A historic moment for the United Kingdom

The assisted dying bill has serious problems, but it's through

Photo by Nick Fewings

The United Kingdom’s House of Commons just passed a bill that, once it goes through the committee process, will legalize assisted dying in England and Wales. The past few months of debate have been extremely fraught and, at 330 to 275, the vote was relatively close.

With this vote, assisted dying continues its expansion around the world. Thankfully, the majority of members of parliament didn’t fall for the misinformation and bad takes that have proliferated in attempts to stop the bill from passing. Other jurisdictions considering legislation have much to learn from how the U.K. process went.

While I’m glad the bill has passed, it has many problems. As with Oregon and New Zealand, it will require a person to be likely to die within six months due to a terminal illness. This excludes people who are suffering and want to die but have non-terminal illnesses, including people with multiple sclerosis, amyotrophic lateral sclerosis, disabilities, mental disorders, and others.

The current proposal also requires two physicians and a High Court judge to approve the request. Many jurisdictions have shown that two independent physician assessments is a sufficient safeguard. Requiring a judge’s approval will delay access.

Finally, the bill will only allow the medication to be self-administered by the patient (i.e., so-called assisted suicide instead of euthanasia). This approach, which follows Oregon and Switzerland, has the significant downside of making it more difficult, and sometimes impossible, for people with physical disabilities to have an assisted death. The bill describes in detail how the physician may help. They are permitted to

(a) prepare that substance for self-administration by that person,

(b) prepare a medical device which will enable that person to

self-administer the substance, and

(c) assist that person to ingest or otherwise self-administer the substance

This is better than other jurisdictions, but a provision that allows the provider to directly administer the medication in situations where those three options are insufficient would be better.

The bill gets some stuff right. Providers who are unwilling to assess or provide information must refer the patient to a willing provider. Providers are also permitted to mention assisted dying without needing to be asked about it by the patient. Laws that require the patient to initiate the conversation, such as in Australia and New Zealand, contribute to unequal access to people with lower health literacy.

There’s a saying among PhD students that the best dissertation is a finished dissertation. Politics is the art of the possible, so the best bill is a passed bill. The close vote shows that a more ambitious bill likely wouldn’t have made it through. Assisted dying continues to be a winning issue and, most importantly, patients will now have access to an important end-of-life option.