In considering the scenarios of the third reading of the Terminally Ill Adults (End of Life) bill, I thought long and hard about what this moment would be like. There are some who have portrayed this as a victory for those who support assisted suicide, but whatever the outcome there would be large swathes of the public unhappy with the decision. Some are worried their life will go on too long, and there are those who fear their lives will be cut short, and we still don’t have better palliative care. It is a postcode lottery, with no plans in place to improve it.
No legislation stands in isolation. Lay on the current proposals for swingeing cuts to the challenging welfare bill, and the discrimination that disabled people face in every part of their lives, and there are many who are worried about their future. The bill that is now going to make its way to the Lords does not take any of that into account.
So-called “safeguards” will not hold. An amendment to ensure that advice is accessible to those with autism, for example, was voted down. Indirect coercion is hard to detect or prove and has happened in Oregon, the first US state to allow assisted dying. Coercion would most likely not be direct and implicit, but in quiet conversations where the conclusion is implied.
The proposed punishment of up to 14 years in prison is useless if the crime cannot adequately be detected. During Covid we saw countless cases of disabled people being assigned “do not attempt resuscitation” orders.
A recent Not Dead Yet UK survey shows 57% of people agree that for those disabled people who struggle to access the support they need, they may be more likely to seek assisted suicide. A compassionate society is not one that suggests death as an answer to the many it is failing.
UK legislation is amendable, and frequently revised, meaning that the expansion of the eligibility criteria, contrary to popular belief, would not be difficult.
Disabled people are required to advocate for themselves in every stage of life, and this legislation will only exacerbate the pressures they face and the underlying assumption that their lives are worth less. I know from personal experience.
Choice is a hard one to argue, but legalised assisted suicide is not a choice if the alternative is insufficient care and lack of support.
Professor Kevin Yuill writes:
In an unusually packed UK House of Commons last Friday, 314 MPs voted for the Terminally Ill Adults (End of Life) Bill and 291 voted against. The ‘assisted dying’ bill, as its proponents call it, thus passed its third reading – but only just. This was MPs’ final say on whether to legalise assisted suicide in England and Wales. The bill now heads to the House of Lords.
Although opponents of assisted suicide ultimately lost the vote, we can take some succour from just how many MPs switched sides. The majority voting in favour last week was less than half of what it was in November at the second-reading vote. It is clear that the more assisted suicide was debated, the more the backlash grew – in parliament and among the public. The publicity around the bill fuelled an opposition movement that was far larger and more vocal than when MPs last debated this 10 years ago.
Friday’s debate made it clear that fewer and fewer people are being fooled by the euphemisms of the assisted-suicide lobby. ‘Assisted dying’, ‘shortening death’ – these are just pretty labels for something far uglier. ‘Assisted dying’ simply means assisted suicide. ‘Shortening death’ is meaningless. You can’t shorten death, you can only shorten life – by killing. What the bill actually permits is a doctor prescribing poison so that a patient can end his or her own life. It means turning the health service into a suicide service. It means doctors can be charged not with saving the lives of the sick, but with ending them.
Much of the press woke up to the dangers, too. Aside from the Daily Express, which urged MPs on its front page to give celebrity Esther Rantzen the ‘present’ of an assisted suicide, most newspapers turned against the bill. Even The Times, which was previously supportive of assisted suicide in principle, called on MPs to reject what it described as a ‘deeply flawed’ bill.
Several Labour MPs – Kanishka Narayan, Markus Campbell-Savours, Paul Foster and Jonathan Hinder – deserve credit for switching from yes to no between readings. They clearly engaged with the arguments and understood the bill’s shortcomings.
Contrast that with the bill’s sponsor, Kim Leadbeater, who dismissed questions about her legislation as mere ‘noise’. Eager to curtail debate, she pushed it through the Commons as quickly as possible. Indeed, parliament allotted just 65 hours to discuss this literal matter of life and death (although a few more hours were squeezed in). The parliamentary debates on banning foxhunting, in contrast, were given 700 hours.
