Article
Assisted dying
Care
Comment
Politics
5 min read

Suicide prevention groups are abdicating their responsibility on assisted dying

Not speaking out is a dereliction of duty to vulnerable people

Jamie Gillies is a commentator on politics and culture.

Three posters with suicide prevention messages.
Samaritans adverts.

On Friday, Kim Leadbeater’s assisted suicide bill will return to the Commons for a second day of report stage proceedings – when MPs consider amendments. Third reading, when the House votes on the bill itself, is expected to take place the following Friday. Opponents of this controversial bill will be hoping that enough MPs feel uneasy about it to say ‘this far and no further’. They will need around 30 MPs to have changed their minds since a vote last year in order for a defeat of the legislation to be assured. 

As politicians have weighed this issue, there’s been a conspicuous silence from one constituency you’d expect to have been outspoken: suicide prevention organisations. People might be surprised to know that Samaritans, perhaps the best-known suicide prevention charity in the UK, a cornerstone of prevention efforts since the 1950s, did not submit evidence on the bill before Westminster or a separate bill at Holyrood. Other groups like Suicide Prevention UK (SPUK) and Papyrus have also been silent. One has to wonder why, given the bearing a law change would have on their work. 

Suicide prevention charities and their volunteer counsellors do incredible work. Over the years, millions of people in desperate circumstances have received life-changing support. Today, every person contacting a suicide prevention helpline is told that their life has value, and that there is hope in the bleakest of circumstances. Every caller without exception is also told not to harm themselves. But this couldn’t continue under an assisted dying law. A two-track approach would have to be devised, depending on a caller’s circumstances. A scenario helps to illustrate this point: 

Caller: “I am thinking about ending my life”. 

Adviser: “Please know that there is hope. I’m here to listen and I can offer support, so you don’t have to make that choice.” 

Caller: “Well, I have terminal cancer you see…” 

Adviser: “Oh, sorry, I need to put you through to a colleague. Your situation is a bit more, err, complex. You need to know your legal rights”. 

Some proponents of assisted dying are quick to dismiss concerns about suicide prevention, arguing that assisted dying and suicide are wholly separate categories. However, this argument doesn’t hold water. Whilst campaigners use euphemistic terminology and employ Orwellian rhetoric about ‘exercising choice at the end of life’, and people ‘shortening their deaths’, it is clear that the bills they promote would permit suicide with the enablement of the state. 

An assisted dying law would see doctors prescribing lethal drugs to certain patients which they can take to end their own lives. The dictionary definition of suicide — “the act of killing yourself intentionally” — has not changed. Neither has legislation giving expression to this idea. Logically and legally then, assisted dying involves suicide. 

Samaritans is clear on this. A ‘policy brief’ on assisted dying published in November — the most recent statement on the issue by the organisation — begins by saying that it usually applies to terminally ill people and involves “assisting the person who is terminally ill to hasten their own death”, adding: “The act that kills them is performed by the person themselves”. Their death is a suicide, in other words. 

You might assume an organisation that says, “every suicide is one too many”, whose stated aim is to see “fewer people die by suicide”, would be opposed to assisted dying - or at the very least concerned about it. However, Samaritans goes on to say that it does not “take a position on whether assisted dying is right or wrong, or on what the law should be on this matter”. Why? Because it “would involve making a range of judgements” that could compromise people’s “perception of our ability to provide non-judgemental emotional support”. 

Samaritans and other suicide prevention organisations should be intensely interested in what the law says. The introduction of assisted dying in any part of the UK would mean suicides being condoned and enabled in healthcare settings for the first time — a radical departure from the existing approach. Professionals always counsel against suicide, no matter a person’s motivation for wanting to end their life. Every citizen is precious, and every life worth saving. 

Prevention organisations must also realise that a change of this gravity will have a wider impact on culture. Research shows a rise in non-assisted suicides in countries that have introduced the practice. Sending a message that some suicides are permissible might make their prevention work harder. Organisations saying nothing in the face of all this is astonishing. 

