“It is entirely possible that future generations will puzzle over how such a fundamental right could ever be denied to them.” These are the words of David Steel, the veteran former leader of the Liberal party and a Westminster MP for more than three decades, referring to this Friday’s historic vote in parliament on whether to legalise assisted dying.
But Steel could just as well have been referring to a private member’s bill he brought before parliament 57 years ago that was also about the right to bodily autonomy and was the subject of fierce debate and vocal opposition from church leaders.
That bill – passed under a free vote by MPs – became the 1967 Abortion Act, the “landmark legislation that underpins women’s and girls’ right to safe abortion services nearly six decades on”, Steel wrote in the Sunday Times.
One of the arguments deployed by opponents of the abortion act was that it would result in a “slippery slope” – that its strict criteria would inevitably be widened to allow “abortion on demand” up to a pregnancy’s full term.
A similar argument is being used by opponents of assisted dying. But the fears raised more than half a century ago in relation to abortion have not been realised.
Under the original terms of the Abortion Act, a woman could terminate a pregnancy at less than 28 weeks’ gestation under certain conditions, including harm to her physical or mental health or the foetus’s health. Abortion was allowed beyond 28 weeks in very limited circumstances, such as if the woman’s life was at risk.
Since then, the law has been changed twice but the criteria for an abortion have remained the same.
The act was tightened in 1990 to lower the gestation limit for abortions from 28 weeks to 24 weeks, the point at which a foetus was considered viable outside the uterus.
The law was further changed in 2022 to permit women in the first 10 weeks of pregnancy to take medication at home to terminate a pregnancy. This confirmed in law a temporary approval issued during the Covid pandemic, when access to clinics was limited.
Despite the furore at the time around the legalisation of abortion, it is widely accepted today that women should have the right to choose whether or not to continue with a pregnancy. Nearly nine in 10 people surveyed by YouGov last year agreed that abortion should be allowed, with 49% saying the current 24-week limit was about right. Two-thirds of people said abortion should be available to any woman who wants it up to 24 weeks.
In 2022 there were 251,377 abortions, the highest number since the Abortion Act was introduced. The high numbers – of great concern to those opposed to abortion – are an illustration of how the law has been utilised.
As Steel pointed out, there are other areas of the social-legal landscape that are almost unrecognisable from that of the middle of the last century. “For a young person reaching adulthood today, the idea that the state could wield its power to prohibit them from marrying the person they love, dissolving a marriage when love is absent, or choosing when and whether to have children would be viewed as not just alien but irrational,” he wrote.
Those putting forward the “slippery slope” argument on assisted dying often point to other countries – principally Canada – that have legalised it.
Canada’s medical assistance in dying (Maid) laws, crafted in response to a supreme court decision, initially covered only terminally ill Canadians. However, in 2019 a judge ruled that restricting access to those who had a “reasonably foreseeable death” was unconstitutional, forcing federal lawmakers to expand the law.
Now, a person must have a “grievous and irremediable medical condition” to be eligible. They must meet all the criteria of having a serious illness, disease or disability; being in an advanced state of decline that cannot be reversed; and experiencing unbearable physical or mental suffering that cannot be relieved. The Canadian government has shelved an expansion of the law to include people with mental illnesses.
The US state of Oregon, which legalised assisted dying in 1997 and whose law has been used as a model for many other jurisdictions, has not changed its criteria for eligibility in the past 27 years.
Kim Leadbeater, the Labour MP who has put forward the assisted dying bill to the Westminster parliament, has said there is a misconception that the scope of the law has been broadened in other countries.
Of her bill, she said this weekend: “The strict eligibility criteria make it very clear that we are only talking about people who are already dying. That is why the bill is called the terminally ill adults (end of life) bill; its scope cannot be changed and clearly does not include any other group of people.”
