Assisted Dying

Between zoom calls, banana bread- baking and the tsunami of Covid-19 announcements, you may have missed the Government’s most recent decision relating to assisted dying. In December, Matt Hancock announced that the Government would allow terminally-ill people to travel to Dignitas during the second lockdown.

The immediate reaction to the health secretary’s statement was that it is a common-sense decision; if people follow social distancing guidelines they provide a minimal risk of spreading Covid-19, and travel to Switzerland and other European countries for the purpose of assisted dying was also permitted before the pandemic. The shadow health secretary echoed the sentiments made by Matt Hancock but highlighted the fact the government should have made this decision months ago and left terminally-ill people without clarity for far too long. However other MP’s, including Fiona Bruce, were vehemently opposed to the government decision arguing, "[it is] completely inappropriate, indeed insensitive to go anywhere near considering making access to any form of suicide easier at this time.". Moreover, many MPs and advocates of assisted dying see this as little more than a token gesture, with it becoming increasingly difficult to not only find flights to Switzerland, but also to procure the documents necessary for a terminally ill patient to prove they are of sound mind in deciding to end their lives.

Now, this could easily be seen as a minor decision about a subject largely ignored up until this point by a government in the midst of contending with a global pandemic. However, assisted-dying advocates argue that if this administration is content with allowing its citizens to undergo physician- assisted dying in Switzerland, what moral right do they have continuing to prevent and criminalise the practice in the United Kingdom.

On the contrary, I’m sure many would argue whether a change in the law is really necessary? Why can’t terminally-ill patients just travel to Switzerland? Well, I find one of the most compelling challenges to this statement is encapsulated in a conversation between Conservative MP Daniel Kawcynski and a constituent. Daniel Kawcynski asked, “why don't you go to Switzerland?”, to which his constituent answered “No, I'm an Englishman, I want to die in England. And I think it's extremely important that our citizens have this right.” Deciding to end one’s own life is undoubtably the most emotionally charged and impactful decision a person could ever make. It carries extreme emotional, religious and social gravitas; we should surely remove any factors which put these people under greater emotional turmoil, especially since the UK government is complicit in allowing its citizens to undertake this practice in other countries. We also cannot forget the financial impact of travelling to Switzerland for terminally-ill people whose condition may have already had a negative economic impact.

I accept that many would wholeheartedly disagree with this argument and its sentiment. They would argue the contrary, that government has already gone too far by allowing its citizens to travel elsewhere to undertake assisted dying and should both condemn and limit the ability to do so . Pro-lifers question whether a change to the law would settle the argument or instead lead to a slippery slope. At the moment it is being argued that only terminally ill patients with less than six months to live would be eligible. However, in the European countries where assisted dying is legal, the debate has already shifted. Campaigners now focus on children and those suffering from mental illness and their ability to decide when they can end their lives. They may point to the example of Nathan Verhelst ; Nathan underwent gender reassignment surgery which left terrible scarring. This left Nathan in deep emotional turmoil and he chose to end his life through assisted dying 2 years after the surgery at the age of 44. Would the general public be in favour of assisted dying in this circumstance?

Assisted dying is an incredibly divisive issue, it echoes many of the arguments made for and against abortion. It is a question of whether the individual has the right to determine what should happen to their own body or that in all circumstances life is sacrosanct and should be defended. I believe fundamentally this is a debate between the collectivism of religious belief and a defence of individual liberty. It is a question to what extent we must respect the autonomous decisions of the individual when their actions have the possibility of affecting those around them, whether we must champion society or its essential constituents.

It is important to make clear that all forms of assisted dying in the United Kingdom are against the law, the latest attempt to legalise the practice was in the form of a private members’ bill initiated by Lord Faulkner in the House of Lords. This bill was handily defeated and although Lord Faulkner has attempted to reintroduce the bill in January 2020 it will likely be voted down again when the second reading is eventually scheduled. Any private members’ bill is incredibly unlikely to become law as the government decides both how time is spent and what bills are debated in both the houses of parliament. For pro-assisted dying legislation to have any chance of passing it needs the endorsement of the government party in power. Even then any bill on a charged issue such as assisted dying would be put to a free vote; meaning that party whips would allow their MPs to vote with the conscience. Therefore, an assisted dying bill also needs the support of a majority of MPs throughout the whole house.

First and foremost, if the law is going to change in the United Kingdom, a clear appetite for a change in the status quo must be obtained. Within the general public this seems to be the case, approximately 80% of the population believe that a doctor should be allowed to end the life of terminally-ill patient who is suffering. Furthermore, this is not a novel or emerging belief; a large majority of the population have held this opinion since surveying on this topic began in 1984. However, for this legislation to be successful it must also undoubtably gain the consent of the medical profession who will be charged with helping their patients to die. This wide-held consensus in the general population is not mirrored in the medical profession; only 40% of surveyed BMA members believe the law on assisted dying should change and in palliative care doctors any change is opposed by 70%. Reasons vary but one of the most common responses is that it will lead to poorer end of life care as the focus shifts to assisted dying procedures.

Regardless of whether you are for or against assisted dying. It is clear that Boris Johnson need to make a decision. Medical law needs to be flexible as not only medical knowledge and technology improves, but as public opinion changes. This government is obsessed with focus groups, with the Cabinet Office spending millions of pounds on contracts with polling companies such as YouGov. This current administration seems to create legislation based on what Boris and his team deem to be the most popular. It would therefore follow they would be in favour of allowing assisted dying. But, this would certainly not sit with the socially conservative membership of the party.

The conservative movement prides itself on being pragmatic and basing decisions not solely on party ideology, but what is best for the country. However, in the moral debate surrounding assisted dying the Tories must make a decision whether it is in favour of personal liberty and independence from state intervention or whether it will continue to defend the religious beliefs of its membership. This could be a defining moment in the direction of Boris Johnson’s premiership, we will see if he takes the initiative to lead his party.