Critics of the Assisted Dying Bill have been warning for a while that it would lead to a ‘slippery slope’. Their fears are looking increasingly legitimate.
The bill, introduced by Labour MP Kim Leadbeater, had its first reading in the Commons yesterday. In the last few days, some of those with conditions that might not qualify under the proposed legislation are voicing their concern about not being included. Is there already a danger that the scope of the bill will be expanded to include them?
The relationship between doctors and patients would change forever
Sir Nicholas Mostyn, a retired judge, set up a feisty group of Parkinson’s sufferers who produce a podcast called, rather brilliantly, Movers and Shakers. Mostyn is up in arms because, he says, those with Parkinson’s might ‘be left on the beach’:
‘Parkies [the podcast’s term for people with Parkinson’s] will never get a terminal diagnosis, so this bill is no f***ing use to us at all. In Spain, Parkinson’s is one of the most common reasons for seeking assisted death. We are going to be left on the beach here. There is a cohort of people like us who it is not going to help and we are left with the existing, most unsatisfactory law.’
It hasn’t taken long, has it, for the slippery slope to resemble a black run. Would anyone actually bet that within five years of an Assisted Dying Bill becoming law there wouldn’t be a compassionate extension to those with incurable suffering like Sir Nicholas? And another five years after that, for people who are not terminally ill, such as those with psychiatric disorders, also to be eligible, as they are in Belgium? And if any future law ends up allowing individuals to take, say, barbiturates, rather than having a nurse or doctor administer the dose, it probably would not take long for the provision to be challenged on the basis that it unfairly discriminates against those without the physical capacity to swallow the pills/capsules unaided.
I don’t mean to pick on Sir Nicholas here. Movers and Shakers has done a fine job in putting Parkinson’s on the map when it comes to recognition of the condition. They’re a splendid group. But that doesn’t mean the Assisted Dying Bill should have a broader scope to include those who non-terminal conditions like Parkinson’s.
My mother had Parkinson’s. And if you will forgive me for personalising the issue – always a dodgy device in an argument but here impossible to avoid – I think that there could be nothing more pernicious than presenting suicide as one of the suites of options available to sufferers. My mother had a side order of bouts of dementia as well, but the point about her is that she suffered intermittently from one of the lesser known aspects of the condition: depression. She didn’t move and shake much (many do, some don’t) but she did sometimes cry, and when you asked her why, she said despondently: ‘I don’t know’.
As it happened, the depression didn’t last long. She was devastated at the loss of independence that the condition entailed – at the outset. The prospect of being helped to wash was simply horrifying to her; as for the likelihood of being helped to go to the loo; it was unthinkable. But that was before it happened. She was fortunate in that she had good care provision in Ireland. And by the time she had got used to her situation, she looked forward keenly to the visit of the lady whose job it was to help her have a shower. She became accustomed as well to using a commode, with help, very quickly.
What didn’t come easily, however, was the idea of being a burden to me. I remember the time when she said: ‘You’d have so much more time and money if it weren’t for me’. True. I would have had. But I did everything I possibly could to pay for the private component of her care and to be with her as often as I could. Why? Because she was my mother. Had assisted dying been an option, and if I had been unscrupulous, it would have taken no effort whatever to push her to the point of doing something she thought wrong for my sake.
You say that families don’t do these things? I say they do. My husband works in the NHS and does care plans for the elderly. He has encountered a few individuals who do not want their children to know when the time comes for them to die because they’re scared of them. Old people are often vulnerable. And if assisted dying becomes the norm, it would be so very easy to push some of them over the edge.
At a debate last night on assisted dying at the Royal College of Psychiatrists, one of the first questions was: how on earth could the profession be expected to provide evidence of mental capacity when the NHS, and mental health services generally, are so drastically overstretched? The supervision of a judge? Have you registered the backlog in the criminal justice system already? Where are these judges to come from? We hardly have enough for serious cases as it is. What sounds like robust legislative protection on closer inspection just isn’t.
But the real objection to assisted dying is simply the principle of the thing. It will introduce into our relations with each other a new element, which is that dying before our time would be an option where once it wasn’t. Altruistic dying, meritorious suicide for the sake of the grandchildren (school-fee provision), guilt dying, for fear of being a burden, simple lassitude and depression dying; these are all things that were once unthinkable and might now be a possibility. The relationship between doctors and patients would change forever, just as it has done in the Netherlands since the introduction of assisted dying.
This bill is for the strong minded, not for the poor souls in rubbish care homes or with relations who aren’t supportive. It’s for the likes of Esther Rantzen, who has as much moral and financial support as it’s possible to have, and seems anxious to extend her personal autonomy that bit further. In fact, this is exactly why I feared the advent of a Labour government – not the tax element of their programme, but its MPs’ tendency to adopt any cause generally perceived as being progressive.
Assisted dying is fine for the strong, for the Nicholas Mostyns, for the articulate, those who won’t be browbeaten by their family, those who have choice in every other aspect of their lives. But what about those who don’t have these things?
Instead of focusing on helping people die, we should be extending the best possible palliative care – an area in which Britain is an actual world leader – evenly across the country, not in a bizarre patchwork of provision. We should, in short, be ensuring that people have choices – in how they’re enabled to live, in their end of life care – not in whether to die.
Watch Lord Moore and Lord Falconer debate assisted dying on SpectatorTV:
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