The Health, Sport and Social Care Committee of the Scottish Parliament has called for evidence on Liam McArthur MSP’s ‘Assisted Dying for Terminally Ill Adults (Scotland) Bill’. In the meantime, in the House of Lords, Lord Falconer has drawn second place in the Ballot for an Assisted dying for terminally ill adults bill.
These are but the latest attempt to change the law in the United Kingdom on this issue. The first attempt was in the House of Lords in 1936. In that debate Lord Ponsonby quoted from Thomas More. On the island of Utopia, someone with an incurable disease could ‘dispatch himself out of that painful life… or else suffer himself to be rid out of it by another.’ Lord Ponsonby invited peers to imagine what a dying patient feels ‘when he sees his friends around him and knows that he is only a burden to them’ (emphasis added).
Lord Ponsonby failed to recognise that, More was not describing an ideal society but was engaging in satire. This is easier to see if we ask who seeks the sick person’s death and why. More did not say that the sick person asks for death but that the priests and magistrates ‘exhort’ the sick person to die. The first reason they provide is not that the sickness is ‘grievous’ to the person but that he ‘is not able to do any duty of life, and by over-living his own death is noisome and irksome to others’ (emphasis added).
The idea of that an authority figure might proactively ‘exhort’ someone to end their life or ‘be rid of it by another’, only because they are ‘irksome’ might seem like a dystopian fantasy but it is effectively the current reality in Canada. Frequently sick or disabled people have been offered ‘medical aid in dying’ proactively, without having asked, and sometimes repeatedly. These include people who ‘simply cannot afford to keep on living’ or were feeling suicidal or had attempted suicide. In one case, a veteran and celebrated Paralympian who had been trying to get a wheelchair ramp for her house was offered assisted dying instead!
More holds up a mirror to us and asks what kind of society we want. Is it one in which people who are terminally or chronically sick or disabled are encouraged to think that they are ‘only a burden’ and to seek assisted death? Or is it a society where people receive the assistance they need to live and are encouraged to value their lives?
If anyone should doubt that this is the choice that faces us today then they should watch Lizz Carr’s extraordinary documentary ‘Better Off Dead’. In it, a succession of disabled people recount having been told by others that, ‘if my life was like yours then I’d want to kill myself’, or even that they are a ‘drain on society’.
Such thoughts are sometimes expressed by respected figures. Baroness Mary Warnock once said that people who experience dementia were ‘wasting the resources of the National Health Service’ and that assisted death should be offered if someone ‘wants to die because they are a burden to their family or the state’ (emphasis added). Similarly, Matthew Parris has argued, in the context of the current Scottish Bill, that ‘we simply cannot afford extreme senescence or desperate infirmity for as many such individuals as our society is producing.’
When the law changes the culture changes and such thoughts only become more prevalent. Legalising assisted suicide would place an extra burden on sick and disabled people by forcing them to ask if they are a burden to others. In Oregon, the number seeking death in part because they feel a burden to others has increased significantly over time (up to 54.2% in 2021). In Canada in 2022, 4,625 people (35.3%) had their lives ended because they felt they were a burden to others.
Do not think that the pressures felt in Canada would not occur in Scotland or in England and Wales because the law is only for people with terminal illness. In 2016, of seven countries with assisted suicide or euthanasia, three limited eligibility to terminal illness (Canada, Colombia, and the United States). In 2021, two out of three expanded their laws to cover people who did not have a terminal illness (Canada and Colombia). The Scottish and English Bills begins with terminal illness, but there is every reason to believe that it would later expand further as has happened in other countries. Do we really want to follow Canada?
The Anscombe Bioethics Centre is encouraging responses to the Health, Sport and Social Care Committee from anyone with concerns about the Bill.
Do we want assisted death for people who feel they are ‘only a burden’ ?
Professor David Albert Jones
David Albert Jones is Director of the Anscombe Bioethics Centre, in Oxford, Research Fellow at Blackfriars Hall, Oxford, and Professor of Bioethics at St Mary’s University, Twickenham.