Assisted dying won’t work

Well, the pro-choicers have got their way. In two years’ time, if Kim Leadbeater’s reassurances hold good, we’ll have the option, if we tick the boxes, of ending our lives with a handful of ground-up barbiturates or some other undisclosed cocktail of painkillers at the expense of the NHS. We now know what is the guiding principle that animates the MPs that voted this through. It’s not solidarity; it’s not the principle that Danny Kruger articulated, that ‘no man is an island’ and what affects one affects us all. No. Austin Mitchell put it concisely: ‘this is about choice’. Or as Kim Leadbeater said obligingly, if we have the choice to die we have the choice not to die; there is no compulsion. Very obliging, I’m sure. These were two large principles at stake, solidarity with the vulnerable or the autonomy of the individual. And the Commons went for personal autonomy.

But what a lot of hostages to fortune there are after the second reading. It was wonderful to see so many MPs who have hitherto been entirely silent about palliative care prefacing their support for the bill with a commitment to it. Kit Malthouse, co-chair of the committee for choice at the end of life, was especially eloquent about it not being either-or. But the awkward reality is that those countries where assisted suicide is legal have slipped down, some quite significantly, in the global league table of palliative care provision. As several MPs pointed out – often in interjections – we do not actually have proper, uniform, proactive palliative care now (Wes Streeting’s face when this point was made was especially expressive); would it not be a thought to put decent provision in place before debating the death option?

Then there were the ‘safeguards’. Kim Leadbeater again said that the bill had the toughest safeguards in the world but it wasn’t long before some of them lost their lustre during discussion. Danny Kruger pointed out that the two ‘medical practitioners’ mentioned in the bill who would be signing off permission for assisted death did not have to be doctors who knew the patient; they didn’t even have to be doctors. Nope, they could be simply people of standing in the community. As Danny K joked, he might qualify. It took a bit of scrabbling around for a backbencher to find the relevant passage, but it was, wouldn’t you say, quite an important issue?

As for the issue of judicial oversight, an important element of Kim’s safeguards, the problems there weren’t answered either. Kit Malthouse declared with magnificent disdain that it was quite ridiculous to think that the judges wouldn’t deal with whatever the Commons put their way. But you know what? As the justice secretary, Shabana Mahmood, correctly pointed out earlier, the Family Courts can’t cope with the existing workload, and there aren’t enough High Court judges to deal with all the cases and to give them adequate scrutiny.

Then there’s the question of coercion, which Diane Abbott was eloquent about – including the self-coercion of those who did not want to be a burden. Labour’s Rachael Maskell was very good about this; it was a bill for the strong, not the weak, she said. In fact hers was arguably the best speech of the day, emphasising that if MPs were not confident that this bill was safe, they should vote against.

There was, actually, not as much about the examples abroad as you’d expect, even though Danny Kruger spent so much time getting disability campaigners from Canada over to Westminster to talk about how Maid, its euthanasia system, works in practice. We were periodically reassured that things work just fine in Oregon. Au contraire, friends. If you look at the stats, you find that for over 40 per cent of suicide candidates, not wanting to be a burden was a powerful factor.

Let’s see how long it takes for people with incurable and degenerative but not fatal conditions to challenge this legislation

And then there’s mission creep, which Kim Leadbeater was insistent would not happen. Let’s see, shall we, how long it takes for people with incurable and degenerative but not fatal conditions to challenge this legislation in the courts so it applies to them too. I give it a matter of months. And then if it’s applied to incurable suffering rather than a ‘six month to live diagnosis’ (several MPs pointed out that this provision is especially weak since diagnoses are notorious difficult), how long before mental health is included?

But the most puzzling contribution of all was from Layla Moran, who declared she didn’t want to be bothered just yet about the practicalities. It was all about the principle and if MPs didn’t like it, they should just vote for the second reading and save their objections for the third. But, dear Layla, there was a bill in front of you stuffed with practicalities. Didn’t you notice?

So, the MPs have voted for Choice. But once there’s time to see how the Act actually works – and I’d say that’ll be just before the next election – they should return to the Commons for another debate to see how all those promises and safeguards work in practice. Universal satisfactory palliative care provision? Enough judges to scrutinise applications? Applications approved by people who actually know the patient? A reduction in suicide rather than an increase in it? Oversight by people who are expert in identifying coercive control? Let’s see how these safeguards work. And if they don’t, can MPs give this another go? Trouble is, for lots of lonely, ill and weak people, it’ll be too late, even if MPs can be held to account.