Tell me if this sounds like scaremongering. According to one Westminster insider, if the assisted-suicide bill passes, people might receive lethal drugs simply because their care costs are too expensive. The same source argues that feeling like a burden could be seen as a ‘legitimate’ reason for an assisted death. Others are even blunter: one peer believes someone might be assisted to die because of their difficult circumstances – ‘for example, because you are poor’. Or because you don’t want to get – to put it crudely – ‘worse and worse and more disabled’.
Who is issuing these melodramatic warnings? The first two remarks come from the Commons sponsor of the Terminally Ill Adults (End of Life) Bill, Kim Leadbeater. The other two are from its Lords sponsor, Lord Falconer. It’s nice, in a way, to have some honesty about what this era-defining legislation would mean if it is approved by the House of Lords. To begin with, the reform was sold as a precisely targeted option for a tiny number of people beyond the help of palliative care: one MP predicted it would apply to ‘40 patients a year’. Now, anyone can see that it is a societal sea change, and the bill’s proponents scarcely try to deny its more unsettling implications. Every time they speak, the assisted-suicide campaign loses a little more of its shine.
And it has been a very shiny campaign, endlessly polished up by a small industry of lobbyists and PR people, and handled ever so gently (with a couple of distinguished exceptions) by a broadcast media that have struggled to grasp the – not especially complicated – issues. But you can’t get away with that forever.
In parliament, Leadbeater and Falconer have repeatedly struggled to defend their position, often descending into incoherence – as when Leadbeater argued that doctors should be able to raise assisted suicide with children, as this ‘creates safeguards’. At other moments, they have relied on outright fabrication, misrepresenting the nature of assisted suicide where it has been legalised. At the same time, a long list of organisations has denounced the bill as amateurish and dangerous. It’s bad law, say Liberty and the specialist Lords committees on legislation. It relies on decision-making mechanisms that are not in line with ‘good clinical or professional practice’, says the Royal College of Physicians. The bill’s indifference to the causes of suffering borders on ‘therapeutic nihilism’, says the Royal College of Psychiatrists.
The nightmare scenarios come easily to mind. Given the astronomical cost of care, can I justify draining my family’s savings when the speedy alternative is there for the asking? Even leaving money out of it, the feeling of being a burden is ubiquitous among those ill enough to qualify for an assisted death. By establishing a National Suicide Service, the legislation drags into its scope all kinds of people whose lives are already at risk. Homicide experts warn that the bill could be ‘the worst thing, potentially, we have ever done to domestic-abuse victims’. Eating-disorder charities say the bill puts their clients at ‘grave risk’. The bill is ‘very dangerous’, says the government’s adviser on suicide prevention.
Yes, under the bill, you need a six-month prognosis, but half of these are incorrect, and a fifth of people who receive one are still around three years later. You need to have ‘mental capacity’, but this is an extremely low threshold – a severely depressed person might pass a capacity test with flying colours – and Britain’s biggest mental-health charity, MIND, says it’s ‘really clear the safeguards… are not adequate’.
If the bill becomes law, then, we should imagine, not a few telegenic campaigners being given – to take Esther Rantzen’s example – ‘the chance to die in my favourite place, my New Forest cottage’, but a significant proportion of the most vulnerable people in the country being funnelled towards… well, towards what exactly? The scheme has been kept deliberately vague, but it looks set to involve all the clumsiness of the big state and all the ruthlessness of the private sector. The NHS, whose founding principles would literally be redefined to include assisted suicide, will provide the service, perhaps in the ‘hallways, offices and cupboards’ where one in five A&E patients is now treated.
At the same time, it seems likely to be a contract offered to the least squeamish health provider out there, at a profit margin ‘impossible’ to predict, according to care minister Stephen Kinnock. Whoever gets the contract, it seems unlikely that they will have a financial incentive to ensure every safeguard is followed to the letter. The experience of other jurisdictions is that the monitoring is desultory, the supposedly rigid requirements are ignored or abolished, and after a while dubious deaths are greeted with a shrug. One New Zealand doctor, after recounting some disturbing cases from her country, told me: ‘These are not surprises to all of us who campaigned against it. There’s no surprises in any of these consequences.’
Or as Sir John Chilcot observed in his inquiry into the Iraq disaster: ‘We do not agree that hindsight is required.’ As with Iraq, blindingly obvious risks are being downplayed because the man at the top has decided the end goal. ‘Keir wanted it to happen’, one aide explained to The Guardian last year. ‘It’s as simple as that.’
It also appears, thanks to a sensational recent leak, that Starmer wanted to pretend otherwise. A 2023 strategy document recommended a private members’ bill – the most slapdash means of lawmaking – as a way of providing ‘political cover’ for the Labour Party, while allowing the government to ‘control the parameters of legislation carefully through working with advocacy groups and government civil servants to draft the legislation’.
Starmer has thus avoided accepting responsibility, as has everybody else. MPs voted the bill through on the promise the Lords would fix it. Now pro-assisted-suicide Lords are trying to intimidate their colleagues into waving the bill through, since it passed the Commons, after all.
At least Tony Blair put himself front and centre and accepted the buck stopped with him for the Iraq decision. It would be fitting, for our own age of institutional failure, if the biggest political blunder of a generation was forced through without anyone admitting they were responsible, and if it came into effect only after its originator has retired from politics into a second career of international NGOs and corporate boards.