The legalisation of assisted dying, including euthanasia and physician assisted suicide, is increasing in countries across the world. It constitutes a key contemporary debate, exciting fierce and partisan views, indicating social and medical transformations of attitudes to death, extension of liberalisation and self-determination in relation to the body. Current discussions, especially in psychiatry, palliative medicine and oncology, emphasise the complexities of assessment and decision making, as medical, psychiatric and psychosocial factors intermingle. In this paper we discuss the contribution psychoanalysis has to make to the debates and practices of assisted dying in current contexts. We note, the paucity of psychoanalytic literature on the subject, but by linking the literature of palliative and end of life care, with the psychoanalytic understanding of suicide, we identify that psychoanalysis has the capacity to significantly inform practice, and psychoanalytically informed psychotherapy can be an important intervention for people requesting assisted death. Finally, we illustrate the above theoretical and clinical considerations with reference to the case of Mrs W, and present the treatment and the main points of clinical reflection arising from it.