I risk being accused of hypocrisy with this article, as I am a strong advocate of going to Dignitas. So when it looked as if assisted dying might be legal in the UK, I was quite excited. But as the details of the Assisted Dying Bill became clear, I reconsidered.
What is the Assisted Dying Bill?
The Terminally-Ill Adults (End of Life) Private Member’s Bill, sponsored by MP Kim Leadbetter, passed its second reading in the UK Parliament in November 2024. The draft legislation proposes granting people medical assistance to die if they have six months or less to live, with the approval of two doctors and a judge.
The bill is currently at the committee stage, which is supposed to involve a detailed examination of the bill, scrutinised line-by-line, with full public transparency. The committee should hear evidence from witnesses and consider proposed amendments. After the first committee meeting in January, the amended Bill can be found here.
Problems with the conduct of the committee stage
The membership of the committee was heavily stacked (14:9) in favour of Leadbetter’s Bill, while requests to join from experienced Parliamentarians with relevant expertise were rejected. Four Labour MPs wrote an open letter expressing concern that the committee met in private to discuss what oral evidence to accept, thereby preventing public scrutiny; the selected witnesses were heavily skewed in favour of the bill.
Also of concern was the exclusion of evidence from:
- The Royal College of Psychiatrists
- Disability rights organisations
- The British Geriatrics Society
- Other countries which have assisted dying
After negative publicity, the Committee U-turned on evidence from the Royal College of Psychiatrists and Disability Rights UK.
Although Leadbetter continues to claim the bill offers the “strictest safeguards in the world”, nearly every one of her safeguards has now been removed or diluted.
Judges will no longer give approval for assisted dying
Although the bill passed its second reading containing the provision that the assisted death must be certified by two doctors and a judge, Leadbetter has now removed the need for a judge’s approval. The new proposals require an Assisted Dying Review Panel of three people, comprising lawyers, psychiatrists and social workers, to approve assisted dying applications. Leadbetter has called this new proposal “judge plus” but many were quick to point out that in fact it is ‘judge minus’.
It is this development in particular that could cost Leadbetter the bill. Up to 140 MPs who had previously backed the bill are said to be reconsidering their position.
Practicalities have not been addressed
No-one seems to have considered whether the ‘assisted dying’ service will be a part of the already overstretched NHS or be a separate service, or whether and to what extent it could be outsourced to private companies. The Times reports that assisted dying could be provided by private companies.
How much training will doctors and nurses need to participate in the assisted dying programme? How will outsourced private companies be regulated and quality control assured?
Opt-outs are important if the bill becomes law. Will doctors and nurses be able to opt out of being part of assisted dying without prejudice to their careers? Will care homes and hospices be able to decline it?
Apparently, there are not enough psychiatrists to take on the Assisted Dying Review Panel work. A poll on this issue only had a 10% response rate from psychiatrists; of those 10%, only a third said they would be willing to participate in an assisted dying service.
It’s the same with social workers. The Telegraph reports they are “too busy to sit on assisted dying panels… and will need more funding to meet the needs of the assisted dying bill”.
What happens in other countries where Assisted Dying has been introduced?
Canada offers assisted dying under the Medical Assistance in Dying (MAiD) programme. The Mail reports that Canada is now euthanising 10,000 of its citizens a year, representing more than 3% of all deaths. That’s an increase of a third on the previous year. The original 2016 legislation was restricted to the terminally ill, but was broadened three years later to cover “grievous and irremediable” non-fatal illnesses. It is likely to be expanded to include mental suffering in 2027. Fewer than 50% of patients who opt for euthanasia see a palliative care team.
Healthcare staff have been caught ‘suggest-selling’ assisted dying to people with costly medical conditions who have no desire to die. One of the most horrific examples is Christine Gauthier, who served 10 years in the Canadian armed forces, where she sustained a bad injury. She requested funding to install a stair lift in her home in 2018. When there had been no progress four years later, a caseworker from Veterans Affairs Canada contacted her to offer assisted dying.
Both Belgium and the Netherlands allow assisted dying for adults with non-terminal physical conditions or mental distress, and in some circumstances for children, thereby undermining the requirement for ‘capacity’ when giving informed consent. In all these countries, the scope of the original assisted dying legislation has been extended.
