On Friday the UK Parliament will vote on whether to allow assisted suicide for the terminally ill, at least those considered to be in the last six months of their lives. The Bill is posited to have “robust safeguards”, despite Sir James Munby, former president of the High Court Family Division, describing the judicial safeguards as falling “<a href="https://transparencyproject.org.uk/assisted-dying-what-role-for-the-judge-some-further-thoughts/"><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color">lamentably short</mark></a>,” Justice Secretary Shabana Mahmood stating the law will make the elderly and vulnerable “burdens” and put them in a “<a href="https://www.spectator.co.uk/article/shabana-mahmood-the-disgraceful-treatment-of-kate-forbes/"><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color">dangerous position</mark></a>” and Britain's two longest serving MPs describing the scrutiny given to the law “<a href="https://www.theguardian.com/commentisfree/2024/nov/20/politics-dangerous-assisted-dying-bill-law-illegal"><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color">wholly unacceptable</mark></a>”.
One of the principal arguments against assisted suicide and euthanasia is the observed experience of various countries around the world that have already legalised such practices. Many oppose doctor-assisted death because they have seen how it has played out in other countries. From sick babies to mental illness to neurological and developmental disorders, to simply just being old, “assisted dying” – the sanitised euphemism for assisted suicide and euthanasia - is touted as the solution from the cradle to the grave for anyone who might be inconvenient, especially when they are inconvenient to the state.
One of the starkest examples of the slippery slope is offered by Belgium. Famous for its Trappist beer and buttery chocolate, it also has the most extreme euthanasia law in the world. First legalised in 2002 and only the second country to do so since Nazi Germany, the law was broad from the outset, allowing euthanasia for any adult with "constant and unbearable physical or mental suffering". In 2014, the law was extended to include children of any age. The law intentionally makes room for those suffering from mental illness to receive euthanasia, with autism accounting for <a href="http://obdurate"><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color">five per cent of deaths in this category</mark></a>.
The Belgian Euthanasia Commission notes that “<a href="https://www.ieb-eib.org/en/news/end-of-life/euthanasia-and-assisted-suicide/euthanasia-in-belgium-analysis-of-the-2020-commission-report-1921.html"><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color">the failed suicide attempts made the people concerned aware that there was also another, more dignified way of ending one’s life</mark></a>”. In other words, a teenager’s cry for help can lead directly to euthanasia. In 2019, six per cent of all deaths were registered as euthanasia.
The Netherlands experienced a similarly quick progression from “robust safeguards” to euthanasia in almost any circumstance. In 2002, the country legalised euthanasia for adults with a terminal illness or who were suffering in a way which was unbearable and could not be alleviated, including mental illness, though courts began allowing euthanasia under specific conditions in the 1970s and 1980s. In 2004, the <a href="https://www.nejm.org/doi/full/10.1056/NEJMp058026"><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color">Groningen Protocol </mark></a>was introduced to allow euthanasia for infants up to the age of one with severe disabilities, marking one of the few laws worldwide permitting euthanasia for infants. In 2023, Dutch law was expanded to allow euthanasia for children between one and 12 years. Euthanasia has long been available for children aged between 12 and 16 with parental consent, and between 16 and 18 parental consent is not required; parents are simply informed. In 2020, the Supreme Court of the Netherlands ruled that physicians could euthanise patients with dementia if they had expressed a wish to die before the onset of their condition.
In Flanders alone in 2007-2008, <mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color"><a href="https://bioscentre.org/wp-content/uploads/2020/11/Euthanasia_and_Assisted_Suicide_GPike_WEB.pdf">7.9 per cent of all euthanasia deaths of minors occurred “without explicit request</a>”</mark>. A 2009 study found that <a href="https://bioethicsobservatory.org/2021/06/euthanasia-slippery-slope-affects-not-only-terminal-patients/40935/?utm_source=chatgpt.com"><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color">1.4 per cent of all deaths by euthanasia</mark> </a>had been carried out “without an explicit request”. In other words, these were cases of involuntary euthanasia. In his 2004 article <em><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color"><a href="https://dredf.org/wp-content/uploads/2012/10/hendin-psychiatric-times-2004.pdf">The Case Against Physician-Assisted Suicide: For the Right to End-of-Life Care</a>,</mark></em> Dr Herbert Hendin found that about 25 per cent of Dutch physicians reported they had "terminated the lives of patients without an explicit request" from the patient. Additionally, one-third of physicians indicated they could conceive of doing so.
Today, there is significant pressure to allow euthanasia for people experiencing “completed life” or those who feel they have lived a full life and wish to die — essentially allowing the practice on demand.
