The central issue before MPs, as they decide how to vote on the latest version of Kim Leadbeater’s assisted dying bill, is how to value individual autonomy relative to collective responsibility for vulnerable members of society when making regulations around the end of life. Should terminally ill people be allowed to end their lives with medical help? If so, under what safeguards? The question remains ethically, medically and legally complex.
Technological and social changes enabling people to live much longer have created challenges around the resourcing of care and experiences of ageing and dying. There are profound questions about how we manage the final stages of life – and what we owe to those living through them.
Ms Leadbeater, a Labour backbencher, has taken on the challenge of steering this bill through parliament with principle and empathy. The past nine months have seen an impassioned debate that has, rightly, filtered beyond parliament and the news media into everyday life. From the start, as this newspaper noted, public opinion has sided with the bill’s backers.
Yet even such public backing is tempered by serious concerns. Earlier this week, Gordon Brown cited a poll commissioned by Care Not Killing in which two-thirds of respondents agreed that the government should “sort out palliative and social care first”. That concern is not misplaced. Too many people do not receive adequate end-of-life care. There is a danger that assisted dying, if introduced without sufficient protections or investment, could feel less like a choice and more like a pressure.
Legalising assisted dying wouldn’t open the door to something entirely new – it would bring into the open a phenomenon that already exists in the shadows. In Britain today, life and death decisions hinge on opaque prosecutorial discretion. Those who help a loved one die, often with kindness, face prosecution for murder or manslaughter. Or they may not. The Crown Prosecution Service decides, after a police investigation that can be traumatic: homes treated as crime scenes, phones seized, grieving families interrogated. For many, it’s not the act that scars, it’s the ordeal that follows.
For the bill’s advocates, the goal is simple: to spare people needless suffering. Some have watched loved ones endure drawn-out deaths; others, like the TV presenter Esther Rantzen, want control over their own. Some doctors see assisted dying as a humane choice. Many supporters of the bill are motivated by compassion, but questions remain as to whether the necessary safeguards and public investment have been seriously addressed.
While many believe that a choice about dying is their right, it is essential to reflect carefully on the implications of such a momentous change on people with less agency and fewer resources. For a parliament less than a year old, this is a moment of political maturity and a test of its ability to handle one of the most emotionally charged questions of our time.
MPs may pass the bill on Friday, but there is no doubt that the legislation will need further refinement in the Lords and government assurance to ensure that compassion is not compromised by cost-cutting, that vulnerable people are not left exposed to subtle forms of coercion, and that the values of care and dignity are central to how we support those at the end of life.
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