Rt Hon Sir Robert Buckland KBE KC is Conservative MP for South Swindon and former Lord Chancellor.
Public debate on the question of assisted suicide has been mounting for some months. But this weekend, Matthew Parris argued in the Times that it is a good thing that terminally ill people end their lives as increasingly our system is burdened by them.
Parris and I agree on many things. But I am deeply troubled by his approach here.
He and others make several important mistakes. First, seeking to ascribe an objective value to the necessarily-subjective question of other people’s quality of life. Second, that the state could and should thus legislate to somehow codify such a value, and plug it into a dispassionate cost/benefit analysis. Finally, that when this calculation tips into the red, a life can (and perhaps, should) be reasonably ended.
One can dispute this reasoning on many points. But to me the really fatal flaw is that the hypothetical subject of this calculation is always modelled on the strongest, or at least the average, of us – not the weakest.
Those who argue for assisted suicide say that it respects individual autonomy. Perhaps so. But as Parris concedes, that autonomy is subject to many external pressures. What he seems not to recognise, or will not admit, is that these pressures weigh very differently on different people.
Consider what has unfolded in Canada since the law there changed in 2016, giving rise to what is dubbed ‘medical assistance in dying’, or MAID.
Initially, Ottawa only legalised assisted suicide for terminally-ill patients. Within five years, however, this was expanded to those with a “previous and irremediable condition”. This was to start with a highly-subjective phrase, but judges and doctors have since stretched it farther than many might have thought possible even a few years ago.
Since then, the story of what has unfolded in Canada has been nothing less than chilling.
A woman who was too poor to afford housing which didn’t trigger her allergies has been killed by the state; a Paralympian who struggled to procure a wheelchair ramp was encouraged, by her own social worker, to consider killing herself. A soldier with PTSD was offered assisted suicide whilst seeking help.
Just last week, a judge in Calgary gave permission for a 27-year-old autistic woman to take her own life, and openly admitted that he did so despite not knowing why she wanted to die.
These stories should not just make us sad, they should make us angry. But it should also give us pause that a country with which we share so many ties, and so much of our political culture, is sanctioning the death of those with physical and mental disabilities.
Proponents of reform will say that it could never happen in the UK, that we would have proper safeguards in place. But how could we ever be certain such safeguards were effective? Having foresworn capital punishment because of the unavoidable risk that the state would kill innocent people, can we really justify taking a more lax approach with the lives of the sick and the vulnerable?
Safeguards can, imperfectly, guard against institutional failure. But we cannot set mere safeguards against social pressure. Not just because we cannot possibly account for all the ways in which such pressure works against individual autonomy outside the scope of the system, but because societal expectations are what ‘safeguards’ are calibrated against in the first place.
That is Parris’ point, after all: that once the taboo against assisted dying is dismantled, official and public attitudes towards it will shift. The insurmountable problem is that we know against whom it will shift hardest: the poor, the vulnerable, the disabled, and the sick. Or, to categorise these people as they will appear in the state’s utilitarian calculation: the expensive.
We have no right to make assumptions about the value of the lives of others. We certainly have no right to do so when there is a clear financial incentive for us, or for the government, to place a thumb on the scales.
There are always risks in policymaking, and it is politicians’ responsibility to weigh the balance between the costs, risks, and benefits of any proposal. In this case, the risks are just too high to make even the most restrictive legalisation acceptable.
At best, we risk discouraging the terminally ill from making the most of their lives and viewing themselves as a burden on others. At worst, we risk creating a system in which mentally ill, disabled, and elderly are regularly urged to kill themselves by the very institutions which are meant to protect them.
That is no longer a hypothetical scenario. Canada shows exactly how it can happen in a country very like this one, and why. It is our responsibility not to let it happen here. Some taboos deserve to be left in place.
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Author: Sir Robert Buckland MP
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