Bravo to Kim Leadbeater. She can expect a rough ride for introducing an assisted dying bill. If passed, the Leadbeater legislation will enter the history books as another basic right brought in by a Labour government. Even though the public has for years backed the right to die – in the latest poll by 75% for to 14% against, and the My Death, My Decision campaign reckons a huge majority of MPs in the new parliament are set to back it – she will come under ferocious cannonades from those vehemently opposed.
After Leadbeater topped the private member’s bill ballot, hundreds of good causes were pressed on her, from saving ferrets to catching puppy smugglers. She opted for the one that will relieve the most human suffering, not just for the relatively few people likely to speed the end of their lives, but for millions who fear exiting through a torture chamber of agony and anguish. Anyone who receives a terminal diagnosis fears how the last stages of their life may be, not knowing what they will have to tolerate. What if they are among those who find that even the best palliative care doesn’t ease their pain and distress? Knowing you can decide when to go lifts much of the dread.
I think of two deaths. The last stages of my mother’s liver and bowel cancer were dreadful: don’t imagine morphine is a gentle floating away – it detaches the mind, but not always the pain, while blocking the gut until an undignified death, obsessed by constipation. By the time her state was bad enough to long for death, it was far too late for her plea to go to Dignitas in Switzerland: those who take that grim and expensive path to a desolate death room need to go early, long before life becomes insufferable.
Some people might never have reached that point, but fear accelerates their departure. My mother, despite good palliative care, begged her GP to help her die. It might have been done once upon a time, he said, but since Harold Shipman’s multiple murders of elderly patients, every ampoule is counted, making it far too dangerous for a doctor to do anything of the kind. “Oh, where’s Dr Shipman when you want him!” she said to him, with what was left of her laugh. So she suffered on needlessly to the bitter end, and we suffered with her helplessly.
The other death was that of my friend Jill Tweedie, the great Guardian writer. Stricken with motor neurone disease, she well knew the horrors that lay ahead, as her father had died of it: it paralyses the body while leaving a lively brain to await a slow, excruciating death by suffocation. She was determined to escape that total incapacity and long asphyxiation. She had many medications, two of which a doctor had told her should never be taken together, as it would be lethal. She arranged with a clinic to take her in for respite care, but she had only one intention.
Waiting until she was alone, telling no one, she checked herself in and died overnight, weak and fragile, with all her mental faculties. She had taken all the pills, and her death was registered as “natural”, causing no blame, leaving no untidiness; but she was forced to make her choice far too soon, while she was still physically capable. It left everyone haunted by the image of her dying alone, unable to say goodbye. It didn’t have to be that way.
Leadbeater’s bill might cover the first of those deaths, by allowing assisted dying once two doctors predict death within six months. But that wouldn’t have covered Jill’s case, or those of the many others with degenerative diseases who want to choose how long to live. The final title to be published next week will use the words “choice at the end of life for the terminally ill”. We don’t yet know what time limit, if any, there will be: the text of the law being passed in Scotland talks only of the “terminally ill”, not of any set time that counts as “terminal”.
Many campaigners will hope for the same in England and Wales. Others, rightly in my view, will press for “incurable suffering” as the single criterion, extending choice to many more people. However, some fear any widening jeopardises the bill. Wisely, Leadbeater says it’s “important that the debate is broad and robust and very open” so every option gets a hearing before MPs decide.
Opponents will try to strangle the bill with restrictions. The bishops again oppose it, whipped in by their convener of the Lords Spiritual, the bishop of St Albans, who last week said, nonsensically, that the bill could encourage medical serial killers such as Harold Shipman and Lucy Letby who “get a thrill from killing”. Christians, he said, believe “life is a gift” and taking life is “sinful”. On the BBC’s Sunday Morning Live, a Catholic writer told of her mother’s excruciating death from brain cancer, but claimed “suffering is a necessary part of life”. That’s a personal belief in a God of cruelty from the religion that wears a symbol of torture round its neck, but what a wickedness to inflict that on others.
Leadbeater can expect a mauling from those warning she opens a dark door to mass euthanasia, greedy children hastening their inheritances and a “slippery slope” to hurry NHS bedblockers to an early grave. People will feel pressure to die, for fear of being a burden! In my view, saving children from your lingering bad death is a good reason to depart before your life becomes unbearable to you, and awful for them to watch and remember.
Thirty-one countries and territories allow assisted dying, each with their own safeguards: the Oregon law has stayed unchanged for 40 years, Swiss law unaltered for 80 years. Might there ever be bad cases? Weigh that small risk against the absolute certainty of terrible suffering described by palliative care professionals in their horrific report, The Inescapable Truth. This is not for the squeamish: on average, 17 British people die terrible deaths every day. “Some will retch at the stench of their own body rotting. Some will vomit their own faeces. Some will suffocate, slowly, inexorably, over several days.” So when you hear Jesuitical reasonings and political sophistry about why people should be denied the right to escape such a fate, remember this will not just rescue a few from shocking deaths, but all of us from fear it might happen to us.
Polly Toynbee is a Guardian columnist
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