On assisted dying

On Friday, the third reading of the Terminally Ill Adults (End of Life) Bill was passed in the House of Commons.
Assisted dying should, obviously, be legal. Ending one’s own life is not illegal, so it is bizarre that assisted dying is. This isn’t a restriction on death—it’s a restriction on autonomy. It prevents people who require assistance from doing something they are legally entitled to do. That is, to me, quite obviously wrong.
In a civilised society, we ought to strive to make legal activities accessible to all. We ought not to prevent disabled people from doing things the rest of us can.
Of course there need to be safeguards by the bucketload to prevent abuse—just as in myriad other areas where vulnerable people need assistance. But our starting point should always have been that we support those who, through disability or infirmity, are unable to carry out legal activities the rest of us can access.
It is morally reprehensible to hold people to a different legal standard on the basis of physical capacity.
The bill now moves to the House of Lords, where the Lords Spiritual will have their say: the 24 bishops appointed to our legislature by the Church of England. It is absurd that we have an upper house with more church-appointed clerics than doctors. It is unjustifiable that there are more bishops of a minority religion in the Lords than people under the age of 45.
In a secular, multicultural society, it is ethically indefensible to distort the debate by handing structural power over scrutiny of this legislation to a narrow theological bloc. Ethics and theology are not the same thing—especially in a society as plural as ours. We ought not pretend that a group which only began admitting women in the last decade has any kind of ethical authority relevant to the modern world.
Look: we’re handing 24 unelected bishops an automatic vote on how we die. Tell me your legislature’s a basket case without telling me your legislature’s a basket case.
And yet: bishops having a say makes more sense than assisted dying being framed as a medical issue. It’s not, it never should have been, and no one benefits from pretending otherwise.
Death is a spiritual, familial, social and, for some, religious event. It’s only the bizarre and persistent myth that death is a kind of medical failure that has pushed it out of sight and, all too often, into hospitals. Decisions about death ought not to be based on clinical prognostications—they are moral and existential choices.
Of course, doctors have a role. But that doesn’t make death a medical issue any more than it makes flying a plane a medical issue. A medical opinion may inform whether someone is fit to be in the cockpit, but a million other factors decide when and where the plane is headed.
Death is natural and expected. It comes to us all and concerns us all. It is one of the few unavoidable truths that touches and unites every human being on the planet. The idea that doctors are uniquely significant gatekeepers to end-of-life decisions is misguided and offensive—and I say that as a doctor.
Of course assisted dying should be legal. But I’m not nearly smart enough to know how it should work, or how to implement sufficient safeguards to prevent abuse. I do know I wouldn’t ask bishops or doctors—just as I wouldn’t ask them to design systems to safeguard against abuse in financial transactions, legal dealings, or any other domain where care and access must be balanced. I would look to other countries who seem to have made more sound progress with these issues.
Of course assisted dying should be legal. And I hope there are people smarter than me who can make it work.
The image at the top was created with GPT-4o.
This post was filed under: Health.