Assisted dying policies are beset by moral hazards
British politics has many charming uncodified institutions, from Black Rod’s door-knocking to the many polite fictions which pepper the constitution. A less charming one is the Assisted Dying Bill, which has been introduced, in one form or another, seven times over the last nine years. Its supporters, who seek to legalise euthanasia, are convinced that they are destined for victory — and they seem to have public opinion on their side.
Now they have added to their ranks Matt Hancock, the disgraced former Health Secretary, who supports it “as a freedom-loving Conservative”, as if he were discussing cutting up some regulatory red-tape. He compares it to the decriminalisation of homosexuality and the legalisation of gay marriage: merely the latest progressive struggle which is bound to succeed, for the arc of history is long, and bends toward justice.
On the very same day as Hancock’s declaration, it was reported in Canada that an injured veteran was casually asked if he wanted euthanasia when he was simply trying to obtain healthcare, without him ever having expressed an interest in ending his life. The week prior, the Associated Press reported cases where Canadian patients chose to die due to inadequate income support, and where disabled people who refused euthanasia were called “selfish” and accused of being a drain on resources, in one case by a hospital’s director of ethics.
Such reports have been legion ever since Canada legalised euthanasia in 2016, after its Supreme Court struck down the legal prohibition on assisted suicide because it infringed a constitutional right to life. Since then, many have chosen to die because, in the words of one who applied for it, they “simply cannot afford to keep on living”. Poverty itself is not a valid ground for euthanasia, but almost any chronic condition — including hearing loss in at least one case — can be. From 2023, mental illness will be a qualifying ground as well.
No doubt euthanasia’s proponents will dismiss Canada’s experience as an aberration and argue that it is possible to regulate away the moral hazards associated with the practice. The same argument was made by Canada’s judges, who brazenly dismissed the experience from the Netherlands, where children as young as 12 can now choose to die, and where a doctor was acquitted of murder even after admitting to euthanising an elderly woman despite her persistent protestations that she did not want to die.
But we do not even need to leave these islands to see what legalised euthanasia would look like in the UK. At the height of the the Covid pandemic, the very National Health Service which Hancock oversaw issued ‘Do Not Resuscitate’ orders for disabled patients — including ones with learning disabilities — who did not want, or in some cases did not know about them, while care homes reported that NHS representatives had ordered them to issue blanket DNR orders for all of their elderly inmates.
And one only has to consider the experience of the now-memory holed Liverpool Care Pathway, under which patients were starved to death in the name of “end-of-life care”, to realise the immense potential for abuse of legalised euthanasia within the NHS. Healthcare is ruinously expensive; euthanasia is cheap and value-for-money. No healthcare administrator, however well-intentioned, can ignore utilitarian considerations entirely, but the legalisation of euthanasia will make the moral hazard irresistible.
The incontrovertible truth is that, at a time of ageing populations and strained government budgets, it is absolutely impossible to establish a euthanasia regime that will not be abused, as has happened in every country which has legalised it.
Even if one has no inherent moral objections to a tightly regulated, limited scheme of euthanasia for those in unbearable pain at the end of their lives, such a scheme cannot and will not exist under present conditions. The slippery slope is real — do we really want to follow Matt Hancock down to the bottom of it?