The Assisted Dying Bill: Why MPs Must Look Beyond the Rhetoric

Assisted dying campaigners, including Dame Esther Rantzen, have welcomed plans for the first Parliamentary vote on the issue in nine years. The bill, formally introduced on 16th October, will give terminally ill adults in England and Wales, who have six months or fewer to live, the right to get medical help to end their own lives. But while support for euthanasia remains high, author Paul Carroll explains why his latest novel should act as a warning about the introduction of assisted dying legislation

Kim Leadbeater’s private member’s bill on assisted dying (AD) this month is a triumph for pro-AD campaigners, many of whom believe the law change they so desperately desire is now within their grasp.

The mood music has changed considerably since the last parliamentary vote on this subject in 2015, and MPs, many of which are newcomers to the Commons, will find themselves under intense pressure to bend. They would be wrong to do so.

When I set about writing Shaking Hands with Elvis, a ‘black mirror’ exploration of assisted dying, I confess I was generally in favour of the concept of a voluntary ending of life in extreme medical circumstances. However, the extensive research I conducted writing the book set alarm bells ringing.

Shaking Hands with Elvis imagines a world where welfare has been slashed, the NHS has disappeared, and the government is actively promoting assisted death with slick marketing and the lure of financial incentives – and they’re not restricting their offer to the terminally-ill.

Call it satire, call it farce, the novel nevertheless poses a twofold challenge to the reader: what would you do if confronted with a similar choice – not only if you were terminally-ill, but perhaps depressed, lonely, or poor? And how far do you trust those in charge of protecting our life and welfare? These are questions we may be asking ourselves sooner rather than later.

Everybody insists assisted dying is an emotionally charged subject (they’re not wrong), but laws are not – and shouldn’t be – based on emotions; they need to be centred on the common good. MPs need to look beyond the rhetoric and the headlines in the forthcoming debate and understand exactly what they will be letting the country in for if they ultimately pass this law.

For instance, let’s take the promise of ‘strict controls’ and ‘safeguards’ that are cited as being the bedrock of any new legislation (effectively the catch-all that applicants must be terminally ill with less than six months to live while making a voluntary decision). Great in theory, but the bitter truth is such ‘guarantees’ will crumble under legal challenge within a few short years, as they have in many other countries.

Take Canada’s MAID (Medical Assistance in Dying) legislation for example, introduced in 2016. This was amended only three short years later following Truchon v. Canada, with the Superior Court ruling the original law was unconstitutional because it did not allow for the assisted dying of persons who were not facing an end-of-life situation.

An amendment in qualification criteria from ‘a reasonably foreseeable death’ to a ‘grievous and irremediable medical condition’ promptly saw the number of assisted deaths soar. It’s a simple case of: ‘Why has a person with a terminal illness more of a right to end their own life than me?’ Suffering and pain, a desire to end it all, is not the sole preserve of a single category of terminally ill citizens when those with, for example, neurological disorders, depression, or ‘tiredness of life’, identify an equal need.

Pro-AD campaigners solemnly declare such amendments to an assisted dying bill couldn’t possibly happen here and that strict protections would remain in place. Yet that’s pretty much what campaigners claimed in Canada a decade ago. (There’s also a slight irony that in attempting to change the law in England and Wales, campaigners maintain it can’t be changed again.)

Secondly, it’s intriguing how pro-AD bodies never disclose, beyond achieving a change in the law, what they would consider a good outcome in the future. A thousand deaths a year? Ten thousand?

Take Canada again. Currently four percent of deaths there are assisted. That equates to around 15,000 assisted deaths a year (and this is set to grow still further under proposals to include mental illness as a qualifying condition in the next amendment of the law).

Apply that Canadian metric to assisted dying to this country and you could be looking at nearly 30,000 UK assisted deaths a year by the early 2030s after a new law was passed. Contrast that figure to the fifty people (average one a week) currently going to Switzerland from these shores each year for an assisted death.

The normalisation of ‘assisted dying’ will have an inevitable effect of cheapening life, where we become desensitised and accept an unnatural end to life as almost routine. This potentially leads to coercion – both direct and indirect – not only drawing into the net those with medical problems (terminal or otherwise) but the old, the vulnerable and the economically disadvantaged too.

The pro-AD lobby is certainly skilful in its campaigning, with the use of high-profile celebrity leads and its deployment of compelling euphemisms (‘a good death’, ‘dignity’, ‘humanity,’ ‘choice’, ‘rights’ strike very powerful chords while arguably implying the opposite). It’s also undeniably well-intentioned and you’d require a heart of stone not to sympathise with extreme individual cases.

But is this a case of ‘be careful what you wish for’? The sum result of its activities may be that it creates more problems than it solves.

The assisted dying debate is a moral and ethical minefield, with opponents contending, quite rightly, that it’s impossible to have a safe system of medicalised killing. But if, ultimately, assisted dying is to be legalised in this country, then maybe it’s time for the pro-AD lobby to outline its next set of objectives: limiting mission creep, holding power to account, and protecting against future abuses.

Paul Carroll is a British novelist who hit the international headlines earlier this year after changing his mind about assisted suicide and cancelling his Dignitas membership.

A former PR guru turned author, his books put the ‘stab’ into ‘establishment’ and include Shaking Hands with Elvis (2024), Don’t Ask (2021), Trouble Brewing (2017), Written Off (2016) and A Matter of Life and Death (2012). Born and brought up in Leeds, he lives in Altrincham, Greater Manchester.