The legend that is Professor Kevin Yuill writes:
Today, a bill hoping to legalise ‘assisted dying’ for the terminally ill in England and Wales was formally introduced to parliament. It is due to be debated in the House of Commons at the end of next month. Although it is a private members bill, put forward by backbench Labour MP Kim Leadbeater, prime minister Keir Starmer says he is committed to allowing a vote on the issue.
If the parliamentary debate is anything like the one that’s been happening elsewhere, this doesn’t bode well. Discussion around assisted suicide and euthanasia (ASE) is dominated by emotional pleas, logical inconsistencies and outright myths.
Here are 10 of the most egregious:
1) The British people overwhelmingly support ASE
The support rate for ASE, we have been told over the years, is ‘more than 90 per cent’. The assisted-dying movement leans heavily on a supposedly supportive public to justify itself.
However, support has cooled as of late. More in-depth polling shows that British people are actually deeply ambivalent about legalising ASE. A poll commissioned earlier this year by the group Living and Dying Well found that legalisation came 22nd out of 23 issues in terms of importance to voters, only beating ‘regional devolution’. It also showed that, out of 54 per cent of those who gave an opinion on ASE (nearly a fifth of respondents put ‘don’t know’), most respondents favoured it in principle but didn’t think it was safe or practical.
An even more recent poll this month found that, while 63 per cent of British people favour legalising assisted dying, less than half (45 per cent) want their MP to vote for the law. A majority also say they don’t know enough about how it would work in practice to support a change in the law. Even a poll commissioned by pro-ASE campaign group Dignity in Dying this year found that fewer than half of all Britons wanted their MP to vote for ASE.
2) Assisted dying is not suicide
‘Assisted dying’ sounds much more pleasant than ‘assisted suicide’. But if a doctor hands you a gun and you shoot yourself, we all know that you would be committing suicide. If she hands you a rope and you hang yourself, that’s suicide. Yet if you have six months left to live and she hands you deadly poison and you ingest it knowingly, we are meant to believe that this is not suicide but ‘assisted dying’? ASE campaigners are desperate to hide the reality of what they want to legalise.
3) Safeguards can ensure that ASE is safe and limited
Leadbeater said earlier this month that, ‘wherever [an assisted-dying] law has been introduced… and it’s got strict, limited criteria with proper safeguards and protections, it hasn’t been widened’. She claimed there is no danger of a ‘slippery slope’. The trouble is, proponents of ASE tend to spin the globe, cherry-picking their examples of supposedly ‘safe’ assisted-dying laws.
They invariably ignore the Netherlands, where at least 39 people with learning disabilities or autism have been euthanised. They also turn a blind eye to Belgium, which has changed the law to include children. Most egregiously, the assisted-dying camp ignores Canada, pointing instead to Oregon, where ASE has been legal since 1997. ‘See?’, they say, ‘the safeguards work’. Except when they don’t.
There is no jurisdiction where ASE has been legalised where the eligibility criteria have not been relaxed. In Oregon, the definition of what constitutes a ‘terminal’ illness has been massively expanded – so much so that it can include mental illnesses like anorexia. Similarly, the ‘cooling off’ period for patients to change their minds has been cut from 14 days to less than 48 hours. Non-residents are now also allowed to apply for assisted suicides.
In Canada, the slide down the slippery slope has been even more dramatic. The Canadian government introduced its medical assistance in dying (MAID) programme in 2016 for those who were close to death and suffering unbearably. Just a few years later, in 2020, the eligibility criteria were expanded to those whose death was not ‘reasonably foreseeable’. A further vote to extend euthanasia to all those suffering from mental illness will take place in 2027.
This all follows a grim but undeniable logic. If death is redefined as medical treatment, how can it be denied to anyone who is ‘unbearably suffering’?
5) This is not a threat to the vulnerable
Assisted-suicide advocates insist there is no truth behind the claim that those at the margins of society will be placed most at risk from legalisation. It tends to be the educated and wealthy who opt for an assisted suicide, they say. Apparently, this proves that ASE is a freely made ‘choice’.
However, there are now numerous reports from Canada about people who asked for MAID because they were poor, homeless or could not afford medical treatment. Recent research found that at one hospital in Ontario, 58 per cent of requests for MAID were from people belonging to a lower socio-economic status (SES), despite the fact that only 39 per cent of the hospital’s catchment were ‘low SES’.