Evidence from the Royal College of Psychiatrists (RCPsych)
The Committee was shamed into hearing evidence from the Royal College of Psychiatrists (RCPsych), which was initially disallowed. RCPsych said it had several concerns:
- Whether it’s possible to assess reliably a person’s capacity to decide to end his or her own life, especially when mental health issues are involved.
- Can consent serve as an adequate safeguard against coercion? Vulnerable individuals might be pressurised into choosing assisted dying, with coercion coming from family members with personal or financial motivations but also from societal pressures.
- Individuals with mental disorders, intellectual disabilities and neurodevelopmental conditions often face barriers to accessing palliative care and may be more susceptible to coercion.
- The introduction of assisted dying legislation could undermine suicide prevention efforts.
An elder abuse charity also gave evidence after initially being excluded. It said it was “witnessing an epidemic of abuse against older people” and reiterated the legislation’s potential harm to vulnerable, elderly, mentally ill and disabled people.
‘Mission creep’
There is the very real danger of the legislation’s scope being extended, as we’ve seen in Canada, with assisted dying offered to those with mental health issues, eating disorders, chronic conditions and those who feel they are a burden. “Being a burden” is one of the leading reasons for patients requesting assisted suicide, cited by 50% in Canada 50%; 43% in Oregon and 60% in Washington. Studies have shown that often ‘being a burden’, not pain, is the main reason for requesting assisted dying. UK Medical Freedom Alliance (UKMFA) reports that Leadbeater admitted that under her bill a person would qualify for assisted death for the sole reason of saving his or her relatives money.
The Telegraph reports that Kim Leadbeater has already proposed an amendment to include people with terminal mental disorders or disabilities in the bill’s scope. This would be a particular risk for people suffering from eating disorders because the ‘terminal illness’ “may have arisen as a result of their mental illness and this needs to be properly considered”, according to the Telegraph. Assisted dying laws abroad have already enabled at least 60 patients with anorexia to end their lives. A representative from the UK’s leading eating disorder charity said “eating disorders should never be classified as terminal”.
What about palliative care?
Palliative care seems to be in a parlous state. HART points out that the sector is seriously underfunded, with only 30% of hospice funding provided by the Government. Hospices rely on fundraising to survive, which is much reduced with the cost of living crisis, while large NHS pay rises have pushed up wage bills for hospices. The Budget made things worse because hospices are not exempt from the rise in Employers’ National Insurance Contributions. The number of people dying each year in the UK is going up significantly, while hospices are making service reductions and redundancies.
The Spectator reports a palliative care consultant saying: “Every night in my hospital, and every weekend from Friday to Monday, you cannot see a palliative care nurse or doctor.” The equalities watchdog argues that “because provision of palliative care was so patchy… the terminally ill would have no viable alternative but to have an assisted death, thus denying them a free choice”.
If the money and energy that had gone into this bill had instead been used to improve palliative care, to allow terminally ill individuals to live their final days free of pain and with dignity, the clamour for some form of assisted dying might not have been so loud. The Telegraph notes that “unlike other similar assisted dying legislation in other countries, the bill failed to make any commitment to provide extra funding for palliative care”. But once we allow assisted dying, there is no longer any incentive to fund and support palliative care. A recent JL Partners survey of the public showed that 64% of respondents are in favour of palliative care over assisted dying legislation.
At the end of the day, assisted dying is just cheaper and easier for the state, particularly as healthcare spending is normally highest in the final year of life. UKMFA points out that assisted suicide would cost the equivalent of just one week of palliative care, whereas a good hospice can cost thousands of pounds a month.
Can doctors accurately predict death within six months?
No, and we shouldn’t expect them to. So many factors are involved that it’s impossible to be precise. In fact, the Telegraph reports hospital data indicating that doctors’ prognoses were wrong more than half the time and that patients given six months to live can still be alive three years later.
Furthermore, the Telegraph says that the draft bill proposes using the Department of Work and Pensions’ fast-tracked benefits scheme, which entitles patients with just six months left to live to be fast-tracked onto Universal Credit, highlighting eligible patients. But a doctor’s prognosis that is suitable for ascertaining who may receive Universal Credit is unlikely to be suitable for ascertaining their suitability for assisted dying. And it rather smacks of trying to avoid paying the Universal Credit. Furthermore, Department for Work and Pensions (DWP) data obtained by the Telegraph revealed that a fifth of those benefit claimants are living much longer than expected.
