In England and Wales, a bill to legalize assisted suicide faces Catholic opposition

Kevin ClarkeNovember 27, 2024

Anti-euthanasia protesters demonstrate outside the Royal Courts of Justice in London in July 2017. (CNS photo/Neil Hall, Reuters)

Resistance to legislation that would add England and Wales to the short list of nations that have approved medical assistance in dying appears on the rise as an important debate on the measure in Parliament approaches. On Nov. 29, the “Terminally Ill Adults (End of Life) Bill” is scheduled for a vote in the House of Commons. If it passes this “second reading,” the legislation would continue to committee review and an amendment process on its way to becoming law. A similar proposal is moving through the legislative process in Scotland.

The bill proposes to give adults in England and Wales the right to end their lives, and to seek assistance in doing so, if they are expected to die in six months and face grave suffering. The last time an assisted dying measure was brought before the House of Commons, in 2015, it was overwhelmingly voted down.

The bill’s long title states that end-of-life permission would be granted “subject to safeguards and protections.” But many in England and Wales are wondering how strong those safeguards and protections will prove to be during a period of increasing scarcity and spending scrutiny for the United Kingdom’s National Health Service.

In a pastoral letter published in October, Cardinal Vincent Nichols, archbishop of Westminster, urged U.K. Catholics to oppose the assisted-dying legislation. “The evidence from every single country in which such a law has been passed is clear,” he wrote. “The circumstances in which the taking of a life is permitted are widened and widened, making assisted suicide and medical killing, or euthanasia, more and more available and accepted.”

“This proposed change in the law may be a source of relief to some,” the cardinal wrote. “But it will bring great fear and trepidation to many, especially those who have vulnerabilities and those living with disabilities. What is now proposed will not be the end of the story. It is a story better not begun.”

The measure faces solid resistance from Conservative M.P.s, but even some Labour Party members have expressed misgivings about the plan’s implications. The measure was introduced by Labour M.P. Kim Leadbeater, but Prime Minister and Labour Party leader Keir Starmer has declined to take a position on the vote, choosing to “remain neutral on the passage of the Bill and on the matter of assisted dying.” That means Labour M.P.s, including government ministers, will have a free vote on the proposal.

Pollster YouGov-U.K. reports that the proposed law has the support of 73 percent of Britons. But its critics say the proposal is not as popular as supporters claim. Another survey, this one commissioned by anti-euthanasia advocacy Care Not Killing, suggests that support for assisted dying falls off sharply when Britons are offered alternatives and are informed of how far—and how quickly—other countries have ethically traveled after legalizing life-ending interventions.

Gordon Macdonald, the chief executive of Care Not Killing, said in a press statement: “When presented with the facts the Great British public want parliamentarians to fix the NHS, properly funding palliative and social care, not introduce a dangerous and ideological policy that would pressure the vulnerable, the elderly and disabled people into ending their lives prematurely. The message could not be clearer, we need care, not killing.”

Canada’s increasingly infamous “medical assistance in dying” regime was passed in 2016 with the stipulation, like the U.K. proposal, that it would be limited to people with terminal diagnoses who were in deep physical suffering. But MAiD in Canada has rapidly expanded to include people with nonterminal, chronic illnesses, including long-term mental health issues (though this provision has been postponed until 2027) and, most notoriously, people who have struggled to receive government support in living and individuals whose “terminal” illness were declared to be hearing loss and autism spectrum disorder. In October, the province of Quebec began accepting “advance requests” for assistance in dying that will allow people with forms of dementia to end their lives after their condition renders them incapable of giving consent.

The use of MAiD now accounts for 4.1 percent of all deaths in Canada. That figure lags behind the Netherlands, where MAiD accounts for 5.1 percent of deaths. But within Canada, both British Columbia and Quebec, with rates of 5.5 and 6.6 percent, respectively, exceed that of the Netherlands.

According to Care Not Killing, 56 percent of the people they surveyed agreed that the current diminished state of the National Health Service “was likely to push some people into assisted dying if it were made legal.” And 57 percent agreed that “given the lower cost of assisted dying compared with palliative care, there would likely be pressure on the NHS to offer assisted dying were it to become legal.” Two-thirds of their survey respondents said that the governing Labour Party should prioritize “sorting out palliative, social and end of life care before even thinking about assisted dying.” Seven in 10 urged the creation of a royal commission to examine the current state and potential of palliative and end-of-life care in the United Kingdom.

According to Mr. Macdonald: “When members of the public hear that some countries have extended laws on assisted dying to include children under 12; that some people have felt pressure to opt for assisted suicide or euthanasia because they feel they are a burden on loved ones and how in the UK a clear majority of palliative care doctors oppose changing the law, support drastically deteriorates.”

Cardinal Nichols was among the faith leaders in England and Wales who jointly issued a letter opposing the bill on Nov. 24, expressing deep concern “about the impact the bill would have on the most vulnerable, opening up the possibility of life-threatening abuse and coercion…. In the UK, it is estimated that 2.7 million older people have been subjected to abuse; many of these may also be vulnerable to pressure to end their lives prematurely.” The faith leaders added: “Disability campaigners and those working with women in abusive relationships have also highlighted the danger of unintended consequences should the law be changed. The experience of jurisdictions which have introduced similar legislation, such as Oregon and Canada, demonstrate how tragic these unintended consequences can be. Promised safeguards have not always protected the vulnerable and marginalised.”

The faith leaders regretted that even in loving families, “people towards the end of their life can still feel like a burden.”

“This is especially the case while adult social care remains underfunded. In this environment, it is easy to see how a ‘right to die’ could all too easily end in feeling you have a duty to die.”

“We believe that a truly compassionate response to the end of life lies in the provision of high-quality palliative care services to all who need them,” they concluded, noting that palliative care “remains worryingly underfunded.”

Medical aid in dying is legal under varying circumstances and limitations in Austria, Belgium, Canada, Germany, Luxembourg, the Netherlands, New Zealand, Portugal, Spain, Switzerland and Australia. Assistance in dying is currently not protected under federal law, though it is legal in 11 U.S. jurisdictions: California, Colorado, the District of Columbia, Hawaii, Maine, Montana, New Jersey, New Mexico, Oregon, Vermont and Washington. According to a Gallup survey published in August, 71 percent of Americans support euthanasia, (Gallup used the expression “end a patient's life by painless means”), and 66 percent believe that doctor-assisted suicide should be legal.

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