I hope this is the last piece I ever have to write about assisted dying
MPs, read this horror before you vote today. Here's how some people are slowly dying, right now, in mortal agony untreatable by the best palliative care: 'Some will retch at the stench of their own body rotting. Some will vomit their own faeces. Some will suffocate, slowly, inexorably, over several days.' An average of 17 people a day are dying these bad deaths, according to 2019 figures, as reported by palliative care professionals who see it happen.
The Inescapable Truth, a report from Dignity in Dying, revealed what is usually kept hidden from us: the shocking last months for the unluckiest. It could happen to you or me. The assisted dying bill's final Commons vote today is no abstract debate about slippery slopes or what God wants: to do nothing is to inflict torture on many.
The vote may be tight: unwhipped private members' bills rely on MPs turning up. At second reading, 330 were in favour, 275 against. After 100 hours of detailed scrutiny and many strict amendments, more than 40 MPs switched both ways. No longer a judge, but an expert panel with a lawyer, social worker and psychiatrist will examine each application. Compromises include a four-year wait after royal assent for the service to be set up. An ITV News vote tracker expects 154 MPs to vote for it, 144 against, 22 undecided and 21 abstainers.
Opponents are wheeling out their last-gasp tactics. Catholic bishops this week warned that the future of care homes and hospices will be put into 'grave doubt' by the legislation: 'Institutions whose mission has always been to provide compassionate care in sickness or old age, and to provide such care until the end of life, may have no choice, in the face of these demands, to withdraw from the provision of such care.' Disingenuous is a polite word – under the bill, health and social care workers can refuse involvement in the assisted dying process.
God moves in such mysterious ways that some of his followers hide his involvement, without publicly revealing their religious reasons for opposing. The campaign group Our Duty of Care doesn't mention God on its website – nor the fact it shares an office with and is financed by evangelical groups. Membership of Care Not Killing, which runs the Our Duty of Care campaign, is largely religious. Only God ordains the time of our entrances and exits. The mystery is its secretiveness. Presumably that's because his word cuts very little mustard in a country where 53% have no religion.
Others of the faith avoid mentioning him, such as Jacob Rees-Mogg on GB News, accusing Labour of 'a cult of death', with Labour MPs 'voting to finish off the elderly' in the week of the 'terrible vote from the House of Commons to allow infanticide of babies in the womb', after the Commons decriminalised women ending their pregnancies. Cult of death? That sounds more applicable to those willing to let others die in painful agony.
But not all opponents are religious. One of the oddest is the Royal College of Psychiatrists (RCPsych). Although the bill requires patients to be mentally competent to request assisted dying, among other objections the RCPsych reminds MPs that 'terminal illness is a risk factor for suicide'. That's the point – a time when suicide might be quite rational. Offering psychiatry instead of an easeful potion could be greeted with expletives from those in agony.
Disability groups have been persuasive, fearing they may be pushed towards shortening their lives, always at risk of being treated as inconvenient. But polling of those with disabilities shows 78% in favour assisted dying, in line with the rest of the population.
Scotland, Jersey and the Isle of Man have moved ahead of England on this, and France just joined the many countries in legalising the right to die. Hundreds travel to Dignitas in Switzerland: 52% of Brits say they would consider this grim and lonely death, but few can afford the £15,000. About 650 suicides of the dying are recorded; there may be more of these lonely, unassisted deaths.
If I sound intemperate, it's the memory of my mother's prolonged painful death: she thought her good GP would ease her way out but, post-Shipman, he couldn't. No, as some hope, morphine is not a kindly drug wafting you away – it can't remove all pain. Enough people have witnessed bad deaths that public opinion is strongly behind the right to die.
Opponents warn people may be pushed into a faster death because they are a perceived burden on their family. To avoid inflicting suffering on those around you seems to me a good reason for not leaving a miserable memory of your final months. Knowing it's an option, even if never used, will comfort many given a terminal diagnosis. What if, opponents keep warning, someone is pressed into it? Everything is a balance of risks: set the absolute certainty of some horrible deaths against the possibility that a dying person may lose a few months of life. Which is worse?
As Labour reaches one year in office, this vote should join this week's abortion decriminalisation as another milestone in the long history of personal freedoms that is always the party's legacy. While Harold Wilson never personally backed Roy Jenkins's long list of radical reforms, Keir Starmer has vociferously supported both bills. If it passes, it goes to the Lords, where 26 bishops will do their damnedest to stop it, reminding us why they should be removed along with the hereditaries. I have written often over many years on the right to die when we choose. I hope I never need to again.
Polly Toynbee is a Guardian columnist
In the UK and Ireland, Samaritans can be contacted on freephone 116 123, or email jo@samaritans.org or jo@samaritans.ie. In the US, you can call or text the National Suicide Prevention Lifeline on 988, chat on 988lifeline.org, or text HOME to 741741 to connect with a crisis counselor. In Australia, the crisis support service Lifeline is 13 11 14. Other international helplines can be found at befrienders.org
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