This is likely to alter forever the doctor-patient relationship
Up until now, we have always looked to doctors to act in our best interests. If we now have to consider that they could be involved in certifying suitability for assisted dying or even administering the drugs, a fair degree of patient suspicion could creep in. It makes a nonsense of the fundamental principle of medical ethics: “First, do no harm.”
And we have only to look back at the COVID-19 pandemic, when then Health Secretary Matt Hancock stockpiled the sedative and respiratory depressant Midazolam to give to care home patients with Covid. Midazolam, morphine and ‘Do Not Resuscitate’ notices were forced on patients without consultation or consent involving either the patient or their families. This resulted in a large number of patient deaths shortly after the Midazolam had been administered. We don’t need an Assisted Dying Bill when our health care system can already kill us indiscriminately in care homes.
As Dr Vernon Coleman reminds us: “The Nazis ran a euthanasia programme for a while. After a short period, Hitler abandoned it because he considered it morally indefensible.”
Dr Rachel Nicoll is a medical researcher, lecturer and writer. You can contact her here.
To join in with the discussion please make a donation to The Daily Sceptic.
Profanity and abuse will be removed and may lead to a permanent ban.
Canadians murder about 20.000 per year with MAID.
Abort babies.
Cull the old.
Part of the Rona Medical Nazism playbook as well I remember (shots also sterilised men and women).
For a few years, until assisted dying becomes commonplace, it will be your choice, with increasing amount of pressure from the medical profession.
Then at some point, once they have softened the ground, it will no longer be a choice.
I suspect you’ll be able to buy a certain number of years of life after you become economically inactive, then the state will kill you.
I just checked the 2023 report for MAID. There were 19,660 applications of which 15,343 appear to have been granted.
Demand for MAID increased by 15% in 2023, a slowdown from the 35% growth rate of previous years.
I’m broadly in favour of people being able to access clean efficient methods of suicide if they so wish. My fear is that you get the state involved & it all turns into a racket.
I often envisage myself getting diagnosed with dementia & deciding to kill myself. Ideally I’d like it to happen the day after life becomes not worth living, but that’s also, in all likelihood, the day after you stop being able to do it yourself, then it’s too late.
My concern is that this Bill is not the “kind” thing it is being sold as. We know that we have a problem in this country with the Government, they have as individuals and in their manifesto that they are comfortable with telling lies and never acknowledging or apologising. In the past Mr Starmer not only supported the Lockdowns, he wanted to go harder and longer, he wanted people to be made to take the fake experimental injections through even stricter restrictions on the non injected.
We then look at the record since they came into power. They have removed the Winter fuel allowance on all but the very, very poorest, luckily for the elderly the Winter was not hard this year. Then they have taxed the population to the highest since the war, meanwhile they have through their Green,Net zero religion ensured that people are getting closer to the point of heat or eat.
The Government needs to reduce the costs of the NHS and welfare, the elderly and chronically sick use these systems heavily, there is also the fact that the elderly are living longer and so are taking the State Pension for longer.
So call me cynical but wouldn’t Government sponsored help to end your life because you feel a burden, that nobody cares, that you are disabled or old and as those lovely people in Davos who Keir Starmer spoke of with admiration “useless eaters”. What would be the commercial cost benefit to the State by helping these people to do the right thing?
Those who want to end their lives if physically able already have the ability to do so. Those who cannot and who seriously want to die, even with good palliative care, which seems to have been bypassed by Ms Leadbetter , after all that is a cost. Then they should be asisted to travel to Dignitas, or if as does happen a Spouse helps them to die, the Spouse should be examined by a Judge to decide whether it was a case of compassion or cruelty.
This State sponsored killing bill is frankly a foot in the door for a Brave New World society model, where those of us not amongst the elite class are allowed a certain number of years of life and the unproductive or imperfect amongst us are removed from society, for as I am sure our Elites would tell us rather like they did in the plandemic that it is the right thing to do to protect society and our NHS. Don’t buy it and especially not from these people.
And their excuse is….After 15 years of a Tory disaster. I seem to remember, as you pointed out, and to quote Mark Steyn — They voted with the Tories on all the big economy destroying stuff.
Well done for pointing out the NICE Guidelines, end of like care Pathways — NG163. As pointed out, that is the April 2020 spike in deaths. Also in 2020 during the fake pandemic, there was a Shipman clause removed where there needs to be two Drs to sign the death certificate.
