Dying with dignity? The problems with the latest move to legalise assisted suicide

Dying with dignity in a caring, compassionate environment, surrounded by those we love. I don’t think anyone would want their or any other person’s end of life to be anything other than like this. However, how we achieve such a good death has become an increasingly hot topic of controversy.

The fundamental disagreement over the last few decades is whether a good death involves good social, medical, spiritual, and palliative care support up to death, or whether people should also have the option to either kill themselves with medical assistance (assisted suicide) or be killed by a medical or other authorised practitioner (euthanasia).

The latest iteration of this debate is a new bill, being presented on 16 October 2024 in the House of Commons of the UK Parliament by Labour MP Kim Leadbeater. We understand its second reading (where a vote on whether to take it forward is likely to be held) will be on 29 November.

The newly elected Labour Prime Minister, Sir Keir Starmer, has promised government time to debate such a bill. At the time of writing, we know nothing of what this bill will contain. Still, it is thought likely it will be similar to Lord Falconer’s bill that was until recently being debated in the House of Lords, but now, we learn, has been withdrawn to give the Leadbeater Bill a better chance in the Commons.

If it follows the pattern of the Falconer Bill, the Leadbeater Bill will aim to legalise medical and other assistance to allow a person in the last six months of life to take their own life. Such a bill, advocates have argued, would be humane and compassionate, with suitable safeguards to protect vulnerable people from being coerced into taking their own lives. Current British law makes assisting anyone to take their own life illegal. Many argue that this is inhumane, and as a result, there have been numerous unsuccessful attempts to change the law over the last two decades.

However, we know it will be challenging to maintain the bill’s limited scope. Even before its first reading, up to 54 MPs are calling for the bill’s provisions to include a wider group of patients facing ‘intolerable suffering’.

A bill introduced to the Scottish Parliament this March has less clearly defined provisions than Falconer’s, and it is hitting problems as lawyers, legislators, and the public raise their various concerns about such an expansive law. We have seen in countries that have brought in similar legislation the push towards more expansive provisions, including offering assisted suicide or euthanasia to people with anorexia, arthritis, hernias, diabetes, and even tinnitus. Canada is now seriously considering offering assisted death (including euthanasia) for those with mental illness. Canada is perhaps the most egregious example of this rapid expansion of assisted suicide and euthanasia provision.

Many others, including the current Secretary of State for Health and other ministers, are concerned that the current crisis in the NHS, the increasing deterioration of access to palliative care in many parts of the country, and the crisis in social care make this a terrible time to introduce such legislation. If we cannot care well for the dying, the disabled, and other vulnerable individuals, introducing legislation to make it easier for them to be able to take their own lives is problematic, to say the least. Not least when we are also struggling to prevent suicides in society in general.

It is also not clear that the public is as behind it as campaigners make out. While many support the option when polled, support rapidly dwindles when the safeguarding and other practicalities are discussed. A recent poll suggests that introducing such legislation is very low down on the public’s list of priorities for the new government.

Indeed, other polls show that we are failing to provide adequate end-of-life care in this country and that people would like to see those deficiencies fixed above everything else. If people are dying badly, the greatest need is to improve the quality of our services rather than take the cost-cutting option of helping them kill themselves.

As to the argument that people are dying in extreme pain, the evidence from other jurisdictions is that pain and physical suffering are not the drivers of individual calls for assisted suicide and euthanasia but more the fear of being a burden to family and friends. It is a sad reflection on our culture and society that the best we feel we can offer those who find the burden of life too great is to help them kill themselves rather than give their lives dignity and value by other means.

There are many reasons to be concerned about such a bill becoming law – more than I have space to explore here, but you can read CMF’s extensive range of blogs on the topic on our blog pages.

We will have further news and updates on how you can engage with the issues in the coming weeks. Also, check out the Care Not Killing campaign and the medics’ group, Our Duty of Care, to explore other ways of engaging. If you are a UK-based healthcare professional concerned about this bill, you can sign the Our Duty of Care open letter to the British Prime Minister.