Article
Assisted dying
Care
Comment
Politics
6 min read

Assisted dying’s problems are unsolvable

There’s hollow rhetoric on keeping people safe from coercion.

Jamie Gillies is a commentator on politics and culture.

Members of a parliamentary committee sit at a curving table, in front of which a video screen shows other participants.
A parliamentary committee scrutinises the bill.
Parliament TV.

One in five people given six months to live by an NHS doctor are still alive three years later, data from the Department of Work and Pensions shows. This is good news for these individuals, and bad news for ‘assisted dying’ campaigners. Two ‘assisted dying’ Bills are being considered by UK Parliamentarians at present, one at Westminster and the other at the Scottish Parliament. And both rely on accurate prognosis as a ‘safeguard’ - they seek to cover people with terminal illnesses who are not expected to recover. 

An obvious problem with this approach is the fact, evidenced above, that doctors cannot be sure how a patient’s condition is going to develop. Doctors try their best to gauge how much time a person has left, but they often get prognosis wrong. People can go on to live months and even years longer than estimated. They can even make a complete recovery. This happened to a man I knew who was diagnosed with terminal cancer and told he had six months left but went on to live a further twelve years. Prognosis is far from an exact science. 

All of this raises the disturbing thought that if the UK ‘assisted dying’ Bills become law, people will inevitably end their lives due to well-meaning but incorrect advice from doctors. Patients who believe their condition is going to deteriorate rapidly — that they may soon face very difficult experiences — will choose suicide with the help of a doctor, when in fact they would have gone on to a very different season of life. Perhaps years of invaluable time with loved ones, new births and marriages in their families, and restored relationships. 

Accurate prognosis is far from the only problem inherent to ‘assisted dying’, however, as critics of this practice made clear at the – now concluded – oral evidence sessions held by committees scrutinising UK Bills. Proponents of Kim Leadbeater’s Terminally Ill Adults (End of Life) Bill and Liam McArthur’s Assisted Dying for Terminally Ill Adults (Scotland) Bill have claimed that their proposals will usher in ‘safe’ laws, but statements by experts show this rhetoric to be hollow. These Bills, like others before them, are beset by unsolvable problems. 

Coercion 

Take, for example, the issue of coercion. People who understand coercive control know that it is an insidious crime that’s hard to detect. Consequently, there are few prosecutions. Doctors are not trained to identify foul play and even if they were, these busy professionals with dozens if not hundreds of patients could hardly be counted on to spot every case. People would fall through the cracks. The CEO of Hourglass, a charity that works to prevent the abuse of older people, told MPs on the committee overseeing Kim Leadbeater’s Bill that "coercion is underplayed significantly" in cases, and stressed that it takes place behind closed doors. 

There is also nothing in either UK Bill that would rule out people acting on internal pressure to opt for assisted death. In evidence to the Scottish Parliament’s Health, Social Care and Sport Committee last month, Dr Gordon MacDonald, CEO of Care Not Killing, said: “You also have to consider the autonomy of other people who might feel pressured into assisted dying or feel burdensome. Having the option available would add to that burden and pressure.” 

What legal clause could possibly remove this threat? Some people would feel an obligation to ‘make way’ in order to avoid inheritance money being spent on personal care. Some would die due to the emotional strain they feel they are putting on their loved ones. Should our society really legislate for this situation? As campaigners have noted, it is likely that a ‘right to die’ will be seen as a ‘duty to die’ by some. Paving the way for this would surely be a moral failure. 

Inequality 

Even parliamentarians who support assisted suicide in principle ought to recognise that people will not approach the option of an ‘assisted death’ on an equal footing. This is another unsolvable problem. A middle-class citizen who has a strong family support network and enough savings to pay for care may view assisted death as needless, or a ‘last resort’. A person grappling with poverty, social isolation, and insufficient healthcare or disability support would approach it very differently. This person’s ‘choice’ would be by a dearth of support. 

As Disability Studies Scholar Dr Miro Griffiths told the Scottish Parliament committee last month, “many communities facing injustice will be presented with this as a choice, but it will seem like a path they have to go down due to the inequalities they face”. Assisted suicide will compound existing disparities in the worst way: people will remove themselves from society after losing hope that society will remove the inequalities they face. 

Politicians should also assess the claim that assisted deaths are “compassionate”. The rhetoric of campaigners vying for a change in the law have led many to believe that it is a “good death” — a “gentle goodnight”, compared to the agony of a prolonged natural death from terminal illness. However, senior palliative medics underline the fact that assisted deaths are accompanied by distressing complications. They can also take wildly different amounts of time: one hour; several hours; even days. Many people would not consider a prolonged death by drug overdose as anguished family members watch on to be compassionate. 

Suicide prevention 

 It is very important to consider the moral danger involved with changing our societal approach to suicide. Assisted suicide violates the fundamental principle behind suicide prevention — that every life is inherently valuable, equal in value, and deserving of protection. It creates a two-tier society where some lives are seen as not worth living, and the value of human life is seen as merely extrinsic and conditional. This approach offers a much lower view of human dignity than the one we have ascribed to historically, which has benefited our society so much.  

