Assisted dying bill: ‘If I need this in the future, will it be too late?’
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MPs will vote on whether or not to back the assisted dying bill on 29 November. But what is in the bill, and why is it splitting opinion?
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Read time: 9 minutes
In brief…
- MPs will vote on Labour MP Kim Leadbeater’s assisted dying bill on 29 November, which would legalise the euthanasia process for people with six months or less left to live.
- Proponents of the legislation argue it is about the power of choice, a peaceful death and less trauma for families. Opponents say the NHS is not in a fit enough state, the bill is being rushed and raise concerns about coercion and pressure.
- The News Agents are genuinely conflicted on where they stand.
Why MP Kim Leadbeater supports the assisted dying bill
What is the assisted dying bill?
On 29 November, MPs will vote on a bill which if passed would legalise assisted dying in England and Wales.
In the UK, it is currently against the law to assist a suicide or attempted suicide.
But if Leadbeater’s private members bill became law, those who are deemed terminally ill would be able to request and lawfully be provided with the assistance to end their life, subject to approval from a high court judge.
To meet the criteria, one must:
- Be over 18, lived in England and Wales for a minimum of 12 months, and be registered with a GP
- Have a "clear, settled and informed wish to end their own life", they must have come to the decision voluntarily, without coercion or external pressure. Coercing or pressuring someone to take the decision would carry a prison sentence of up to 14 years
- Be expected to die within six months
- Able to make two distinct declarations, signed, about their desire to die
- Capable of satisfying two independent doctors that they are eligible - with at least a week between each doctors' assessment
- If both doctor’s find the individual eligible, then they must apply to the High Court for approval of their request
- • If the High Court decides that the individual is eligible, then there is a 14-day reflection period (or 48 hours if death is imminent)
A form of assisted dying is legal in a range of countries, from Switzerland and Canada to multiple US states.
Leadbeater’s bill is modeled off the system in the US state of Oregon, which has gone unchanged since 1997.
The last vote on assisted dying was in 2015, which failed to pass through the Commons after MPs voted against the bill in a second reading, by 330 votes to 118 .
A recent poll by YouGov found that three quarters of the country were in favour of assisted dying.
But Lewis Goodall notes: “Admittedly, that's about principles. They don't have to think about the practicalities as MPs do."
What are the arguments in favour of the bill?
Many MPs in support of the bill have a fundamental belief in the right to choose.
Leadbeater told The News Agents last week the bill is about autonomy, choice and dignity. Currently, she argues terminally ill people are deprived of this.
It is also argued that those who are terminally ill have immense fear about how the end of their life might look, and often this leads to suicides.
According to campaign group Dignity in Dying, around 300 to 650 terminally ill people commit suicide every year.
Another study found that terminally ill people were more than twice as likely to take their own lives as the general population. This is traumatic for their families and friends
The deaths terminally ill people suffer can often be incredibly painful and undignified. Proponents of the bill say assisted dying would guarantee a safe and peaceful death.
Many people with terminal illnesses also travel abroad to where the process is legal to end their lives. It can be costly, and can often leave the loved ones who accompany them feeling like criminals.
If you decide to go to Switzerland for an assisted death, Leadbeater notes, “there's no proper funeral” and “you're shrouded in secrecy because you can't tell family and friends”.
More than 50 leading doctors have also thrown their weight behind the proposed change to the law, arguing it would improve the quality of end-of-life care rather than threaten it.
In a letter to The Times, they wrote that “the blanket prohibition of assisted dying has made the way we deliver end-of-life care in this country more cruel and more dangerous.”
They added: “Every supporter of assisted dying understands the value of excellent palliative care, but end-of-life choice and better palliative care are not mutually exclusive, they go hand in hand.”
Leadbeater has claimed Prime Minister Keir Starmer supports her bill. Other MPs in favour include former Labour leader Ed Milliband, and the Labour MP Jess Phillips.
What are the biggest concerns?
The bill states that only someone who has an “inevitably progressive illness, disease or medical condition which cannot be reversed by treatment” and whose death “can reasonably be expected within six months” is eligible for assisted dying.
But many doctors agree that it can be difficult to accurately predict how long someone with a terminal illness has left to live.
Critics say the bill could pressure doctors to give an uncertain prognosis and point to cases where critically ill patients have lived far longer that doctors said they would.
It may also pressure people to end their life earlier than they ought to because they don't want to be a burden on their families and loved ones, opponents of the bill such as Health Secretary Wes Streeting have argued.
