This is undoubtedly the most difficult article I have ever written – and I’ve written a lot. To die or not to die, that is the question. And I genuinely do not know the answer.
This was unquestionably the toughest and most significant decision of all 650 MPs’ political careers. The result was tight, but the Assisted Dying Bill will be passed onto the next stage of parliamentary scrutiny with 330 votes in favour and 275 against.
Assisted dying is so divisive because there are arguments on both sides. It is utterly heartbreaking to hear stories of people in such terminal pain that they cannot wait for their lives to end. Kim Leadbeater, the MP who brought this bill to Parliament, opened the debate with a story of a man with bile duct cancer, leaving him throwing up faeces for five hours before choking and dying. That is an unthinkably abhorrent way to die.
On the other hand, once the genie is out the bottle, you cannot put it back. Consequently, many fear that legalising assisted dying for the terminally ill will trigger a slippery slope to legalising assisted dying for the disabled or mentally ill. Understandably, these concerns are exacerbated by the fact people in these situations may not be able to communicate their feelings – leaving their fate in the hands of their family or a doctor.
How on earth would you sleep at night knowing you decided to kill a relative or patient, even if out of concern for their wellbeing?
What if you were terminally ill – would you choose to end it quickly and painlessly? Or would you fight on in the hope you have enough time left to see all your friends and family one last time, or tick some final to-dos off your bucket list?
The point is, assisted dying seems the most unnatural thing in the world. But it’s not the act of ending a life that is the problem here. It’s wrestling with the irreversible choice. Do you, or don’t you? Which way will Caeser’s hand turn? If you choose to end it, there’s no going back…
This polarised bill has highlighted just how difficult it is to decide whether someone should be allowed to choose when to die. Having this choice is almost more painful than not having the choice at all. At least, in the current way of doing things, there is one path to follow – and once your time is up, it’s up. But imagine if, lingering in the back of your mind like an unwelcome guest, was the thought you could end it all tomorrow if things get bad enough. Assisted dying adds more burdens than it removes.
Having said all that, my mind naturally casts back to the terminally ill, who know the pain that lies ahead and want to die peacefully before their condition goes downhill. How is it fair to let another human being go through that pain when they are asking to die, and when we have the technology to help them do it safely and peacefully?
Assisted dying could reduce suicide attempts, which can be dangerous and violent ways to die. There were over 5,656 suicides in the UK in 2023 – an increase on the previous year.
Suicide is the leading cause of death among 10-19-year-olds in the UK.
Suicide is the leading cause of death among under 35s in the UK.
Suicide is the leading cause of death for men under 50 in the UK.
Suicide is a big killer – and the terminally ill are more than twice as likely to take their own life. Although suicide is a problem in itself, assisted dying could reduce the number of terminally ill people committing suicide, making a chosen death more controlled and peaceful.
Having said that, the snag for me remains this. How can you consciously make the choice to kill someone unless you are sure that is what they want? And in the case of mentally ill people, how can they even be sure that is what they want? Perhaps you’d argue mentally ill people are not terminally ill – but then where do you draw the line? How can you tell someone they have the right to end their life if they have terminal cancer, whilst denying that right to someone with clinical or treatment-resistant depression (TRD)?
The problems here are coercion and access. The terminally ill may feel a pressure to end their lives to relieve the burden from their families. Equally, not all terminally ill people will be able to communicate their decision themselves – leaving it up to doctors and relatives, which is a distressing decision to be held responsible for. And in terms of access, I again question how assisted dying for the terminally ill will not open the door to assisted dying for all – because who sets the boundaries? Who decides which patients are eligible and which are not?
Perhaps we have to ask ourselves if we are doing enough for people in end-of-life care. The UK’s social care system has been overwhelmed for some time. Is it time to properly invest in restructuring and reviving our social care system first, before deciding whether to kill it off completely? Maybe that’s a metaphor for this entire, difficult debate.
Surprisingly, I have reached the end of an article without expressing a firm verdict. Usually, by the end of the first line, perhaps even before that, you will know only too well where I stand on something. But not today. MPs were similarly not told how to vote by their parties. This was a very individual decision.
And so, I have laid out the key arguments – and I shall let you decide which camp you sit in. Or, rather, like so many of us, I suspect you may end up torn between both, sitting on the unsatisfactory fence in the middle whilst you decide between life or death.
Image: UK Parliament / Flickr
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