I have long believed that every individual with a terminal illness should have the autonomy to choose a dignified end to their suffering. I have supported assisted dying, convinced that compassionate legislation can relieve unbearable pain. Recent debates have reignited a conversation that is both deeply personal and political.
My conviction comes from enduring ideals and painful personal experience. In the final week of my mother’s life, I witnessed the physical and emotional anguish of terminal illness. Although her suffering was brief, those days were marked by excruciating pain. Had she had the option of assisted dying, she might have chosen a more controlled, peaceful departure. I remain grateful her pain was short-lived, yet I cannot help but think of those who suffer for far longer.
However, I harbour serious reservations about the current legislative approach. While Kim Leadbeater’s bill recognises individual choice, it risks overshadowing the urgent need for improved palliative care within our NHS. I have been influenced by concerns raised by disability campaigners, including Mary Regnier-Wilson’s tweets. She argues that the bill erodes trust in our healthcare system by pressurising vulnerable individuals into seeing assisted dying as their only escape from a failing support structure.
This perspective underscores a broader fear: that legalising assisted dying without addressing systemic issues will normalise a shortcut in end-of-life care instead of prompting the necessary investment in comprehensive support. Our palliative services remain under-resourced, with funding and staffing shortages and outdated facilities leading to substandard care. The bill’s narrow focus risks diverting attention from these critical reforms.
Critics contend that legalising assisted dying may offer a temporary escape for those in unbearable pain, but it does little to tackle broader healthcare inequalities. In a society where many already suffer from inadequate care, introducing assisted dying without first strengthening essential services feels nonsensical. As one poignant question asks, “what’s the point of living well, if we are unable to help those people die well too?”
Disability Rights UK warns that the bill could profoundly devalue disabled lives. Many disabled individuals face entrenched inequalities and pervasive ableism, with their lives often regarded as expendable. Additionally, safeguarding concerns highlight the risks for those in a system that already devalues them. These factors call for a cautious, balanced approach to any assisted dying legislation.
There aren’t enough psychiatrists to conduct the robust assessments required by the bill. The legislation relies on thorough evaluations to determine mental competence and safeguard against decisions influenced by treatable conditions. However, the current shortage raises the risk that these vital safeguards may be compromised, with overburdened professionals forced to rush assessments and overlook nuances, coercion, or depression.
Kim Leadbeater has expressed disappointment in the cynicism surrounding the healthcare system and the perceived lack of faith in doctors. But as Mary Regnier-Wilson points out, this scepticism is not unfounded—many disabled and chronically ill individuals have faced repeated failures in care, not being listened to, and a lack of appropriate treatment. A responsible bill would recognise these realities and include safeguards that acknowledge the NHS is not infallible, rather than assuming a perfect system that does not exist.
My reflections are nuanced. If you ask me now, I would say “Yes” to having the option of assisted dying should I be diagnosed with a terminal illness. But this is the view of someone relatively healthy today. I cannot predict what the future holds. Life is unpredictable—consider my great uncle, who lived to 102. For 20 years, he was invariably insistent he had a terminal condition, predicting he’d die within six months. Though we suspected he was more a stubborn hypochondriac than truly ill, his recurring forecasts serve as a poignant reminder that our perceptions of quality of life and our choices can evolve.
Ultimately, the debate over assisted dying should not force a false dichotomy between legalising it and improving palliative care. We must strive for an integrated approach that respects individual autonomy while addressing the deficiencies in our healthcare system. True compassion means empowering individuals to decide how and when to end their suffering—provided we ensure every patient receives the best care throughout their illness.
In the end, the conversation around assisted dying is as complex as it is personal, touching on freedom, inequality, and societal values. My mother’s final days have deepened my belief that assisted dying can be humane under the right circumstances. Yet we must not let a legislative quick fix distract from reforming palliative care and social support systems. Only by addressing both can we build a framework that honours life—and death—with equal dignity.
* Nick Da Costa is Chair of the Federal Conference Committee
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12 Comments
Rather than “overshadowing the urgent need for improved palliative care within our NHS” I suggest the Bill has done an excellent job of highlighting it.
Of course this must not be an either/or, but rather than being a “legislative quick fix” the Bill is rightly getting a lot of scrutiny, and I trust that the relevant experts will improve it as required.
But this might be the only chance in my lifetime to gain the right to choose a dignified end for those facing terrible suffering from terminal conditions, and I sincerely hope it does not slip away.
This comment is key: “ Ultimately, the debate over assisted dying should not force a false dichotomy between legalising it and improving palliative care”
Legalising assisted dying should not force anyone to avail themselves of this option if they don’t wish to. But it would be profoundly illiberal to deny the option to those who do wish to avail of it.
Meanwhile today we have the worst of all worlds: under-resourced palliative care, people being forced to suffer against their wishes – and medical professionals sometimes taking decisions on behalf of people without their knowledge or consent. The Leadbetter bill isn’t perfect (imo it doesn’t go far enough) but it’s a start & far better than what we have today.
“The Leadbetter bill isn’t perfect (imo it doesn’t go far enough) but it’s a start & far better than what we have today.”
