WWhen MPs vote on assisted dying this Friday, they will try to answer two questions rolled into one. First comes the ethical choice. Is it ever allowed for one person to help someone else take their own life? Then comes the challenge of regulation. Under what conditions can such consent be legally granted?
It is not easy to separate these considerations. Sometimes you have to go through implementation scenarios before you get a vision of the previous principle. But when legislation is drafted, the two questions should logically be answered in order, and not in parallel. When and how are only relevant debates if the answer to the question of whether assisted dying is ever possible is yes.
Conversely, if you believe that there are never any circumstances in which it should be legal, you do not need further research on the severity of the disease or the degree of clinical and judicial supervision required before the procedure. can move forward.
There is a religious objection on the grounds that human life is sacrosanct and the timing of its end is a decision of God alone. There is also a secular aversion to laws that facilitate intentional killing, even in the name of mercy. Some argue that putting such a power on the statute book is inherently decivilizing and that no sufficient protection exists to prevent such power from being abused. In those cases, the discussion about optimal regulatory frameworks is over before it begins.
My own opinion is that a person of sound mind, facing a certain and harrowing death, has the right to choose a gentler path to the grave. It is not necessarily a crime to help that person complete the journey. That belief then opens the second set of considerations: the step from ‘if’ to ‘how’.
On that point, I am convinced that the regime of safeguards contained in Kim Leadbeater’s bill – strict by international standards – would neither permit coercion nor make it a consumable of death, as opponents of the bill warn. There is no international evidence that there is epidemic bullying and people being forced into euthanasia. I am not convinced that systems designed to give terminally ill people the opportunity to die with dignity will be exploited by a hitherto unnoticed mass of callous, impatient, venal family members.
But the risk cannot be reduced to zero. It can only be minimized and weighed against the potential benefits, for which the evidence base is strong. It is the testimony of people who do not want a long, painful death and of those who wish their deceased loved ones could have been spared one.
Critics of the Leadbeater Bill rarely say what further safeguards might shift the balance of risk towards sufficient reward to satisfy them. For the most vocal among them, the honest answer would be none. The rules that interest them are not the rules contained in the bill itself, but the carelessly more lenient rules projected onto the bottom of a slope made slippery by the worst possible hypotheses.
That rhetorical device works. Enough doubts have been sown to make many MPs amenable to reform in theory reluctant to adopt sensible reform in practice. But the bill’s rejection will not be read as an instruction to reconsider and craft more robust protections. It will be a victory for the ‘no, never’ camp not in accordance with public opinion and this is probably not the majority view in the House of Commons.
This conflation – the blurring of the boundaries between ethical principles and practical measures – is unfortunately an unavoidable function of the process.
I can’t blame Leadbeater for taking the opportunity presented to her by winning the lottery that decides which backbenchers get to propose private members’ bills. It is easy to see why the government used this event to allow a vote on something that deserves parliamentary consideration but was not in the Labor manifesto. There is a tradition of private members’ bills serving as vehicles for social reform, such as the decriminalization of abortion and homosexuality in the 1960s.
The more recent practice has meant that the government has gone to great lengths to prepare legislation – for example on same-sex marriage – while MPs can still vote freely. That model might have made more pre-legislative consultation possible. The Leadbeater Bill was solidly drafted, but suddenly found itself on hard ground that might have been better prepared if an independent committee, led by experts, had gathered medical evidence and lessons from abroad.
But the major opportunity that is being missed is the use of innovations in public consultation, often grouped under the heading of deliberative democracy. These are the citizens’ juries and assemblies convened in other countries and by some local authorities in Britain to resolve controversial issues in a way that promotes practical dialogue about deep-seated allegations.
The island of Jersey had convened a civilian jury in 2021 before passing assisted-dying laws earlier this year. When Ireland voted for same-sex marriage in 2015 and legal abortion in 2018, both ballots emerged from forums of public consultation. They did not reach a consensus, but they did lay the foundation for mutual understanding between the rival parties in the discussion. This series is credited with helping to avoid the kind of divisive polarization inflicted on Britain by the Brexit referendum.
If used properly, these instruments cannot compete with parliamentary representation or ministerial discretion. Governments are still making decisions, and parliamentarians are still debating and examining the law. But no one involved in these processes believes they enjoy the public’s trust. The civic fibers that should bind an electorate to its democratic institutions have withered in a climate of cynicism and mistrust.
Where that connective tissue is frayed, populism fills the void. Without new ways to navigate hard policy choices that enrich our collective ability to talk about trade-offs and cost-benefit comparisons, politicians who govern with respect for facts and evidence will continue to lose to demagogues who campaign with the sense of easy salvation.
The willingness to acknowledge complexity and the willingness to compromise are not capricious traits of a rarefied technocratic elite. They are normal, everyday human characteristics that a healthier democracy would routinely entail. The debate around assisted dying was an opportunity to show how that could work. It’s not too late yet. MPs could pass the bill on second reading, recognizing that change is needed, but amend it in committee to allow for a process of public deliberation on the contours of the reform.
Or they can simply continue as if the ritual performance of debates in the theater of parliament is the only engagement the public needs. But they should not be surprised if the audience switches off.