The Cruelty of Assisted Dying

Kevin Yuill writes:

In Prue and Danny’s Death Road Trip, aired this week on Channel 4, Prue Leith of Great British Bake Off fame invites her son, Tory MP Danny Kruger, to accompany her on a road trip as they explore the question of assisted dying. Together, the pair visit parts of the US where assisted suicide is legal, as well as Canada, where a much more extensive system of euthanasia and assisted suicide was legalised in 2016, called ‘medical assistance in dying’ (MAID).

The catch is that Prue and Danny are on different sides of the debate. Prue is an atheist, while Danny is a conservative Christian. Prue has been a member of Dignity in Dying, a well-funded pro-assisted dying campaign group, ever since her older brother died a long and ‘most horrible death’ in 2012. Danny, a fervent opponent of legalising assisted dying, is chair of the All-Party Parliamentary Group for Dying Well.

The resulting documentary is perhaps the best-produced so far on the assisted-dying debate. Too often, assisted dying is portrayed in the media, whether in soaps, films or in one-sided documentaries, as simply a personal matter for a dying person, and as a means of alleviating needless suffering. Prue and Danny’s Death Road Trip, however, is thoughtful and balanced. It considers the wider social ramifications of treating death as a form of healthcare.

Prue and Danny go first to the state of Washington, where it is legal for a doctor to assist a patient in ending his or her life by prescribing lethal doses of medication. Euthanasia – where a doctor ends a patient’s life, usually via lethal injection – is still outlawed. This is Prue’s opportunity to impress upon Danny the case for legalising assisted dying. A woman called Sher talks movingly about how her parents chose to die together after they were both diagnosed with Parkinson’s disease and terminal cancer. This is powerful stuff.

In fact, nearly all of the first section of the documentary gives Prue’s side the upper hand in the argument. That is, until they travel from Washington to Atlanta. Here, they interview a doctor who questions whether assisted suicides are any more peaceful than executions. Prue sees this as a red herring. She asks whether different drugs could be prescribed to allow for a more peaceful death. And she suggests Danny is ‘scaremongering’ by exaggerating the pain caused by a lethal dosage of medication. To this he replies: ‘I think you’re scaremongering.’ He points out that, in general, ‘People are unlikely to die terrible and agonising deaths’, if they are allowed to die of natural causes. Touché. Even according to the campaigners at Dignity in Dying, just over one per cent of people suffer as they die in the UK. That gives most of us good odds.

From this moment on in the documentary, Danny’s arguments triumph. Danny and Prue cross the border from Washington to Vancouver Island in the Canadian province of British Columbia.

Over the past year or so, horrific stories have been coming out of Canada about people being offered MAID rather than medical care. This has made Canada a no-go area for proponents of legalised assisted dying. In the UK, Dignity in Dying mentioned Canada 88 times in its tweets between 2016 and May 2022. But since stories have emerged of Canadians being offered euthanasia because they were poor or homeless, Dignity in Dying has been silent about Canada. Until Prue and Danny’s Death Road Trip documentary this week, the liberal media in Britain had largely steered clear of it, too.

In British Columbia, we meet Dr Stephanie Green. She comes across well, despite the fact that she has dispatched at least 300 people. Unlike in Washington, Canadian doctors are able to inject their patients with poison, rather than simply prescribing it. This was the preferred method of death for all but seven of the 10,064 MAID cases in 2021.

In British Columbia, we meet Dr Stephanie Green. She comes across well, despite the fact that she has dispatched at least 300 people. Unlike in Washington, Canadian doctors are able to inject their patients with poison, rather than simply prescribing it. This was the preferred method of death for all but seven of the 10,064 MAID cases in 2021.

It is in Prue and Danny’s meeting with Green that we begin to see the self-deception involved in the case for assisted dying. When Danny asks Green about the Hippocratic oath and whether she is violating its prohibition on killing, she squirms. ‘I don’t believe I’m killing patients. I believe the illness and disease are killing the patients. We don’t say killing’, she says. She then demonstrates how to inject lethal substances into a patient.

As Prue and Danny look out on to a beautiful vista of houseboats, Prue muses that ‘it’s often the lack of dignity and joy in life’ that makes people opt for an assisted death. The pair then move on to Toronto, where Prue is made uncomfortable by the disturbing case of Roger Foley. Foley was a disabled man who was offered MAID, but not medical care.

Prue and Danny also meet Dr Ramona Coelho who thinks the Canadian legislation has gone too far. In her view, MAID threatens the disabled, vulnerable and old. She tells Prue and Danny of other cases where MAID has been offered to patients with curable diseases who had previously expressed no interest in dying.

If all that weren’t troubling enough, Canada is currently proposing to extend its MAID programme to allow people suffering from a mental illness to qualify. Prue says that she’s ‘on the fence’ about assisted dying for cases of mental illness alone. Danny isn’t. ‘If someone was trying to jump off a bridge’, he says, ‘the natural inclination would be to try and stop them. So why is this any different?’

Prue and Danny meet John Scully, a former BBC and CTV journalist, who has suffered with extreme depression and PTSD for 30 years. He wants to have an assisted death when it becomes legal. He has attempted suicide twice, but he says he can’t try it a third time. ‘It’s a mess’, he explains, ‘I screw it up, and it is terribly devastating to the families’. Prue, obviously rattled, says she is conflicted. Danny concludes – correctly, in my view – that Scully’s story goes to the heart of the debate. It forces us to reckon with the question of whether an individual patient’s wishes trump the wider impact on society. What does it mean for people’s families and loved ones if suicide is made so easily available? And what message does it send to those with suicidal thoughts – that it is right to act on them?

Prue and Danny’s Death Road Trip deserves great credit for exploring the grim situation in Canada. After all, Canada is the logical endpoint of legalising assisted death. If death comes to be seen as medical treatment for suffering, how can it be denied to anyone who suffers? Earlier this month, Canada moved to delay the expansion of MAID to patients with mental-health difficulties for a year, but the federal government is still committed to the principle.

The best safeguard against the kinds of horror stories appearing in Canada would be not to legalise any sort of assisted dying in the first place. In the UK, all forms of assisted dying are illegal, but the Isle of Man is currently considering legalisation. Meanwhile, Jersey has approved legalisation in principle and is currently taking steps towards setting up an assisted-dying service.

As Prue and Danny’s Death Road Trip shows, legalising assisted dying could take us down a very dangerous path.