As noted above, assisted dying poses practical questions as well as philosophical ones. If the law changes, organisations will no longer be able to adopt a universal approach to suicide prevention. A call to a suicide prevention helpline from a terminally ill person will have to be handled differently to a call from a person who is not terminally ill. For some, suicide would be a healthcare ‘right’. How will organisations navigate this? Doesn’t it concern them? 

There has been some advocacy from individuals engaged in suicide prevention, if not from organisations. In February 2024 psychiatrists wrote to The Times to warn that the Westminster assisted dying Bill would “undermine daily efforts to prevent suicide”, particularly among the elderly. Louis Appleby, the UK Government’s suicide prevention adviser has also spoken against a change in the law, arguing that it would harm efforts to drive down suicides. 

Appleby explained, “once the principle behind suicide prevention has been set aside, once any part of the ground has been ceded — not only to allow suicide but to assist it — we have lost something we may not get back. There are countless causes of irremediable hardship, many reasons people may want to make despairing choices. Could they become exceptions to suicide prevention too?” This principled position is exactly what you’d expect from someone whose job is protecting hurting people, no matter their personal situations. 

I’m loath to criticise suicide prevention groups as I deeply appreciate their work. However, by not contributing to the debate on assisted dying, they are abdicating their responsibility to shape a policy that would impact their mission, and the people they serve. A policy that would lead to state-sanctioned suicides and impact culture in profound ways. It’s terribly sad to see groups that fight to end suicides failing to stand against a policy that would harm their work. Failure to speak today may be viewed as a dereliction of duty in years to come. 

With a final vote on Kim Leadbeater’s Bill days away, and the decisive vote on Scottish plans not due for months, there is still time for suicide prevention groups to enter the fray. I pray that they will.

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Article
Assisted dying
Comment
Freedom of Belief
Politics
5 min read

Holding an opposing view is not 'imposing' belief on the assisted dying debate

Opposing interventions from believers on dishonesty grounds is a sinister development in public debate

Nick is an author and Senior Fellow at Theos,a think tank.

A graphic shows a gallery of people with religious symbols on their clothing.

“There are some who oppose this crucial reform,” Esther Rantzen wrote recently of MPs who dared to opposed Kim Leadbeater’s Terminally Ill Adults (End of Life private member’s bill. “Many of them have undeclared personal religious beliefs…  [do] they have the right to impose them on patients like me, who do not share them?” 

This is a peculiarly common argument for those who support the right to Assisted Dying, which is surprising as it would be hard to come up with a less coherent case against religion in public life. The idea that elected MPs engaged in parliamentary debate are “imposing” their will on other people is odd. The idea that MPs have undeclared personal religious beliefs is strange too. I think it’s fair to say that most people know that Shabana Mahmood is a Muslim or Tim Farron is a Christian, and for those that don’t know that but do have access to Google, it takes less than five seconds to find out the religious beliefs of an MP. 

Perhaps most tellingly, however, why is it that we should be alert to – read wary of – MPs religious beliefs? Do the non-religious not have beliefs of which we should be cognizant? If my MP is motivated by a philosophy of relentless, Peter Singer-like utilitarianism or vague, incoherent secular humanism I’d like to know. 

In truth, Rantzen’s intervention in this debate, like that of a number of others – Lord Falconer, Simon Jenkins, Humanists UK, etc. – is part of a recent and rather dispiriting attempt to de facto exclude religious contribution to public debates by accusing them of being dishonest. 

To be clear, secular voices have long tried to exclude religious ones, but the tactics change. Back in the New Atheist heyday of the early twenty first century, all you needed to do was splutter something about sky fairies or Bronze Age beliefs or mind viruses to close down any sort of religious intervention. If, as Richard Dawkins famously put it, faith was one of the world’s great evils, comparable to the smallpox virus only harder to eradicate, no sensible parliament could possibly want to heed what faith had to say. 