The process exposed an alarming number of new MPs – especially the 2024 Labour intake – as depressingly out of their depth. Many owe their positions to their loyalty to Keir Starmer, a known supporter of assisted suicide, not to any great grasp of policy. Some clearly hadn’t even read the bill properly, let alone understood the broader moral implications.
For instance, Labour’s Jim Dickson, in an obsequious question to Leadbeater, said the bill had ‘the strongest safeguards’ against wrongful killings ‘of any jurisdiction in the world’. To back up his claim, he cited the impact assessment, which was published last month. But the impact assessment makes no such claim.
Or take Chris Coghlan, a Lib Dem MP, who says he ‘voted for assisted dying for the relief of suffering’, even though suffering is not mentioned in the bill as a reason for granting an assisted suicide.
Then there was Christine Jardine, Liberal Democrat MP, who warned that if children were not informed about assisted suicide, then they would just Google how to kill themselves and suicide attempts among young people would spike. Thus, a policy of assisted suicide was presented as a means of suicide prevention. This mixture of Orwellianism and idiocy was common from the pro-assisted-suicide side.
After last week’s vote, Kim Leadbeater was praised in the media for supposedly hearing both sides patiently. She did nothing of the sort. She dismissed critics, leaned heavily on tear-jerking anecdotes and turned the debate into an exercise in emoting rather than thinking.
Assisted suicide may have narrowly passed, but the political wind is still blowing against it. The day after the Commons vote, the Daily Mail reported that Reform UK, the party currently topping the polls, could pledge to repeal Leadbeater’s legislation ahead of the next General Election.
To which all I can say is: bring it on. A full, frank public debate is precisely what this issue needs. The fight to stop the inhumanity of assisted suicide is far from over.
While parliament is in recess, I am spending most of my time working on the programme and speakers for this year’s Battle of Ideas festival in London on 18 & 19 October. (What do you mean you haven’t got your ticket yet?! You should head over to our ticket page now!) I am also preparing for the legislative period ahead. One crossover is the theme of assisted dying, which we will be discussing at the festival, and Kim Leadbeater’s Terminally Ill Adults (End of Life) Bill is also one key laws that I will be involved with back in Westminster as it starts its passage through the Lords on 12 September.
I have serious reservations about this law in principle, given that it will fundamentally change the relationship between the state and individuals, and between the NHS and patients. One worry I have is that so many safeguarding amendments were either never discussed or were voted down in the House of Commons. Huge concerns have rightly been raised about the way this bill, on such a weighty matter, was introduced by means of a private members’ bill. Moreover, the committee that was supposed to scrutinise the legislation was stacked with a majority of supportive MPs, a disproportionate amount of ‘expert’ testimony was from those in favour of the Bill, and MPs were given insufficient time for proper debate.
One amendment I will be arguing for, that MPs rejected, is to allow certain hospices and care homes to opt out. With barely any debate, it was voted on and was defeated by 279 votes to 243 in the Commons. As former No10 director of legislative affairs Nikki da Costa (who will be speaking at the Battle of Ideas) commented on X, it now ‘looks like there will be no hospice, nor care home, where you can be certain ending the life of the terminally ill will not be suggested nor normalised’.
For me, this is a red flag. Unsurprisingly, hospice doctors, who well understand the complexity of death, are overwhelmingly opposed to legalising assisted death. A 2019 survey found that 81 per cent of them were against it. The best way to procure a ‘good death’, in my opinion, is through hospice care, whose expertise is precisely in offering unparalleled dignity to patients in their care, as they face the end of their lives. I think we should be putting all our energies and resources into improving funding and access to desperately needed palliative-care services and hospices, instead of enacting a law that normalises suicide and arguably puts the most vulnerable at risk.
