The assisted dying bill does not protect the sick and disabled

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Roula Khalaf, Editor of the FT, selects her favourite stories in this weekly newsletter.

The writer is a political journalist and disability advocate

I read the draft of the assisted dying bill as soon as it was published, just after 10pm on a Monday, fear and anger surging through me. As a disability advocate, I’d met the backbench Labour MP proposing the bill, Kim Leadbeater, a few days previously. We discussed the serious concerns I and many others have about the legislation — she told me repeatedly that I would be reassured by the tight language in the bill. But if anything, reading it made me even more alarmed: as written, this legislation poses a real threat to sick and disabled people.

While proponents of the bill are keen to emphasise that it only applies to those who are terminally ill and not to disabled people, this is not the watertight safeguard they profess it to be. The line between those groups is extremely blurry and long-term prognosis is not an exact science. Society also does not tend to view the two as separate. And, indeed, some supporters of assisted dying inside and outside Parliament have already started to call for eligibility to be expanded.

So it is only right that we apply what we know about how society treats disabled people to our analysis of the bill. And once we do, the alarm bells clamour.

The main issue with the proposed legislation is that it makes it a crime to coerce someone into assisted dying, yet does not define what that coercion could look like nor set out a method for determining its absence. This is a huge oversight. As I told Leadbeater, sick and disabled people are one of the most at-risk groups for coercion and abuse, whether in relationships in a romantic or familial setting or in institutional care. Many are already made to feel like burdens, or have essential support withheld as a means of control. It is astonishingly naive to argue that doctors and judges could spot this type of coercion, especially when it is not explicitly described in the bill.

That’s before you consider the coercive effects of society at large — constant discrimination, including strangers telling you that in your position they would kill themselves — and the acute care crisis which is the background to this bill. Are you making a free choice to die if it is underpinned by the state’s failure to provide you with adequate pain relief? What about if it is based on your feelings of guilt that your children have been left to care for you, with the wait for social care longer than your life expectancy? What about if the NHS will not fund the wheelchair that would allow you to get to the bathroom? There is, undeniably, a coercive impetus here, but the bill remains silent on these complications.

Such considerations tie in with another concern that the bill fails to address: coercion from medical and legal professionals themselves. The bill assumes that in these positions of power an individual would only act as a check or safeguard. But disability activists like me know all too well that they could potentially be the biggest risk of all. Medical ableism is a well-documented phenomenon, with disabled people routinely ignored and patronised, treated as drains on limited resources or simply assumed to have poor quality of life. We saw the deadly consequences of these attitudes during Covid, when thousands of disabled people had “do not resuscitate” orders placed on their files without their consent.

When we met, I pleaded with Leadbeater to recognise the risk doctors can pose to those she says she wants to help. Yet the bill makes this risk even worse than expected by giving doctors the explicit right to mention assisted dying — even to patients who haven’t asked about it. To anyone who has experienced the reality of some doctors’ attitudes to disability, this is simply unconscionable. 

Unless parliament acts to address these and other issues, the bill leaves sick and disabled people open to being coerced into early graves. As it stands, it simply must not pass.