‘Why legalising assisted dying would create a “two-tier” system in our NHS’
Ruth Jones
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As the Second Reading of my colleague Kim Leadbeater MP’s Private Members’ Bill on assisted dying approaches, I intend this article to be part of an ongoing debate about legalising assisted dying/assisted suicide (AD/AS). Having said that, I disagree with Mr Richards’ assessment of the issue published in July.
The law is not in a “messy state”. The 1961 Suicide act has achieved an important balancing act, continuing to discourage suicide, and treating suicide attempts and the families of successful suicides with compassion and sympathy.
Suicide is not – as it was prior to the act – illegal in itself, but assisting or encouraging it remains so.
We also have the important right to refuse medical treatment and even nutrition and hydration. We cannot be legally force-fed, or forcibly treated as competent, free adults.
The 1961 Act combines a stern face – promising up to 14 years in prison for those who assist suicides – with a kind heart.
Mr Richards notes there have been only three successful prosecutions in a decade. Many would regard that as evidence the Act does its job.
He is right to say grieving relatives must sometimes face unsettling investigations but the law regards the protection of human life as paramount. Whenever a life is taken, the law must investigate.
Getting the law right
Fear of a bad death is understandable and no one denies there are situations where ending a life might be the compassionate thing to do. Indeed, I witnessed my father suffer before he died as a result of terminal cancer. But we should be reassured as medical technology improves.
Bad deaths are increasingly rare and, thankfully, becoming rarer. We need to ask why palliative care doctors, who have witnessed thousands of deaths, are most opposed (80%) of any in the medical profession to legalised AD/AS.
Many will ask: why not pass the law for those very few cases where suffering takes place and the patient has a clear, settled wish to die? My fellow parliamentarians need to appreciate that changing the law – even in very limited terms, as Falconer’s Bill does, is a profound step that will change our perception of the value of a human life. This is something Mr Richards appears to appreciate – and we must think hard about what we might be about to do.
Legalising AS/AS will usher in an unequal two-tier system. Suicide will be an acceptable way to end some lives – those which we consider sufficiently wretched – but not others.
Instead, we should continue to try to prevent the suicide of all citizens, whether young or old, rich or poor, or disabled or abled, not changing the law to make an exception for some people.
Most who argue in favour of legalising AD/AS are motivated by compassion but there is also an insidious utilitarian aspect. After Canada legalised “medical assistance in dying”, the Office of the Parliamentary Budget Officer reported on the substantial savings to be made from its extension. Net savings in Canada, according to their figures, are so far over $600 million.
Do we want to achieve savings in the NHS by ending lives prematurely? Those who might think it can’t happen here should consider one-time member of the House of Commons Matthew Parris’ recent article advocating euthanasia for the elderly or the story of a health insurance CEO in Belgium who advocated expanding their euthanasia laws to prevent a social care crisis. The “cradle to grave” philosophy of the NHS must not be corrupted by euthanasia or assisting suicides.
Public opinion
A poll suggests the British people are deeply ambivalent about AD/AS. 56% who express an opinion support its legalisation in principle but feel there are too many complicating factors to make it a practical and safe option in Britain.
60% of respondents worried legalising AD/AS would fundamentally change the relationship between doctor and patient. Most believed AD/AS would inevitably place an incentive on health professionals to encourage some people to end their lives early. I agree.
Legalising AD/AS would be a profound step, and would undermine equal treatment, suicide prevention, and ensuring the NHS remains a positive force in all our lives.
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