In this context, I was shocked to hear that St David's Hospice in Holyhead (in North Wales, where I grew up) has been forced to close its doors in October. It has served the community of Holyhead and the wider Anglesey region for years, offering palliative and end-of-life care to countless individuals and their families. I became aware of this from an old friend, Gel Murphy, whose 61-year-old brother Brian recently passed away after a brave battle with cancer after a stay in this hospice.
Gel tells me: ‘We were there with him, the staff are angels, they always went an extra mile. They made food and put us up. The hospice staff at Holyhead are amazing. They even put myself, my sister and niece up.’ The decision to close this vital facility, with its specialised local support network and access to dedicated professionals, would leave a significant gap in the healthcare services and increase the strain on families who are already grappling with the emotional and physical demands of caring for a loved one with a life-limiting illness.
Hospices like St David's are part of a wider network of hospices in Wales that provide essential care to more than 20,000 children and adults affected by terminal and life-limiting illnesses each year. Ironically, they provide a huge cost saving for the NHS, with over two thirds of hospice care delivered through charitable fundraising, rising to over 85 per cent for children’s hospices. Bangor University Research last year found that the mean cost for a hospice patient staying for 14 days was £5,708, compared to £6,860 for the cheapest hospital-based option.
However, despite the fact that significant public expenditure savings could be achieved through increased utilisation of hospice-based care (statutory funding as a proportion of hospice care expenditure across Wales was just 30 per cent and St. David’s Hospice receives just 24 per cent) now every hospice in Wales is forecasting a deficit for this financial year.
While healthcare in Wales is notoriously under par, this funding crisis is replicated throughout the UK. Government policies, such as the national insurance hike and minimum wage increases mean that the hospice sector is having to consider significant cuts.
Incredibly, while the NHS is exempt from the national insurance rise, private and charity-run health and care organisations are not. Leaders of some charitable organisations that administer health and social care have aired their concern that can this only exacerbate budget pressures and could mean further cutbacks in a sector that has already seen beds close and nurses laid off to save money in the last year.
Lord Howard of Lympne, a Conservative peer and vice-president of Hospice UK’s board of trustees, said the additional contributions would create estimated additional costs of £34m per year for hospices. I, along with a majority of peers, supported an amendment, tabled by Liberal Democrat peer Baroness Barker, to amend the National Insurance Contributions (Secondary Class 1 Contributions) Bill.
In the meantime, the likes of St David’s Hospice need solidarity, so it would be great if you can sign and share this petition to urge the decision-makers to keep St David's Hospice open in Holyhead and ensure it continues to provide its invaluable services to our community.
And politically, we should resist the chilling reality of politicians pushing state-assisted suicide, at the very time when policies designed by parliament are so carelessly denying crucial end of life care and facilities.
Elaina Plott Calabro’s article on Canada is far too long to reproduce here, but it is a vital read, and Jonathon Van Maren makes it clear that there are signs of a fightback:
In 2010, twenty-one-year-old Andrew Lawton attempted suicide by swallowing a bottle’s worth of pills in a public bathroom. His depression had become unbearable. Thankfully, he failed, and after weeks in a coma, began a long recovery. Earlier this year, he was elected to Canadian Parliament and has become a key advocate of a new law to halt the scheduled expansion of euthanasia to those suffering solely from mental illness.
Bill C-218, the “Right to Recover Act,” was tabled by MP Tamara Jansen and would make it a criminal offense to provide “medical aid in dying” (MAiD) to someone suffering solely from a mental illness. The Supreme Court overturned criminal prohibitions on assisted suicide in 2015, and the next year Parliament passed Bill C-14, which legalized euthanasia for those “enduring intolerable suffering” with a “reasonably foreseeable death.” In 2021, the Trudeau government passed Bill C-7, legalizing MAiD for those struggling with mental illness.
