Many people with life-limiting disease are vulnerable to emotional distress associated with physical, spiritual, psychological and social stressors. Psychological stress and affective disorders have the potential to influence decision making, particularly at the end of life. This article discusses the main reasons why assisted suicide and physician-assisted suicide (PAS) should remain illegal in the UK. In particular, it explores the problems associated with safeguarding ‘vulnerable’ patient groups and assessing mental capacity. The article also examines guidance for nurses regarding what to do if a patient asks for assistance to die or for information on assisted suicide and PAS.