Debate: should MPs vote to permit assisted dying for the terminally ill?

The House of Commons is debating the Assisted Dying Bill, which, if passed, would allow doctors to prescribe a lethal drug dose to terminally ill patients who are deemed to have less than six months to live.

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Yes, argues Stephen Bush, Staggers Editor

Euthanasia is a class issue. In Britain, we already have the right to die: all you need is 200 Swiss francs (£150) and a flight to Switzerland (£30 with EasyJet). What we don’t have is the right to die if you don’t have a spare £180. Or if you want to die at home. Or you aren’t physically able to travel that far anymore.

What we don’t have is the right to die if you’ve worked in low-paid jobs all your life and are on the state pension.

We already recognise the right to refuse treatment – to sign a Do Not Resuscitate notice. To stop undergoing radiotherapy. So in the United Kingdom, we have the right to die: slowly, or at £300 a pop.

But it’s not just about legal inconsistency – otherwise, it would be as well to charge people who made the journey to Switzerland, or to ban people from refusing treatment. It’s also about the basic human right to say “No”. To decide what happens to your body – to walk away when things aren’t going well. To die in as painless a way as possible. We should no more restrict the right to die a little early, in comfort, than we do the right to morphine.
 

No, argues James Newcome, Bishop of Carlisle

MPs are debating what Rowan Williams, the former Archbishop of Canterbury, has described as "probably the sharpest moral and legal question of our time". The Assisted Dying Bill, if passed, would permit a terminally ill patient with a prognosis of less than six months to be given a fatal dose of poison that they themselves would administer under the supervision of "an attending health professional".

Many regard it as self-evident that we should make this fundamental change to the law, and some opinion polls suggest that public opinion is markedly shifting in that direction. Much is made of the idea that assisted suicide makes a society more "compassionate" with those who argue against it portrayed as heartless or unfeeling.

But the argument of those who oppose a change in the law desperately needs to be heard. It isn’t simply the reactionary response of a few religious cranks but rather goes to the very heart of what we think "society" means.

Those in favour of the Bill insist that we should not need to be a burden on our families, our carers or the NHS as we near the end of our lives. Indeed, in some parts of the world where assisted suicide is legal, this is a factor in requesting it.

But this ignores two vital considerations. One is the simple fact that "being a burden" on someone else is part of what it means to be human, as is having the privilege of caring for others in need. It is through interdependence that our humanity grows, not through getting rid of ourselves or relatives when we become financially or emotionally demanding. Every parent knows that. So do hospice staff and many of those who care so patiently and devotedly for "burdensome" family and friends at home.

The other consideration has to do with the potential danger of this law for the most vulnerable people in our society, including those who are elderly and disabled. As it stands, the current law offers protection for them from possible manipulation (conscious or unconscious) by others. The "right to die" can easily become a "duty to die". But the law also protects families, doctors and carers from being manipulated or coerced by elderly relatives or patients who are tired of life and want an easy way out. Pressure can be exerted in either direction.

As for the philosophical dimension of this debate, there seems to be a growing recognition of the fact that it is shifting away from the alleviation of suffering towards an exaltation of personal choice and control over the time and method of one’s death.  That raises the issue of whether there should be any limits on the exercise of what we like to regard as our moral freedom.

So far, the law of this land has made it very clear that there are limits, and some commentators point to the moral incoherence of prosecuting police or prison officers who fail to prevent their charges from voluntarily committing suicide – while at the same time encouraging doctors (who have taken an oath "not to give poison to anyone, though asked to do so") to help their patients to kill themselves.

This also raises the much-derided but extremely significant slippery-slope argument. Whether the debate is about degree of suffering or about personal autonomy or both, it would make no sense to limit assisted suicide to those who are reckoned to have only six months left to live.

In fact, it is arguably those who face a lifetime or many years of suffering (eg. with motor neurone disease or locked-in syndrome) who should have this option available to them; and it doesn’t take long before "assisted suicide" for a very few becomes "voluntary euthanasia" for many, as it already has in Belgium.

A number of doctors have recently pointed out that better palliative care, properly resourced, is a far better option than assisted suicide. The present law may not be perfect, but it works well and makes a clear statement about the way in which, as a society, we value every human life, however seemingly unproductive it may be.

James Newcome, Bishop of Carlisle, is the lead bishop on healthcare and medical ethics in the House of Lords

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