“The thief comes only to steal and kill and destroy; I came that they may have life, and have it abundantly” (Jn 10:10 RSV).

Life – all life – is precious to God

If someone’s life is in danger, our natural impetus is to try and save them. I’m so thankful for the basic child first aid course that I attended at our local children’s centre when my daughter Emily was a baby. It meant I knew what to do when I returned to the room to find her as a toddler literally trying to climb up the wall in panic totally unable to breathe as some seemingly innocuous item had got stuck in her windpipe. I jumped into action, using my basic training to dislodge the blockage. I’ve actually had to do something similar often through the years, as Emily’s small mouth and poor chewing skills make her prone to choking.

My husband Martin and I have both had to step in to prevent suicides – Martin stayed talking to one young woman who was about to throw herself into the River Tyne until the police came to take over; I had to call 999 and race to get to my mentally ill friend’s house when she messaged me to tell me she’d taken an overdose.

My husband Martin and I have both had to step in to prevent suicides ...

Harrowing incidences, but at least two of these had a happy ending. Emily is celebrating her 18th birthday this weekend with a big party; the friend, with much help, came through the worst of her mental health problems and lived to enjoy life again.

Saving life

Saving life, in all its permutations, is central to the Christian gospel. As Jesus said, “I came that they might have life, and have it abundantly” – and he proceeded to demonstrate this in every way, with the healing of body and of mind, the raising the dead to life, and the transformation of once selfish lives to ones that lived for His Kingdom.

Lifesaving in all its forms originated or progressed under the influence of Christianity – whether we think of early Christians rescuing abandoned babies left to die of exposure, hospitals run by monasteries, Florence Nightingale transforming nursing care for wounded soldiers, and, most relevantly to current concerns, the start of the hospice movement. As a nation with a once-strong Christian foundation, this impetus to preserve life still runs strong in our people – though there are sadly many who would walk on by when action is needed.

Overturning a long-held principle

On the 29th November, MPs are to debate – for only half a day! – and vote on whether to allow assisted dying. For all we can really empathise with anyone who is suffering and no longer wants to live, a change in the law would remove that legal – God-given – assumption that we should do all that is reasonably possible to prioritise life, and that life, is, essentially sacred, whether old or young, healthy, disabled or sick.

the scope of the assisted dying bill will in all likelihood be widened, and analysis suggests that the supposed ‘safeguards’ to protect the vulnerable are open to abuse.

Of course, for someone with an estimated six months or less to live, what life is left will, in most cases, be short, often sadly with suffering. However, once this legal threshold is breached, evidence from elsewhere makes it clear that the scope of the assisted dying bill will in all likelihood be widened, and analysis suggests that the supposed ‘safeguards’ to protect the vulnerable are open to abuse.

Attend to those who have no voice

There are many big-name voices calling for assisted suicide. In more in-depth First Aid training, we are taught that, when assessing a multiple casualty incident, we should always (temporarily) ignore those who are making the most noise – they are not those who are most at risk. We must go first to those who are silent – who are unable to cry out due to the extent of their injuries. With the upcoming vote, those who have no voice are those most at risk of abuse of the assisted dying agenda, very often through coercion, which can be impossible to spot by an untrained medical professional.

Below, we are publishing the briefing paper on assisted suicide produced by the Lords and Commons Family and Child Protection Group, of which Prophecy Today’s founder and still mentor Clifford Hill was a founding member.

We must go first to those who are silent – who are unable to cry out due to the extent of their injuries.

The paper highlights harrowing cases where even with today’s legal protections, people considered vulnerable have been subjected to ‘end-of-life care’ without their consent. Please do read this – and please write to your MP to express your concerns about the dangers of this Bill, as they contemplate which way they should vote.

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Briefing Paper – The Risks of Legalising Assisted Suicide

The fine line between assisted dying and unlawful homicide

The full text of The Terminally Ill Adults (End of Life) Bill, introduced by Kim Leadbeater MP and due for its second reading on 29th November, has only recently been published. The Bill’s supporters are urging MPs to 'vote for compassion, choice and dignity'. This Briefing paper would also urge MPs to vote for compassion, choice and dignity, but with a significant difference in interpretation.

Current care for the dying

The UK is rightly seen as a global leader in palliative care, but notwithstanding that, there is strong and compelling evidence that vulnerable and/or elderly patients, not necessarily suffering from terminal conditions or otherwise approaching death, on admission to hospital are being routinely and inappropriately medically assessed as ‘end-of-life’ and being prematurely put on end-of-life care plans, with the result that they die. Such assessment includes a Do Not Resuscitate (DNR) order, all too often imposed without the knowledge or agreement of the patient or their family, accompanied by the withdrawal of vital medication, including for these purposes food and hydration, combined with the inappropriate prescription of opioid drugs, including midazolam and morphine, administered with the sole object of rendering the patient comatose and hastening death.

Exact numbers are unknown – recently bereaved families, though enraged at the heartless treatment received by their loved ones, often just want to be left alone to grieve – but for the recent Report of the Lords and Commons Family and Child Protection Group (LCFCPG), When End of Life Care Goes Wrong, we received complaints from around 800 such families – the tip of a very large iceberg.

