Once redefined as a force for good, there is a horrific internal logic to legalising assisted suicide that demands sacrifices from everybody in society. Many MPs have expressed sympathy for it in principle, but have serious misgivings about its negative consequences in practice, particularly in the context of our broken NHS and social care system, our fluctuating economy and our ageing population. Increasing numbers have concluded they cannot vote for Kim Leadbeater’s Terminally Ill Adults private members’ bill.
A worrying number, though, remain in favour, not just in principle but also in practice. They have either not yet seriously considered the real-world consequences of such a law, or if they have, they believe the costs are worth it. One sacrifice that disturbs me most is their apparent blithe acceptance of those who feel they are a burden being medically killed, as in Oregon or Canada. The bill makes no mention of suffering or pain. For at least some MPs the reason for seeking assisted suicide does not matter at all. It’s the autonomy, stupid!
The chaotic Report Stage debate on Friday illustrated how many other disturbing positions MPs find themselves defending once they commit to the idea that Britain needs a national suicide service.
As was the case at Committee Stage earlier this year, on Friday, Leadbeater failed to offer support for an amendment to prevent doctors from raising assisted suicide with patients who have not themselves brought it up. As there are a few patients like Esther Rantzen, who may want it currently but do not have legal access to it, this ramrod approach means that, should this Bill become law, all patients must expect to be offered it when they face a terminal diagnosis. Although a six-month life expectancy guesstimate is required to be approved for assisted suicide in the proposed law, there is nothing in the bill to stop a doctor from suggesting it to a patient who has much longer to live, earlier on in their treatment.
Given the Royal College of Psychiatrists’ intervention prior to Report Stage, highlighting how suicidality spikes at the time of terminal diagnosis, and that such depressive reactions resolve once the patient adjusts to their new reality, it was especially reckless of MPs to not exclude doctors from introducing the idea when patients are at their most vulnerable. But then again, if you have committed to the idea that access to assisted suicide is a fundamental good, it would be limiting the “good” to put any barriers in the way.
The knock-on effects of this for hospices will be huge. The religious ones will likely be forced to close
Similarly, they rejected an amendment to give hospices and care homes the right to opt out of involvement in assisted suicide. This heartless decision effectively prioritised assisted suicide over the institutional freedom of hospices and care homes, bypassing a more balanced approach that would have allowed some hospices and care homes to be suicide-free spaces, which would have catered to that portion of the patient population who are afraid of it.
Now there will be no institution in which a terminally ill person can reside where they can know that suicide will not be suggested to them and will not be taking place in the room next door.
The knock-on effects of this for hospices will be huge. The religious ones will likely be forced to close. But all hospices rely on charitable donations for the bulk of their funding, and are bolstered to stay open only by thousands of hours of volunteer work per week. A large proportion of regular hospice supporters will become less generous with their time and money if they feel their efforts are contributing to assisted suicides. The special place that hospices hold in their communities, as charities around which all can unite with shared affection, will be lost forever. Most tragically, some patients who need good palliative care will refuse to enter a place where they know patients are given poisonous cocktails by their doctors.
The delusion that palliative care could be preserved and uncorrupted with legal assisted suicide operating parallel to it has been shattered by those MPs’ decision. Any claims they make that palliative care is as important to them as assisted death are hollow. An institutional opt-out only makes sense to MPs who value the institution as much as that from which an opt-out is being sought. And so it was rejected.
An amendment protecting people with Down’s Syndrome from being offered assisted suicide was cautioned against by the Government’s own Minister because such a protection may constitute “disability discrimination”.
To defend the goodness of assisted suicide, a former surgeon and now MP, Neil Shastri-Hurst, felt compelled to argue against a ban on raising assisted suicide with a child, claiming “To deny them the opportunity for a considered conversation about their future … is to abandon them.”
It is our lawmakers who are abandoning us by embracing assisted suicide as a legitimate therapeutic option, sacrificing the real goods of safe hospices, trusting doctor-patient relationships, and freedom from subtle state coercion into early death for the vulnerable. We are being led into an assisted deathtrap, in which lives — and more — will be lost.
