By Angela Craig
Legislation supporting assisted suicide is steadily moving forward in both the Westminster and Scottish Parliaments. Opposition has grown, as the possibility of such dangerous powers becoming law comes closer. The pro-euthanasia narrative that assisted suicide is all about individual ‘choice’ is increasingly being challenged. The voices of disabled people’s organisations like Not Dead Yet have been joined by professional medical and legal groups. Yet recent votes show those opposed to legalisation – who instead want to see real choices, starting with support for living decent and equal lives, for decent medical, social and palliative care – are still a minority in parliaments. It is vital that socialists raise their voices against these proposals. They need to be stopped.
In Jersey and the Isle of Man assisted suicide legislation has recently been agreed and is at different stages towards being operative. The details of the legislation differ in each case. Changes in these, albeit small, jurisdictions are exploited by euthanasia advocates to suggest a climate of inevitability.
Scottish MSPs out of step with public opinion
In Scotland, on 14th May, a pro-assisted suicide private members bill, moved by Liberal Democrat MSP Liam McArther, passed its first parliamentary stage by 70 votes to 56. All three current and past SNP first ministers as well as the current Labour leader spoke out against the proposals. The bill is wider in scope than its Westminster counterpart as it has no requirement for a terminal diagnosis. Voting was split across the parties, with the exception of all seven Green MSPs who voted in favour. For context, the last time such proposals were debated, in 2015, they were heavily defeated.
Polling in early May showed the vote is out of step with public opinion in Scotland: 62 per cent of Scots agreed that disabled people who struggle to access the health, social care and other support they need, given the current state of the NHS and social care funding, may be more likely to seek assisted suicide. This rose to 71 per cent for disabled people polled. Additionally, 66 per cent of people agreed that the Scottish Parliament should prioritise improving access to care for disabled people before considering whether to introduce assisted suicide. This rose to 76 per cent for disabled people polled.
Westminster
On 16th May the Terminally Ill Adults (end of life) Bill – proposed by Kim Leadbetter – started its Report stage. The debate was highly charged and quite different to the Second Reading debate in November.
The bill ended its Committee stage with a number of changes, the most significant being the dropping of the requirement for High Court oversight of assisted suicide applications. This supposed ‘gold standard’ of safety, which had reportedly secured the votes of a number of MPs in the Second Reading vote, was dropped by Leadbetter in favour of lower level, and gruesome sounding ‘Assisted Dying Review Panels’. The change makes sense if significant numbers of people are expected – one way or another, jumping or being pushed – to ‘request’ assisted dying: expecting them all to go through application to the High Court would not be practicable.
The Committee Stage has been criticised on a number of grounds. Its composition, meant to reflect Second Reading voting, had disproportionate representation for the bill’s supporters. The list of those invited to give evidence was criticised for heavily favouring supporters of the legislation and squeezing out critics such as disabled people’s organisations. Despite this being a Private Members’ Bill, the committee contained two ministers, both supporters of the bill, who were active in steering the bill forward. One of these did the ‘wrap up speech speaking for the government in the Report Stage debate’. Supporters of the bill had the input of government drafters for their amendments, assistance not available to opponents. The bill is being treated as government-backed in all but name.
In the lead up to the latest debate there were public statements against the bill by such organisations as: the Royal College of Psychiatrists, which said there were ‘many unanswered questions’ which meant they could not support the bill; Association of Palliative Medicine, who are specialists in work with terminally ill people; and the Law Society which questioned the safety of the definition of capacity in the bill. A poll of GPs by the BBC, published on 14th May, showing strong opposition. The formal position of the College of GPs is neutrality.
Also just a week before Report stage the government published its Impact Assessment which presented a brutal cost-benefit analysis. It estimated 5,000 people a year dying by assisted suicide in England and Wales by its 10th year, and assumed savings of £59.6 million a year in ‘unutilised healthcare’ in addition to estimates for unpaid pensions, unpaid attendance allowance, unpaid personal independence payment, and unpaid care home fees and domiciliary care fees. The ‘sinister’ narrative embedded in this was denounced by disabled people as well as medical professional organisations who feared the consequences of cost-saving incentives shaping future medical care.
Powerful arguments against but ‘slippery slope’ emerging
The debate saw powerful arguments against the bill. In the months since the Second Reading the potential real world consequences have become more discussed and awareness has risen. Despite this, in parliament voting showed opposition is still a minority. Several MPs referred to their constituents being scared and to the concerns raised by disabled people and others who face discrimination. Even greater dangers ahead were signalled by proponents of the bill who spoke to amendments which would widen its scope significantly. Most countries with assisted suicide laws have seen a widening of eligibility after the initial passage of legislation. In Canada depression is now a qualifier; in the Netherlands children are eligible.
Some key arguments were:
- Legislation will intensify a coercive climate – a sense of a ‘duty to die’ – above and beyond individual cases of coercion. An amendment to stop doctors raising assisted dying if the patient has not asked about it is being opposed by the bill’s movers.
- That the legislation, and the medical approaches it will foster, will impact unequally on different people. Supporting the proposed prohibition on doctors suggesting assisted suicide, Diane Abbott argued that many people do not ‘have confidence in the face of authority and if a doctor raised assisted suicide with them, however tactfully or professionally, they will feel that they are being steered in that direction’.
- That care homes should not have to offer assisted suicide. Florence Eshalomi cited a palliative care consultant working with ethnic minority communities in Bradford who said, people say ‘we are scared. We are really fearful that this is going to result in disproportionate impact on our community. We’ve seen this through Covid, and we are scared.’
- That feeling one is a burden should explicitly be ruled out as qualifying one for assisted suicide.
- That greater protections for learning disabled people are needed – amendment 101 would seek to prevent medical practitioners initiating a conversation about assisted dying with a learning disabled patient.
- That depressive wishes to end one’s life are common after a terminal diagnosis but they often pass and should be met with emotional support and good palliative care.
On the other side, the Bill shows the direction of travel aimed at by its supporters. Pro-euthanasia MPs spoke in favour of amendments to widen the scope of the legislation so that people with, for example, neurodegenerative conditions, but not a terminal diagnosis, would be eligible.
The Report stage will resume on 13th June. There are a very large number of amendments and it is up to the Speaker to declare which are allowed a hearing.
The debate ended with two votes that show something of the balance of opinion (albeit there were a sizeable number of MPs not present). A vote on the lead amendment from Kim Leadbetter (a tinkering amendment to protect specific medical workers from being forced to work in this area) passed by 288 votes to 239, a majority of 49. A progressive amendment to that clause – to allow employers to stop employees providing assisted dying – was defeated 243 to 279, a majority of 36. Left MPs such as Abbott and Corbyn voted against the closure motion and for the amendment.
In the short time before the next stage of the votes socialists should do anything possible to encourage MPs to vote against this dangerous legislation.