It’s understandable that those who have seen friends or relatives suffer intense unremitting pain as a result of conditions that will inevitably end their lives where there seems to be no means of alleviating that should want a change in the law in order to put an end to such a situation.  There are also very strong arguments supporting the right for people to have control over their deaths as well as their lives, a right to choose which is consistent with other campaigns relating to bodily autonomy, for example to choose to have an abortion. 

THE HISTORY

The difficulty is in supporting people’s right to decide to end their lives whilst safeguarding those who don’t wish to exercise that right.  Whilst supporters of the Bill believe that such safeguarding is possible both history and the experience of support for assisted dying in other countries prove this is very unlikely to be the case.

The capitalist system relies heavily on inequality and oppression.  This is particularly the case for disabled people who are seen to be “lesser”.  The euthanasia movement has had a particular focus on disabled people who have been deemed to have lives not worth living.  At the beginning of the last century involuntary euthanasia of disabled people was legal in some US states and was discussed by key members of the British Labour Party.  The US, the UK and Germany developed programmes of compulsory sterilisation of disabled people and support for eugenics in discussing the need to cleanse society of disabled people. Nazi Germany went further, under the T4 programme designed to exterminate disabled people, killing children by means of lethal injection, starvation and hypothermia, whilst gas chambers were constructed specifically to kill disabled people, described as “useless eaters” and “lives unworthy of life”.  In all at least 250,000 people were killed.

Though discussion of euthanasia died down as a result it has not gone away entirely. The euthanasia movement continues to exist into this century, though the Voluntary Euthanasia Society changed its name in 2006 to Dignity in Dying.  In 2008 Baroness Warnock, a supporter of euthanasia, told the Telegraph that people with dementia should be allowed to end their lives in order to avoid being “a burden to their families or the state.”  The idea that disabled people are a burden on the state has continued in the policies of both Conservative and Labour Governments in recent years and has led to thousands of deaths of benefits claimants.

During the early days of the COVID pandemic, the public was told not to worry as the majority of those dying were elderly and disabled people; older patients, offensively labeled “bed blockers”, were discharged to care homes despite the certainty of infecting those living there; and many disabled people had Do Not Resuscitate (DNR) notices placed on their medical records without any consultation.  Early advice to doctors about rationing the use of equipment suggested that those who “had lives least worth living” such as mobility or other physically impaired, autistic and learning impaired people could be at the back of the queue for access to life-saving equipment. And in the last week a petition to Parliament to include euthanasia for disabled people in the Assisted Dying Bill has started doing the rounds.

It is no surprise that many disabled people are fearful of what the outcome of passing the Assisted Dying Bill might be, especially in a culture where people are valued according to the ways they benefit the capitalist system.

ARE SAFEGUARDS REALLY SAFE?

The loosening of safeguards in countries where assisted dying has been made legal also gives cause for concern.  This has happened in practice  in every country which has legalised euthanasia, assisted dying or assisted suicide.  Organisations promoting assisted dying claim that laws have not been changed but disregard the many ways in place which new practices have been developed and safeguards amended. 

In Canada the law included provision for elements of the Medical Assistance in Dying (MAiD) programme to be revised should change be deemed necessary.  As a result the requirement for those seeking Assisted Dying to have terminal

Illness has been removed, and autistic people and those with learning impairments and mental health conditions are considered eligible; increasingly people are asking to be allowed access to MAiD for the effects of societal issues such as lack of access to appropriate housing; there is also increased support for the idea that poverty should be regarded as grounds for being allowed access to MAiD.

MAiD is the fifth most likely cause of death in Canada.

In the Netherlands and Belgium children and people with mental health conditions are included; in the Netherlands newborn babies less than a month old with physical impairments or deformities are allowed to be euthanised.

Organisations in support of Assisted Dying often cite US states such as California and Oregon as examples of good practice but even there there have been significant changes with cooling-off periods removed for 25% of people opting for assisted dying in Oregon, and reduced to 48 hours in California.  In both states non-terminal illnesses such as anorexia and arthritis have been included.

A Netherlands political party is now suggesting that anybody over seventy should be allowed access to Assisted Dying.

THE POLITICAL CONTEXT

In 2021 Keir Starmer spent ninety minutes on the last day of Labour Party Conference repeating ad nauseam the sentence “we are the party of hard working people”.  A sentence he continues to repeat three years later despite concerns from individuals and organisations representing disabled people. 

The idea that we are valued only to further the interests of the capitalist system results in the oppression of both those who cannot work and those who need (and legally should be given but often aren’t) support in order to work. 

Whilst much is made of the danger of individual coercive control, state control is a major factor in the oppression of disabled people.  Thousands have been killed as a result of benefits sanctions though the DWP has failed to release the figures.

John Pring’s book The Department details the way DWP including through lack of safeguarding has been complicit in numerous deaths including suicides.  There have been numerous reports of benefit claimants being asked why they hadn’t attempted suicide.  In other countries with similar political systems Assisted Dying has been suggested as an alternative to proper medical care.

Medical provision is lacking.  Often professionals reveal a lack of awareness of the needs of disabled people.  Though Britain is regarded as having the fourth best palliative care in the world that is still inadequate as specialists in palliative and geriatric medicine admit – it doesn’t mean this country is good, just that most of the rest of the world is even worse.  Every day in the UK 320 patients fail to get the care they need.  Whilst there are some conditions where there is no pain relief that is effective it is also likely that there are people who are not granted sufficient pain relief.  A number of pieces of research suggest that women, older and disabled people are thought to be prone to exaggeration and therefore are not given the treatment or pain relief that they need.

Sadly the changes some people had expected with a change of government have not materialised.  The aim to “get people working”, all the rhetoric about the costs of supporting those who need support is still there, including Starmer’s article in the Mail on Sunday which talks about the “bulging benefits bill blighting our society.”  Though the rest of the article resists the Tory rhetoric the ageist and disablist attitudes are still there.

THE BILL AND ITS PROVISIONS

Whilst there is a need for compassion and support for people who wish to choose to end their lives, this Bill is not the way it needs to be done.  The timescale for people in the last stages of life to be able to be able to access assisted dying is considerable: appointments to be organised with two doctors, possibly three and possibly a specialist consultant as well asa wait while doctors’ recommendation goes before a judge to be sanctioned would in themselves take considerable time to organise given the current state of the NHS, and would be extremely difficult and potentially distressing for someone who has reached the final stages of life.

The Bill is also oppressive in giving the state the ability to make the life or death decision.  Doctors and lawyers however supportive are in this case agents of the state with more responsibility for ensuring the law is followed even if its processes are in themselves oppressive than supporting individual autonomy and need. 

There is also the issue of timescale.  The bill needs more detailed discussion but is going through Parliament excessively quickly, allowing far too little discussion of a change this important.

A final question:: suppose the Tory Party which is moving further right gangs up with Reform UK?  How will the measures in this Bill be dealt with then?  How will this affect disabled and older people?  The voting power is there to make it happen.