Apparently the Meacher Bill is being debated in Parliament as some people call for a change in the law on “assisted dying”. It takes a certain sensibility to decide in the midst of a pandemic that the most pressing task is to help the vulnerable to kill themselves. It also displays a quintessentially British hypocrisy that a year after clapping NHS staff we are now seeking the same doctors to act against their own conscience. Either way though I couldn’t let this lie and so wrote this rather lengthy letter. I have mildly tweaked it in order to protect my anonymity but otherwise it’s verbatim as sent to my MP.
Thank you for taking the time to read this admittedly lengthy email and for your work in Parliament during this challenging time. I write to express my opposition to the legalisation of assisted suicide and to ask you to write to the Secretary of State for Health and Social Care and Secretary of State for Justice on this issue.
As you may know, a small group of MPs and Peers are endeavouring to encourage the Government to reconsider the legalisation of assisted suicide in the UK. I believe that a change in the law has a very strong probability of having catastrophic consequences for the most vulnerable in our society. Perhaps surprisingly I am not going to seek to persuade you to agree with me. It is enough that you recognise that the nuances of this issue are so complex, so clearly unresolved (and I suspect unresolvable), that to plough ahead with a call for a change in the law would be profoundly unethical.
As you may well know, last November the Government rejected a review of the law around assisted suicide. It had been previously rejected by Parliament in 2015, and on numerous occasions before that.
Throughout this email I use the provocative term assisted suicide rather than the preferred assisted dying. That is because the latter term is misleading. Supporters of assisted dying would be duty obliged to oppose the wishes of Debbie Purdy, Terry Pratchett and Tony Nicklinson among others, none of whom were dying.
By chance I attended a Quaker meeting on “assisted dying” last year and was surprised to find myself in the extreme minority among attendees in my opposition to a change in the law. Yet while still being undaunted, even these supporters of a change acknowledged that some members of the public feel now, during the Coronavirus pandemic, is not the right time for such a change. On that point (if on little else) I am in absolute agreement with them. At present many people are experiencing unprecedented loneliness, uncertainty and change.
The pandemic has shown how terminally ill & disabled people are marginalised, pressed to agree to DNR notices and large numbers of deaths occur in care homes.
Evidence from overseas demonstrates that assisted suicide can never be a ‘safe’ law., Incrementally but inevitably, the ‘right to die’ extends from ‘hard cases’ to a more holistic provision, despite the best intentions of those arguing in favour of mild regulated reform. Belgium and the Netherlands have expanded their provision of assisted suicide and euthanasia to include children. The American state of Oregon has expanded its list of applicable conditions to now include arthritis, complications from a fall, and kidney failure, among other non-terminal conditions.
The latest reports from American states that have sanctioned assisted suicide demonstrate that vulnerable patients have sought to die for fear of burdening their families. For example, 51% of patients from Washington state in 2018 cited Concerns that they would be a burden on their family, friends, and caregivers, should they continue to live, whilst only 4% of patients in Washington that year were referred for psychiatric or psychological evaluation.
More experienced medical professionals in end of life care are less likely to support assisted suicide. In November 2020, over fifty doctors working in palliative medicine and other end-of-life care occupations signed a letter to the Times opposing the legalisation of assisted suicide in the UK. A recent British Medical Association survey found that 76% of palliative medicine specialists opposed the legalisation of assisted suicide, and would refuse to participate in any such procedures. Notably, not a single doctors’ group or significant disability rights organisation in the UK supports changing the law on assisted suicide, including the British Medical Association, the Royal College of General Practitioners, the Royal College of Physicians, the British Geriatric Society, the Association for Palliative Medicine, Disability Rights UK, and the United Kingdom’s Disabled People’s Council.
Setting aside the evidence both anecdotal and fact-based suggesting societies fear of physical disability in general, the much referenced 85% in favour of a change in the law appears to reflect society’s fear that they will suffer inferior treatment if they become sick. On the basis of Covid, the latter fear is well founded, yet the general response has been to want better health & care services.
