Drama can sometimes help us to understand complex political, ethical and cultural issues. Hot on the heels of ITV’s story about the scandal of the Post Office Sub postmasters, a new drama from Channel 4 has highlighted another issue – assisted dying – in its serial, Truelove.
Truelove: dramatising the dilemmas
Truelove follows the story of a group of old friends, all in their 70s. In the pub after a funeral, they agree that if any member of the group is faced with a terminal illness, they will all help them to die with dignity at a time of their own choosing. All very drunk, they swear, “Truelove”. Predictably, this happens, and one of them asks for the promised help. In the cold light of day, they face the prospect that standing by their promise means breaking the law, and possibly ending their own lives in jail. When a second case arises, we see the dangers of abuse.
The series shows them facing the dilemmas, and the impact on their personal lives and relationships, uncovering old wounds and tensions from the past. It shows us experienced police and a coroner tacitly choosing to look the other way, while a young ambitious constable defies her superiors to pursue what she suspects (rightly in law) is a crime.
What the group promised was illegal, but many will think it is right: an expression of “true love”. But the issue is not simple, as Truelove demonstrates.
Changing laws round the world
In recent years, attitudes to this issue have been changing. More than 250 million people around the world now have access to some form of assisted dying law. It is legal in eleven US states, in Australia, New Zealand and seven European countries. Legislation is planned in France, and in Germany the Constitutional Court has ruled that a ban on assisted dying is unconstitutional.
In Britain, things move more slowly, and resistance is more powerful, though polls suggest that it is not more widespread. The campaign for change is led by Dignity in Dying, who have made specific proposals for change.
The Isle of Man is leading, and could become the first jurisdiction in the British Isles to legalise assisted dying. In October 2023, a Bill passed its Second Reading there with 70% support, and it is expected to become law in 2025.
In Jersey, after a public consultation, and a citizens’ jury which voted strongly for change, legislation is being drafted for decision later this year.
In Scotland, a proposed Bill was put to public consultation in 2022, and received 76% support from over 14,000 respondents. That Bill is now before the Parliament.
In Ireland, the Dáil has created a Special Committee on assisted dying, following the publication of a private member’s bill which received strong public and political support.
Changing guidance to the Courts
In the light of Supreme Court rulings in individual cases, the Crown Prosecution Service has revised its guidelines. They now advise that assisting a suicide, a suicide pact or ‘mercy killing’ should be distinguished from murder or manslaughter, if the deceased individual had reached a voluntary, settled and informed decision to end their life, and if the suspect was motivated wholly by compassion. But these guidelines do not change the law – assisted dying in any form remains illegal and still carries the risk of investigation, prosecution and serious jail time.
Assisted dying: a task for Parliament
In the UK itself, the Supreme Court has been asked several times to rule in favour of assisted dying in specific cases. Each time, it has maintained that this must be a matter for Parliament to decide. However, in 2018, after rejecting Noel Conway’s case, three senior supreme court justices acknowledged that the issue was of “transcendent public importance”, and called for Parliament to act.
Unsurprisingly, MPs are reluctant to grasp such a sensitive nettle. Nevertheless, there have been several attempts to introduce legislation. Most recently, in 2021, Baroness Meacher introduced an Assisted Dying Bill in the House of Lords. Despite its wide support, opponents presented a long list of ‘wrecking’ amendments, and the Bill ran out of time.
However, following a Westminster Hall debate, in December 2022, Parliament’s Health and Social Care Select Committee launched its first ever formal inquiry into the issue. It is expected to report later this year. The political parties view this as a matter of conscience, and they will not take party positions. So, if Parliament decides to legislate, it will be by a free vote. When it finally happens, it will certainly be contentious; views are strongly held, and the debate may well become unpleasant. However, Truelove dramatises clearly the painful dilemmas which face well-intentioned people under the current law.
Campaigners are asking Parliament to rule that, in very specific circumstances, it should be legal to assist someone to die: if they are of sound mind, have a clear terminal diagnosis for conditions like cancer or motor neurone disease, and it is their clear settled wish.
Some people object to change on religious grounds, though it is unclear why that should affect non-believers. Others believe that it is always wrong to kill anyone, and abandoning that principle is the first step on a slippery slope, leading to the killing of inconvenient elderly relatives or disabled people. They argue that palliative care can relieve most of the pain and distress. Truelove also highlights the very real dangers of abuse by relatives or carers, if there is inadequate regulation or supervision.
Supporters of a change in the law argue that it is cruel to force people to choose between solitary suicide, and spending the last months of their lives in pain and distress (for themselves and their loved ones). They claim that it is possible to put proper safeguards in place to prevent abuse, and that palliative care does not always deal with the pain. They argue that an avoidable risk to a few should not outweigh the suffering of many.
The medical professions no longer oppose change
In the past, the medical professions have opposed change, fearing that legalising assisted dying might affect their relationships with patients, and conflict with their codes of professional ethics. However, eight professional bodies have recently switched to a neutral stance, and none now opposes change. As a group very directly affected by any change, the College of General Practitioners has set up a working group to study the implications for their members.
UK Public opinion supports change
In March 2019, Populus polled 5,695 people in the UK on the issue. Overall, 84% supported the proposal advocated by Dignity in Dying, and only 9% opposed. Support was overwhelming among all groups, ages, parties and regions. And there was majority support among all religious groups except Muslims (and even they only opposed change by a narrow margin of 48% to 37%). Christians supported the proposals by 82% to 11%.
It is very clear that there is widespread public support for a change in the law. Truelove’s dramatisation can help people understand some of the issues and recognise the importance of proper safeguards if change is to happen. When the Parliamentary Health and Social Care Select Committee reports later this year, we will see whether MPs, perhaps in a new Parliament, will grasp the nettle.
Truelove is transmitting on Channel 4, and you can watch the whole series on catchup.