How do we introduce assisted dying? Experts and politicians hope someone else has the answer

The Guardian

31-01-2025

There is something about the sound of Prof Sir Chris Whitty's voice that inexorably takes me back. Whenever he speaks it's hard not to think about R numbers and social distancing, masks and variants. His was the judgment we learned to trust in the days when the only certainty was that thousands were going to die; his the not-quite-inscrutable face we studied for clues that some politician had just said something stupid. For those reasons and more, I would very much like to know what the chief medical officer thinks about assisted dying for terminally ill people. But when he came before the committee scrutinising this most sensitive of issues on Wednesday, he wouldn't say.
Whitty answered all questions posed about the proposed new law, including how accurately doctors can predict that someone has only six months left. (Not entirely, though he explained that they're better at predicting that death will come in the foreseeable future – which seems more important here than whether it's five, six or seven months exactly, though Whitty didn't say the last part.) He wasn't asked how well doctors can predict what that death might be like: how much pain or indignity it's likely to involve, which might be equally hard to say but is what I'd want to know. (Some apply for assisted death without ever using the option, just to know it is there if needed.)
But on the principle of whether doctors should be allowed to help patients die, Whitty said he must be neutral. It was 'entirely for society' to decide.
For much of Tuesday, the committee heard from people who studiedly had no view. The General Medical Council, which investigates complaints against doctors, is officially neutral. The British Medical Association moved from opposed to neutral after re-surveying members, which you might take to mean doctors are warming to this or – as the anti-assisted dying MP Danny Kruger hinted in committee – that more activist junior doctors are (polling suggests palliative care doctors remain overwhelmingly opposed).
The prime minister is officially neutral, although everyone thinks he's privately in favour: medicine's in-house journal, the BMJ, says it 'continues to strive to represent all voices'. The committee heard this week from individuals with strong views – the British palliative care doctor Rachel Clarke, who is against, an Australian counterpart evangelising about how well it works there – but many institutions remain uneasily on the fence precisely because there's no consensus among members, making it impossible for one individual to speak authoritatively on behalf of the divided masses. But ultimately, that's what making laws requires politicians to do.
I still want to be convinced by this bill. My father's was what people call a good death – peaceful, with enough warning for us all to be there – and why shouldn't everyone have that? But a nagging worry remains about people feeling obliged to take the quick way out given pinched NHS resources, horribly patchy palliative care and guilt about burdening children. It is an unfortunate coincidence for this bill to run alongside yet another review of funding long-term care, leaving the idea that you could save everyone a fortune by taking yourself to Dignitas hanging unhelpfully over both.
I believe in open parliamentary scrutiny, and hoped it would clarify things. But social change this profound needs both consensus – a sense that the country decisively wants change, that parliament is catching up with, not outrunning public opinion – and authoritative leadership. Currently it has neither.
The clearest lead comes from the health secretary, Wes Streeting, who is vocally opposed. Though I understand the prime minister's desire not to force his own views on an issue of conscience, in practice that means devolving the public handling of Kim Leadbeater's bill to a backbench committee – some members more impressive than others – while ministers get dragged in behind the scenes anyway. This week brought reports that because the courts might be overloaded if judges heard every assisted dying application, professional panels could process them instead, a potential relaxation of safeguards said to have ministerial backing.
As for consensus, though polls show about two-thirds of the public in favour of assisted dying, polls also show two-thirds of young Americans are optimistic about the Trump presidency: let's just say people often don't know how they'll feel about the future until they've been carefully walked through all possible ramifications.
If society is to decide, who or what is society and how can we be sure what it thinks? There are models – the extensive public debate running up to the Irish referendum on legalising abortion is one, the philosopher Mary Warnock's report on regulating IVF another – which could have given parliament a more confident starting point. As it is, dozens of MPs are thought to have voted for the bill to reach this stage of scrutiny but reserved final judgment – a thoroughly sensible holding position, but one that reinforces the sense of everyone looking anxiously to someone else for a lead.
Whatever this is it's not the Irish model, which blew the argument wide open for everyone. And it's not the Warnock one, which derived its intellectual and moral authority from establishing core principles that endured even as the science rapidly evolved. Is it so unreasonable to ask that the business of ending a life be handled with the same care and thought as the business of creating it?
Gaby Hinsliff is a Guardian columnist