Death is something most people don’t want to think about. Unlike our ancestors, most of us don’t encounter it until, in late middle age, we see it come to our parents. Some people have good deaths, calm, with no pain, loved, and with achievements to look back on. Others fall ill, losing control of their lives and their bodies, with no way of ending the pain. Those of us who have witnessed such deaths know the distress of standing by, unable to help a suffering loved one.
Other countries have faced the issue
Around the world, people have increasingly seen this as cruel and unnecessary. Country after country has passed laws allowing people, in specific circumstances, and with safeguards and limits, to choose to end their lives, with medical assistance when necessary. Usually this applies only to people who have an incurable terminal medical condition which will lead to death in a relatively short time.
Assisted dying is now legal in seven European countries, eleven US States, five States in Australia, New Zealand, and Canada. Proposals are being debated in Jersey, Ireland, Isle of Man, and Germany. The Scottish Parliament are now completing a public consultation on the issue, and legislation is expected.
People want change
A new poll has just been held to test public opinion on the issue. YouGov explained, to 1725 adults:
A proposed new law would allow terminally ill adults the option of legally seeking assistance to end their lives. This would mean being provided with life-ending medication, to take themselves, if two doctors were satisfied they met all of the safeguards. They would need to be of sound mind, be terminally ill and have 6 months or less to live, and a High Court judge would have to be satisfied with their decision.
When it asked if Parliament should allocate time for this to be discussed, 80 percent of people agreed.
When asked whether they would want their MP to vote in favour of the change, 75 percent of people agreed.
Agreement was consistent across gender, party, and region. On both questions, people over 50 were most strongly in support.
So the people clearly want the law changed, but Parliament continues to drag its feet.
The law is unsatisfactory and uncertain
Test cases have asked the Supreme Court to overrule this law. The Court has said that the present situation is unsatisfactory, but that it is a matter which only the elected Parliament can decide.
The law itself is clear: it is a crime to help anyone to die, whatever the circumstances. But in practice the police may decide not to take action, and the Director of Public Prosecutions may decide that, in a particular case, a prosecution is not in the public interest. So nobody can tell in advance what will happen, and the dying person knows that they are asking their helper to risk prison for an act of kindness.
Every year 200 people kill themselves without help, and many more people continue to live, sometimes for years, with intolerable pain, leading to certain death at an arbitrary point in the future. This is not how we treat our pets.
The doctors
Understandably, doctors are nervous of taking a position. They see much more death than the rest of us. They know well how distressing it can be, and polling suggests that a majority are in favour of changing the law. But they are reluctant to say so loudly: a doctor who can be caricatured as in favour of killing patients risks her reputation.
But there are signs of changing medical opinion. For a long time, the British Medical Association and the Royal College of Physicians were opposed to change, but both have recently shifted to a neutral position, joining most of the national healthcare bodies. However, the Association for Palliative Care, and the Royal College of Surgeons remain opposed.
An Assisted Dying Bill
MPs are reluctant to consider the issue. Although, in polling, 80 percent of both disabled and religious people support change, both groups have powerful lobbies fighting against it.
Since the Commons is unwilling to act, the House of Lords has stepped in. In 2021, Baroness Meacher (Chair of the campaigning group Dignity in Dying) launched a Private Member’s Bill on Assisted Dying in the House of Lords. Her Bill would legalise assisted dying (as defined in the poll above) subject to strict safeguards and alongside access to high quality palliative care. In December 51,000 people signed a letter to the Prime Minister supporting the Bill, and this time, it passed its Second Reading in the Lords unopposed. But then, over 200 amendments were tabled. Some of these raised proper concerns about drafting and safeguards, but others were clearly designed to undermine the principle. As a result, it will not now progress.
A new approach
In response, former Scottish Secretary Lord Forsyth tried a different approach. He tabled an amendment to the government’s Health and Care Bill, which is currently going through the Lords. This amendment would have required the Government to present a draft assisted dying bill to Parliament within a year, and make it subject to a free vote. The government would not take sides in the debate, and MPs would treat the issue as a matter of individual conscience.
Forsyth was clear that his amendment was not supporting assisted dying. He was arguing that, on a matter where the Supreme Court has said that the law is unsatisfactory and there is clearly widespread public opinion in favour of change, Parliament should consider the issue seriously. A draft Bill would enable them to examine all the arguments and clarify the law one way or the other.
The Lords refuses to act
On 16th March the House of Lords rejected Lord Forsyth’s amendment, by 179 votes to 145, despite support from several senior Peers. They included a former Archbishop of Canterbury, a former Director of Age Concern, former Cabinet Ministers, lawyers and doctors. The debate can be seen on Parliament TV, (starting at 18.41). Unusually, the government chose to Whip its members to vote against, while the other parties allowed a free vote.
Peers opposed the amendment on two grounds. One group was firmly opposed to the legalisation of assisted dying, and was determined to block any more discussion of the issue. A second group took the Government position, that constitutionally the House of Lords should not instruct the elected Chamber or the government to produce a Bill which they did not support (although the Commons would have had the chance to reject the amendment when it returns to them).
As several Peers pointed out, when no major party wants to take the risk of promoting a Bill, even when it has wide public support, the only mechanism for change is a Private Members Bill. But such Bills almost never succeed without active support from the government of the day. So despite what a clear majority of people, and especially those most directly affected, want, nothing will change.
Death comes to all of us, and any one of us may find ourselves approaching the end, desperately wanting to end the pain, and with no one to help. Once again, our Parliament has failed us.
