The Darkness of Assisted Dying

Rosie Norman writes:

Recently, Sir Keir Starmer, clearly charmed by Dame Esther Rantzen’s continued pleas in the media, promised MPs a free vote on legalising assisted dying should Labour get into power.

Back in 2015, MPs voted against a similar bill on assisted suicide. However, recent reports by the All-Party Parliamentary Group for Choice at the End of Life indicate that sentiments among MPs and the public have changed significantly since then.

There are several reasons why this should be a cause for concern.

The first is Canada. Canada legalised assisted dying in 2016. MAID (Medical assistance in dying) was initially permitted for adults whose deaths were considered to be “reasonably foreseeable”. This meant that only those with serious and incurable diseases were eligible for MAID, with the approval of two physicians. Fast forward to 2021 and MAID’s eligibility criteria waived the need for the “reasonable foreseeability of natural death”. This represents a worrying development.

As any philosophy student will know, assisted dying is one of the typical examples of an ethical dilemma, the classic bulwark against which is the “slippery slope” argument. Philosophically speaking, “slippery slope” arguments tend not to be considered very robust and can even be defined as a form of logical fallacy. Yet Canada — probably much to the chagrin of philosophy professors — seems determined to prove the relative strength of this kind of ethical defence.

In March of this year, Canada was preparing to expand its medical assistance in dying laws further still. The proposed expansion would mean that this time people “suffering solely from a mental illness” could be eligible for MAID. While these have been put on hold for now, it looks likely that they will come into effect in 2027.

Over the past year or so, there have been increasingly disturbing stories coming out of Canada. Stories which suggest that MAID is already being implemented inappropriately. For example, there is the case of a 27-year-old woman with autism who has been approved for MAID (her father is currently campaigning to block this). In another case, an otherwise healthy grandmother who was approved for MAID following complex mental health issues triggered by a severe head injury. There are also reports that the service is being offered to veterans suffering from PTSD and other forms of complex trauma, as highlighted by Kelsi Sheren.

The idea that anyone suffering solely from a mental illness would be able to access what is effectively state backed suicide is absurd. Yet Canada’s solution is to continue to aggressively roll out its protocol. From care homes to hospitals, assisted dying services are increasingly becoming a normalised end of life “care” provision.

Another concern regarding the changing tide on assisted dying is the prevalence of mental illness among young people. Gen Z’s mental health is frequently reported as being worse than that of any previous generations. Youth suicide rates are climbing and antidepressant prescriptions for children are common. Time and time again, Gen Z poll as being uniquely anxious, depressed, and generally maladapted.

As Abigail Shrier’s recent book Bad Therapy highlights, studies continually suggest that mental health experts and “therapy culture” are perpetuating this swell in mental ill health among young people. The therapy industry has incentivised treating the least sick patients for the longest amount of time. And since in 2024, going to a therapist is tantamount to getting a diagnosis, more and more young people are getting diagnoses.

Yet on MAID’s proposed amendments, these same young adults could be eligible for assisted dying in future. The new psychiatric qualification for MAID is utterly alarming. Not least because, as any decent therapist will know, it is very difficult to ascertain whether or not a psychiatric illness is irremediable.

Finally, we should be concerned that assisted dying is being presented as the compassionate answer to human suffering. Classically, “compassion” means something along the lines of entering into another’s suffering and, on account of this, showing them mercy. But what is “mercy”? Normally, it is what people ask for when threatened with death. Here, though, we are faced with a complete inversion of the concept. This inversion poses an existential threat to the most vulnerable members of society.

Those in favour of assisted dying frequently retort that it engenders respect for patient autonomy. However, autonomy refers to command over one’s own actions. It is difficult to see how patient assisted suicide or euthanasia in any way increases patient autonomy. In both instances, the patient is still relying on a healthcare professional to end their life.

Indeed, patients are not always thinking in their own interests — and, moreover, states can be avoiding costlier and more complicated means of improving their wellbeing. Research from a 2022 report has found that around 35.3% of people who apply for assisted dying do so because of concerns around being perceived to be a burden to friends, family, or society. This raises the question: why aren’t we first addressing this care gap, instead of going straight to assisted dying?

By 2027, those suffering from addiction, depression and even people with learning difficulties could be offered MAID. Surely this is not what compassion looks like? The dire implications for those who are most vulnerable are obvious, especially given that it seems as though it is already being misused.

What Canada demonstrates is that assisted dying is simply making it easier to terminate life in response to suffering that is in part socially mediated.