Even back then, however, there were subtler arguments against faith, which usually came in the form of semi-digested Rawslian political liberalism, and demanded the religious participation in public debate had to obey the strictures of “public reasoning”, using logic and language that “all reasonable people” will understand. 

There are quite a few holes in this particular away of thinking (who are “reasonable people” anyway?) but as a rule of thumb, it’s not a bad one to follow. It is quite right and proper, if only as a matter of pragmatism, to speak in terms that your opponents will get, just as it is right and proper, as a matter of courtesy, to be open about what ultimately motivates you. 

And so that is what religious figures – MPs, leaders, institutions – do. Having read through pretty much all their contributions to the assisted dying debate, in parliament and beyond, I can testify that not many people, on either side of the debate, quote scripture or invoke papal teaching as a way of persuading, let alone commanding, others. (As it happens, parliamentarians haven’t really done that since the 1650s, but that’s another story).  

Rather, they argue in terms of policy and principles. They talk about the risk of legislative slippage, of changing attitudes to the vulnerable, of the need for better palliative care, of existing pressures on the NHS, etc. This is quite right and proper. As James Cleverly remarked in the Common debate in November, “We are speaking about the specifics of this Bill: this is not a general debate or a theoretical discussion, but about the specifics of the Bill”. And so that is what they did. 

Does anyone seriously think it is a good idea to compel a believing Jew to stand up in parliament and declare her faith before she were allowed to speak? 

In effect, religious public figures, whether or not their beliefs are “declared”, do what they have (rightly) been asked to do by those who have appointed themselves as gatekeepers for our public debate. And so this has forced the usual suspects to pivot in their argument. No longer able to dismiss religious contributions for what they say (“don’t quote the Bible at me!”) they are now compelled to dismiss them for what they don’t say. Hence, the trope that has become popular among such campaigners – “you are not being honest about your real motivations”. 

A new report from the think tank Theos, entitled, How much have your religious views influenced your decision?”: religion and the assisted dying debate, unpacks the various objections that have been levelled at the religious contribution to the debate, and then systematically dismantles them.

Some of these objections are old school in the extreme.  

Religious belief is too intellectually inadequate or disfiguring for debates of this nature. 

Religion is insufficiently willing to adapt and compromise for politics.  

Faith is ill-fitted or even inadmissible in a secular polity or culture.  

But the report majors on the newer objection, so clearly displayed by Esther Rantzen, what we might call “dishonesty” objection, that religious contributors are fundamentally dishonest about their motivations and objectives. 

In truth, this is no stronger than the more tried and tested objections, and it displays a serious, possibly intentional, misunderstanding of what a religious argument actually is. To quote the political philosopher Jeremy Waldron, such secular campaigners “present it as a crude prescription from God, backed up with threat of hellfire, derived from general or particular revelation, and they contrast it with the elegant simplicity of a philosophical argument by Rawls (say) or Dworkin [and] with this image in mind, they think it obvious that religious argument should be excluded from public life.” 

Contemporary arguments against religion in public life are slightly more sophisticated than Waldron’s caricature here, but not much. The idea that religio should be “declared” as a competing interest, so as to stop religious participants in debate from being “dishonest” is every bit as sinister, against both the letter and the spirit of plural, liberal democracy. Does anyone seriously think it is a good idea to compel a believing Jew to stand up in parliament and declare her faith before she were allowed to speak?  

As the assisted dying debate returns to parliament for the final push, there will be much animated debate. That is quite right and proper. A democracy needs vigorous and honest argument. But part of that honesty involves opening the doors of debate to everyone, and not subtly trying to exclude those with whom you disagree on the spurious grounds that they are being dishonest.

Support Seen & Unseen

Since Spring 2023, our readers have enjoyed over 1,000 articles. All for free. 
This is made possible through the generosity of our amazing community of supporters.

If you enjoy Seen & Unseen, would you consider making a gift towards our work?
 
Do so by joining Behind The Seen. Alongside other benefits, you’ll receive an extra fortnightly email from me sharing my reading and reflections on the ideas that are shaping our times.

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Editor-in-Chief