Assisting Suicide Should Have No Place

118 academics write:

We write to express our concerns about the forthcoming debate around assisted suicide in connection with Kim Leadbeater’s Terminally Ill Adults (End of Life) Bill. A Private Member’s Bill is an inadequate parliamentary process for an issue of such ethical and legal complexity.

Basing the argument for change simply on the need for “choice” is too simplistic. Laws must be concerned for the safety of the whole population, especially the most vulnerable. Research has shown that a person’s stated wish to die is frequently unstable and depends on the care and support they receive. The decrease in the rankings in terms of palliative care of countries with assisted suicide or euthanasia is worrying in this regard. Such care, not the offer of assisted suicide, is the ethical imperative.

The effectiveness of any supposed “safeguards” (even when described as “the strictest … anywhere”) needs detailed scrutiny. Coercion would be a reality with a change in the law. To deny this is to ignore the 400,000 cases annually of domestic abuse for older people in England and Wales. If the law were to change, we would see people with terminal disease feeling they should accept assisted suicide because (as has been the case for over 47 per cent of those seeking assisted suicide in Oregon and over 59 per cent in the State of Washington) they would feel they were a burden to friends and family.

Experts in the subtle field of mental capacity and disability can err in their assessments and non-experts would have to spot where a question about decision-making capacity arose in the first place. Capacity assessments would not assess whether someone felt they were a burden. And being informed about palliative care by a non-expert is very different from receiving it. Even a High Court judge would find it difficult to investigate all such complexities.

Fundamentally, inventing a clear-cut moral distinction between the provision of something for the purposes of killing and the killing itself, undermines the western legal, ethical and common-sense affirmation that being formally “party to” an action involves shared responsibility for that action. The proposed Bill relies on worrying differences between, on the one hand, “providing”, “preparing” a medical device to “assist” a person to take lethal drugs (all of which are regarded as legal in the Bill) and, on the other hand, “inducing” another person to take the lethal drugs (which would warrant up to 14 years in prison).

Oregon, often held up as the paradigm where eligibility criteria have not expanded, has in fact shown slippage. The definition of “terminal” turns out to include non-terminal conditions where the person has refused treatment, which would include anorexia and type-1 diabetes.

It lacks prudence to allow such a radical change to healthcare practice at a time of crisis for the NHS, especially given the increased financial pressures on general practice, hospices and care homes.

To allow assisted suicide would be to upend the ethics of healthcare. As Lord Walton (a neurologist) said, the prohibition of intentional killing “is the cornerstone of law and of social relationships.” Assisting suicide should have no place in medical practice or in a civilised society.