Assisted dying inquiry: NSS calls for reform

The National Secular Society has called for reform of the law regarding assisted dying in its submission to a parliamentary inquiry.

In November, the Health and Social Care select committee announced the first ever parliamentary inquiry into assisted dying. Helping someone to die in England and Wales is currently punishable by up to 14 years in prison.

The NSS submission made the following arguments:

Patient autonomy

Patient autonomy should underpin any reform to the law, with mentally competent adults able to choose the time, setting and manner of their death. There is scope for reasonable disagreement on the eligibility criteria for accessing assisted dying.

Widespread public support

Polling shows 84% of Brits support legalising assisted dying. An even greater proportion of the disabled community (86%) is in favour of reform and strong support is also seen amongst the religious (80%).

Failings of the current law

Even the best palliative care cannot alleviate all suffering in all cases, with an estimated 5,000 terminally patients a year experiencing no pain relief at all in the final three months of life.

Additionally, serious illness is associated with a higher risk of suicide. For example, suicide rates in patients with low survival cancers are 2.4 times higher than the general population.

The criminalisation of assisted dying is increasing the risk of botched suicides amongst these patients because they lack the expertise to end their own lives peacefully. It also punishes those motivated entirely by compassion who seek to help them.

Travelling abroad to access assisted dying, at an average cost of £10,000, excludes those who are less well off and forces some patients to die earlier than they otherwise would, as they must be still physically able to travel.

Robust safeguards

The current legal framework on assisted dying includes no prospective safeguards for patients. This means the circumstances of assisted suicides in England and Wales are investigated only after the patient's death, when it is too late to protect the patient if suspicions are raised.

By contrast, the last attempted reform of the law brought by Baroness Meacher included robust prospective safeguards: the patient's request would require approval by two doctors and a high court judge.

Safe and effective precedents

Assisted dying was legalised in the US state of Oregon in 1997. Of over 36,000 deaths in Oregon in 2017, only 143 resulted from assisted dying. Reform of the law has not come at the expense of high quality palliative care and not a single complaint of actual or attempted abuse has been recorded by Disability Rights Oregon as of 2018.

Religious opposition to reform

Theological sanctity of life arguments have been a key driver of opposition to greater patient choice at the end of life, with Catholic bishop John Sherrington describing Baroness Meacher's bill as an "unprecedented attack on the sanctity of life".

While everyone should have their say when it comes to assisted dying reform, religious dogma should not be considered a rational, compassionate, or legitimate basis for policy making.

Some religious groups, recognising that sanctity of life arguments increasingly fail to resonate with the public, have sought to disguise their theological opposition to reform. Campaign group 'Better Way', for example, makes arguments against assisted dying couched in secular terms but fails to acknowledge that is it is backed by the charity Christian Action Research and Education.

Legal challenges to assisted dying reform in the UK are increasingly being bank-rolled by US based religious groups. A 2019 judicial review of the Royal College of Physicians' stance on assisted dying was partially funded by Alliance Defending Freedom, a Christian organisation that campaigns to "recriminalise homosexuality" in the US.

NSS: The law 'should uphold patient autonomy'

NSS campaigns officer Dr Alejandro Sanchez said: "The law concerning assisted dying should uphold patient autonomy. The religious views of some, however sincerely held, should not restrict the freedoms and choices of others.

"While we recognise there is scope for reasonable disagreement on this issue and welcome intellectually honest debate around it, we urge Committee members to be mindful of theological opponents of assisted dying obfuscating their language, motivations and funding."

The NSS has also responded to a consultation on the implementation of assisted dying in Jersey, after its legislature approved reform in principle in 2021, and a consultation on a proposed bill to legalise assisted dying in the Isle of Man.

Photo by National Cancer Institute on Unsplash