The Trudeau government paused but did not cancel the expansion of the MAiD regime twice after sustained public pushback. “Most Canadians don’t know that under our current laws it is legal, although delayed, to give someone MAiD even if the only thing they’re struggling with is a mental illness,” Jansen told me. “That law is set to take effect in March 2027. Experts have been sounding the alarm for years, saying this law is dangerous.”
Lawton cites his own story as proof. “At my lowest points, I was convinced that there was no way I could live a life I’d be happy with and that I was better off dead than alive,” he told me. “I was wrong. I got better. My fear with the expansion of MAiD is that it normalizes and legitimizes this dangerous idea that death can be the answer to mental health challenges. I would have availed myself of MAiD had it been available to me then. If I had, I probably wouldn’t be here now.”
At a July 9 press conference to launch a public campaign in support of the bill, British Columbian Alicia Duncan joined the MPs to tell her mother’s story. Donna Duncan was in a car accident in 2020 and suffered a concussion; during Covid lockdowns, she had difficulty accessing care and her physical and mental health suffered. Alicia and her sister were told that their mother was scheduled for MAiD only two days before the appointment in October 2021. She had no terminal diagnosis other than depression.
The sisters were horrified, but certain the law would intervene to help them save their mother. The police told them there was nothing they could do, but a provincial judge granted them a warrant for their mother’s arrest under the Mental Health Act. Donna was sectioned in the hospital psychiatric ward she once managed as a nurse. “I can’t explain to you how traumatic it is to be relieved that your mom is in a psychiatric unit,” Duncan said. “We thought at this point she would be safe, that she would be protected.”
But forty-eight hours later, under the Canadian law, she was assessed again. And being a psychiatric nurse, she knew exactly the things to say to pass the assessments. Four hours later, we received a text message that my mom was dead, and her body had been taken to a crematorium. I have since been diagnosed with PTSD. My sister has been diagnosed with PTSD. And under the expansion of our law in 2027, this would qualify us for medical assistance in dying. That irony is also not lost on us.
To date, the Fraser Health Authority has refused to release Donna’s MAiD assessment records. Her daughters are still seeking answers.
If Bill C-218 fails, Alicia Duncan’s story will become common in Canada. Every Canadian knows and loves someone who has struggled with mental illness; most know someone who has experienced suicidal ideation. Many people with mental illness have the will to end their lives, but do not have the means. Once MAiD is offered to those suffering from mental illness, they will have both the will and the means. Many suicide attempts, like Lawton’s, thankfully fail. A lethal injection delivered by a physician will ensure death, with no chance for recovery—and no second chances.
Few Canadians are yet aware of the gut-wrenching scenarios they will face if suicidal loved ones opt for euthanasia and the law prevents them from doing anything to save them. In Calgary, a desperate father appealed to a judge to prevent his twenty-seven-year-old daughter—who suffers from autism, but is physically healthy—from accessing MAiD. The judge ruled that although the father would experience “profound grief,” the daughter’s “right to self-determination” ultimately outweighed the suffering of her father.
In another case in British Columbia, sixty-one-year-old Alan Nichols, who had a history of depression, was euthanized after his family admitted him to the hospital for a psychiatric episode in 2019. His family had taken him to the hospital to be placed on suicide watch. As his sister-in-law Trish Nichols plaintively asked a Senate committee in 2023: “Alan did not have a valid diagnosis for MAiD. Would you feel safe now, bringing your suicidal loved one to seek medical care for recovery when there are no oversight or stringent safeguards surrounding a procedure that kills people?”
A previous bill to criminalize MAiD for mental illness, put forward by former MP Ed Fast, failed in 2023 by a narrow margin of 167 to 150. Jansen’s bill revives that previous effort, and the Right to Recover Act has already attracted the support of many organizations, including Indigenous Disability Canada, Inclusion Canada, and Physicians Together with Vulnerable Canadians. A public campaign encouraging Canadians to tell their own stories of mental illness and recovery has been launched, with Andrew Lawton sharing his own filmed testimony and urging parliamentarians to vote in defense of the vulnerable.