... we received complaints from around 800 such families – the tip of a very large iceberg.

From these 800 complaints, 17 were selected to feature in the report, their cases having been first subjected to full medical assessment by Emeritus Professor Sam H Ahmedzai FRCP, a cancer and palliative medicine specialist, who acted as Clinical Adviser to the 2019 NICE NG142 guideline on service delivery for people in the last year of life; and to legal assessment by barrister and medical law specialist James Bogle.

The stories contained in the Report are both horrifying and alarming, with decisions often being made on what doctors assess as current or expected ‘quality of life’.

Some of the cases:

1. A twenty-year old woman with learning difficulties, who reportedly ‘loved and led a full life’, was admitted to hospital for routine eye surgery. She was in hospital for some three and a half weeks, during which time she received no nutrition. Unbeknown to her parents, and despite repeated pleas to help their daughter, she had been placed by doctors on an end-of-life care pathway. At the inquest that followed her death, it was found by the coroner that malnutrition, ‘due to inadequate management of her nutritional needs’, and neglect had been the primary causes of death.
2. An elderly man was admitted to hospital with constipation – the medical team caring for him said treatment was ‘futile’ and attempted to pressure the family into agreeing to the withdrawal of all treatments. The family in this case mounted a legal challenge, which went to trial in the High Court, where the family won a declaration that treatments were not ‘futile’, that the patient had ‘a life worth living’, and that treatment should therefore continue. He survived another 7 months, before finally succumbing to a hospital acquired infection.
3. A second elderly man, assessed on admission as not having ‘a reasonable quality of life’, unexpectedly died 30 seconds after receiving an unspecified and unidentified injection. In subsequent conversation with the coroner, the man’s heartbroken daughter was told that her father’s death had not been due to natural causes and the family was advised to contact the police. Unfortunately, with no explanation of what might have happened, the patient’s body had already been cremated, making investigation impossible. Had an inquest been possible, the coroner expressed the belief that an inquest jury would have brought in a conviction of unlawful killing.
4. An 86-year-old lady with diabetes was admitted to hospital with pneumonia after breaking a leg. For reasons unexplained, she was put on Nil-by-mouth, and her daily medications were stopped, including Bisoprolol for heart failure. She had no problems with swallowing, and repeatedly asked for food. The Consultant refused all requests from her distraught family to reinstate treatment, with the result that she died a week later.

These are just a few of the many cases reported to us by grieving and aggrieved relatives. In every case included in the report, the patient wanted to live – but was not given the choice.

The Consultant refused all requests from her distraught family to reinstate treatment, with the result that she died a week later.

If this is happening while assisted suicide remains a crime under UK law, what will happen should that protection be removed? Proponents of assisted suicide argue that everyone has the right to choose how they will die, and that safeguards will be put in place to guard the vulnerable against abuse. Our Report proves, however, that such safeguards are already inadequate to protect those whose lives are deemed not worth saving – how then can they hope to better protect the elderly, disabled and vulnerable, should assisted suicide and euthanasia become legal?

Assessments are already being made as to the quality and value of life, with inhumane and callous treatments being imposed by doctors and medical staff who think ‘they know best’. Should assisted suicide and/or euthanasia become legal, those with adverse medical conditions requiring help to live will inevitably feel pressure to relieve others of the burden posed by their existence. This is coercion, and whether overt or psychological makes no difference. Many who would prefer to die ‘naturally’ will fall victim to the implied notion that, once they are no longer useful, they have a duty to stop burdening their families and the State. How then can we determine to what extent a decision is being freely made?

Evidence from a few jurisdictions where assisted suicide and euthanasia are legal

In Canada, medical assistance in dying (MAID) was legalised in 2016 for people aged 18 and older with a grievous and irreversible medical condition, and where death was judged as reasonably foreseeable in the near future. In the eight years since then, eligibility has been extended to include people not suffering from terminal illness, and now also includes those suffering from mental illness, such as depression and dementia¹. In 2022, medically assisted deaths accounted for 4.1% of all deaths in Canada, and there are an increasing number of reports of hospital staff offering medically assisted death to those with non-terminal, but incurable conditions.²

In 2022, medically assisted deaths accounted for 4.1% of all deaths in Canada, and there are an increasing number of reports of hospital staff offering medically assisted death to those with non-terminal, but incurable conditions.

