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How on earth has Britain got itself into a situation where an assisted dying bill that will contain the strongest safeguards in the world is being presented as an attack on the vulnerable? Those of us who want mercy for desperate, terminally ill people are being portrayed as thoughtless zealots, or useful idiots for those who want to rid themselves of burdensome relatives. The conservative lobby in parliament is tuning out the vast majority of voters who are united in support for assisted dying.
When Sir Keir Starmer came to office, his backing for a humane and limited right to escape the agonies of terminal illness looked set to make him one of the most consequential prime ministers of recent times. He rightly wanted to give parliamentarians a free vote on this fundamental matter of conscience. But he was reluctant to put his stamp too firmly on it knowing his cabinet was split. Downing Street therefore backed the MP Kim Leadbeater to bring a private members’ bill.
This was a mistake. Leadbeater and her bill are now in serious trouble. Having insisted that a High Court judge should oversee each case, and presented this to MPs as a vital safeguard against abuse, she has recognised that it is unnecessary and would put too much pressure on the courts. Instead, she has proposed an even stronger safeguard — that cases be referred to an expert panel. But her slight stumbles in the spotlight have let her opponents claim that the process is shambolic, that a vitally important question has not been given enough thought and that there are insufficient protections.
The tragedy is that Leadbeater and her Downing Street backers have been overreaching with their protections in efforts to persuade those who accuse them of being unscrupulous. I can’t find any other country that uses judges in this way. Most jurisdictions — including states in Australia, New Zealand and America — rely on the opinion of two independent doctors. In Oregon, which legalised physician-assisted suicide in 1997, and the Netherlands, which did so in the 1980s, multiple surveys and reports — summarised in the Journal of Medical Ethics in 2007 — have found no evidence of vulnerable groups being put under pressure, or disproportionately asking to die.
The idea of the panel also has few precedents. The nearest analogy is Spain, where cases are referred to a lawyer and a health professional once two doctors have certified that a patient meets the criteria. In 2023, fewer than half the 766 Spanish requests for help were carried out, with a quarter of applicants dying before their wishes were followed. That is hardly a “slippery slope”.
If the British bill does go through, it is so narrowly drawn that few people will qualify. Around one Briton a week travels to Switzerland to die — and this won’t change much. Even those with motor neuron disease will not qualify unless doctors believe they have only six months left to live. The former judge Sir Nicholas Mostyn, who has Parkinson’s disease, has argued for extending that to neurodegenerative diseases. End-of-life suffering for Parkinson’s patients is “intolerable”, he has said, with some unable to swallow or breathe. “This is what I’m facing. And I’d like to know why opponents are determined to condemn me to that.”
This is the question we must keep coming back to. Many of those with strong religious faith believe life is sacred. I respect that. But I find it hard to be warned against “playing God” when medicine keeps people alive against their wishes. That is not my God. Nor was it the God of my old friend Frank Field, the devout Catholic and former Labour MP who changed his mind about assisted dying after watching a close friend endure the horrors of cancer. He didn’t want an assisted death himself, but he didn’t believe it was right to deny mercy to others.
It sometimes seems to me that we are living through a uniquely cruel age. People are living longer and with more complex diseases than ever before. My grandfather, a vicar, would often give the last rites to people who had stopped working only a few years before; the lingering death was rare. We have also lost the reassurance that a family doctor who knows us might speed things up with a vial of morphine to ease the pain. That compassionate process came to end after Dr Harold Shipman was convicted of multiple murders of mostly elderly people 25 years ago.
Two words dominate this debate: “vulnerable” and “burden”. The Christian Conservative MP Danny Kruger says Labour progressives should oppose changing the law, because politics should be “about protecting the vulnerable from abuses of power”. Indeed. But who is abusing who? Doesn’t the state abuse its power when it blocks those who are suffering unrelenting mental and physical torture but are physically unable to take their own lives? The only route out for Tony Nicklinson, the rugby player who lived for seven years with almost complete paralysis, was to starve himself to death in front of his family. Is that not a grave injustice?
Opponents have also weaponised the idea that not wanting to be a burden is somehow unnatural. No one should be pressured into dying by a relative trying to get their hands on their money. But it is a deep human instinct to want to protect one’s loved ones from anguish, to want dignity. My father didn’t want me to see him in the state he was in when he was dying. He didn’t want to endure my suffering as well as his own. “I hope I don’t die in hospital with tubes sticking out of me,” he used to say. He did.
If this bill is rejected, it is unlikely to be considered again for many years. To many MPs who haven’t made up their minds, it feels easier to do nothing. But the status quo is indefensible.