Should medically-assisted death be legal?
We, as humans, have a lot of control over our lives. But we have no control over when it begins and most of us have little to no control over how or when it ends.
For those who grow into old age, the end of life can be uncomfortable, both emotionally and physically. Managing that discomfort is part of the cycle of life. But for a very few, the end of life is unbearably painful.
Should they have a right to decide to end their lives early? And should doctors be allowed to help them?
Late in 2024, the British Parliament debated a bill to legalize medically-assisted dying in England and Wales. The vote in Parliament was expected to be close. Though about two-thirds of British voters say they support legal assisted dying, previous efforts to legalize the practice had not come close to passing.
Here is what the proposed bill said. Patients must have a terminal illness and a prognosis of less than six months to live. They must have the mental capacity to make an informed decision. Two doctors must evaluate patients, seven days apart, to confirm the diagnosis. Patients must make two separate declarations of their choice; both must be signed and witnessed.
A family court judge must review each case to make sure the legal requirements have been met. And finally, there is a mandatory 14-day reflection period required before proceeding. The individual would be given a dose of medication; the patient would be required to administer the dose. No other person would be permitted to administer it. In other words, the proposed bill specified a lot of safeguards around the practice. The rules were designed so that assisted dying could not be done impulsively.
In the end, the vote was not particularly close: by a vote of 330 to 275, British MP’s voted “yes” to advance the bill. This vote didn’tmake the bill a law; instead, it was a procedural vote that allowed the bill to continue on its path to passage. But it was an important step. Within a few years, medically assisted dying could be legal in England and Wales.
What are the arguments for and against the bill?
Let’s start with the arguments against the bill. You might expect that the primary arguments against assisted dying would come from religious principle—that life is sacred, a gift from God, and that ending a life early interferes with God’s plan and the natural course of life and death. Taking a life is wrong as a matter of principle, even if humans invent ways to rationalize the act.
But religious principle was not the strongest argument advanced against the bill in Britain. In secular Britain, the strongest arguments were practical. Opponents of the bill worried that the law could not adequately protect the disabled and the vulnerable, that they might be pressured by family members to end their lives prematurely.
Another argument is that this is a “slippery slope.” While we may be able to agree today on what conditions should be eligible for a medically-assisted death, it would be all too easy for these conditions to be relaxed, little by little, so that at some point in the future, it may be legal for people with non-terminal conditions, eating disorders, disabilities, or mental illness to end their lives early.
Another argument focused on the accuracy of patients’ prognosis. The law would allow patients with terminal illnesses and six months or less to live to make this choice. But life expectancy is a subjective judgment. And we’ve all heard stories about people who were given some short amount of time to live, but wound up surviving much longer.
Finally, many doctors expressed discomfort with the idea that they should assist with taking a life. This goes against the fundamental medical principle to “first do no harm.”
What, then, are the arguments in favor of assisted dying?
The most powerful argument is that people should be free and empowered to make this most personal of decisions about their own lives. Nobody wants to think about a painful end, but some people are facing just that. It is heartbreaking to think about, but some people develop degenerative diseases that kill them slowly.
Instead of suffering right up to the very end, patients who want to do so should be able to choose an end that is not excruciating. Sometimes just having the option is comforting. In the Australian state of Victoria, about one out of every five people given the medication never take it.
Many British MP’s said they had personally been against the bill until they spoke to someone whose parent or spouse suffered gravely in the final weeks of life. Some patients who received excellent end-of-life care still suffered an agonizing death. The sponsor of the bill said that it’s not about patients ending their lives, but about shortening their deaths.
Another argument is that people already have some control over the manner and time of their deaths. Doctors and patients make many subjective decisions that can hasten or postpone the exact moment of death. For example, patients can decline treatment and surgery. Doctors can prescribe painkillers they know may hasten the moment of death. A prescription to induce death is another tool in an existing toolbox, not a brand-new type of decision, according to this argument.
And anyway, you can even argue that assisted dying is legal for British citizens, or, for some of them, at least. British residents with money have the option to travel to Switzerland for a medically-induced death, and dozens of people per year do just that. But should people who are already suffering have to get on an airplane, go to a foreign land, and reach the end far away from the comforts of home and their loved ones? And shouldn’t those without the economic means or ability to travel also have this option?
Ultimately, the arguments in favor prevailed in Britain—for now. The vote in November 2024 was to advance the bill. That means it will move to additional readings, revisions, and debates, before being finalized and passed into law.
If it does become law, England and Wales will join several other jurisdictions that have legalized medically-assisted dying in the last decade. They include Canada, Australia, New Zealand, Spain, Austria, Colombia, and several states in the U.S. It has been legal in Switzerland, the Netherlands, Luxembourg, and Belgium for longer.
Jeff’s take
In the “Dig Deeper” section of the website, I always put two stories about the main topic. Today, I’ll put one that advances each argument—one for and one against. They are both from The Times of London. So if you’re interested in this topic, you get two full points of view in English.
If you’re not listening on the website, go to PlainEnglish.com/745. Once you’re there, find the tab called “Dig Deeper” and you’ll see the links to the two articles.
Great stories make learning English fun