Today’s vote in favour of assisted dying is more catastrophic than historic

In a decision that has come as something of a shock to both sides of this impassioned debate, MPs have voted this afternoon of a bill to legalise assisted dying in England and Wales. Although the bill will still have to navigate months of parliamentary scrutiny and approval, this will amount to little more than tightening the language and technicalities. The fact is, the principle has been established and Britain now joins just a small handful of countries around the world whose legislators have decided to impose assisted dying on their populations.

The final vote was 330 MP in support, with 270 against. Labour and Liberal Democrat MPs voted overwhelming for the bill (Labour 234 for, 147 against; Liberal Democrats 62 for, 11 against). Conservatives were largely against (92 against, 23 for). We are told that most MPs received hundreds of letter from their constituents on the subject, though few legislators were saying whether or not their constituents overwhelmingly supported or opposed the bill.

There was no public debate on this fundamental issue of human rights, and no referendum, which frankly there ought to have been. Sadly, MPs clearly thought the public was too dull and too uninformed to be consulted and they knew far better when it came deciding an issue that hits to the very core of the sanctity of human life and the Hippocratic oath. However one justifies or decries the result, most are agreed that this is very likely a seminal moment in British political history and social policy and, whatever comes next, today’s vote was probably the most profound and significant that any of the current crop of legislators will ever be involved in.

After the vote, as MPs dashed off to get their trains home for the weekend, the best that was left were promises that the new bill would be scrutinised like no other, and improvements would be made to the initial text to ensure that adequate protections and safeguards are put in place. That may sound reassuring to some, but this bill has already pushed into highly questionable legal territory, not least that every application for assisted dying must be submitted to the High Court for approval.

The worrying rationale at the heart of this new bill is a recognition that doctors can’t be trusted on their own to assess a patient’s capacity to end their own life, so this now needs to be ratified by the High Court. Of the 37 countries around the world that have legalised assisted dying, none have gone for this approach, and with very good reason.

When it comes to other potential end-of-life situations such as refusing operations, extend care treatments or blood transfusions – British law is content that capable and competent patients and their medical advisers can make decisions that may end a person’s life. However, Labour MP Kim Leadbeater’s Terminally Ill Adults (end of life) Bill lays out that in the case of a requested suicide, the subject suddenly becomes a vulnerable person in need of the protection and direction of the state.

Of itself this is a fundamental contradiction of the existing law on the voluntary decisions around end-of-life issues, but the requirement to take assisted dying decisions through the upper courts creates a whole plethora of patient issues that clearly haven’t been considered properly.

Much has already been made of the potential pressures of becoming a burden that terminally ill people may feel, but facing a lengthy, traumatic and uncertain passage through the High Court could well encourage some patients to push for this route prematurely while they are still able and strong enough to do so.

It seems there could also be profound implications for the High Court itself. Professor Adam McCann, Associate Professor of Criminal Law and Criminal Justice at the University of Reading has warned that our already pressured High Court may simply find itself unable to cope with the volume of applications. Looking at the latest (1922) assisted dying case statistics from the USA (0.6% of all deaths) and Canada (3.9% of all deaths) Prof. McCann has estimated that if a corresponding percentage of patients were presented here in England and Wales, it could result in as many as 22,509 application coming before the High Court in any 12 month period, a figure that would simply overwhelm and log-jam the system.

Concern has also been expressed by many legal experts about the arbitrary nature of the six months’ limit placed on those seeking early death, and there have been arguments put forward for dismissing this requirement altogether as many patients determined to be suffering from a terminal illness can be expected to survive for longer than this. It has even been argued by some legal athorities that there is actually a stronger argument for assisted dying for those who are confronting a long period of incapacity and decline, rather than just a few months.

The very existence of considerations such as these ought to have acted as an obvious warning that this area of legislation, and the Leadbeater bill in particular, is open to the most blatant abuses and transformations. In other countries where assisted dying laws have come into effect it has only been a matter of months before idealogues have pushed for – and won – calamitous extensions and variations of the law to encompass other situations and circumstances. Most common of these revisions is to shift the legislation from arbitrary time periods such as six months, to a far more vague and unreliable measure such as the patient’s degree of suffering.

Perhaps this is understandable in a society where – sadly – personal autonomy and relativism are fast becoming the new pillars of secular ideology, but heading in this direction reduces the human person to a commodity to be disposed once their usefulness or potential for companionship has taken its course. Gripped by an irrational fear of pain and illness, or the need to care for our declining loved ones – at one end of the spectrum society does seem intent on creating a lifespan that includes only the good memories, whilst at the other it is apparently content to allow others to exit life’s journey just because at a particular moment of hopelessness life seems – to them at least – pointless.

Both of these extremities are of course unbearably difficult for those passing through them, but creating a law that simply mandates extermination is no solution to the problem.

Whether it’s end-of-life care or mental health support, what the very appearance of the Leadbeater bill demonstrates is the lamentable lack of interest from many legislators over the years in providing meaningful and comprehensive care services in these areas. Both counselling and palliative care services are transformative and incredibly effective, but we already have a broken health system in this country that is failing to provide even basic care to its citizens, so to put it bluntly there has been little interest in committing funds and resources to people whose lives are compromised or ending anyway.

Following the vote Bishop John Sherrington, Lead Bishop for Life Issues, expressed his disappointment at a bill that the Catholic Bishops of England & Wales consider to be “flawed in principle and also contains particular clauses that are of concern”.

“In addition to being opposed to the principle of assisted suicide, we are particularly concerned with clauses in the bill that prevent doctors from properly exercising conscientious objection, provide inadequate protection to hospices and care homes that do not wish to participate in assisted suicide and allow doctors to initiate conversations about assisted suicide,” said Bishop Sherrington.

“We have expressed the view, during this debate, that genuine compassion involves walking with those who need care, especially during sickness, disability and old age. The vocation to care is at the heart of the lives of so many people who look after their loved ones and is the sign of a truly compassionate society. It is essential that we nurture and renew the innate call that many people have to compassionately care for others.

“It remains the case that improving the quality and availability of palliative care offers the best pathway to reducing suffering at the end of life.”

As well as the many doubts being expressed about this particular bill, profound questions also need to be asked about private members’ bills in general, and how such initiatives are handled when they come before parliament. After today’s vote Prime Minister Keir Starmer will be able to call Esther Rantzen to confirm that he has honoured his personal pledge to her, but what’s far less clear is how much support – or more crucially – debating time his Labour government will give to this bill as it progresses through its next stages.

Many of the MPs who spoke today complained that this whole thing has been a rushed process, but seemingly there just weren’t enough concerned voices to put a stop to it. The hopes of those who voted against are now resting on creating as much debate, deliberation and impediments as possible as the bill passes through its next stages. That’s all very well but this new Labour government was voted in by many in the faint hope that it just might have the passion and capability to address and correct some of the most urgent and problematic social and political issues this country is facing right now.

Today, after just one member was able to present a personal bill to the house, it looks highly likely that other more vital legislation is going to be held up in the queue whilst legislators battle out the small print on a subject that, frankly, few citizens were particularly interested in before the Member of Parliament for Spen Valley intervened and so dramatically altered the course of British legal history.

Joseph Kelly is Catholic writer and theologian