Heed The Warning Signs

Echoing the doubts even of many people who say that they might not necessarily be opposed to the principle, Philip Pilkington writes:

Over the weekend it was announced that a vote would be introduced to legalise assisted dying in Britain, with the Labour government saying it will not obstruct an MP from drafting a private members’ bill on the subject. While polling shows that assisted dying carries the support of most of the population, it remains a deeply divisive issue, with disagreements reaching across party lines. Prime Minister Keir Starmer is said to have a “strong opinion” in favour of allowing assisted dying, and has previously supported a change in the law.

It is likely a coincidence that the bill is being introduced just a week after the Office for Budget Responsibility (OBR) published its report showing the desperate state of Britain’s economy and finances. But in the future it may not be viewed that way, as the two issues are almost certain to become linked. One of the core problems highlighted by the OBR report was how an ageing population could put serious pressure on the Government budget between now and 2070, and it does not take much imagination to see how assisted dying might be seen by some — such as former MP and Times columnist Matthew Parris — as a “solution” to such a problem.

When a society ages, it has fewer working-age people to pay taxes and a growing elderly population which is reliant on the state. As older people age past the point of being able to take care of themselves, some of the workforce must leave their roles in the productive economy to become carers.

All of this puts a massive strain on resources. But because it is a simple numbers game, there is no obvious solution. Raising the retirement age can help at the margin, but as the older share of the population grows the effects of such manoeuvres do not last long. There is, however, one potential solution: eliminate some of the elderly population.

This may sound extreme, but the logic would probably not be that the state simply mandates a certain maximum age. Rather, we might imagine a society and healthcare system that finds itself under severe strain and starts putting pressure on the elderly and infirm to “take advantage” of euthanasia. Systems which are experiencing strains on their resources do everything possible to lower costs.

We can already see this logic at work in Canada. Since legalising euthanasia in 2016, the country now has some of the highest rates for assisted dying in the world. In 2022, 4.1% of people in Canada died through euthanasia — almost one in 20 deaths. There have been numerous reports of Canadian physicians putting pressure on ill or disabled people to allow themselves to be killed. Yet despite the enormous rates of euthanasia and the obvious abuses, the country is considering expanding services to people with mental illness. This is currently postponed, but it will likely become law at some point, thereby expanding the scope of the euthanasia programme further.

With an ageing society in the UK and an effectively bankrupt Treasury, to legalise assisted dying would be to play with fire. Proponents typically think of assisted dying as just a kind way to limit suffering, one choice among many in a consumer society characterised by abundance. But the reality is that Britain over the next 50 years will be one in which resource conservation will be key. Given this incentive structure, most of the liberal thought experiments about assisted dying become redundant — and human life becomes merely a liability on a balance sheet.

And Lauren Smith writes:

According to 28 randomly selected members of the public, assisted suicide or euthanasia (ASE) should be legalised in England for the terminally ill. Over eight weeks, a ‘citizens’ jury’ – set up by the Nuffield Council on Bioethics – listened to evidence presented by experts. In the end, the majority of jurors agreed that the law should be changed.

The ‘majority’ in this case was just 20 people. Seven jurors disagreed that ASE should be legalised and one remained unconvinced either way. Yet the tiny size of this sample didn’t stop pro-euthanasia group Dignity in Dying claiming that ‘the British people are demanding an assisted-dying law’. As Sarah Wootton, Dignity in Dying’s chief executive, put it, ‘it is inarguable that the public wants this reform to happen’.

Thankfully, policy is not decided on the say-so of 28 people, let alone the say-so of Dignity in Dying. But the conclusion of this citizens’ jury comes at a time when a vote in parliament on assisted suicide seems not only likely, but also imminent. Earlier this year, before the UK General Election, now prime minister Keir Starmer promised he would give MPs a free vote on the issue. Somewhat uncharacteristically, he is keeping that promise. A vote could be put to the House of Commons before the end of the year.

At the weekend, the Mail on Sunday reported that Starmer was planning to fast-track an ASE bill through parliament. To do this, he is reportedly encouraging MPs to introduce a new private members’ bill on the issue. Labour MPs have reportedly been offered extra staff and resources to make drafting a hypothetical bill easier.

On the surface, ASE may seem like a cut-and-dry issue. A poll earlier this year found that a majority of people in the UK support legalising the practice. But things are a great deal more complicated than that. Many are still very concerned about ASE – and a full public debate about this issue hasn’t really properly begun. According to that same poll, over 40 per cent of Brits worry that legalisation would incentivise healthcare professionals to encourage patients to die, in order to relieve the burden on the NHS. Nearly half think there are too many complicating factors to make ASE a practical and safe option in the UK. Most people also think that there are many more important issues for the government to focus on. Indeed, the public ranked it as 22 out of 23 as a policy priority, with only regional devolution ranked lower.

Indeed, even Starmer’s cabinet is far from unified in favour of legalisation. Which is why he intends to give them a free vote. Justice secretary Shabana Mahmood has already said she has no intention of supporting an ASE bill. ‘Once you cross that line, you’ve crossed it forever’, Mahmood has said. ‘If it becomes the norm that at a certain age or with certain diseases, you are now a bit of a burden… that’s a really dangerous proposition.’ Health secretary Wes Streeting has aired similar concerns, saying that he feels ‘deeply uncomfortable’ with the prospect of vulnerable people being potentially ‘coerced’ into an ‘assisted death’.

Given what we’ve seen happen in countries that have legalised ASE, Mahmood and Streeting are right to be concerned. In Canada, the Medical Assistance in Dying (MAID) programme has made suicide all but a routine form of healthcare. When MAID was first introduced in Canada in 2016, it was supposed to be exclusively for terminally ill patients to end their suffering. But in 2021, the eligibility criteria was expanded to include those with serious and chronic physical conditions – even if those illnesses were not life-threatening.

As a consequence of these expansions, the number of MAID deaths has increased drastically. As of this year, MAID accounts for a huge four per cent of all deaths in Canada, making it the fifth leading cause of death. This is unsurprising, given that Canadian doctors very rarely deny requests to die. A patient can be dispatched within just two weeks of applying for MAID.

The accessibility and normalisation of assisted suicide in Canada has created a situation where elderly and disabled people are often made to feel like a burden on the healthcare system and their families if, for whatever reason, they haven’t asked to die yet. In a story that came to light in July, a Canadian woman with cerebral palsy, while receiving care in an Alberta hospital, said that she felt pressured to request MAID. She alleged that a nurse told her that she should ‘do the right thing and consider MAID’. She ‘wasn’t living’, the nurse allegedly told her, she was ‘merely existing’.

In a similar case, a man suffering from cerebellar ataxia (a disease that attacks the brain and muscles) said that while staying in a hospital in Ontario, he was repeatedly asked if he wanted an assisted death. He claims he was told that he could either choose to die or leave the mostly government-funded facility. Then there’s Christine Gauthier, a Paralympian and veteran. When she asked the authorities if she could have a stairlift installed in her home, she received a letter asking if she had ever considered euthanasia.

The situation in Canada is set to get a whole lot worse. MAID is due to be expanded to allow those suffering solely from mental illnesses to be accepted into the programme (although the date for the rollout has been pushed back until 2027). We need only look to the Netherlands to see where this can lead. There, physically healthy young people are being euthanised to ‘cure’ conditions like depression and anxiety.

This is the future that Starmer is putting the UK on a ‘fast-track’ towards. If we refuse to heed the warning signs from places like Canada and the Netherlands, we risk devaluing life for the most vulnerable in society. Britain must not repeat these horrors.