Oregon, the first state in the USA to legalise assisted dying in 1997, is often seen as a model by the pro-euthanasia lobby of laws and practice that have not developed over time. However, in 25 years, the rate of patients dying by doctor-assisted suicide rose from <a href="https://blogs.bmj.com/medical-ethics/2023/10/27/twenty-five-years-of-the-oregon-model-of-assisted-suicide-the-data-are-not-reassuring/"><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color">16 cases in 1998 to 278 in 2022, marking a 1,737.5 per cent increase</mark></a>. Perhaps more worryingly, during the same period, the proportion of patients referred for psychiatric evaluation sharply declined from 31.3 per cent to 1.1 per cent.
In New Zealand, the End of Life Choice Act 2019 legalised assisted suicide and euthanasia for individuals meeting specific criteria. The Act came into force on November 7, 2021, following a public referendum at the 2020 General Election. The law was sold to the general public with “robust safeguards”. Those wanting a lethal cocktail or injection must suffer from a terminal illness, likely to end their life within six months and be in an advanced state of irreversible decline in physical capability. Just three years later, David Seymour, the law’s architect and now Associate Health Minister, is seeking to widen the scope.
In Australia, euthanasia has only been legal across all states since November 28 of last year. However, less than a year later, there are already calls to expand it. There is significant pressure to extend the law to include patients suffering from dementia, which would effectively remove the provision of meaningful consent. Additionally, Andrew Denton, the founder of Go Gentle, a campaign group instrumental in passing the law, has described it as the<a href="https://www.gogentleaustralia.org.au/who_we_are"> “first step” and said he now wants to make assisted dying “accessible to all”</a>.
Philip Nitschke, leader of Exit International and another strong proponent for the Australian law, believes euthanasia should be available under any circumstances. The Peaceful Pill eHandbook and its associated forum, which Nitschke authored, encourage readers to use the drug Nembutal to end their lives. Despite the book allegedly only being available to those over the age of 50, it has been linked to multiple deaths of <a href="https://www.abc.net.au/news/2014-07-25/euthanasia-forum-coached-young-man-into-taking-his-life-mother/5623408">young people in their 20s</a>. Nitschke is undeterred by these deaths, believing them necessary to allow others to end their lives.
However, the country that has demonstrated the quickest and most chilling example of the slippery slope is Canada. In 2016, Canada’s Parliament passed legislation to allow Medical Assistance in Dying (MAiD) for adults with a grievous and irremediable medical condition who experience unbearable suffering and whose natural death is "reasonably foreseeable". In 2021, Canada expanded MAiD to include individuals whose death is not reasonably foreseeable, removing the requirement for the patient to be terminally ill. Amendments were also made to remove the minimum 10-day waiting period for those whose death was foreseeable. In 2023, lawmakers approved a provision to expand MAiD for individuals suffering solely from mental illness.
In February 2023, the Canadian Special Joint Parliamentary Committee on Medical Assistance in Dying issued a report recommending that MAiD be introduced for minors.
When euthanasia and assisted suicide became legal in Canada in 2016, such deaths accounted for less than 0.6 per cent of all fatalities. By 2017, that had risen to one per cent. Quebec is the only province that has released its 2023 data, where it accounted for 7.3 per cent of all deaths, the highest rate in the world.
The impact this has had on Canada’s palliative care is stark. Leonie Herx, chair of the Division of Palliative Medicine and an Associate Professor in the Department of Medicine at Queen's University, Kingston, Ontario, told the <em>Catholic Herald</em> that “we have been taken backwards by decades in palliative care” and that euthanasia in Canada “has become a replacement for gaps in mental and social health care”.
The evidence across countries that have legalised euthanasia and assisted suicide is clear: it invariably stretches far beyond the initial stated intention.
The 2023 Dutch law, which legalised assisted dying for children under 12, finds its strongest legal parallel in Kinder-Euthanasie (the child euthanasia policy in Nazi Germany), which similarly did not require the consent of the child in question. Canada has also shown an appetite for following in the footsteps of Nazism in the implementation of euthanasia, administering it to individuals suffering from mental illness whose primary reasons were “unmet social needs”, such as isolation and fears of homelessness.
The key difference is that in 1946, the architects of such policies – which led directly to the Holocaust – were held to account, whereas the Netherlands seeks to expand the scope of its laws to include social reasons, and the “<a href="https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html"><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color">Government of Canada remains committed to supporting the autonomy of eligible persons to seek MAiD</mark></a>”.
Despite all these examples from around the world, Dignity in Dying, the campaign group formerly known as the Voluntary Euthanasia Society, has claimed that “<a href="https://www.dignityindying.org.uk/assisted-dying/key-questions/"><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color">where assisted dying is legal there have been no cases of abuse and no widening of the law</mark></a>”. An abundance of evidence proves otherwise.
When one cuts through the spin, the propaganda, the lies and the euphemisms, it becomes vividly clear that on Friday the House of Commons faces a clear and simple choice. Our MPs will be asked to choose between life and death. Please write to your representative while there still is time.
<em>(Photo by Ben Stansall / AFP via Getty)</em>