There are few laws that, if passed, would save thousands of lives. Bill C-218 is one such law. As Conservative party leader Pierre Poilievre, who is supporting the legislation, stated: “MP Tamara Jansen’s The Right to Recover Act will save countless lives. . . . Our loved ones suffering with their mental health deserve support, not assisted death from the government. Recovery is possible. We will not give up on them.”
And Professor Kathleen Stock writes:
I used to set philosophy exam questions, so here is one. Imagine there has been a small, but still significant, increase in illegal late-term abortions at home, thanks to a new pills-by-post scheme introduced during a pandemic. This means there has also been a small rise in criminal prosecutions of women. Which of the following is the most urgent ethical task: a) try to reduce the number of at-home abortions involving third-trimester babies; or b) stop the prosecutions of women who have them?
On Monday, in another stunning PR victory for that ever-darkening project popularly known as feminism, MPs went for option b, voting to decriminalise at-home abortion for women for any reason and at any stage of pregnancy. Thanks to an amendment to the Crime and Policing Bill backed by several Labour ministers, providers will still face sanction for falling foul of existing rules, but women carrying out their own abortions will not.
As is now traditional with major social engineering enterprises, this arrived in Parliament with barely any warning, leaving onlookers blindsided as MPs sewed the thing up in a two-hour debate. Also as usual, the ability to think more than one chess move ahead was missing in action. Late-term abortions are dangerous for the mother as well as intentionally lethal for the baby. Without the deterrent of prosecution acting as a brake on misuse of the pills-by-post scheme — which parliament separately declined to withdraw, and which is easy for people to game — there will now be more deaths. As Jim Shannon MP pointed out, bravely attempting to inject a note of reality into parliamentary debate, after decriminalisation was introduced in New Zealand, late-term abortions increased by 43% in the first year.
But such facts are of little interest to radical pro-choicers, who simply start with the principle that a woman should have total control of her reproductive capacity no matter what the costs to others, and take argumentative matters from there. One way to stop rises in both prosecutions and third-trimester baby deaths would be to modify the pills-by-post scheme, to make it harder to get them; but this too would pit you against the almighty cause of reproductive freedom, allegedly deterring women from having early abortions because they don’t want a face-to-face consultation with a GP.
Unsurprisingly, this sudden glimpse of the cold libertarian priorities lurking behind a fluffy feminist curtain has produced some pushback. For a few plain-speaking and unabashed freedom-lovers, backing decriminalisation means admitting that the painful deaths of other human beings will be a regrettable but necessary cost. But for abortion absolutists within mainstream feminism, intent on continuing to see themselves as caring people, an elaborate rhetorical game of hide-the-dead-baby has now begun.
And the task is trickier than usual. You can’t rely for cover, when it comes to late-term abortions, on the metaphysical ambiguity of personhood; not when the topic is someone who can recognise her mother’s voice, suck her own thumb, and have dreams. A narrative our activists have imported from American identity politics, about the pressing political threat of frothing evangelistic pro-lifers, is hard to make convincing — especially since the parliamentary vote wasn’t even a close-run thing.
So the preferred strategy is emotional misdirection. We are, then, decriminalising all abortions for the benefit of the women wrongly prosecuted, who didn’t know they were pregnant, or who were suffering miscarriages at the time. (Any thoughts on the use of this general tactic for getting rid of, say, rape laws go unrecorded.) Or — if we really must think about the perpetrators the law was actually designed to target — can we please realise that they only ever get rid of their perfectly viable babies because they are “desperate” and otherwise faultless in intention, perhaps even positively altruistic? The fact there is already clear evidence of other psychological possibilities is ignored. In this moral universe, killing a full-term baby — rather than, say, putting her up for adoption — not only never makes you a monster, it quite possibly also qualifies you as a saint.
