Allison Gardner MP: ‘You don’t have to oppose assisted dying to know that this bill isn’t right’

Like many MPs, I have spent a great deal of time over the past few years deeply considering the assisted dying debate. I have not drawn a firm conclusion on the principle of the matter itself. Like many, I have personal experience of losing loved ones, and I have seen difficult deaths. I understand why people want parliament to consider changing the law.

But the question before parliament is not about whether we think introducing assisted death is ethical in the abstract. The question is if this bill, in this societal moment, is the right way to do it. Having looked closely at the evidence, experiences of other jurisdictions, views from healthcare and disability organisations, and the practical implications of what is proposed, my first conclusion is clear: it can’t be this bill.

My greatest concern with the text before us is the inadequacy of the safeguards provided. We know that systems designed to protect vulnerable people can fail, and in this legislation, the consequences of a failure could be fatal.

The safeguards on paper that are meant to prevent patients from being coerced to die cannot truly account for all the pressures of life. Doctors will be asked to adjudicate whether someone is being forced to participate against their will. Take, for example, victims of domestic abuse. Coercive control does not always involve an explicit threat. However, years of manipulation, financial abuse and psychological pressure, leaving someone feeling that they are a burden on those around them, are no less real. A terminal diagnosis, increasing dependency and the prospect of expensive or exhausting care could make those pressures more significant, leading someone to “choose” to die when they may not otherwise have done so. 

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The government’s own equality impact assessment of the bill acknowledges that disabled people are twice as likely as non-disabled people to experience domestic abuse, including coercive behaviour. While the bill may insist on doctors being satisfied that a patient’s decision is voluntary, the sheer volume of likely applicants (as many as 10,428 or more by Year 10) increases the likelihood that coercion will be missed. A flawed assessment of a situation can unintentionally lead to a tragic death. Notably, not a single organisation which supports victims of domestic abuse backs this bill. 

At the core of our party’s DNA is a commitment to uphold the vulnerable and fight for equality in the face of structural discrimination. It seems to me that this bill, then, given its detailed risks, is at odds with a central tenet of who we are and what we stand for as a party. 

That brings me to my second conclusion: not now.

As Andy Burnham has identified and settled on as a priority issue at the very start of his tenure as prime minister, Britain is in the middle of a crisis in palliative and end-of-life care. Three quarters of hospices in England are running a deficit, two in five are planning further clinical cuts, and 380 hospice beds are currently out of use because of funding pressures. 

I support and uphold the principles of free choice and bodily autonomy. But it isn’t fair to act like this assisted dying regime would offer a “free choice” in our current climate if the alternative to a premature death is a lengthy wait for a failing care system to come to one’s aid.

The risks within this context will be particularly acute to those who already face structural discrimination. The government’s new equality impact assessment warns that people from ethnic minorities will be disproportionately likely to opt for an early death under the bill due to the influences of poorer access to healthcare, lower-quality care and poverty. If someone is struggling to obtain hospice care, social care, adequate pain relief or support for their family, we should be asking how we provide those things, rather than assuming that the existence of a legal option to die resolves the underlying problem.

Given the high stakes involved, it seems particularly unwise that the vehicle for this attempt to legalise assisted dying was a private members’ bill, and that a threat now looms large that the same bill will be shoehorned into law via the Parliament Acts if need be. The sponsors of the bill seem likely to reject any attempts to amend the text, leaving many significant flaws in the bill highlighted by the House of Lords in the previous session unaddressed by MPs, in order to leave this option on the table. Assisted dying was always going to be a complex issue that required time and dedicated attention to avoid the bear traps inherent in legislation of this kind. Unfortunately, the means being used to bludgeon this clearly flawed bill into law feel recklessly inconsiderate of the importance of getting the content right.

While I remain open-minded on the wider issue of assisted dying, I am equally resolute that this bill, and this timing, falls short of what is safe and fair for our public services and our vulnerable groups. If and when parliament offers a new choice for terminally ill patients at the end of life, we must ensure that they have the care, protection and support to make that choice genuinely free.