It is often said the definition of insanity is trying the same thing and expecting a different result. We would be wise to apply this maxim to today’s debate in Parliament about whether to legalise assisted suicide.
When MPs last voted on this issue, in 2015, the idea was rejected decisively by 330 votes to 118. This result cannot be attributed merely to the political makeup of Parliament at the time: more Labour MPs voted against than for legalisation, as did more Conservative MPs, while Liberal Democrat MPs were split evenly.
The 2015 vote was sandwiched in between two other “once-in-a-generation” decisions: the Scottish independence referendum in 2014 and the Brexit referendum in 2016. It is not entirely clear, however, why less than a decade later, another vote is required uniquely on assisted suicide – particularly given the outcome on the issue was far more convincing than the results in the two referendums.
It is even more puzzling when one considers that the reasons for rejecting legalisation are more compelling now than they were back in 2015, in light of what has occurred elsewhere in the intervening years.
In 2016, the year after the Commons vote, Canada legalised assisted dying for the terminally ill or people for whom death was “reasonably foreseeable”. Canadian MPs had been warned about the expansion of and abuses under similar laws in the Netherlands and Belgium, but convinced themselves they would fare better and be able to introduce assisted dying safely.
And yet just five years later in 2021, Canada extended Medical Assistance In Dying (Maid) to the non-terminally ill, while people with mental illness are set to be eligible to die under the scheme from 2027. So normalised has Maid become that Paralympian Christine Gauthier reported she was offered it unprompted after applying for the installation of a stairlift in her home.
Not to be outdone by Canada, the Netherlands and Belgium have also continued along the path of ever-increasing expansion in their assisted dying practice. “Couples euthanasia”, a recipe for coercion, is on the rise in the Netherlands, with 66 people dying last year in this way; the country also agreed last year to expand the law to cover children of all ages, and its Parliament is soon expected to debate allowing anyone over the age of 75 to apply for state-assisted death even if they are completely healthy.
In 2016, one year after the Commons rejected assisted suicide, a minor died in Belgium under its assisted dying laws for the first time, while last year 48 people there were granted assisted deaths for psychiatric conditions.
Aware of the bad PR that Canada, the Netherlands and Belgium provide for their cause, campaigners often cite the US state of Oregon as a model for the law they would like to introduce here. However, in 2017, the Oregon Health Authority, describing its law as a “permissive law”, announced that its definition of terminal illness (a necessary criterion for assisted suicide in the state) included any illness which would lead to death without treatment, rather than those which could not be cured with treatment.
This has led to assisted suicides in the years since for people with anorexia and diabetes. Last year, Oregon also removed its residency requirement, opening the door to so-called suicide tourism.
These are not rogue places. Canada and Oregon are part of the Anglosphere, while the Netherlands and Belgium are two of our closest neighbours. Yet none of these places has managed to avoid the expansion and abuses that supporters here seek to play down.
Having tried and failed to extol Oregon as an example to follow, supporters of a law change seem now to be pointing instead to Australia and New Zealand where legalisation is so recent that no definitive lessons can be drawn. Even so, the Bill before Parliament does not include the same level of mandatory reporting with regard to assisted deaths as is required in jurisdictions in those countries, making it more likely cases of abuse would go undetected.
It is not just the international track record of assisted suicide laws that ought to give MPs greater pause for thought now than nine years ago. As Wes Streeting, the health secretary, has noted, the current state of our NHS, still recovering from the Covid pandemic, and the increased pressure on palliative care and hospices, means our public services are not in a fit state to consider introducing a right-to-die law that would risk leaving vulnerable people feeling they had a “duty to die”.
If MPs had good reason to reject assisted suicide in 2015, they have even greater reason to do so now. Supporters of legalisation are not proposing something untested and untried, but a law change for which the consequences elsewhere can be clearly seen – and the lessons are alarming. Nor are suggestions that there would be a push to expand an assisted suicide law here speculative: campaigners have already been lobbying for a more permissive law.
Elsewhere, assisted suicide laws have put vulnerable people at risk and sent a message that the lives of the elderly, terminally ill, disabled people and those with mental health struggles are not worth living. It would change society for the worse, not the better, if MPs voted for such a change here in the UK. Having overwhelmingly rejected legalisation nine years ago, for Parliament to change tack now, given what has happened in the intervening years, would be nothing short of insanity.
Baroness Grey-Thompson is a former Paralympian
