Trigger Warning: This article makes reference to suicide and cancer.
“Assisted dying is much more than a debate.”
For those suffering with a terminal illness these words, spoken by the Bishop of Whitby, now hit much closer to home.
On 29th November 2024, MPs in Parliament voted in favour of legalising assisted dying in England and Wales, which marked the first time in nearly a decade that MPs have voted on the issue. Following the five-hour debate, which comprised recounts of emotional stories from both sides and resulted in large-scale demonstrations outside Westminster, the historic vote passed with 330 MPs in favour and 275 against.
Having now surpassed the first legislative boundary, the bill must undergo months of serious deliberation and practical planning if it is to be granted a part of official law. If it is passed, it will allow terminally ill adults who are expected to die within six months to seek help to end their own life, provided that they express a “clear, settled and informed” wish, free from coercion or pressure, at every stage of the process.
Inevitably, this proposal has incited strong moral reactions from all sides of the debate, with more than 160 MPs requesting to speak on the matter in parliament. And this issue is no less pertinent outside of the traditional political spheres. The proposed bill has received support from campaign groups, such as Dignity in Dying, which insists that terminally ill people reserve the right to end their life in the most humane way possible. But the bill has also levied outcries from others, who argue that it diminishes the value of disabled people’s lives.
I spoke to the Rt Revd Barry Hill, the Bishop of Whitby, who is one of the three Suffragan Bishops working alongside the Archbishop of York, to better understand his perspective on the proposed bill, named ‘Terminally Ill Adults (End of Life) Bill’.
“As a Christian, I feel it’s important to affirm the dignity of human life and to do everything we can not to undermine palliative care.”
Rt Revd Barry Hill, the Bishop of Whitby
“My mum’s disabled, my wife lived through cancer and I’ve been with many people as they process terminal diagnoses and I entirely get the instinct that says we want to minimize suffering for those that we love and for ourselves….But for me, having weighed and thought about it, I’ve come to the conclusion there is no way it can be done which protects the most vulnerable,” he told me.
In addition to looking after the north of the Diocese, Bishop Barry Hill has recently been one of nearly 800 Church of England clergy to sign an open letter opposing the proposed assisted dying bill now on its way through Parliament.
“For me, the main concern is around [the] protection of the most vulnerable,” he told me, “as a Christian, I feel it’s important to affirm the dignity of human life and to do everything we can not to undermine palliative care.”
Some people feel that they cannot support this Bill, however much they may agree with it in principle, for practical reasons relating to the safeguarding of vulnerable people. The phrase “slippery slope” is often thrown about in these kinds of discussions and is particularly pertinent in academic debates.
But what does this actually mean?
This philosophical argument is commonly appealed to when discussing ethical issues such as capital punishment and abortion. The slippery slope argument claims that permitting or performing one slightly morally dubious action will inevitably start off a dangerous chain reaction, where increasingly immoral actions will naturally follow. People often use this argument without realising, when they say things like: “if you keep playing violent video games, you will become desensitised and one day end up hurting someone in real life” and “if we allow women to have abortions, they will use them like birth control’. A particularly persuasive slippery slope argument will involve showing how the first action plausibly entails the proposed conclusion, by connecting a reasonable line between the two.
“I think we see evidence from around the world that once you’ve started on a slippery slope, however gentle the gradient, the trajectory is kind of unstoppable,” the Bishop conferred.
Laws similar to the UK’s assisted dying bill have passed in other parts of the world. For instance in the US, Oregon enacted the Death with Dignity Act in October 1997, which allows a terminally ill adult to request their doctor to prescribe them medication which will bring about their death. In the Netherlands, minors may request euthanasia from the age of 12, with consent from their parent or guardian. Similarly, Canada, New Zealand, Australia, and Spain have all introduced assisted dying laws over the past ten years.
“I don’t see a way that it can be done where there’s not a pressure on people not to be a burden on others.”
Rt Revd Barry Hill, the Bishop of Whitby
The Bishop said: “When assisted dying was introduced in Oregon, concern about being a burden for others wasn’t a factor given by the vast majority of those seeking assisted dying.” This study collected data from over 2000 recorded deaths in Oregon across a 25-year period. It showed that in the first five years of the assisted dying law, an average of 30% of participants were concerned with feeling like a burden.
But in 2017, almost half of those ending their lives (46%) cited their concerns about being a burden as their motivation for dying. “At the same time, the proportion referred for psychiatric evaluation prior has dropped from almost a third to only one in a hundred. The law itself hasn’t changed but the pressure felt by those unwell and the scrutiny of medics has,” the Bishop said.
Despite this, the results of a YouGov data tracker suggest that the UK public is still largely in favour of the Bill. Upwards of 60% of people think that the law should be changed to legalise assisted suicide in terminal cases (note that this number has been decreasing slightly over the last few months of this year).