Professor Allan House, a psychiatrist who appeared before the Westminster Committee that’s considering Kim Leadbeater’s Bill, described the danger of taking this step well: “We’d have to change our national suicide prevention strategy, because at the moment it includes identifying suicidal thoughts in people with severe physical illness as something that merits intervention – and that intervention is not an intervention to help people proceed to suicide.” 

 Professor House expressed concern that this would “change both the medical and societal approach to suicide prevention in general”, adding: “There is no evidence that introducing this sort of legislation reduces what we might call ‘unassisted suicide’.” He also noted that in the last ten years in the State of Oregon – a jurisdiction often held up as a model by ‘assisted dying’ campaigners – “the number of people going through the assisted dying programme has gone up five hundred percent, and the number of suicides have gone up twenty per cent”. 

The evidence of various experts demonstrates that problems associated with assisted suicide are unsolvable. And this practice does not provide a true recognition of human dignity. Instead of changing the law, UK politicians must double down on existing, life-affirming responses to the suffering that accompanies serious illness. The progress we have made in areas like palliative medicine, and the talent and technology available to us in 2025, makes another path forwards available to leaders if they choose to take it. I pray they will. 

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Article
Comment
Mental Health
Politics
4 min read

Rachel Reeves’ tears: public life still mocks those who show anything but the positive

‘Mental health awareness’ is failing, our words are not matched by our actions

Rachael is an author and theology of mental health specialist. 

 

 

A woman sits and holds back a tear.
Rachel Reeves on the front bench.
Parliament TV.

It’s a bad day at work. Everyone is on high alert, and tempers are frayed. You have your own reasons for being extra ‘on edge’, but now isn’t the time to get into it because it’s the big weekly meeting and everyone is going to be there - worse still, the cameras are going to be there. Despite this, you take a deep breath and take your seat (which, although an honour, is regrettably in the front row).  

But as the fractious meeting begins, you feel the ache of impending tears at the back of your throat, and to your horror, your eyes fill. You do your best to wick them away, but you know they’ve been spotted when someone opposite announces how miserable you look. 

Many of us will have been in a similar, if probably less public, situation at some point in our careers when the emotions we stuff down in the name of professionalism spill out - but I doubt any of us will have done so in the House of Commons with cameras trained on every movement and a less than friendly crowd opposite.  

There have been countless articles already speculating about the reason for the tears of the Chancellor, Rachel Reeves, during Prime Minister’s Questions - but most seem devoid of sympathy or empathy, concerned only with the political implications, but not the person at the centre of this story.  

Our reaction to Rachel’s tears is an echo of the sentiment behind the Welfare Reform Bill, which seems to say that need is unacceptable and we should all be able to don that famously British ‘stiff upper lip’ and just get on with life.  

Regardless of what you think of the Welfare Reform Bill, the way it has been briefed and communicated has raised anxiety and fear amongst the disabled community (me included).  

The main message has been that too many people are receiving Personal Independence Payments (PIP) for mental illnesses such as anxiety and depression, with even the former Prime Minister Tony Blair telling people to ‘stop diagnosing themselves’ to combat out rising welfare bill - despite the fact that accessing PIP requires rigorous assessments and support from medical professionals. (It also has a 0.01% fraud rate and was designed to compensate people for the extra cost of being disabled which is estimated to be up to £1000 a month.) 

This tableau is emblematic of how ‘mental health awareness’ is failing in this country; our words are not matched by our actions. 

We know, 27 years after the first ‘Mental Health Awareness Week’, that mental health is important, that emotions are natural and valid - and yet we mock any leader who shows anything but positive emotions.  

We know that people suffer, are disabled by and killed by mental illnesses, and yet we seek to strip support from those who need it most, claiming that they are diagnosing themselves. 

We need a different approach, both to how we handle emotions in public life and the way we talk about those who need extra support due to their mental illnesses.  

Emotions aren’t bad - they help us connect, keep us away from danger and allow our bodies to release unbearable tension, as in the case of crying, whereby tears of pain are intricately designed to help us cope. The tears we shed when faced with chopping a pile of onions are chemically different to those that fall when we are grieving, angry or in pain. Tears of pain should inspire us to reach out to the one in pain with compassion not contempt.  

The way Jesus led 2,000 years ago shows us another way, both of leading and emoting.  

Jesus consistently welcomed those most in need; from healing the woman who had bled for twelve years, considered unclean and rejected by her community, to healing a paralysed man lowered through his roof by friends.  

And yet his ministry was not just one characterised by miracles and might, but demonstrated humility and humanity as he wept over the death of his friend Lazarus and allowed himself to be stripped of all strength as he hung on a cross made for criminals.  

The night before he died, he gathered his friends and through tears and blood-soaked sweat submitted to the Father in the most painful way, and I, like many others, draw comfort and strength from Jesus’ willingness to cry.  

As preacher Charles Haddon Spurgeon said, "A Jesus who never wept could never wipe away my tears."  

So perhaps rather than mock Rachel’s tears, they should cause us to rethink how we approach need and recognise none of us are immune.  

Perhaps, we may even join with Paul’s words in his letter to the Corinthians: “For when I am weak, then I am strong.” 

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