by Kevin Meagher
Tellingly, the House of Commons website carries a warning about the research briefing on the Terminally Ill Adults (End of Life) Bill, due to receive its Second Reading in the House of Commons today.
‘This briefing discusses issues around suicide which some readers may find distressing,’ it intones in bold writing. It’s grim subject matter to be sure, but there is still a need for candour. We are talking about ending human life, courtesy of the state’s healthcare professionals. What could be more distressing?
The proposed legislation would ensure that two doctors assess each request for an assisted death, ensuring the candidate had a ‘clear, settled and informed wish to end their own life’ and that they have reached this decision voluntarily, without pressure. If both doctors agree, the person may apply to the High Court for approval.
Kim Leadbeater the Labour backbencher promoting the Bill, is merely the latest campaigner seeking to alter the law in this area, following previous failed attempts by former Lord Chancellor Lord Falconer, in 2014 and former Labour MP, Rob Marris, in 2015.
Nothing about this issue is new.
‘Assisted dying’ – euthanasia in old money – remains an ethical Rubicon for our society, and one with ramifications beyond whether we allow a small number of patients in extremis and bound to expire the option of doing so earlier than nature intended.
For once we redefine the relationship between physician and patient in such a profound way, the door is opened to deeper questions and wider applications.
Indeed, if the Bill is ostensibly about facilitating a patient’s conviction that their life is ‘not worth living,’ how long will it be before the assertion is made of other sick and vulnerable adults: ‘Your life is not worth living.’
Alarmist? Remember what happened during Covid, when the commodification of human life played out in real time, as minsters illegally discharged asymptomatic elderly patients to care homes, spreading the virus which resulted in tens of thousands of deaths. Or the ‘do not resuscitate’ orders put on the notes hundreds of elderly and disabled adults without their or their families’ consent.
A culture of death already stalks our society whether this Bill passes or not. But does anyone seriously think there won’t be legal challenges to extend the scope of the proposed legislation? Granting physician-assisted suicide for people with six-months or less to live, as the Bill suggests, is entirely arbitrary. Why not 12-months, or longer?
Why not offer it to children with terminal illnesses, as the Belgian government now does? Or to people with mental health illnesses, as the Dutch government allows? This Bill is the opening of a debate, not the closing of one.
And while the measure is presented almost as a reserve power for exceptional cases, the evidence from Canada is that once legislated for, the volume just keeps on rising.
Medical Assistance in Dying as they call it, accounted for 4.1% of all Canadian deaths in 2022, up nearly a third on the year before. Since the introduction of federal legislation in 2016, 44,958 Canadians have been euthanised. (More than the 42,000 Canadians killed during the entire Second World War).
Back to Blighty.
In July, the Labour manifesto described the NHS as under ‘unprecedented stress’ and rather than offering free for all healthcare ‘we now find ourselves with a de facto two-tier system – with working people regularly forced to scrape together the means to go private.’
None of this is lost on older, vulnerable adults. They don’t want to be a burden either to their families – or to broader society. And while many will run the risk of coercive control, with grasping relatives casting a covetous eye on their granny’s house, there’s a good chance that frail, sick, old granny will come to the conclusion, of her own volition, that she would be better off dead.
Then there’s the politics.
This is a Private Members’ Bill because the government doesn’t want its fingerprints all over such divisive subject matter. That’s why there was no mention of it in the Labour manifesto back in July. Privately, many MPs and ministers rue the day this issue was green-lit.
Collective cabinet responsibility may have been set aside, but even supporters of the Bill are suggesting it will require significant amendment in committee stage. When ministers and civil servants need to intervene to save it, the Bill becomes, de facto, government property.
And while the public is broadly in favour of the principle of reform, (three-quarters support assisted dying, according to YouGov this week), they are also mercurial. Fervour for assisted suicide wanes when practical issues are discussed.
This is why the Health Secretary, Wes Streeting, has counselled against supporting the Bill on the basis that it will have serious implications for the NHS. Not least the sheer number of clinicians who will protest and refuse on moral grounds to participate in a process where they would be involved in deliberately ending a patient’s life.
If passed, the legislation will set clinician against clinician and require a constant operational readiness with enough doctors and nurses on-duty that are willing to administer death to those that have opted for assisted suicide. Indeed, you can imagine a scenario where there are insufficient staff available, and the NHS is sued for not killing its patients.
And what of hospices, will they have separate wings where clinicians are comforting the dying and ones where they are administering fatal drugs?
Surely the Justice Secretary, Shabana Mahmood, is right when she warned that assisted dying would mark a ‘profound shift in our culture’ and risks a ‘slippery slope towards death on demand.’ Moreover, she has warned that the Bill’s so-called safeguards are ‘particularly weak.’
But something else, too. If Labour MPs vote through this Bill, it effectively kills off the party’s Christian socialist tradition. Labour will have brought in euthanasia.
With a quarter of voters opposed, the liberal, atheist strain in the party that prizes personal autonomy in all matters will find itself in a head-on collision with millions of Labour’s communitarian voters, for whom this measure is anathema. On a day of big, important considerations, Labour MPs should find time to be mindful of the adverse electoral implications.
Wherever you stand – for or against – this rushed, patchy, unworthy Bill is not the correct vehicle to address such complex moral, legal and operational issues and deserves to be voted down.
Kevin Meagher is the associate editor of Labour Uncut
Tags: Assisted dying, assisted suicide, Kevin Meagher, Kim Leadbeater, Shabana Mahmood
