This week 70 MPs and Peers wrote to the Lord Chancellor, stating their concerns about recent calls to change the law on assisted suicide in the UK.

In their letter to Rt Hon Robert Buckland QC MP, they respond to a recent letter from the All-Party Parliamentary Humanist Group, who have asked the Lord Chancellor to consider whether the law should be reviewed and doctors allowed to give patients lethal drugs to end their lives if they meet certain criteria.

The letter argues that the UK should heed the example of jurisdictions that have changed the law, where the 'narrow' safeguards originally introduced that limited assisted suicide to people with certain conditions, or with a short amount of time left to live, have been eroded over time and the law has incrementally expanded.

They also argue that changing the law would not protect vulnerable people, who would feel a pressure to die for fear of being a burden on others. Assisted suicide would also normalise all suicide, which has been seen in places such as the Netherlands where the suicide rate has increased by 20 per cent since the law was changed.

They finally argue that, rather than introduce assisted suicide, better investment in end of life care is needed:

Dear Lord Chancellor,

We are writing to you to outline our grave concerns about the renewed calls to change the law on assisted suicide and euthanasia, including the recent letter to you by Crispin Blunt MP and Baroness Joan Bakewell in their capacity of co-Chairs of the All-Party Parliamentary Humanist Group. Their letter requests the Government establish an inquiry into whether the law should be changed to license doctors to supply or administer lethal drugs to patients who request them and who seem to meet certain conditions.

No new enquiry

We do not consider that a new inquiry into this complex and emotive subject is warranted. The matter has been extensively investigated since the 2004 inquiry led by the former Lord Chancellor Lord Mackay, and most recently was the subject of a Private Member’s Bill in 2015, when it was rejected by a majority of 330-118.

The law has been tested in court on a number of occasions and in each case judges have concluded, in the later (2019) words of Lord Sumption who passed judgment on Nicklinson v. Ministry of Justice (2014), that ‘the law should continue to criminalise assistance in suicide’ even if in some difficult cases people will break the law [1]. This is a view we share.

The slippery slope

Mr Blunt and his colleagues write that the evidence has materially changed since the topic was first discussed in Parliament. It has indeed. We now have much more experience of how such laws evolve. In Oregon, which is the campaigners’ declared model for an ‘assisted dying’ law, cases of assisted suicide have risen fifteen-fold since it was introduced in 1997 [2]. This reflects the tendency in jurisdictions where the law allows assisted suicide or euthanasia for successive extensions of what is practised, tolerated and permitted. There are escalating numbers of deaths over time in every jurisdiction, and in almost all places the categories of those who qualify for assisted suicide or euthanasia has been expanded.

A report from the National Council on Disability published in 2019 found the laws in the handful of US states that had gone down this route, including Oregon, were ineffective at preventing abuse, and oversight of mistakes was absent [3].

Canada’s 2016 Medical Assistance in Dying law is being expanded in scope, almost before the ink is dry on the statute, to offer euthanasia to more and more groups of people [4]. The legislation itself proposes a review with the possibility of extending euthanasia to mature minors and those with solely mental health conditions.

In the Netherlands, where euthanasia is allowed, patients have their lives ended without their explicit consent, their formal permission having been obtained in advance. We see how laws which were supposed to be limited to mentally competent terminally ill adults, now allow the euthanasia of non-mentally competent adults; disabled children aged under 12 months; disabled adults; and even those with treatable psychiatric problems such as depression and anorexia. Indeed, between 2012 to 2017 there was a six-fold increase in cases of euthanasia of patients with psychiatric conditions [5]. A Bill has been proposed in the Dutch parliament to extend the euthanasia law to include the elderly who are simply ‘tired of life’ [6].

Euthanasia is, sadly, the natural destination for a law allowing assisted suicide, which replaces what we have now – a law based on the rational and widely-accepted principle that we do not involve ourselves in deliberately bringing about the deaths of others – with a law based on artificial and arbitrary criteria like a prognosis of terminal illness. Such laws by definition contain within themselves the seeds of their own expansion.

