Britain’s House of Commons is set to vote Friday on assisted suicide legislation that has sparked an intense national debate over ethics, freedom and compassion.
The Terminally Ill Adults (End of Life) Bill, introduced by member of Parliament Kim Leadbeater of the Labor Party, would allow terminally ill adults in England and Wales to seek medical assistance to end their lives.
“We think that a lot of human rights are so strong and so significant that even if you consent to them being violated, that’s not OK,” Dr. Calum Miller, a British physician and pro-life advocate who opposes the measure, told The Washington Times. “Slavery is a good example. If you ask people: ‘Do you think slavery should be legal and should you be able to sell yourself into slavery, even if it’s fully consensual?’ Most people will say ‘No, because it’s fundamentally a violation of human dignity.’ I think the right to life is the same.”
But Tory political commentator and bill supporter Albie Amankona told The Times that the aversion to this kind of care is simply an aversion to granting suffering people dignity within their own death.
“We’re all going to die. What are we saying — that people shouldn’t? The point is, what is the least harmful way that people can? What is the least harmful way to get to that outcome? Is it really to watch someone die in pain, in hardship, suffering?” Mr. Amakona said.
Ms. Leadbeater argues that the bill is airtight, offering “the strictest safeguards anywhere in the world” that would prevent “very harrowing” deaths.
Under the legislation, terminally ill adults over 18 years old, who are expected to die within six months, would be allowed to seek assistance in ending their lives, with approvals required from two independent doctors and a High Court judge.
But critics wonder whether judges would actively assess each case or merely defer to the medical evaluations.
Given the limited number of High Court judges in the United Kingdom — just 108 — and some estimates suggesting there could be up to 5,000 to 6,000 cases annually if the legislation is passed, concerns have been raised about how this system would function in practice.
“It’s not a serious bill,” Alexander Raikin, visiting fellow in bioethics at the Ethics and Public Policy Center, told The Washington Times, calling the bill’s limitations “laughable.”
“There’s only so many judges, and there’s quite a lot of demand that’s going to happen — from people who are frail, from people who are vulnerable, from people who are isolated, from people who feel like a burden — as we know in every jurisdiction has legalized this,” Mr. Raikin added.
The business of death
Labour politician Jess Phillips recently acknowledged the logistical challenges but didn’t find them sufficient for blocking the bill’s passage.
According to U.K. newspaper The Times, Ms. Phillips said though the National Health Service (NHS) is “not yet ready for the widespread implementation of assisted suicide,” the public could rest assured that “new innovations will come in all sorts of ways.”
Many skeptics find the concept of “new innovations” more than troubling. Suicide pods, for instance, have already caused legal mayhem in Switzerland, where at least one Brit a week travels to legally end their lives, according to data from the Assisted Dying Coalition.
Florian Willet, head of a Swiss right-to-die group The Last Resort, is being detained amid an inquiry into the death of a 64-year-old American woman in northern Switzerland who became the first person to use a Sarco suicide capsule. An autopsy reportedly found “strangulation” marks on her neck after the woman’s death inside the capsule.
Mr. Willet, who was present at the woman’s death, has been in custody for more than a month since the cause of death was thrown into question, according to several reports.
A source close to The Last Resort suggested the marks could be linked to the woman’s rare bone infection, skull base osteomyelitis. The right-to-die group denies any wrongdoing.
But prosecutors have expanded the investigation to consider the possibility of murder, prolonging Mr. Willet’s detention as the case unfolds.
Even so, pod designer Philip Nitschke told The Telegraph he is “absolutely” keen to bring the Sarco pod to the UK should the vote go through.
“It seems to me that it will just provide an additional option for those who don’t want the needle and who don’t want the drink … who do like what I describe as the stylish and elegant means that is provided by this device in some idyllic location,” Mr. Nitschke said.
But professor David Albert Jones, director of the Anscombe Bioethics Centre, argues that the legislation isn’t just questionable from the standpoint of ease — it’s a radical shift in the basis of medical ethics.
“This is a departure from the traditional understanding of medicine, going back to Hippocrates, really, that it’s not the function of medicine to end people’s lives,” Mr. Jones said. “The function of medicine is to make people better, or, if they can’t make them better, to at least feel better. But if you’re dead, you don’t feel better.”
He said there’s a broader societal responsibility to protect individuals from harm, one that’s set to be discarded if Parliament votes in favor of Ms. Leadbeater’s bill.
“If we think of young people who take their own lives when they’re in prison or in hospital or in a training base, then we naturally ask questions: ‘What was everybody else doing? Who had responsibility? Could it have been stopped?’ You have to take reasonable steps to prevent people from harming themselves,” the bioethicist said.
Economics of living
Dr. Miller says his fear of the bill partially stems from his intimate knowledge of the medical system. He said doctors often approach quality of life discussions with a looseness he thinks will transmute into pressure on patients to die — economically motivated pressure.
“I mean, I already see people in the healthcare profession pushing people towards, you know, not having treatment … it’s really not a big leap from there to the idea that doctors would promote this for people. And especially when you look at the economic situation, we have a very poor birth rate,” Dr. Miller said.
“We don’t have enough kids. We have to rely on immigration to keep our workforce afloat, and we have an aging population, we’re going to have, I think the number of people with dementia or Alzheimer’s is going to triple over the next decade or two,” he added. “It’s widely accepted that there’s going to be a huge increase in the proportion of the population that needs care, and that it is just completely economically unviable for the UK.”
