Legalizing Assisted Suicide: A Slippery Slope
The British parliament is currently debating legalisation around assisted suicide, which has long been a contentious issue since it raises profound ethical, social, and medical questions. Proponents argue it offers dignity to terminally ill individuals seeking relief from unbearable suffering in their final years. By offering them a legal route to end their suffering such laws reduce the need for people to go abroad or implicate their loved ones in criminal activity.
However, opponents caution against the broader societal consequence of assisted dying laws. The most alarming of these is the potential for a “slippery slope” effect, whereby the initial intent to limit assisted suicide to exceptional cases erodes, leading to a normalization of death as a solution to various forms of suffering and vulnerability. Canada offers a cautionary tale in this regard that serves as a stark warning of how such legislation can evolve, moving from providing a compassionate option for the terminally ill to encompassing individuals struggling with other non-terminal conditions and difficult life circumstances.
Canada’s Medical Assistance in Dying (MAiD) program, legalized in 2016, was initially designed with strict safeguards to ensure it was limited to adults facing imminent death due to terminal illnesses. These safeguards have gradually loosened over time and now the eligibility criteria has expanded to include individuals with chronic illnesses, even if their deaths were not reasonably foreseeable. More controversially, Canada is now set to extend MAiD to individuals whose sole underlying condition is mental illness, which raises questions around consent and eligibility.
Furthermore, reports have surfaced of Canadians seeking assisted suicide due to poverty, lack of access to adequate healthcare, loneliness or housing insecurity. In one case a woman who was diagnosed with Multiple Chemical Sensitivity, a condition in which exposure to common household chemicals can lead to adverse symptoms such as nausea and shock, applied to end her life after she struggled to find suitable housing and survive off her meagre disability benefits.
Rather than addressing the root causes of their suffering, the system has offered them death as a solution. A 2022 report revealed cases where individuals with disabilities, who lacked sufficient support, turned to MAiD out of desperation rather than genuine choice. This shift underscores the danger of normalizing assisted suicide: it risks transforming a safeguard for the terminally ill into a tool that exacerbates systemic inequalities and abandons society’s most vulnerable.
Once assisted suicide is legalized, the criteria for eligibility often become a subject of debate and gradual expansion. In Canada, this progression illustrates how difficult it is to contain the practice within the limits originally promised. Currently, Canada’s MAiD death rate is 4.1%, with the province of Quebec having the highest rate in the world at 5.1%. There are even reports that suggest medical professional often suggest this option to people who would have not considered it otherwise. If the UK were to legalize assisted suicide, it is reasonable to expect similar pressures for expansion over time.
The initial argument for assisted suicide centres on terminal illnesses where death is imminent and unavoidable. Yet, once society accepts that some forms of suffering justify assisted death, it becomes challenging to exclude others. Mental health conditions, for instance, often involve profound suffering, and advocates may argue that denying these individuals the same option constitutes discrimination. However, unlike terminal illnesses, mental health struggles are often treatable, and recovery is possible. Offering death as a solution risks undermining efforts to improve mental health services and reinforces the stigma that such conditions are insurmountable.
Legalizing assisted suicide also risks fundamentally altering societal attitudes toward the value of human life, particularly for those who are vulnerable. In a healthcare system already under strain, the availability of assisted suicide could lead to subtle, unintentional coercion. Patients who feel like a burden on their families or the healthcare system might perceive assisted suicide as an expectation rather than a choice. This risk is especially pronounced for elderly individuals, people with disabilities, and those facing financial hardship.
The Canadian experience illustrates how easily societal priorities can shift. Instead of investing in better palliative care, mental health support, or social services, offering assisted suicide becomes a cost-effective alternative. In the UK, where the National Health Service (NHS) is already grappling with funding shortages, this risk cannot be ignored. By making assisted suicide a legal option, society may inadvertently communicate that some lives are less worth living than others, eroding the principle of equal dignity for all.
While the suffering of individuals facing terminal or chronic illnesses cannot be dismissed, there are more ethical and effective ways to address their needs without resorting to assisted suicide. Comprehensive palliative care, which focuses on alleviating pain and improving quality of life, should be prioritized. Studies have shown that when patients receive high-quality palliative care, their desire for assisted suicide often diminishes. In cases of mental illness, greater investment in mental health services, including therapy, medication, and community support, is crucial.
Furthermore, the focus on legalizing assisted suicide risks diverting attention and resources away from these alternatives. It creates a false dichotomy, suggesting that the only choices are unbearable suffering or death, when in reality, a third option—improved care and support—can and should be pursued.
The assisted suicide bill under consideration in the UK could represent a dangerous step toward normalizing death as a solution to suffering. Whilst there may be some very extreme and rare cases in which such a measure could be justified, the Canadian experience demonstrates how even strict safeguards can erode over time, leading to a widening scope of eligibility and unintended consequences. By offering death as a solution to individuals struggling with mental health issues or systemic inequalities, society risks abandoning its most vulnerable members and undermining the intrinsic value of life.
The UK should focus on addressing the root causes of suffering, whether through improved healthcare, mental health services, or social support systems. Assisted suicide may seem like a compassionate option in rare cases but how can we be confident that it does not evolve into a widespread and dangerous practice that targets and punishes the most vulnerable? The lesson from Canada is clear: once the door to assisted suicide is opened, it becomes exceedingly difficult to close. Therefore, the UK must think about this very carefully!