Streeting said: “I'm concerned about the risk of people being coerced into taking their lives sooner than they would have liked.”
In Canada, which has a slightly different assisted dying system to the one proposed in the bill, a survey found that more than a third of citizens who ended their life under its system said in advance they felt themselves to be a burden to their families and loved ones.
Meanwhile, there are also concerns terminally ill patients themselves would be coerced into making the decision to end their own life through assisted dying.
While the bill would make coercion a criminal offence with up to 14 years in prison, it is argued that this would be hard to predict or prove.
Concerns around the state of the NHS and whether it would be capable of facilitating this new system have also been raised.
Streeting has warned he would like to see an improvement to the quality of palliative care before assisted dying becomes legalised, arguing end-of-life care is currently “not good enough for patients to make an informed choice.”
The private members bill is also being rushed through the House of Commons as MPs were given only two and a half weeks to go through the details, some MPs have argued.
This includes Labour MP Dianne Abbot and Conservative MP Sir Edward Leigh.
They wrote in a joint article: “The inadequacy of this timescale is heightened by the unprecedented number of new MPs. Parliament will have sat for just 12 weeks by the time MPs vote on what is, quite literally, a matter of life and death."Many MPs are still relatively unfamiliar with normal parliamentary procedure, let alone for private members’ bills, of which this will be the first in this Parliament."
Other MPs who have said they are voting against the bill include former Conservative Prime Ministers Boris Johnson, Liz Truss and Theresa May. Lib Dem leader Ed Davey has also said he will not back the bill.
Assisted dying bill 'difficult to navigate' for MPs
What’s The News Agent’s take?
Jon Sopel says: “I cannot think of a single piece of legislation that I have seen in the four decades I've been a journalist… where people are genuinely as conflicted and unclear about where they stand on it.”
Lewis Goodall agrees: “This is a big, big piece of legislation, it would probably be the biggest social reform we've had since gay marriage, or arguably since the abortion act of 1967.”
Emily Maitlis says her worry is that if the bill is voted down, there won’t be another chance to legalise assisted dying for another 5 to 10 years, given that the last vote was in 2015.
She notes: “I'm thinking I'm suddenly going to realise I might need this in the future and it will be too late.”
But Emily points out that there could be an inequality in who would opt to end their life via assisted dying and who would not.
That’s because those with access to private healthcare, and in turn private medicines, could have a better quality of end-of-life care and may not be in as much pain as someone being treated on the NHS.
This could mean wealthier terminally ill people may decide to try to live for longer, while others may opt to have an assisted death earlier, she implies.
Jon notes: "You don't want to create a situation where people think, ‘I've got assisted dying, I don't need to worry so much about palliative care'. I think Wes Streeting is saying we've got to worry about palliative care in this country, and that people are being offered good end of life care when they've been given a terminal diagnosis".
Lewis notes that advocates of the bill argue "it's not necessarily an either or", you can have both good quality of palliative care and the option of assisted death.
But he argues that while practicalities are important to discuss, “deep down this should be about principle”.
Lewis says he finds the argument put forward about coercion particularly frustrating.
He notes: “We are talking about people here who are terminally ill and have six months left or so to live. Even if that were not the case, I'm always intrigued that we don't reckon quite as much with the idea that just because someone can theoretically be coerced, that it means someone else should not be able to exercise their right.”
Lewis points out that if this same argument was applied to legislation on abortion, it would never have been legalised as there are circumstances in which young women will be coerced into having an abortion.
“We know for sure right now that there are many people who are dying in horrendous pain and feel that they do not have the autonomy and liberty and agency to end their life in a manner of their choosing.
“I think it’s about balancing harms, and my view is that the autonomy and freedom for someone to be able to exercise that right is a harm that's worth balancing against that of coercion,” he adds.
Emily and Jon are less clear on where they stand.
Emily says: "I haven't got a side on this. I don't know instinctively what I feel about this, frankly.
“But the sense I'm getting is that a lot of [MPs] who would very much support it in theory, are finding when they come up to it on Friday, they are not quite able to bridge that last bit of 'do I want to go there?'"
Jon notes: "I don't know what I think. I honestly can see arguments on both sides.”
But if they were MPs, and absolutely had to vote, what decision would they make?
“I would vote in favor of it,” Lewis says.
Over to Jon. “I am tilting in favor of it.”
And Emily? “I think I'm holding out. And then regretting it,” she says.
Listen in full on The News Agents.