Agreed
@Nick Baird:
Thanks for the comment, Nick. I completely understand your perspective, and I agree that this Bill has shone a spotlight on the inadequacies of palliative care. However, my concern remains that the conversation (and legislation) is heavily weighted towards legalising assisted dying without a parallel commitment to significant long-term investment in palliative care.
I absolutely respect the argument that this may be a once-in-a-lifetime change to secure a right that many feel is overdue. But, in my view we need an equal focus (or a parrallel approach) to looking at ensuring we have high quality palliative and end of life care sorted as well.
@Domonic:
Thanks Dominic. I agree that this should not be an either / or debate, and I agree that legalising assisted dying should not mean that anyone is forced to choose it. The issue that I am highlighting is not whether the option should exist, but how to ensure it is a genuine choice rather than something people feel driven towards due to inadequate care and support.
You mention that today we have the “worst of all worlds” – I agree. But my issue with the Leadbetter Bill is that it only addresses one aspect, and does little else to fix the underlying problems.
You mention that the bill doesn’t go far enough – I would agree, I would want to see the bill go far further on palliative care and enhancing how we care for people at the end of life.
@Nonconfirmistradical.
Thanks for the comment:
I can see why many feel this is a necessary first step, but I worry that once this step is taken, the political momentum to improve palliative care will stall.
Yes, the Bill is a start, but I believe we need more than a start—we need guarantees that those at the end of their lives receive the support they need, whether they choose to live out their days or seek assisted dying.
My main concern with this Bill is the ability of the NHS to do what the legislators in favour of it think they will do.
I have always been in favour of assisted dying and remain in favour of the principle of it. I just think it’s really dangerous to bring this in when the fantasy NHS that leadbeater imagines, where everybody gets proper care from a Doctor who really cares about them, just doesn’t exist.
Legislation is meant to work in all circumstances and meant to be so well written that it binds people to what the legislators intend. This legislation refuses to accept that we don’t live in a society where there is capacity in the NHS to manage this, where there is Equality between living well with a terminal illness, and choosing to control the way you die with a terminal illness.
I’m am increasingly concerned that well-intentioned refinements and hedging around of this bill will help its opponents to sink it. Parliament hardly ever passes a bill that doesn’t need subsequent refinement and this one is no exception. Give the people the choice and reduce the appalling suffering that is still routine for the last months of life for far too many of us. Other nations that care more about their citizens than we do have shown that it can work.
The palliative care issue really is an unhelpful distraction. In England around half a million people die every year, a quarter of a million of us in hospitals where palliative care is patchy at best. One could argue that we already have assisted dying by combining minimal hospital care with a morphine driver, which is the end many of us will experience. The best deaths I have seen were in a hospice and yet in England we have just over 2000 hospice beds. State funding only pays for around 700 of those, with the remainder dependent upon charity. By all means let us fund hospices and take a burden away from hospitals. There will still be that minority for whom waiting for the body to finally give up amounts to torture and we should let them choose a dignified end to life.
It speaks volumes that Kim Leadbeater and her committe even voted 15-8 against an amendment to refer a patient requesting “assisted dying” to a paliative care specialist to discuss possible options for care, before they make a final decision. Leadbeater and her supporters pay lip service to “choice”, but clearly have little interest in offering the choice of a good death which is also a natural death.
The committee have voted down every amendment intended to tighten safeguards. They even voted down an amendment intended to prevent “assisted dying” for anorexia patients.
It also speaks volumes that the committee voted against recieving oral evidence from disability rights groups. Could it be because every disability rights group opposes “assisted dying”?
A valiant group of eight committee members have consistently voted for amendments to protect vulnerable people. Among them is the Liberal Democrats’ Sarah Olney. But invariably the vote is 15-8 against. Always the same 15 and the same 8. Apart from one single occasion when one of the 15 did vote for an amendment and it was 14-9. Kim Leadbeater ensured that her own supporters were in a majority on the committee, dispreportionately so in view of the relatively close vote at second reading
John Reed, you mention that there are not enough hospice places for everyone requiring one. But the answer to this is to increase funding to hospices, and to guarantee a place in a hospice to anyone who needs one. The answer is certainly *not* to enable doctors to administer poison to their patients
The problem for those who oppose assisted dying is that they neglect one important point. If people decide to die they almost always find a way. Often it’s painful, sometimes it takes a long time. We also know that for generations many doctors have prescribed drugs to ‘alleviate the pain’ that often lead to an earlier death. No-one talks about it, but we know it happens.
As a Liberal, I know I do not have the right to demand that people don’t seek an early death. That’s not my choice to make – and to be blunt, it’s not Catherine Crosland’s right either.
I struggle with the idea of assited dying, but this bill makes an honest attempt to put it on a legal footing and as Julian Huppert said on another thread, it’s a shared Liberal value.
There are a number of countries that have already introduced similar laws. Like John Reed and Mary Regnier-Wilson, I fear prevarication will sink the bill.
Mick, If we followed your reasoning to it’s logical conclusion, we would need to end all suicide prevention schemes, and the Samaritans would have to disband. Doctors would be expected to arrange a suicide for anyone who wanted one, for whatever reason. Indeed some countries are already dangerously far along that road, even though they, too, started off by promising it would only ever apply to the terminally ill