The story is similar in Oregon, where the number of yearly assisted deaths increased from 16 in 1998 to 278 in 2022. Over this time, patients’ health-funding status changed from predominantly private (65 per cent) to predominantly government-supported (80 per cent). This implies that, when ASE is first legalised, it is indeed taken up mostly by the comfortably off seeking a bespoke death. But it doesn’t take long before those who have little money or prospects start to view ASE not as a choice, but as their only option.
Not unlike eugenics at the turn of the last century, ASE is cleansing society of those who are shamefully seen as a drag on the economy.
6) This is about freedom
‘Each one of us should be free to make our own decisions about how we live – and die – as long as we don’t harm others’, says Professor Alice Roberts, vice-president of Humanists UK. This simple-minded argument is a recipe for approving – and presumably assisting in – any attempt to commit suicide, for whatever reason.
Surely the same logic could also apply to any kind of ‘consensual’ lethal violence. Should we not be able to engage in duelling, which kills only those who have consented to it? What about consensual cannibalism? Such arguments stretch the ‘harm principle’ beyond all recognition. Death, quite literally, destroys one’s freedom.
7) If you had experienced a bad death of a loved one, you would support ASE
This is a grotesque and insulting claim. Many of us have experienced bad deaths of loved ones and we still think legalising ASE is a horrible idea. This oft-repeated argument reveals that ASE advocacy is an emotional response to an awful situation, not a considered and thoughtful reflection about what should happen in law.
8) Britain’s suicide laws are unfit for purpose
According to Dignity in Dying and its supporters, the Suicide Act 1961 is ‘dangerous and cruel’, a ‘blanket ban’ on compassionate responses to the dying and a ‘broken law’. Guardian columnist Polly Toynbee once dramatically called the Suicide Act an ‘instrument of state torture’.
This is far from the truth. The Suicide Act decriminalised suicide, meaning that those who attempt it would no longer be prosecuted. It does, however, make it illegal to aid someone else’s suicide. This strikes a good balance. It signals not only that suicide is wrong and we ought to discourage it – but also that those who attempt suicide deserve our sympathy, not criminalisation. In other words, we do not want to punish those who feel they want to end their lives, but nor do we want to push the proverbial man teetering on the bridge.
How many people are even prosecuted under this supposedly cruel act of state torture? According to the Crown Prosecution Service (CPS), between 1 April 2009 and 31 March 2024, 187 assisted-suicide cases were referred to the police. Of these 187 cases, 127 were not proceeded with by the CPS and 36 cases were withdrawn by the police. Six cases are ongoing, four were successfully prosecuted. Eight were instead prosecuted as homicide and one case was acquitted. Even under our current laws, no one is now in prison for participating in a genuine mercy killing.
9) Britons suffer terrible deaths because ASE is not legal
Dignity in Dying’s own figures suggest that your chances of dying a terrible death are pretty small. ASE advocates make much of the fact that 17 people a day ‘suffer’ as they die – but that’s just one per cent of all daily deaths. In one report, Dignity in Dying follows this stat up with a dramatic flourish, saying that some ‘will retch at the stench of their own body rotting. Some will vomit their own faeces. Some will suffocate, slowly, inexorably, over several days.’ Dignity in Dying was forced to withdraw the video version of this report after Hospice UK said the film was ‘sensationalist and inaccurate’.
In any case, legalising ASE does not guarantee a ‘good’ death. A 2022 BMJ article found that, in the Netherlands, where euthanasia has been legal for more than 20 years, many dying patients still suffer pain and / or restlessness in their final moments.
10) There is no slippery slope
When I wrote the first iteration of this list for spiked 20 years ago, we lacked any real data on ASE. Now, we have extensive evidence from Oregon, Washington, Canada, the Netherlands and elsewhere. As a result, it is very difficult to maintain the idea that, once legalised, ASE will not expand, both in terms of numbers and ever-widening criteria.
In Canada, within less than a decade, euthanasia went from being a rare exception to something that ended the lives of an average of 36 people every day. More than four times as many people end their lives through ASE than through regular suicide.
The numbers dying have continually increased in every jurisdiction where ASE has been legalised. California has recently experienced a jump in cases. Belgium has gone from 235 deaths in 2003 to 3,423 in 2023. In the Netherlands, euthanasia increased from four per cent of all deaths in 2022 to five per cent in 2023.
Yes, the slippery slope is very real, although this isn’t even the most apt metaphor. We should think of legalising ASE as opening the floodgates to something deeply sinister.
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