In 1997, Oregon became the first US state to legalise physician assisted suicide, allowing terminally ill adults with a life expectancy of 6 months or less to end their lives through the voluntary self-administration of a lethal dose of medication, expressly prescribed for that purpose by a physician.³ Oregon is frequently cited as a best-practice model by those who wish the enactment of a similar law in the UK, and indeed has become the template for Kim Leadbeater’s Bill. It is claimed that there have so far been no recorded cases of abuse. In reality, it is impossible to know how far this claim is or isn’t true, because there is no central management for the system and, therefore, no verifiable data. Death records suggest, however, that around 10% of those who die from self-administration of such drugs do so at least one year after prescription, meaning that their deaths would not have fallen within the 6-month requirement when prescribed. It would also seem that such drugs are now being prescribed for non-terminal conditions, such as diabetes, and there are increasing reports of health insurers refusing to pay out for expensive medical treatment, offering instead to fund the far cheaper option of drugs for assisted suicide.⁴

In 2023, it was also recorded that 43% of those who elected to die by assisted suicide said it was because they felt they were a burden to family, friends, and caregivers.⁵

In 2001, the Netherlands became the first European country to legalise physician assisted dying and euthanasia. The patient had voluntarily to make the request and to be in unbearable suffering, with no prospect of improvement. Since 2002, euthanasia has also been legal for children aged 12 and over, but in 2023 this was extended to children between the ages of 1-12.⁶ Euthanasia has also now been extended to include those suffering from psychiatric conditions and dementia i.e. not from terminal illness. According to Dr Theo Boer, who between 2005-14 sat on a Dutch euthanasia review committee and reviewed a total of almost 4,000 cases, in the past twenty years, deaths from physician assisted suicide and euthanasia have quadrupled and now stand at 5.2% of all deaths in the Netherlands. He adds that, “In some neighbourhoods assisted deaths account for between 15% and 20% of all deaths.”⁷

The Dutch now also allow what they call ‘duo-euthanasia’, allowing couples who can’t face the prospect of a life alone, when their partner dies, to avoid the problem by dying together.

The Dutch now also allow what they call ‘duo-euthanasia’, allowing couples who can’t face the prospect of a life alone, when their partner dies, to avoid the problem by dying together.⁸

Conclusion

In every jurisdiction where physician assisted suicide has been legalised, it has been rapidly extended to include non-terminal conditions, including mental health and neurological conditions, such as depression and dementia. Both the Netherlands and Belgium now also allow euthanasia of children, with the proviso that they fully understand and consent to what is happening. But the question must surely be asked, how can a child, with necessarily limited life experience, possibly understand what is being proposed, or fully comprehend the enormity of the decision they’re being asked to make? At what point do they become sufficiently mature or independent to exercise such responsibiliy?

Whatever is maintained by proponents of a change to the law, it will be impossible to confine eligibility to the terminally ill with projected life expectancy of 6 months of less. Indeed, we are already seeing calls from MPs for the scope of the Bill to be extended to those who are ‘incurably suffering’.

Yet perhaps most persuasive of all, from the evidence we already have of current practice in end-of-life care, it will prove impossible to put in place adequate safeguards to protect the elderly, disabled, and vulnerable from abuse. Any such law can only prove a charter for maltreatment, inevitably putting the vulnerable of all ages at risk. Indeed, in cash-strapped Britain, there is every chance a financially challenged NHS will come to regard any law permitting euthanasia, whether expressly or by implication, as a licence to cull those deemed of limited use and a drain on resources, in order to allow what they see as the best use of limited funds.

... to remove the prohibition against assisted suicide, even where made with the best of intentions, can only sanitise and promote a culture of death, where culling the burdensome and infirm becomes ‘a moral duty’.

In sum, to remove the prohibition against assisted suicide, even where made with the best of intentions, can only sanitise and promote a culture of death, where culling the burdensome and infirm becomes ‘a moral duty’. It need hardly be added that it would also radically undermine respect for, and trust in, the medical profession, which historically has been relied upon to protect, and not threaten, the lives of those in their care.

One can only feel sympathy for those nearing the end of life, suffering ‘unbearable’ pain and wishing to end it all at a time and place of their choosing, but to change the law for those few cannot justify the unquantifiable harm to the many.

Lords and Commons Family and Child Protection Group
Chairman: Carla Lockhart MP Convenor: Revd Lynda Rose Deputy Convenor: Dr Tony Rucinski

Notes

¹https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html
²https://www.ctvnews.ca/health/chronically-ill-man-releases-audio-of-hospital-staff-offering-assisted-death-1.4038841
³https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Pages/faqs.aspx#whatis
⁴https://www.washingtontimes.com/news/2017/may/31/insurance-companies-denied-treatment-to-patients-o/
⁵Oregon Death with Dignity Act, 2023 Data Summary, Oregon Health Authority, Public Health Division, Center for Health Statistics, March 20 2024. https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITY ACT/Documents/year26.pdf
⁶https://www.reuters.com/world/europe/dutch-widen-right-to-die-include-terminally-ill-children-2023-04-14/
⁷Joint Committee on Assisted Dying debate, Houses of the Oireachtas, 26 Sep 2023; https://www.oireachtas.ie/en/debates/debate/joint_committee_on_assisted_dying/2023-09-26/2/
⁸https://www.theguardian.com/world/2024/feb/10/duo-euthanasia-former-dutch-prime-minister-dies-wife-dries-eugenie-van-agt ; https://www.bbc.co.uk/news/articles/c0jjq2vynq7o
⁹https://www.telegraph.co.uk/politics/2024/10/05/widen-access-to-assisted-dying-say-labour-mps/