But what would the UK’s assisted dying bill look like?
Kim Leadbeater, the Labour politician behind the bill, has said that the UK assisted dying bill would have some of the strictest requirements and toughest safeguard measures in the world.
Amongst other requirements, the patient must make two declarations, which are both witnessed and signed, confirming their settled and informed wish to die; undergo assessments by two separate doctors; and seek approval by a High Court judge to be eligible. It would be a long and thorough process: Leadbeater argues it would ensure the person understands the full consequences of ending their life and is confident this is something they want.
The Australian moral philosopher Peter Singer has fervently argued in favour of active euthanasia, which occurs when a physician directly causes a patient’s death, often by administering a lethal drug in injection form. Singer argued that, when Oregon legalised physician-assisted suicide in 1997, the neighbouring state of Washington passed a similar law in 2008. Similarly in Europe, after the Netherlands legalised euthanasia in 2002, Belgium and Luxembourg were quick to follow suit (in 2002 and 2009). In Singer’s words, “[i]t is unlikely that these countries would have legalised euthanasia if there were clear evidence of serious abuses in the Netherlands.” Many supporters of assisted dying have used this argument to rally support for the UK bill.
“When you then introduce the opportunity to die into people’s minds, to alleviate themselves of being the burden of others […] that potent mix is very dangerous.”
Rt Revd Barry Hill, the Bishop of Whitby
To this, Bishop Barry insisted: “I don’t see a way that it can be done where there’s not a pressure on people not to be a burden on others.”
Those in opposition to the bill have raised the issue that legalising assisted dying will make terminally ill people feel pressured to end their lives. Vulnerable people may start to feel as though their life is inherently worth less than an ordinary person, and that they’re causing burdensome work for family and loved ones by continuing to stay alive.
“Think of my mother,” the Reverend asks me, “who’s disabled, who feels almost permanently guilty about the burden she is on other people. When you then introduce the opportunity to die into people’s minds, to alleviate themselves of being the burden of others […] that potent mix is very dangerous.”
In contrast, those in support of the bill often speak about terminally ill patients as having a right to self-autonomy, which includes the right to choose to die by peaceful means. I spoke to Rowen Brady, a second-year history student and Vice-President of Amnesty International Society, to understand her personal opinions on the Bill. She told me that she is a long-time supporter of the ‘Dying with Dignity’ campaign, which advocates for terminally ill adults to have the choice of assisted dying.
“It’s not about the promotion of death. These people are dying regardless and, if they so choose, should be helped to have at the bare minimum the dignity you would give a dog.”
Rowan Brady, Vice-President of Amnesty International Society
She told me: “I’m fully in support for the motion to be passed, and have supported such a motion being passed for several years. To me, most significantly, it is about giving the terminally ill dignity in death. The ability to avoid an agonising and cruel death is the least we can afford for the terminally ill.”
The people who would be eligible to die under the assisted dying bill will have been undergoing immense, unimaginable physical and mental pain for some time. It is very difficult for us to contemplate the extent of this suffering and understand the pain that they would have endured, many of them over the course of several years. Passing this bill, Brady argues, will finally allow terminally ill people to put a peaceful end to their suffering, if they so choose.
“Most people will know of family and/or friends who have passed away, and spent the end of their life in pain, knowing that they were waiting for their body to give out. I fail to see how people can’t empathise with this,” she tells me.
“This Bill is about giving people the choice of a more dignified and peaceful death,” she concluded, “it’s not about the promotion of death. These people are dying regardless and, if they so choose, should be helped to have at the bare minimum the dignity you would give a dog.”
What happens next?
The implementation of a legally dying law would have significant impacts on terminally ill individuals and, more broadly, the palliative care system as a whole. I think that, in the long run, it also has the potential to make significant changes to the way we conceive death and the connotations surrounding it.
“It’s not something we can enter into lightly,” Bishop Barry echoes, “because it is [about] people’s life and death and there are few things, if any, more serious.”
Brady also highlighted the need for more conversation about the topic on campus, saying she would “certainly welcome more engagement on campus, and the expansion of conversation about assisted suicide.”
“It’s an important conversation to have,” Bishop Barry was clear. Although, he reminded me, “it’s not really a debate: it’s not an academic thing. It’s life and death.”
In the next stage, the ‘Terminally Ill Adults (End of Life) Bill.’ will be reviewed and scrutinised line-by-line by a small committee of MPs. Following this, MPs will propose and discuss possible amendments to the bill. MPs will then undertake the ‘third reading’ stage, where they will get a final vote on the bill. After this, all the previous stages are repeated by peers in the House of Lords.
If you’ve been affected by any of the issues mentioned in this article, help is available. Contact Samaritans on 116 123. University of York students can also access support via the Student Hub.