The House of Commons votes on Friday on whether the State should give some of its citizens the right to kill themselves – and actively participate in their deaths.
The Terminally Ill Adults (End of Life) Bill also sets out a legal and medical framework for when that right may be exercised, as well as the cold mechanics of how life would be extinguished.
There could hardly be a more profound moral issue, or a heavier responsibility on our elected representatives to examine every detail.
Yet this Bill was published only three weeks ago, and MPs are being allowed just five hours of debate before voting on it.
While that may be nothing unusual for a private members’ Bill, of which this is an example, is it really enough time to deal with a subject of such magnitude?
At least 160 MPs wish to speak, giving them no more than a couple of minutes each if all are called. Scarcely time to clear the throat.
Emotions are running high. The Bill’s supporters say it champions basic humanity and freedom of choice. Labour’s Kim Leadbeater, who tabled it, argues: ‘We should all have the right to a good life and, where possible, a good death.’
Anyone who has seen loved ones suffer pain and distress towards the end of their days will understand the sentiment behind Ms Leadbeater’s words, and there is no doubting her sincerity.
Labour’s Kim Leadbeater, who tabled the Bill, argues: ‘We should all have the right to a good life and, where possible, a good death.
However, on the other side of the divide, there are deep concerns that by conceding the principle that some people in our society would be better off dead than alive, we cross a moral Rubicon.
There would be no going back – but equally, no certainty about where the path would lead. Evidence from other countries shows how quickly the boundaries of a law intended to apply only to the terminally ill, can creep outwards.
Assisted suicide was introduced in Holland in 2002 for patients whose suffering was deemed by doctors to be ‘unbearable with no prospect of improvement’.
Over the first five years, annual deaths averaged around 1,900. By 2023, as the definition of ‘unbearable’ grew ever looser, it had risen to 9,068 – more than 5 per cent of all deaths.
They ranged from young people suffering from depression and autism to the elderly who felt they had become a burden on their family. Last November, a new Bill was drafted in Holland to give over-75s the option of medical euthanasia if they simply felt they had ‘completed life’.
Ms Leadbeater says there are adequate legal safeguards against a similar expansion of the criteria here, and against the risk of older people feeling under pressure – real or imagined – to end their lives.
Religious leaders and some very senior politicians from across the party spectrum disagree. As Vincent Nichols, Roman Catholic Archbishop of Westminster, puts it: ‘The right to die can become a duty to die.’
There are also deep-seated judicial concerns. The Bill states that mentally competent adults with less than six months to live and expressing a ‘clear, settled and informed’ wish to die may ask for assistance.
Campaigners near Parliament Square last month put up tombstones bearing facts about assisted dying in other countries
If two doctors and a High Court judge agree, the patient would be given ‘an approved substance’ with which to end their life.
But Sir James Munby, former head of the High Court’s Family Division, believes effectively rubber-stamping someone’s right to commit suicide should not be a judicial matter.
Judges are meant to weigh up all the facts of a case before delivering their judgment. Yet they would not be required to question the patient or interview their family.
There is no right of appeal for relatives, no contingency for the ‘approved substance’ failing to work and the whole process is shrouded in secrecy. In short, the bill is ‘defective’, Sir James said.
And what of the potentially altered relationship between the public and the NHS? The primary function of doctors is to heal the sick. Here, instead of saving or improving lives, they would be being paid to end them.
Might that make elderly and infirm patients feel a little less secure in their hospital beds?
To bolster her case, Ms Leadbeater cites a series of opinion polls showing the public to be broadly in favour of assisted suicide. But one survey this week showed 62 per cent believe her Bill is ‘too complex and polarised’ to be rushed through. Statistics can tell many stories, not all of them true.
What is Sir Keir Starmer’s role in this debate? He has long made clear his backing for the right to assisted suicide and promised terminally ill TV personality Esther Rantzen in March that, if elected, he would make parliamentary time for a debate and vote on the issue.
Pro-assisted dying posters on the London Underground. The Bill was published three weeks ago, and MPs are being allowed just five hours of debate before voting on it
He is said to have encouraged Ms Leadbeater to table her Bill and has given Labour MPs a free vote. But if he is so committed, why did he not bring forward a government White Paper, which could have been prepared, crafted and debated at much greater length before an informed decision was arrived at?
Like so much of what his Government has done since coming to power, this is a messy, amateurish and wholly unsatisfactory fudge.
Ministers were asked to remain neutral to avoid infighting, but that was never going to happen on an issue of such importance.
Health Secretary Wes Streeting was the first to cast doubt on the Bill, fearing an adverse effect on already stretched palliative care and warning that it would bring significant cost to the NHS. He also worried that it was the beginning of ‘a chilling slippery slope’.
He was roundly rebuked – first, directly by Ms Leadbeater, and later, behind closed doors, by Sir Keir. But if he feels strongly that the Bill holds hidden dangers, isn’t Mr Streeting entitled – even obliged – to say so? He has at least as much right to his opinion as Esther Rantzen, arguably much more.
Several other Cabinet ministers have since indicated their opposition, exposing the very public division their leader was so desperate to avoid. But this is a conscience vote. What did he expect?
Even in the hands of a competent, mature government, a law allowing the State to sanction killing the sick would be troubling enough. Under this callow and ham-fisted administration, which seems to lurch from one blunder to the next, it is a frightening prospect indeed.
Leaving aside moral judgments on such things as the sanctity of life and role of the medical profession, this Bill is being rushed through far too quickly.
It is a once-and-for-all decision on a matter of great social import. Even those who support assisted suicide in principle must see that. So, what’s the rush?
‘Unreasonable haste,’ said French dramatist Moliere, ‘is the direct road to error.’ With that in mind, it’s surely time to press the pause button on this ill-thought-out and undercooked Bill.