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The Case for Assisted Dying

By Robert McKeever, Lead Organiser of the Reading and East Berkshire branch of Dignity in Dying and Associate Fellow at the Institute of the Americas, University College London.

Robert argues that the terminally-ill have a right to an assisted death based on the principle of autonomy. Polls consistently indicate that there is overwhelming public support for assisted dying in the UK. However, its opponents, especially those driven by their religious beliefs, have so far blocked the legalisation of assisted dying in the UK. Robert argues that the arguments used against assisted dying are not supported by evidence.

‘They tell us that suicide is the greatest piece of cowardice... that suicide is wrong; when it is quite obvious that there is nothing in the world to which every man has a more unassailable title than to his own life and person.’ Arthur Schopenhauer, German philosopher (1788-1860)

If we accept Schopenhauer’s argument for autonomy over one’s own life and death in the quotation above, then we must also support the case for assisted dying for the terminally ill. When the doctor tells you that you have six months or less to live; that prior to death, you may become unable to feed or clean yourself; that you may be unable to speak or see; that, despite the best medication available, you may suffer terrible agony and lose all dignity; that the manner of your dying will cause your loved ones to experience unimaginable distress – would you not want to have a choice to exercise autonomy over your life and death? And would you want to deny that choice to another terminally-ill person?

Strictly speaking, the case for assisted dying does not even require acceptance of Schopenhauer’s premise. The terminally-ill would rather live than die, but they have no choice over that – the sentence of death has already been pronounced. They simply want the freedom to exercise some control over their physical and mental torment.

Such is the power of the argument for assisted dying that it elicits overwhelming public support. A poll conducted by Yonder in March 2019 in the UK found that 84 per cent of the public were supportive of assisted dying. A YouGov poll in February 2022 asked whether people wanted their MP to vote for or against the Assisted Dying Bill: 74 per cent said ‘for’, as opposed to just 10 per cent who said ‘against’, (16 per cent didn’t know). One of the remarkable features of these polls was the consistency of support across political and social divisions. The YouGov poll recorded support from conservative voters at 73 per cent, Labour voters at 79 per cent and Liberal Democrats at 81 per cent. Even more amazing was that Remain and Leave voters were in broad agreement, at 80 per cent and 73 per cent respectively. A Populous poll in 2015 found wide support among Christians (80 per cent), Hindus (91per cent) and Jews (83 per cent): Sikhs (50 per cent) and Muslims (38 per cent) were not so enthusiastic. It is also worth noting that 86 per cent of those with a disability supported assisted dying.

That British people are overwhelmingly in favour of assisted dying is hardly surprising, given developments over the past twenty-five years in societies similar to our own. In the United States, the State of Oregon led the way in 1997 with its Death with Dignity Act. Today, ten States and the District of Columbia allow the choice of assisted dying. Australia, New Zealand and Canada have followed suit, while Spain, Portugal, Switzerland, Belgium, the Netherlands and Luxembourg also allow it. Italy, Austria, France and Germany are moving in the same direction, while closer to home, Jersey and Scotland look set to change their laws in favour.

Brittany Maynard pictured below was just 29 years old when she availed herself of Oregon’s Death with Dignity Act. She was suffering from terminal glioblastoma and rounded on critics of assisted dying:

'For people to argue against this choice for sick people seems evil to me. They try to mix it up with suicide and that’s really unfair, because there’s not a single part of me that wants to die. But I am dying.' Britanny Maynard

Assisted dying is clearly an idea whose time has come. So why hasn’t the UK Parliament moved to reform our laws, especially as current law makes encouraging or assisting a suicide punishable by up to fourteen years in prison? In 2015, a Bill introduced into the Lords ran out of time, while a follow-up Bill introduced in the Commons was heavily defeated by 330 to 118 votes. In 2021, a new attempt was made when Baroness Molly Meacher introduced the Assisted Dying Bill. Like its predecessors, the Bill proposed allowing mentally competent, terminally-ill people to access life-ending medication, to be taken at a time and place of the individual’s choosing. There were safeguards in the Bill: two independent doctors would have to confirm that the individual would be likely to die within six months. And a High Court judge would have to be satisfied that the individual was not only mentally competent, but acting under their own volition, rather than being under pressure from others. The Bill’s supporters were optimistic that it would fare better than earlier attempts at reform. Not only had other countries introduced reforms, but bodies such as the British Medical Association and the Royal College of Physicians had dropped their opposition to assisted dying.

However, like most Private Member's Bills, the Meacher Bill ran out of time. In the British parliamentary system, unless the government of the day is willing to make time for a Private Member’s Bill, it is unlikely to be able to complete all the required stages. Boris Johnson's government was content to allow the Bill to die without a vote, since if MPs were allowed an unwhipped vote, the Bill might very well have passed.

So what are the arguments advanced against assisted dying, and why are their proponents so motivated to thwart majoritarian democracy over this issue? The first is that assisted dying would leave vulnerable people subject to pressures to end their lives sooner than they wished. For example, family members might wish to get their hands on the money of their dying relative and/or wish to be free of the burden of looking after them. The second is that the Meacher Bill could be the beginning of a slippery slope which ended up allowing widespread euthanasia of non-terminally ill people. Both arguments are weak in logic and evidence.

