The Bill has gained support from across the political spectrum, but how empowering is it in action?
Dayna Latham
The Prime Minister has promised a free vote on the latest iteration of an Assisted Dying Bill, brought to the House of Commons via a Private Members Bill. Starmer has emphasised that there is no pressure on MPs to vote one way or another. Set to be debated and voted on the 29th of November, the Bill would need further debates and votes before it becomes law.
What’s in the Bill?
The Bill - called the Terminally Ill Adults (End of Life) Bill - would make it legal for over-18s who are terminally ill to be given assistance to end their own life, providing all requirements are met. The law would apply to England and Wales, with a separate Bill being considered in Scotland, and the process to bring legislation already underway in Jersey and the Isle of Man.
Under the Bill, a doctor could prepare the substance, but the person themselves must take it, and no one else would be permitted to administer the medication to the terminally ill person. Doctors would also not be under any obligation to take part in the assisted dying process.
The law would enable what is called physician-assisted suicide, which is distinct from voluntary euthanasia, where the physician themselves administers the drug to the patient.
Further requirements include that the person must be resident of England and Wales and be registered with a GP for at least 12 months, have the mental capacity to make the choice, be expected to die within six months, and two independent doctors must be satisfied the person is eligible. They must also make two separate declarations, witnessed and signed, about their wish to die.
The bill would also make it illegal for someone to ‘pressure, coerce or use dishonesty’ to persuade another into making this decision.
What arguments are being made in favour of the Bill?
Proponents of the Bill say that it could prevent many horrific deaths, whilst giving people more control over their health and its overall impact on their quality of life.
Naked Politics spoke to Claire MacDonald, from My Death My Decision, a campaign group in support of assisted dying.
“My Death My Decision campaigns for mentally competent adults to have the voluntary choice of an assisted death, if they are suffering from incurable physical conditions or terminally ill. We fully support the Bill. However, we would argue that the eligibility should be based on the suffering of the individual.
“Some opponents of assisted dying say there is a “slippery slope” - but the Health and Social Care inquiry found there is no “slippery slope”: if a country votes for terminally ill people, it stays there - as it has in Oregon for over 25 years. If Kim Leadbeater’s Bill is passed, the scope of the Bill will only change if Parliament votes for it. We support a less restrictive law, but recognise that political pragmatism is necessary. If those with incurable conditions are to be eligible at a future date, it will be because Parliament has voted for that." says Claire.
Why are so many DPOs and disabled people organising against the Bill?
Many of the concerns around the Bill’s impacts on vulnerable people have been voiced by the disabled community, many of whom are wary of potential mission creep and coercion. Protests have taken place outside parliament in the run up to the Bill vote, with placards reading “assist us to live, not die”.
Whilst assisted dying could improve quality of life for terminally ill people, the widely criticised Canadian Model is a possible risk. In the Canadian Model, an assisted dying bill was brought forward that initially only applied to mentally competent adults with "enduring and intolerable suffering" where death is “reasonably foreseeable”, but there has since seen efforts to expand this.
The proposed expansion was passed in 2021 and allows anyone with ‘grievous and irremediable’ mental illness to seek medically induced death too. It was due to take effect in 2023, but has since been delayed by two years, following widespread pushback. It has since been delayed again until 2027.
Without addressing the root causes of suicidality in this country, an Assisted Dying policy has the potential to be used disproportionately by the most vulnerable in our society, including disabled people with unmet health or social care needs.
George Fielding is a campaigner with Not Dead Yet UK - a UK network who are part of a global alliance of disabled people opposing euthanasia and assisted suicide. “It feels wrong to be prioritising giving people an assistance to die over an assistance to live. Under the law as it is proposed, it will be quicker to die than it is to get a care package, benefits and other forms of support. That’s what has happened in Canada, in Belgium, in Australia. It’s become quicker to die than to get the support that you need.”
These issues greatly shape the day to day lives of the most vulnerable in our society, and assisted dying could be very tempting especially to many whose suicidality could be addressed first by better state provisions.
Despite an apparent willingness to liaise with disabled people and their organisations, the ‘safeguards’ written into the Bill address few of the most common concerns. The safeguard against ‘pressure, coercion or dishonesty’ particularly feels weak, despite the tough sentence available for those found guilty - with no definition of what would constitute coercion being given, and no clarity given on how coercion would be proven. “Very few professionals are trained in coercive control. Few doctors are, and I wasn’t, as someone who led a Social Care company. It is on instinct. How are you going to eliminate errors from that? I don't know how you can,” says George.
This is why so many disabled peoples’ organisations have come out against the policy, despite agreeing wholeheartedly with the underpinning principle that we should have ultimate, absolute agency over our own bodies.
“I think it is chilling that we are enabling such a moral, ethical, complex decision to be rushed through so quickly. It’s being rushed, simplified deductively in a hyper emotive state, in environments like Westminster where people with disabilities have never had [adequate] representation or trust. This legislation only serves to prove what most people fear - that we are not seen, heard and represented in democracy and we are not prioritised.”
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