during VSED.
1. Decision of The Supreme Court of the United Kingdom (SCUK)
The SCUK is the final court of appeal in the UK for civil and criminal cases from England, Wales and Northern Ireland. It hears cases of the greatest public or constitutional importance affecting the whole population.
The 2014 Supreme Court decision in the Nicklinson, Lamb and Martin case ruled that:
“A person who is … mentally competent is entitled to refuse food and water, and to reject any invasive … treatment … even though without it he will die. … Medical practitioners must comply with his wishes.”
“The doctor is in no danger of incurring criminal liability merely because he agrees in advance to palliate the pain or discomfort involved should the need for it arise.”
2. Statements from medical professional bodies
2.1. The General Medical Council (GMC)
The GMC is an independent regulator responsible for overseeing doctors, physician associates (PAs), and anaesthesia associates (AAs). Its key functions include setting standards for medical practice, ensuring doctors have the necessary education and training, maintaining a register of qualified professionals, and investigating concerns about patient safety or public confidence.
The 2015 GMC guidance on patients seeking advice or information about assistance to die states that, where patients ask for information that might encourage or assist them in hastening their death:
“Medical professionals should be prepared to listen and to discuss the reasons for the patient’s request.”
“Medical professionals should limit any advice or information in response to … objective advice about the lawful clinical options (such as … palliative care) which would be available if a patient were to reach a settled decision to end their own life.”
“For avoidance of doubt, this does not prevent a doctor from agreeing in advance to palliate the pain and discomfort involved for such a patient should the need arise for such symptom management.”
As at September 2026, we believe the GMC, as the medical regulator, should clarify the professional standards expected of doctors in relation to VSED and how these should be applied in clinical practice, ensuring consistency with the BMA’s guidance and providing a coherent basis for support and care.
2.2 British Medical Association (BMA)
The BMA is a trade union and professional body for doctors and medical students in the UK.
The BMA’s Medical Ethics Committee published UK-wide guidance in August 2026 for doctors who are approached by patients seeking support and symptom relief with VSED following requests from BMA members, other physicians, and other organisations. The introduction to the guidance states:
“It became clear that guidance is needed to provide clarification about the law and ethics of VSED to provide doctors with the reassurance that they need to support patients who have made the decision to elect to VSED and enable them to understand what actions can be taken by the healthcare team whilst acting in accordance with the law.
This guidance provides a legal and ethical framework to enable doctors to engage in patient centred care and provide the best possible support and care to their patients, whilst acting in accordance with the law.
This means that we [the BMA] start from a position of understanding that:
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patients with capacity are entitled to make decisions about treatment refusals and about their nutrition and hydration, including to voluntarily stop eating and drinking in order to hasten their death;
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there is no requirement in the law that a patient needs to be ill or at the end of life to decide to voluntarily stop eating and drinking in order to hasten their death; and
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doctors face no criminal liability for providing advice about clinical care options, nor for agreeing in advance to provide symptom relief to patients who have elected to voluntarily stop eating and drinking to hasten their death, provided that it is appropriately managed. This is part of their duty of care as per General Medical Council (GMC) guidance.”
2.2.1 Application across the board
The BMA states that this guidance has been written for doctors, but it may also be useful for other healthcare professionals and carers. As at September 2026, we have yet to see whether, or how, this guidance will be reflected in statements or guidance issued by the professional bodies referred to below.
2.3 The Royal College of Physicians (RCP)
The RCP is a professional membership body dedicated to improving the practice of medicine, chiefly through the accreditation of physicians by examination.
In its 2021 guidance on supporting people who have eating and drinking difficulties it states:
“Some patients with capacity may choose for themselves to stop eating and drinking, as they are free to do. Some staff may find this particularly challenging and need support to respect the patient’s decision.”
2.4 The Nursing and Midwifery Council (NMC)
The NMC is the independent professional regulator for nurses and midwives in the UK.
We could not find any statements relating to VSED in their Code and Standards.
2.5 Royal College of Nursing (RCN)
The RCN is a nursing union and professional body.
The RCN doesn't offer specific guidance on VSED but it emphasizes the importance of clinical support and patient safety, and encourages nurses to seek guidance from the GP, local hospice, or other clinicians involved in the patient's care.
Different legal frameworks apply in Northern Ireland and Scotland. The following relates to England and Wales.
3. Advance Decision to Refuse Treatment (ADRT) enshrined in the Mental Capacity
Act 2005 (MCA) - England and Wales
An advance decision to refuse treatment (ADRT) is a legally binding document about what medical and healthcare treatment a person wants to refuse in the future, in case they lose the mental capacity to make these decisions.
Mental capacity means the ability to use and understand information to make a decision, and communicate any decision made. A person lacks capacity if their mind is impaired or disturbed in some way, which means they're unable to make a decision at that time.
Whilst a person has capacity, they can refuse to drink or eat by mouth. If a person loses capacity, there is a lack of clarity as to whether a previously stated wish in an ADRT not to be fed and watered by mouth should be respected by health and social care professionals. To explain this further: an ADRT can refuse specified medical treatments, including clinically assisted nutrition and hydration, but it cannot refuse basic care. Because the offering of food and drink by mouth can be viewed as constituting basic care rather than medical treatment, it falls outside the legal scope of an ADRT.
Some people refer to their choice to die by VSED in their ADRT and then, in an accompanying Advance Statement, express their wish to refuse food and water by mouth, as this should be taken into account when best interests decisions are made by clinicians.
4. Medical Certificate of Cause of Death (MCCD)
A medical certificate of cause of death (MCCD) is a permanent legal record that specifies the cause of a person's death. It is used for registering the death, arranging the disposal of the body, and settling the deceased's estate.
Regarding the MCCD, the BMA guidance states:
“Doctors in charge of the patient’s care must ensure that the death is properly certified and reported, following established procedures. In England and Wales, where death has been caused or hastened by VSED, it should be reported to the Coroner. The Coroner will then assess whether an investigation is required. In some cases, however, the death would not be caused or hastened by VSED and so these would not need to be reported. These would be cases where, for example, a patient is terminally ill and elects to VSED, then dies very shortly afterwards. All deaths that are not reported to the Coroner will be reviewed by a medical examiner. In Scotland, medical certificates of cause of death are reviewed randomly by the Death Certification Review Service. In Northern Ireland, all deaths are registered with the District Registrar, and only reported to the Coroners Service for investigation in certain situations.”