When disseminating this overheated stuff, you have to ignore other things you’d normally be keen to point out as a conscientious feminist: for instance, that new reproductive technologies, promoted in the name of freedom, can change social norms unexpectedly in ways that eventually harm both women and children. A lot is being made of the fact that only “a few” late-term abortions take place under current conditions; but since the status quo has criminalisation already in place as a deterrent, current figures say nothing about what might happen later as the permissive environment beds in.
The growing acceptance of surrogacy is a case in point: the more acceptable it becomes, the more surrogates there are out there. And in fact, that gives rise to a further question: what happens when surrogate and abortion pill cultures collide? Transactions between strangers can go wrong; you need to do something with the goods if your buyer refuses. Or what about sex selection? That’s normally something feminists care about, but in this case, they are apparently too busy magicking up a vision of essentially benevolent female nature to notice.
It is hard to say how exactly well-intentioned people ended up here, but the phrase “bodily autonomy” getting madly out of control is one part of the story. At this point, it seems to be operating more like a hypnotic mantra than an important value to be weighed up against other ethical values. Within feminism, it turns otherwise inquiring minds into mush and makes their owners look like cult members. Indeed, from one angle, this new decriminalisation initiative looks like the equally foolish historic venture of self-ID: supposedly about advancing personal freedom, pretending other people’s vital interests don’t matter, fond of histrionic cherrypicked examples, and bound to result in a loss of public support for the overall cause.
The state of the abortion discourse is also reminiscent of campaigns for assisted suicide — a matter on which MPs are also voting this week, as the Terminally Ill Adults Bill returns to the Commons for its third reading. Here, too, the fairly mindless invocation of freedom, autonomy, choice, control, rights, and other such happy-sounding phrases are cutting off attempts to build careful and responsible legislation at the pass.
There is no better demonstration of this than the bizarre shape of Kim Leadbeater’s bill itself, based on one from Oregon. Despite all the surrounding stuff about freedom, at base this is a law motivated by compassion, whether or not it achieves it in practice. Thankfully, she does not propose to offer the much mythologised “freedom to die” to absolutely anyone who has suicidal thinking, but only to those who are terminally ill. The implied rationale for this selection is clearly that terminally ill people suffer terribly, in a way that justifies the compassionate offer of assisted suicide to them, and only to them (at least, at this stage).
With this background compassionate intention, you might assume it would be important for those in charge of the assessment process to probe the nature of an applicant’s suffering, in case it could be alleviated by less drastic means than an early death via the ingestion of poison. Could this person be helped with better medication, social support, or just talking his worries through with a friendly face? Is death really the best solution here? Yet according to the terms of Leadbeater’s bill, the applicant can go through the entire assessment process and reach his final destination with no professional ever asking him why he wants to die. The assumption of terrible suffering gets him in the room, as it were — entirely predicated on the terminal diagnosis — and after that, nobody should check its source. Conscientious amendments mounted at committee stage, insisting that the applicant at least be asked about his suicidal thinking, or even have to meet with a palliative care specialist first, were rejected.
This weird sabotaging of the implicit rationale behind the bill comes from the influence of legislators who can only see the good in something if it superficially appears to enhance personal freedom. In effect, after the initial terms of eligibility for assisted suicide were set, suddenly there was an incoherent reversion to the idea that a terminally ill person can get a death from a doctor for any reason, and authorities should stay out of it. As Rachel Hopkins MP said approvingly during the bill scrutiny phase, imagining herself as an applicant: “It is none of your business why I want to pursue this legal course of action.” A host of useful and responsible amendments were rejected on a similar basis.
Here too, then, as with abortion, excessive deference to the causes of autonomy and rights have hollowed out the original impetus to offer genuinely compassionate help, ensuring the opposite would be true for many. The result is an assisted suicide bill utterly unfit for purpose, that will simply kill off those who might have been compassionately helped in other ways. At some point, MPs will surely have to ask themselves who or what all this freedom is actually good for.
The tide is turning.
ReplyDeleteIf we turn it.
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