Parliament’s vote on how life ends is momentous: if the moral line is crossed there’s no going back

As the UK Parliament approaches the momentous vote on assisted suicide tomorrow, it is worth taking stock of the arguments. Because the arguments in favour of the Terminally Ill Adults (End of Life) Bill fall down on the grounds of principle, practice and the inadequacies of the Bill – and you do not have to be Catholic to accept the arguments against the legislation under consideration on 29 November.

Catholics – and others – believe in “compassion” at the end of life, a word which the proponents of assisted suicide have tried to adopt in this debate. Compassion means to “suffer with” another person. It means accompanying people, especially during sickness, disability and old age, when we know that people are frail and vulnerable.

We believe it is wrong for somebody to help somebody else to deliberately kill themselves, and many non-Christians (and, indeed, non-believers) share that view and are opposing this legislation as a result. Assisted suicide is not compassion as Catholic social teaching understands it.

The best form of care we can give people who are in extreme discomfort is palliative care and pain relief together with good human, spiritual and pastoral support. The Church has called for more adequate funding for palliative care and praised the wonderful work of the hospice movement. The evidence suggests that assisted suicide undermines the provision of palliative care.

Related to this, it is important to note that the proponents of assisted suicide use, repeatedly, the phrase “assisted dying”. Many in the media, including the BBC, have adopted this too. Assisted dying is not the right phrase to use – assisted dying means helping somebody in the last stage of life. It does not mean helping them to commit suicide.

The proponents also argue that the majority of the population are in favour of assisted dying. This is at least partly because people who are asked questions about “assisted dying” in surveys often believe that “assisted dying” simply means pain relief and palliative care. We should be clear that this is a bill about “assisted suicide” – that is allowing doctors to help patients kill themselves.

To mix metaphors, there is no doubt that this Bill is a trojan horse and will lead to a slippery slope – as any bill in this area would. The proponents argue that it will benefit a small number of suffering people who will be able to rationally take a decision about assisted suicide and nobody else need worry.

However, all priests and a huge number of lay people who, in different ways, come into contact with the elderly, sick and disabled know that they are vulnerable and can easily be pressurised to do things which are against their better nature. This may result from hints from relatives or conversations initiated by doctors. The legalisation of assisted suicide would create huge pressure on society’s most vulnerable people.  

Indeed, this legislation has the potential to fundamentally change the relationship between doctor and patient, as well as putting care homes and hospices that may not wish to participate in the offering of assisted suicide in an impossible position (especially those with a religious foundation which many hospices have). If this Bill passes, your doctor will be allowed to initiate a conversation about assisting you in committing suicide if you meet the criteria. To put it mildly, this is a new role for doctors. A doctor should not be allowed to initiate a conversation that leads to him or her offering to help you kill yourself.

The legalisation of assisted suicide assumes away the complexity of this vast range of complex social relationships in favour of personal autonomy for a small number of people.

It is generally said by the proponents of assisted suicide that the law can be defined so narrowly that only those who are suffering greatly from a terminal illness will be able to avail themselves of it. We know that this is not true. As a result of a mix of court judgements on grounds of equality (in legal systems very similar to ours), changes in culture in the medical profession, and the impossibility of drawing precise lines in very grey areas, the criteria for assisted suicide have widened dramatically in countries that have adopted it.  

The criteria have been widened to include (variously) those with non-terminal conditions, those with mental illness, children, those with anorexia and those with dementia. In Oregon, which is regarded as a model by those proposing the current bill, only one-quarter of those choosing assisted suicide cited inadequate pain control whilst over half cited feeling a burden on family and caregivers, and over 90 per cent feared loss of autonomy.

Indeed, it is clear already that the lines, and perhaps the culture, are beginning to shift before the Bill has even been voted on.

A group of MPs has demanded that assisted suicide is made available to people without terminal conditions. In addition, leading campaigners regularly use the phrase “assisted dying does not shorten life, it shortens death”. This is, indeed, extraordinary.

The use of this phrase has the potential to change fundamentally how we think about people in the later stages of life who are very much alive and have a right to the care they need to live in dignity. Some campaigners have used examples of people with dementia to justify support for assisted suicide. The idea that we should allow people to have assistance to end their lives if they are mentally incapable is abhorrent. But expansion in this direction seems more likely than not.

But what about the particular bill before us? It has all the faults described above, but let me mention four specific aspects of this bill which are very problematic and could change the face of medicine and care as we know it.

The first is that the conscientious objection clause is very weak. Any doctor who refuses to participate in discussions about assisted suicide will be required to refer the patient to another doctor who will do so. No Catholic doctor could do that in good conscience. Even when it comes to abortion, the conscientious objection clauses are stronger than this. What this means is that any doctor, upon qualification, will be required by law to co-operate in the deliberate taking of the life of another human being: if not in person, by referral to another doctor. This totally changes the nature of the medical profession.

Secondly, there is going to be a big question mark over Catholic hospices and care homes. Will they be able to continue to provide in-house services if they are required to facilitate assisted suicide for those who request it? It is highly likely that any bill will require them to facilitate assisted suicide. This would be a further challenge for an already stretched palliative care sector, as well as creating major problems for the Catholic care sector which has genuine compassion at its heart.

Thirdly, it appears that a Catholic care home or hospice could not stop their employees from facilitating assisted suicide, whatever the view of the trustees.

Finally, this bill is a profound change for this country and yet only just over two weeks have been given for MPs to look at this bill before they have to vote.

We know that the longer people have to consider assisted suicide the more likely they are to turn against it.

This Bill is rushed and on that ground alone – while even more so in combination with the other points above – it should be opposed.

Photo: Screenshot from the statement by the Catholic Medical Association on assisted suicide at cbcew.org.uk.

Philip Booth is a Professor of Finance, Public Policy and Ethics, and the Director of Catholic Mission, at St. Mary’s University, Twickenham.

Those who wish to contact their MP to express concerns about the new Bill may do so through an online tool provided by Right to Life UK here. It takes less than a minute to do.

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