Assisted dying and countertransference: unconscious forces in life-and-death decisions

Assisted dying debates overlook the powerful unconscious forces that shape end-of-life decision-making. These dynamics influence personal, clinical and societal judgements and may be contributing to the rapid international expansion of assisted dying practices. Strengthening safeguards requires acknowledging these forces and integrating structured psychological assessment, clinician support and reflective practice to reduce unconscious bias and enhance the reliability, transparency and ethical integrity of decisions.