Hard Thinking on Assisted Dying

I am in favour of assisted dying, but I am delighted I won't have to make this decision in Parliament. Here's why.

As a result of reading the final instalment of Tim Shipman’s series on Brexit and the governments that initiated, negotiated, and steered it, I have been thinking a lot about the Leave campaign's successes and the Remain one's failures.

The reason I raise this is I can see echoes of this debate in the same one that is happening around assisted dying and Kim Leadbeater’s Private Member’s Bill on it.

What I mean by that is that I was an emotional Remainer before I was anything else. Being European was a part of my identity. Part of my sense of myself as a global citizen.

Yes, I believed then and now that Brexit was economically harmful. But that wasn’t what I was voting on. I was voting on the strength of my feelings and I actively sought out the information and the experts who would support that feeling with evidence. I didn’t actively seek out the evidence and weigh it up.

I can’t imagine what I would have done if faced with what I could see as a credible argument that Brexit would unleash growth that would be passed to the people and communities I care about. Luckily, the main arguments being made in favour were done so in order to trigger the emotions of those who felt differently from me, so I wasn’t really faced with this.

But I know Leavers whose decision was made just as emotionally. Sovereignty was part of their strongly held identity and as such, there was no evidence of economic harm that was going to change that. They felt that if there were to be an economic hit it would be worth it. And the coolness of the way the economic argument was made actually triggered further feelings of that lack of control they felt they were voting against.

I think I see a lot of that in how the arguments around assisted dying are playing out. Which is a considerably more emotive topic, despite the passions aroused in Leavers and Remainers.

Most of us will have thought about this at some point. What would we do if that were me? If I were dying with no chance of a reprieve? How would I want the last months of my life to be lived? How would I feel if I were nursing a sick loved one through the last months of their life? Would I cling to as much time with them as possible? Or would I want them to end their life in the way of their choosing?

As long as I have had these thoughts I have leaned towards supporting assisted dying. In part because I think I would want it for myself, and, in part because my loved ones have made their own wishes very clear to me.

But I do have concerns about coercion. I do have concerns about safeguarding. I do have concerns about doctor and lawyer ‘shopping’. I think some of the laws around the world - the Canadian example in particular - are too lax when it comes to these issues - sometimes it seems in practice if not in the letter of the law.

Those whose worry is about the bill’s drafting have a right to those concerns. There is no perfect legislation. Unintended consequences do happen. One of my most overused phrases is that the ‘perfect should not be the enemy of the good’. This is a good guard against black-and-white, all-or-nothing thinking. But the good has to be truly good - not just good enough. Especially when it comes to matters of allowing circumstances in which the state has a role in deciding over life and death.

The other key issue that troubles people is one of coercion. This is much harder to legislate against and for. This is where the safeguarding can go so far but no further. And I absolutely understand the fears here. There are safeguards against this in the more obvious external cases. The need to go through two doctors and a judge and convince them this is a choice being made through free will go a long way to addressing this. But there will not be a way of fully and properly knowing how many people will feel an internal sense of burden - to the NHS or to their families.

That is a reasonable concern. It is just not one I think can be legislated for. With all legislation, there is an understanding that it will not just open up or close down choices for the individuals directly involved but also act culturally either as an incentive or a barrier to action. It may well change our thoughts around death and dying in ways - good and bad - that we just can’t set down in black and white on vellum.

This needs to be balanced with the relief that we know it will bring to other people - those desperate to end their pain and suffering. This is not a small consideration either. It is what my loved ones express to me. They don’t want to go through that. It is what I consider. I don’t want to go through that. Or at least that is what I believe now.

Finally, there is the question of the morality of the state sanctioning a right to choose death. For many - especially for those either of religious faith - this will weigh heavily on these decisions.

I am not an active Christian - though I was raised and confirmed in the Church of England. I don’t know when I truly lost my ‘faith’ (my going through confirmation - if I am completely honest - had as much to do with my very serious crush on the vicar’s son, and the chance this process offered to spend more time in his presence, as it did an affirmation of my belief in the church and its teachings. What can I say, I was 11 and he was my first kiss). But I do know what faith feels like and I have watched the more militant atheists of my acquaintance fundamentally misunderstand the power of evidence - or lack thereof - to persuade someone for whom evidence is not connected to belief. There are arguments within the faiths about the role of assisted dying (and a person’s relationship to their faith and how it should be lived is not - despite what many outsiders may think - fully mediated by faith leaders) but if your morality is shaped by your understanding of an afterlife and a way of living and acting in the world that is led by this longevity of your moral and spiritual life these are different levels of consideration and will play just as much a role to play in your decision making - however uncomfortable that makes atheists feel.

All of these are the things that are weighing on the minds of MPs today and they are not easy things to grapple with.

One thing that should be remembered is that if the vote is won today that isn’t the end of the debate in Parliament. The idea that it won’t have enough time is unconvincing to me as this is not the final stage of the passage of the legislation. In fact, the committee stage may well be where a lot of the safeguards can be strengthened. And as it is not a government bill or a partisan issue, there is probably more scope to do this as there won’t be a presumption of whipping for or against any amendments.

So those who lean against the bill for this reason - however they vote tomorrow - will have other chances to allay those concerns.

As I have said, I do believe I would support this legislation tomorrow. I would probably then surprise some of those I walked through the lobbies with by being more sceptical than some at committee stage to make it the best bill I could.

This is where I have landed. Trying to think about what I would want in the case of my own suffering or in giving myself the option to honour the wishes of my loved ones.

Watching the debate unfold online I have seen some of those who have taken views on both sides of the argument harden in their approaches. As their own emotions have been heightened and further inflamed, they have - on occasion - resorted to the extremes of language - with one side accusing the other of wishing to torture the dying and the other accusing the other of wishing to murder them.

However, most of the debate has given me some hope for a movement away from polarisation even as we see the increase of emotionality in our politics. While there are and always will be extremes, the good faith I have largely seen from the more public figures on both sides has led to a better, more nuanced and deeper conversation.

I hope this can continue. Whatever the outcome of both tomorrow’s vote and the final third reading of any bill that comes out of committee people are going to feel very strongly about it. Whoever does not get their way will feel that there has been a moral failing within the legislature of our country. If they then move on to accusations of individual moral failings on the part of MPs that could be very dangerous indeed.

Let us all pray, hope, or work hard to ensure that doesn’t happen.

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