Pressure to die

Our current laws protect the most vulnerable in our society, those who are elderly, sick, or disabled, from feeling pressured into ending their lives. This pressure is a reality in the handful of places around the world that allow assisted suicide or euthanasia. In Oregon over 50% of those ending their lives cite the fear of being a burden on their families, friends and caregivers as a reason for seeking to die [7].

Normalisation of suicide

Assisted suicide normalises suicide in the general population. As one major study found, legalising assisted suicide in Oregon was associated with an increase of 6% per cent in the numbers of suicides, once all other factors had been controlled. Among over 65s the figure was more than double that [8]. Suicide in the Netherlands increased by 20% since the legalisation of euthanasia, significantly more than the rise in neighbouring countries [9].

Palliative care, not assisted suicide, is the way to die with dignity

Doctors who actually treat the terminally ill and those with chronic conditions remain strongly opposed to changing the law, whereas those who lack the clinical experience of providing this type of care are more likely to support a change. The recent BMA consultation showed that doctors who are working with those approaching the end of their lives are the strongest in their opposition to assisted suicide and euthanasia. 76% of palliative care respondents oppose Physician Assisted Suicide and 83% oppose a change in the law to allow euthanasia [10].

They are right. The case for assisted suicide is being rapidly overtaken by developments in medical science. Palliative care is a relatively new branch of medicine, but it is one in which the UK – with its long tradition of wonderful hospice care – is now the world leader. Rather than abandoning this progress and resorting to the dangerous expedient of assisted suicide, we should focus our attention on ensuring that everyone has access to top-quality palliative care.

We urge you to reject the suggestion of a Government review. This review, though ostensibly neutral, would inevitably add weight to the calls for a change in the law, which is of course why it is being promoted by the campaigners for assisted suicide. Such a change could contribute to an increase in suicides in the UK and put pressure on vulnerable people to end their lives prematurely.

Yours,

Danny Kruger MP

Lord Alton

Sir David Amess MP

Caroline Ansell MP

Scott Benton MP

Bob Blackman MP

Sir Peter Bottomley MP

Fiona Bruce MP

Baroness Butler-Sloss

Rt Hon Alun Cairns MP

Gregory Campbell MP

Baroness Campbell of Surbiton

Dr Lisa Cameron MP

Lord Carlile

Miriam Cates MP

Lord Chartres

Rosie Cooper MP

Rt Hon Stephen Crabb MP

Lord Curry

Philip Davies MP

Lord Dodds

Rt Hon Sir Jeffrey Donaldson MP

Rt Hon Sir Iain Duncan Smith MP

Lord Farmer

Tim Farron MP

Baroness Finlay

Nick Fletcher MP

Rt Hon Sir Roger Gale MP

Paul Girvan MP

James Gray MP

Rt Hon Damian Green MP

Baroness Grey-Thompson

Lord Griffiths of Burry Port

Sally-Ann Hart MP

Rt Hon Sir John Hayes MP

Baroness Masham

Paul Maynard MP

Lord McColl

Lord McCrea

Rt Rev Bishop James Newcome

Robin Miller MP

Lord Moore

Lord Morrow

Baroness O’Loan

Ian Paisley MP

Rt Hon Owen Paterson MP

Gavin Robinson MP

Andrew Selous MP

Jim Shannon MP

Lord Shinkwin

Lord Singh of Wimbledon

Alexander Stafford MP

Sir Gary Streeter MP

Baroness Stroud

Sir Robert Syms MP

Derek Thomas MP

Rt Hon Stephen Timms MP

Martin Vickers MP

Sammy Wilson MP

Rt Hon Sir Oliver Heald MP

Baroness Hollins

Adam Holloway MP

Tom Hunt MP

Rt Rev Bishop John Inge

Rt Hon Sir Edward Leigh MP

Rt Hon Dr Julian Lewis MP

Carla Lockhart MP

Chris Loder MP

Tim Loughton MP

Lord MacKay of Clashfern

Read and download the letter on the APPG on Dying Well website.