Last year, Labour MP Kim Leadbeater spoke passionately in a parliamentary debate on mental health care, complaining about lack of support for citizens in need and demanding “a revolution” in treatment.
She was right to say this: it should be a top priority for a country that has hollowed out community psychiatric and social care services with such devastating consequences. Our system ignores too many patients until they explode in crisis – then relies on sedation, restraint and incarceration in secure hospitals or prisons.
“The numbers matter, because they show the overwhelming scale of the problem that we are facing,” she said.
Leadbeater told the story of Amelia, a 16-year-old girl she met the previous week. “She was diagnosed with autism at the age of seven. For the past nine years, her mum, Anna, and her family have been trying to get help and support, and they are on their knees with exhaustion. Amelia has attempted to take her own life several times, and has been so let down by the system that she says that she just does not trust it anymore. It feels to her that she only gets any kind of support when there is an absolute crisis. I believe that, if she had got the support that she needed a long time ago, she and her family would be in a much better place today.”
Such stories are all too familiar. Her speech pointed out how families, teachers and voluntary groups must pick up the pieces for people falling through gaps.
Leadbeater’s party won power because people were desperate for change in a land where the NHS is a mess with massive waiting lists. Overloaded mental services are shockingly inadequate, even for children, and social care fails to support those in desperate need.
Teenagers such as Amelia still end up being dispatched into dreadful secure hospitals – although morally, medically and financially these are the wrong solution for their struggles.
Labour has done little to focus on these issues so far, although it has shown Westminster’s usual obsession with placating doctors at all costs while treating social care as a Cinderella public service whose salvation gets constantly postponed. Even the planned cap on care costs was ditched.
Now Leadbeater, who spoke so strongly about problems caused by glaring gaps in public services, wants to hurl a grenade into these floundering systems by legalising assisted dying.
She is tabling a bill this month to unleash legal euthanasia for terminally ill patients – a measure that would irrevocably change our country and caring services, sending Britain hurtling down a slippery slope of state-sanctioned and doctor-aided suicide.
As a liberal and an atheist, I have no ethical qualms about this concept, and might even choose it myself if confronted with painful death. Yet I have seen also the brilliance of palliative care, an inspirational and empathetic branch of medicine pioneered in Britain that deserves more support instead of being undermined.
Having investigated this supposedly progressive reform in three countries, I am left with profound concerns about its impact – and ultimately, about the morality of injecting such a lethal measure into a nation with deficient health and care services.
Its has been catastrophic in Canada, where one bioethicist warned British MPs last year that euthanasia was being used “to compensate for lack of resources and reduce healthcare costs”.
One woman told me how she was left sobbing after doctors pushed her towards medically-assisted death after diagnosis of stomach cancer. Instead, she flew to the United States to pay for treatment and recovered.
She told me: “I would tell Britain to only accept assisted dying when the health service is fixed – otherwise it is a very dangerous step to take.” And yet Canada’s cancer care and survival rates are better than Britain, which has some of the worst survival rates among wealthy nations while waiting lists rise every year.
Those pushing reform insist things will be different in Britain with protections for vulnerable people – but who can trust politicians and regulators after so many scandals involving agony or death for some of the weakest citizens in our inequitable society?
Even in Oregon, the US state hailed as a prototype for restrictive reform, almost half the applicants said they worried about being a burden on their families.
Some British proponents also say there will be no widening of the reform – just as reformers said in other places before the criteria was extended and the numbers choosing to kill themselves included children, couples wanting to die together, people with psychiatric conditions, and older people with dementia.
Once the door is open, it cannot be closed. In Belgium, I met a bright 23-year-old woman going through the euthanasia process due to mental health problems. “It is like physical pain,” she said. “It feels like I am breaking apart.”
In the Netherlands, where euthanasia now accounts for more than one in 20 deaths, one recent case included a teenager with depression.
One study published last year found eight Dutch people subjected to euthanasia simply because they felt unable to live with their autism or learning disability, along with 16 more closely related cases. Many saw being lonely as a central cause of their unbearable suffering.
Leadbeater spoke about removing fear for people facing death – but what about the fears of people failed by the state who might be pressurised to end their lives, as seen abroad? When so many people cannot access cancer treatment fast enough, struggle to afford care for dementia or are being denied essential support to live with neurodivergency, learning disabilities, or chronic health conditions, then some will choose a despairing death at their most vulnerable or loneliest points.
How much better if Westminster focused on fixing these corrosive problems instead of proposing to kill off some of the people being betrayed by their own collective inadequacy.
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