Dear Secretary of State for Health and Social Care/Secretary of State for Justice,
I write to express my opposition to the legalisation of assisted suicide in this country and thank the Government for its rejection last November of a review of the law around assisted suicide.
Attempts by campaigning MPs and Peers to encourage the Government to reconsider the subject should continue to be resisted. As it was at the time of its comprehensive Parliamentary rejection in 2015, assisted suicide remains deeply unsafe, and I therefore ask that you confirm that the Government will resist pressure to legislate and rather leave this issue to Parliament.
First, assisted suicide can never be a ‘safe’ law. Evidence from overseas demonstrates that, 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 regulated mild 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. Canada has been criticised by successive United Nations special rapporteurs on the rights of persons with disabilities for the impact of its ‘medical assistance in dying’ law on persons with disabilities. Significant concern has been expressed at a “growing trend to enact legislation enabling access to medically assisted dying based largely on having a disability or disabling conditions, including in old age”.
In every jurisdiction that has introduced assisted suicide and euthanasia, the practice has become more common and its scope widened, indicated by consistent annual increases, expansion of applicable illnesses, and disappearance of psychiatric evaluation. Evidence from other jurisdictions suggests that people pursue assisted suicide more often as an attempt to resolve existential problems of self-perception and self-worth than for medically intractable issues. 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. Ultimately, these are existential problems rather than medically intractable issues.
Secondly, 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 care and other forms of end of life care 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 the same percentage would refuse to participate in any such procedures. Notably, not a single doctors’ group or major 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, SCOPE, and the United Kingdom’s Disabled People’s Council.
Rather than legalising assisted suicide, Government and Parliament should commit to improving the quantity and quality of palliative care in our communities, and showing compassion by confirming to our vulnerable fellow citizens that their lives are always worth living. In most cases, high-quality palliative care can effectively alleviate distressing symptoms associated with the dying process. The Association for Palliative Medicine considers that “the drivers for physician assisted suicide, in general society and even amongst some professional colleagues, may be based on fundamental misconceptions of what palliative care can and cannot achieve”. Those who suffer from terminal illnesses deserve the best palliative care available to alleviate the distressing symptoms that can accompany dying. Investment in care for the elderly is essential to underline our common human dignity and equality: values that are foundational to our society, but also fragile and in need of protection.
Endorsing suicidal ideation would betray our duty, shared by Government, Parliament, and wider society, to prevent suicides wherever possible. It is a double standard for any society to allow some people assistance in suicide, even as we do all we can to prevent young people and other vulnerable groups from committing suicide. A truly humane and proportionate response would both acknowledge the sometimes tragic suffering that can accompany the end of life, and care for their needs as fully as possible in their final days. Licensing doctors to supply lethal drugs to their patients is fundamentally different from the withdrawal of ineffective life-sustaining treatment, and would cross the Rubicon in British medicine by introducing suicide as an acceptable form of treatment. Vulnerable patients who experience suicidal ideation should receive high-quality physical and psychological care that reaffirms their inherent dignity, rather than medical confirmation of their diminished view of their own life.
As the COVID-19 pandemic and related restrictions compel us to reflect on the treatment of the elderly and infirm in our society, our Government and Parliament must lead the way by advocating the dignity of those living with terminal illnesses, and avoid the fate of those countries where suicide has been sanctioned as an acceptable form of medical treatment.
I therefore ask that these arguments inform all future decision-making on this issue in the Department for Health and Social Care and the Ministry of Justice, and that the Government confirms it will continue to resist pressure to legislate for assisted suicide, and rather leave this matter to Parliament.
Thank you for your continued hard work in Parliament during this challenging time.