The U.K. Medical Freedom Alliance has just launched a Stop Assisted Dying Bill campaign to oppose bills going through both Westminster and Holyrood. These bills seek to enable terminally ill adults to get help from doctors to kill themselves – known as assisted dying or assisted suicide. In Westminster, Kim Leadbeater’s private members’ Terminally Ill Adults (End of Life) Bill had its first reading on October 16th, and will have its second reading on November 19th. Iain MacArthur put forward a similar Assisted Dying for Terminally Ill Adults (Scotland) Bill in the Scottish Parliament in March, which is currently being examined by the “lead committee”.
These bills pose a very serious threat to the sanctity and dignity of every human life and to medical ethics – abolishing the requirement that doctors “First do no harm”. They would bring about a fundamental change in the relationship between the state and the individual, and between a doctor and his or her patient; the crossing of an ethical Rubicon which would be very difficult to reverse. The state exists to protect the lives of its citizens, not to facilitate the ending of their lives. No longer could an individual assume that the state or their doctor will act in his or her best interests. Instead, death would be recognised as a legitimate treatment for suffering. There is also a significant risk that active euthanasia (killing by a doctor’s hand) would be legalised in the medium-term.
Doctor-assisted dying denies the intrinsic value of human life. Up to now, Western medicine has stuck to the principle that all lives are of equal value – whether you are young and in your prime, or elderly, infirm or dying. If we say that the lives of those who are terminally ill have less value and can be terminated, this will affect how the whole of society views them. It is dehumanising and will dehumanise us all – cheapening life and normalising killing.
Whatever “safeguards” are promised and built in, it will inevitably be a slippery slope as eligibility criteria widen – as seen in Canada, Oregon, the Netherlands and Belgium, which have had such laws for a few years. Safeguards written into legislation are easy to remove over time and our membership of the European Convention of Human Rights (ECHR) will make this almost certain. A group of human rights barristers and legal scholars has warned that the proposal could breach the ECHR by denying some groups access to assisted death, while granting it to others, and will undoubtedly be challenged on discriminatory and equality grounds – but with a view to making euthanasia more easy, not more difficult. In the Telegraph, Dr. Philip Murray, an Assistant Professor in Law at Robinson College, Cambridge, says “no one supporting Ms. Leadbeater’s Bill can claim with certainty that assisted suicide won’t expand in the future” and that “the slippery slope is not a fiction, invented by scaremongering opponents of assisted suicide. It’s a real possibility baked into our present law”. Indeed, Canada initially legislated for Medical Assistance in Dying (MAiD) for those who were terminally ill and whose death was “reasonably foreseeable”. This was successfully challenged in a Canadian court in 2019, by two non-terminally ill people. The Superior Court of Quebec determined that not helping these people kill themselves was “unjustifiable discrimination”, opening the door to any Canadian who is “intolerably suffering” in any way to access MAiD.
Real-world experience of assisted dying and euthanasia legislation exists – and is horrifying. The experiences of Canada, which only legalised MAiD in 2016, is a cautionary tale. In 2022, over 13,000 Canadian citizens were legally killed by doctors, making up over 4% of all Canadian deaths that year, and a 350% (three-and-a-half-fold) increase in deaths by this method since the law was passed in 2016. (Kim Leadbeater estimates that between 0.5% and 3% of deaths each year would be caused by people making use of the new law.) Stories abound of Canadians who are disabled, living in poverty or with mental health problems being offered MAiD as a solution to their predicaments. Campaigners in Canada currently want euthanasia to be available to people in “unjust social circumstances“. Eligibility categories in those countries that have legalised euthanasia have widened to include non-terminally ill patients (Canada), people with treatable conditions (Oregon), psychiatric disorders (Netherlands) and even children (Netherlands). The disability rights campaigner Liz Carr’s recent BBC One documentary Better Off Dead warned of the dangers of assisted suicide legislation for people with disabilities and living in poverty.
It is highly likely that legislating for the choice to die will lead to vulnerable people feeling an obligation to kill themselves, for fear of being a financial, emotional or care burden to their family, the NHS or wider society. In Oregon, where assisted suicide is legal, over half of patients euthanised cite the fear of being a burden as the primary reason for taking this route. Legalising assisted suicide would pose a serious risk to vulnerable groups, particularly in light of the significant economic, access and staffing pressures that already exist in the NHS, and disability rights campaigners are some of the most vocal opponents of assisted dying.
The incentive to improve and provide good palliative care would be gone. It is inevitably easier and cheaper to encourage a terminally ill patient to accept a quick drug-induced death than to put resources, time and energy into putting together a tailor-made and compassionate pain and symptom-relief programme in the last days, weeks or months of his or her life. Or to provide the emotional and spiritual support needed to help a person come to terms with his or her impending death and allow important conversations with friends and family that can bring closure and a sense of peace to all. Sadly, a recent Marie Curie report exposes serious shortcomings in palliative and end-of-life care in this country. It revealed that over 100,000 people die each year without receiving good palliative care. This is shameful and must be rectified. Instead of going down the assisted dying route, resources should be put into widening and improving palliative care.
It is important to recognise that palliative care doctors are strongly opposed to assisted dying, as shown in an Association for Palliative Medicine (APM) poll in 2022, in which the majority of Scottish palliative care doctors indicated they would not be willing to participate in any part of the euthanasia process. Eighty per cent expressed a concern that assisted suicide would have a negative impact on the provision of palliative care and the vast majority believed that the safeguards would not prevent harm to vulnerable patients. According to two leading palliative care consultants, in a letter to the Times in 2020, it is also a myth that assisted dying is necessary to prevent a painful death.
Considering the many current challenges facing our country, legalising assisted dying should not be a priority. A recent poll found that the general public placed legalising assisted dying as 22nd out a list of 23 possible priorities for the new Government. The poll also revealed public concerns over the practicalities of legalising assisted suicide, with more than half of the respondents who expressed a view believing there were too many complicating factors to make it a practical and safe option. Coercion and abuse would be a significant risk.
Over 3,400 doctors and healthcare professionals have signed an open letter to the Prime Minister, organised by Our Duty to Care, warning that assisted dying cannot be brought in safely while “the NHS is broken, [and] with health and social care in disarray” and calling to “instead fund excellent palliative care”. Recent reports, including one by the Care Quality Commission in 2021, highlighted the unethical and inappropriate use of Do Not Attempt Resuscitation (DNAR) orders in the pandemic. They were imposed (often without consultation) on people and could trigger the withdrawal of treatment, fluids and food and implementation of “end of life” drug pathways, hastening death. This created an unsafe situation for elderly and vulnerable patients in the NHS and care sector which must be addressed.
UKMFA has set up a campaign page on our website and we are asking people to urgently lobby their MPs to vote against the Leadbeater Bill at its second reading on November 29th. We have provided links to “calls to action” and helpful resources from many other campaign groups who are fighting against assisted dying – such as Right to Life, Care not Killing, Our Duty of Care, Christian Concern, Together and the Christian Institute. We must all work together to oppose this fundamental change to the practice of medicine.
Dr. Elizabeth Evans is CEO of Medical Freedom Alliance U.K.
Stop Press: MP Danny Kruger has read the Leadbetter Bill, published last night, and written a thread on X outlining why it doesn’t assuage critics’ concerns. He notes: “The Bill imposes an obligation on the NHS to ensure everyone has access to this great new service. … The Bill makes it legal for a doctor to suggest Assisted Suicide to a patient who hasn’t mentioned it (a common problem in cash-strapped health systems), but illegal for a doctor to refuse to refer someone for Assisted Suicide if they request it. No neutrality here.”
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