Other MPs also say the bill has been rushed.
The U.K.’s longest-serving MPs, Labour politician Diane Abbott and Conservative Sir Edward Leigh, joined forces last week to oppose the bill in a joint article for U.K. publication The Guardian, expressing shared fears that the legislation had not seen enough scrutiny from Parliament — something a similar bill in 2015 allowed for.
“Parliament will have sat for just 12 weeks by the time MPs vote on what is, quite literally, a matter of life and death,” they noted, adding that the high number of new MPs unfamiliar with parliamentary procedures exacerbates the problem.
A recent poll commissioned by Care Not Killing found that the British public agrees. While 69% of the British public supports legalizing assisted dying, 62% also believe the issue is too complex and polarizing for MPs to decide on at short notice. Even among supporters of the bill, 57% agreed more time is needed for deliberation.
MPs will have a free vote on the matter, and former Labour deputy leader Harriet Harman has assured the public that the bill will receive “as many days as necessary” for debate. But Ms. Abbott and Mr. Leigh remain firm: The stakes are too high for shortcuts.
A cross-party group of MPs has co-sponsored a “wrecking amendment,” a movement that would sink the bill were it to garner enough MP support.
But supporters of the bill are eager to see it through, focusing instead on what they see as compassion and the minimizing of suffering. Mr. Amankona pushed back on opponents’ concerns about a “slippery slope,” pointing to jurisdictions like Oregon where similar laws have existed for many years. He sees them as success stories.
“The law that’s being proposed in Britain is nothing like what we’ve seen in Canada or Belgium,” he told The Washington Times, citing Ms. Leadbeater’s proposed safeguards. “Maybe some aren’t perfect — they might need to be stronger — but I do not buy this whole slippery slope argument.”
“DIGNITY. Independence. Quality of life. Control. When my formerly fit mum had a severe stroke one morning at the bus stop, all these valued aspects of her life were snatched away from her,” British commentator and bill supporter Mandy Appleyard wrote Tuesday in The Sun newspaper.
In the United States, the practice is available to nearly a quarter (21.6%) of the population. Often referred to as “medical aid in dying,” it’s legal in 11 jurisdictions, including California, Colorado and the District of Columbia.
In Canada, assisted suicide has been legal since 2016 under the Medical Assistance in Dying (MAID) law. This law permits eligible adults suffering from a grievous and irremediable medical condition to seek medical assistance in dying, though the country’s guardrails loosened considerably in 2021, allowing for deaths over problems such as “a serious illness, disease, or disability.”
Globally, more than 400 million people around the world have a legal right to die through assisted dying, according to end of life rights group My Death, My Decision. And 2022 Canadian government data show that MAID now accounts for at least 4% of Canadian deaths.
The Care Not Killing survey revealed key reasons for public backing of the UK legislation: 80% cited the importance of a pain-free death, 76% emphasized the right to choose how and when one dies, and 43% believed it would be kinder to families.
And Ms. Leadbeater has argued that her bill would address the high rate of non-assisted suicides among terminally ill individuals. But data from Oregon suggests otherwise.
Researchers David Paton and Sourafel Girma, found in 2022 that assisted suicide laws, such as those in Oregon, are associated with an 18% increase in total suicides. Non-assisted suicides, rather than decreasing, actually rise by approximately 6%.
‘Hard to watch’
According to Kevin Yuill, author of “Assisted Suicide: The Liberal, Humanist Case Against Legalization” and CEO of Humanists Against Assisted Suicide and Euthanasia,” cultural atomization is to blame for the spread of assisted suicide throughout the globe.
“There is a sort of slightly individualist bent about it as well, which is my body, myself, my choice,” Mr. Yuill said. “But with death, that’s not really an option. Death is always messy, complicated, and destructive. It’s never going to be a neat diary, little ‘Oh, so long, everybody, I’m off’ kind of thing.”
Mr. Amankona argues that messiness isn’t what people are trying to avoid, but rather prolonged pain. The death of a family friend, he said, gave him a stronger understanding of the desire for choice within death.
“She was in so much pain that she tried to throw herself out of the window,” he said. “That was very difficult to see. So we can’t pretend that death can ever come without harm. What we are discussing is what is the least harmful way for that death to happen for a genuinely ill person.”
But Mr. Yuill’s skepticism is similarly rooted in personal tragedy. He recalled the suicide of a close friend at age 18 and its devastating impact on the family.
“I looked at his mother, who’s, you know, she walked around like a zombie. People would almost avoid seeing [the family], simply because it was such an awful event,” he told The Times. “And I just thought … we need to dissuade people from suicide.’”
Mr. Yuill hopes the bill is shot down Friday and the rejection serves as a message to the world.
“If we win this, it’s going to be a real shot across the bow for assisted suicide across the world. Britain’s a pretty big place … And you know, considering all the other countries that will be deciding this, there’s everything to play for,” he said.
Brought to Parliament last month through the Private Members’ Bill ballot, the legislation was only officially published on Nov. 11. And while there is no set government position on the bill, Health Secretary Wes Streeting has publicly expressed his opposition.
On Friday, there will be five hours of debate. BBC reports that more than 100 MPs have shared their wish to speak.