The Shipman clause needs to be reinstated.
After the State-sponsored killing spree of five years ago and associated pandemic of mandatory altruism, I’m not inclined to trust a medical professional licensed to kill by the State.
As for the Assisted Dying Bill – Onward unchristian socialist soldiers.
Every time I see this oafs photo all I hear in my head is “It’s a man Maury, it’s a man!” from the Maury Povitch Show.
I don’t see a man but I do see a hatchet-faced harridan who shouldn’t be allowed anywhere near this sort of decision.
This is all part of Starmer’s Permanent UK Far Left Government Act 2025.
Get rid of pesky non-Labour voting OAPs with the Assisted Culling Bill.
Import millions of Labour’s new voters on small boats, visas etc and give them hotel accommodation welfare payments etc whilst poor white people live on the streets begging for pennies with nothing – and I keep seeing more and more of them.
Get rid of Tory voting Farmers from the Shires and replace them with Bill Gates and Blackrock funded industrial farming with underpaid workers converted to voting Labour instead of Tory.
Latest from a Dutch perspective. I’m pro-choice when it comes to this topic, but I’m against anyone with mental health problems or autism being able to go ahead and end their lives via the state, even though they certainly could by their own hand, as has always been the case. Also, ‘duo-euthanasia’ is a new one on me;
”Nearly 10,000 people died last year after opting for euthanasia. That is 10 percent more than the year before, according to the Regional Euthanasia Committees (RTE) They check whether each death was carried out according to the rules. Doctors are required to report each euthanasia to the committees.
Over 86 percent of the deceased had a common physical condition, such as cancer or a lung disease. Over 400 people (4.3 percent) had a form of dementia. More than 200 people (2.2 percent) suffered from mental disorders.
In six of the 9,958 cases of euthanasia, the doctors did not proceed carefully enough, the committees ruled. One such case involved a woman with a mental disorder that made her see feces everywhere and resulted in her obsessively cleaning everything. When a broken vertebra made her unable to do so, she found it unbearable. According to the review judges, the doctor should have called in an independent psychiatrist to determine whether her suffering was hopeless and whether there were other treatment options. The six judgments will be submitted to the Public Prosecution Service, which will decide on prosecution.
One minor chose euthanasia last year – a boy between the ages of 16 and 18 who had autism, anxiety, and depressive feelings. The committee that investigated his death ruled that the boy suffered hopelessly and the assessment of his request was carried out carefully.”
https://nltimes.nl/2025/03/24/nearly-10000-opted-euthanasia-2024-10-2023
I know of two people who used Dignitas.
Family witnesses spoke of the extraordinary lengths the Swiss volunteers went to to ensure full understanding of disease, providing relevant medical experts and seperate interviews to ascertain any coercion from relatives. Any suspicious circumstances and the patients were denied the procedure.
However, in both cases the candidates who chose this course of action did so because the pain they endured was out of control and inhumane. Palliative care and sufficient pain relief should be prioritised.
A lot of the arguments presented against assisted death are just exaggerated fear mongering. One of my biggest fears as a 75 year old, is to be in such a horrible state as my body fails as to be in a perpetual state of torture and pain kept alive by ever extreme medical intervention with no hope of ever leading a happy productive life. Euthanasia has been going on in hospitals for as long as I have been alive. It is humane. Why can we treat our pets with such kindness and not each other because we don’t trust anybody and there might be abuse?
If approved, who knows where these rights will end up with the level of extreme lobist groups, pushing for ever more extensions.
I don’t support this bill in any form.
Isn’t hospice, assisted dying? You have been doing it here gor fortybyears tgat I know of. What is the difference?
True. For the terminally ill in hospices they heavily sedate the victim and deny food and water. Death takes only a day or so.
I watched this play out before my eyes with a relative as the victim nearly forty years ago.
I was somewhat surprised it was all ‘normal’ and in an hospice where the victim thought it was safer than with the mad medics in an NHS hospital.
There was nothing we could do at least so far as I knew then and now nor what the alternative would have been.
At best it was ‘easier’ than having a conscious person die a bit more slowly in front of us probably in pain as the morphine doses might cease to have effect.
It of course was also cheaper – getting rid of a bed blocker in record time.