The moral case against ‘assisted dying’

What horrors can be done in the name of ‘compassion’.

As parliamentarians prepare to vote tomorrow on Kim Leadbeater’s ‘assisted dying’ bill, those on the side of legalisation have effortlessly claimed the mantle of the liberal, the caring, the kind.

But MPs would do well to see through the cant and doublespeak. There is nothing compassionate or caring or kind or even liberal about the Terminally Ill Adults (End of Life) Bill, or the society it would turn us into.

The bill would allow over-18s in England and Wales, who are terminally ill with six months to live, to apply for a state-assisted suicide. Having secured the consent of two doctors, and one High Court judge, a patient would then be supplied with a fatal dose of medication.

The debate has been almost entirely about ‘safeguards’, to a fault. ‘Assisted dying’ raises profound questions that MPs have barely had time to discuss in the two weeks since the bill was published. (They’ve had less time to discuss the bill than it would take for a patient to apply for and be granted assisted suicide under the terms of the bill.)

Still, the constant talk about ‘safeguards’ is telling. It’s a tacit admission, surely, that the project being embarked upon here – that is being presented to us as a moral no-brainer – is, in fact, fraught with moral peril.

We’ve certainly seen that in Canada, where, in less than 10 years, the law has gone from one closely resembling Leadbeater’s – whereby only those suffering from terminal illnesses, and for whom death is imminent, would qualify – to one which is essentially offering death as an alternative to decent treatment and support.

Amir Farsoud, infamously, applied for ‘medical assistance in dying’ because he was about to be made homeless and didn’t know what to do. (He was eligible due to his chronic back pain.) When Paralympian Christine Gauthier requested a stairlift from Veterans Affairs Canada, she was offered euthanasia instead.

In 2027, Canada is due to extend its programme to the mentally ill. This is already the case in the Netherlands, where terminally ill children can also be euthanised. Even in Oregon, which Leadbeater cites as her model system, assisted deaths have been authorised due to anorexia, arthritis and complications from a fall.

Leadbeater’s assurances that there will be no ‘slippery slope’ would be more reassuring if her bill wasn’t so slippery itself. It defines terminally ill as a ‘medical condition which cannot be reversed by treatment’ – which, as critics have pointed out, could potentially include everyone from anorexics to Type 1 diabetics.

What she calls ‘safeguards’ are really fig leaves. The notion that our 18 family-division High Court judges will have the time to process thousands of assisted-suicide requests each year, carefully considering the potential for coercion or abuse, is for the birds. As Justice Munby, former president of the High Court family division, has put it, this looks like no more than a ‘rubber stamp’.

Supporting this bill requires ignoring the evidence of your own eyes, including a crumbling health service that is clearly struggling to fulfil its primary duty of keeping people alive. It also requires you to ignore the fact that many people outlive their ‘six months’ prognosis, because doctors aren’t infallible. (You might be alarmed to learn that the bill bans families from suing if doctors assisting a suicide turn out to be clinically negligent.)

But opposing assisted suicide requires us to go beyond the problems with this particular bill – and to make clear the profound moral stakes to those who are considering this fundamental rewriting of the relationship between citizens, medical professionals, the law and the state.

First, as Kevin Yuill has long argued in these pages, legalising assisted suicide is an affront to the equality of human life. It effectively creates two categories of citizen: those whose suicide we should all try desperately, collectively, to stop; and those whose suicide we should both allow and actively assist.

This gives official sanction to the notion that certain lives simply aren’t worth living – that certain conditions are so awful that the sufferer would be better off ending it, lest their personal misery become a ‘burden’ on others. No wonder disabled-rights groups are at the forefront of opposing the legalisation of assisted suicide.

Second, there is the moral precedent it would set about suicide more generally – for, despite the clever ‘assisted dying’ branding, suicide is what we’re talking about here. To legalise assisted suicide is to accept the grim conclusion that taking one’s life is not only an acceptable, but even supportable, response to suffering.

This is your slippery slope. It isn’t about how well a bill is drafted or how many doctors have to give their sign-off. If we concede that being terminally ill justifies suicide, assisted or otherwise, why not other conditions? Why not crippling depression, or autism, or unhappiness?

Indeed, in an age in which mental-health categories have been expanded beyond recognition, in which we are exhorted to fixate on our ‘wellbeing’, in which we are told we are all damaged in one way or another, any normalisation of suicide seems particularly dangerous.

I’m not saying that being sad or anxious or a bit lost in life will, within a few years, become a criterion for a medically assisted death, should MPs take the plunge and back Leadbeater’s bill. But the message legalisation would send to all of society, beyond those likely to access these morbid services, will be profound.

Finally, there is the nonsense that this is all about freedom and autonomy. This should instantly make us suspicious, given the kind of illiberal politicians it is coming from. Many of those campaigning for assisted suicide only seem to care about freedom and autonomy when it is the ‘freedom’ and ‘autonomy’ to kill yourself.

That this is not about liberty is obvious. If it were, then why should the so-called right to die only apply to those who have been given six months to live, rather than those who have been given seven months. This is not, typically, how fundamental rights are supposed to work.

More importantly, to present the destruction of the self as an expression of freedom is perverse. Death is the end of all freedom, autonomy, subjectivity. Just as John Stuart Mill argued in On Liberty that there is no right to sell yourself into slavery, there is surely no ‘right’ to request a state-assisted death. As Mill put it: ‘The principle of freedom cannot require that he should be free not to be free.’ Or to exist, we might add.

spiked is opposed to assisted suicide precisely because we are committed to freedom, autonomy and humanity. Because, as humanists, we think human life is to be celebrated – and that no life is ‘not worth living’ by dint of illness and suffering. Here’s hoping MPs reject the doublespeak, and kill the bill.

Tom Slater is editor of spiked. Follow him on X: @Tom_Slater