Rather than legalising assisted suicide, Government and Parliament should commit to improving the quantity and quality of palliative and social care in our communities. Furthermore a Social Care Bill would help the growing number of people with dementia far more than a Assisted Suicide Bill, and confirm that the lives of vulnerable fellow citizens matter. Endorsing suicidal thoughts and attempts would betray our duty under the suicide prevention strategy for all citizens, supported by the Government, Parliament, and broader society. It is a double standard for any community to allow some people assistance in suicide, even as we do our utmost to prevent young people and other vulnerable groups from taking their lives.
A truly humane and proportionate response would acknowledge the sometimes tragic suffering that can accompany the end of life and do everything necessary to care for their needs and alleviate pain in their final days.
I sincerely hope I don’t come across as patronising if I observe that you may well have guessed by now that a good amount of information in this letter comes from a template draft. That is indeed the case and much of the information here has been provided by Not Dead Yet of whom I am a supporter. Indeed there is a possibility that you may have previously received similar letters for that very reason. That I sent this letter in spite of having a journalistic degree is partly out of expediency but is also out of sheer and utter exhaustion.
If you will indulge me for a moment I will tell you about myself. I am near totally blind and have mental illness (OCD). Both conditions are very time consuming and I have endeavoured to keep life and limb together while seeking work through occasional journalism and more frequent stand-up comedy. Three days after my Brighton Fringe show finished I am absolutely exhausted and would prefer just about anything to having to write a lengthy letter about assisted suicide. Yet I don’t think I could live with my conscience if I sat idly by while the lives of very vulnerable people were made even more precarious.
As a widower who lives on his own and receives comparatively low amounts of social care I have no illusion that my life would represent if not exactly many people’s worst nightmare then certainly something nudging in that direction. At a time when I was still partially sighted I recall meeting a woman who told me that she was going blind and would kill herself if she lost her sight. I can empathise with her. At the time when I was still partially sighted I shuddered at the thought of no longer being able to read books, watch movies or see faces.
Yet despite having not received any related counselling nor ever having met an Eye Clinic Liaison Officer in my entire life (except possibly in an informal capacity), I am still here today. That does not make me strong or an inspiration. In light of my mental illness I am actually quite ambivalent about having my sight back but I can tell you that I would dance for joy were my care provision to be increased. The key point here is that beyond the statistics what is at stake here is whether we create a society that helps its most vulnerable citizens to live, or whether it helps them to die. I hope you will, like me, prefer the former.
I would like to end with one point which I have never herd being previously made but which I think makes sense. On a seven point scale with 1 being absolute opposition to assisted suicide and 7 being absolute support, I would place myself at position 2. That is because I have friends who disagree with me or who are undecided. No, I would not wish to occupy position 1 which to me sounds like fundamentalism. If position 5 is mild support but insufficient to require political action, then what is being advocated today is that the Government occupy position 6. What I wish you to consider is the possibility that the very moment assisted suicide becomes legal, society’s position will out of necessity be shunted to position 7 – un-nuanced support. That is because at the very moment assisted suicide becomes legal, the state’s primary responsibility will no longer be to protect the vulnerable (poor, elderly, disabled) who are at risk of being coerced into suicide. No, at that precise moment the people most at need of protection will be the doctors carrying out assisted suicides and the families of those who choose to avail of this service. We have seen from the example of abortion the danger of extremists taking the law into their own hands. Today it’s very hard to speak out against abortion without having to express numerous caveats beforehand and I would not wish for a world where people have to apologise before expressing worry about the ethics of assisted suicide.
As I stated at the start of this lengthy email, I am not asking you to agree with everything that I have written. I actually take a very strong line on free speech (even controversially so) and have endeavoured to practice that in my own life. For example I actually wrote on assisted suicide in 2008 and made a concerted effort to remain impartial. You can read my report here:
All I would ask is that you recognise that this is a very complex issue and that in light of just how unresolved the complexities are, it would be foolhardy even immoral to proceed with a change in the law. Obviously I would hope that you can be persuaded that a change is wrong as a matter of principle but my first commitment will always be to free speech.
To conclude, as my representative in Parliament, I ask that you urgently write on my behalf to the Secretary of State for Justice and the Secretary of State for Health and Social Care explaining why legalising assisted suicide in the UK would be profoundly unsafe. We need help to live, not to die.