The safeguards in the Bill would require that the hypothetical 'grasping relative' couldn’t wait six months or less to get their hands on the family fortune and would rather risk being prosecuted and ending up with no money at all. This is unlikely, but if it did occur, the High Court judge scrutiny could be expected to expose such malign activities. Alternatively, if an individual genuinely wants to cease being a burden on their family, then our friend Schopenhauer would allow them that choice. As for the ‘slippery slope’, this is often the last argument of the desperate. Of course, any act on any subject might be followed by a further act that perhaps broadens the scope of the first. However, that would require further debate and a vote – that is the nature of parliamentary democracy. Opponents of assisted dying in the UK frequently cite the case of Canada, where an initial change of law to allow assisted dying was later expanded to those who were not necessarily terminally ill. However, they usually forget to mention that these changes in Canadian law were the result of judicial, rather than parliamentary action. The judiciary in the UK has made it clear that assisted dying is a question for the legislature, not the courts. Law Professor Emily Jackson examined ‘slippery slope’ arguments in connection with assisted dying and concluded: ‘Slippery slope arguments are in fact often a smokescreen, invoked by people who are fundamentally opposed to legalisation, in order to appeal to people who are not, but who do have concerns about the possibility of abuse’. (Euthanasia isn't a slippery slope | Emily Jackson » IAI TV).

British opponents of assisted dying also either ignore or selectively cite the documented experiences of jurisdictions that allow it. For example, the Oregon Health Authority (OHA) is required to report each year on the operation of the Death with Dignity Act (1997). It has never found a case where undue pressure has been brought upon someone seeking assistance under the Act. However, critics are quick to point out that the OHA’s 2020 Report found that 53 per cent of those seeking to avail themselves of assisted dying mentioned a concern with being a burden on the family. What they fail to mention is that this comes far behind other motivations: inability to engage in activities that make life worth living (94 per cent), losing autonomy (93 per cent) and loss of dignity (72 per cent). Finally, when giving evidence before the House of Commons Health and Social Care Committee in 2023, specialist academics explicitly stated that there was no evidence of slippery slopes or abuse of the laws in other jurisdictions around the world.

Could it be, therefore, that many opponents of assisted dying in the UK are disingenuous about their motives? Given that their stated objections are weak, not to say unfounded, could there be other reasons for their strong convictions? It is worth reflecting on the membership of the All-Party Parliamentary group on Dying Well, the vanguard of opposition in Westminster to assisted dying. Its Chair is Danny Kruger, Conservative MP for Devizes. He is an evangelical Christian, who opposes abortion as well as assisted dying. Another officer of the All-Party Group is Lord Alton, a former Liberal MP, who sits as a Crossbencher in the Lords. Lord Alton is a prominent Roman Catholic, and is a recipient of the Thomas More Award for Religious Freedom. Then there’s Jonathan Reynolds, Labour MP for Stalybridge and Hyde. Reynolds said that his Christian faith drove him to resign from Jeremy Corbyn’s shadow team in 2016. He is Chair of Christians on the Left. Dr Lisa Cameron is SNP MP for East Kilbride. She cites her Christian faith as the reason behind her anti-abortion views. It’s clear that these and most other members of the All-Party Group are inspired by a committed religious belief. While that’s a perfectly legitimate position to take, wouldn’t it be more intellectually honest to acknowledge that their opposition to assisted dying is driven by theological conviction? As the Evangelical Alliance put it before the Health & Social Care Committee: ‘As Christians we believe in the sanctity of life, all human beings are image bearers of God. This means that even in our most vulnerable state, we are still of value to God’ (Assisted Dying Inquiry: important things you need to know - Evangelical Alliance ( Fine, if that’s what you believe, but that is no authority to override the beliefs and choices of the great majority of British people.

'I am not afraid of dying. I just don't want to be there when it happens.' Woody Allen

Of course, as noted above, most Christians support assisted dying. Like secular supporters, they are not moved by greed or other self-interested motives. They are moved by compassion and their belief that everyone should have the choice to end their unbearable suffering and to die with dignity, conscious of their loved ones gathered around them. I’ve always loved the Woody Allen quotation: ‘I am not afraid of dying, I just don’t want to be there when it happens’. Sadly, that’s one choice we don’t have – we should, however, have the choice of assisted dying.

Useful Links

Reading Branch of Dignity with Dying -

Evangelical Alliance - Assisted Dying Inquiry: important things you need to know -

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Jul 16, 2023

Whenever I have engaged in a dialogue with a self-styled “pro-lifer” when discussing the subject of pregnancy termination, I always challenge them by stating that they are not pro-life but are pro-birth.

By and large, once they have had their way and forced some unfortunate woman into having a birth they neither want nor can afford, all the interest of the so-called “pro-life” person vanishes.

I go on to say to them, if you are truly pro-life, then you must be prepared to meet all the financial costs of that child until they become an adult and are well on their way through the rest of their life.

Assuming around £10,000 per year to fully support such a child so…

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