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Is Labour’s assisted dying plan a way to balance the books?

Assisted dying has become a fraught debate in the UK. Credit: Getty

September 17, 2024 - 7:00am

Over the weekend it was announced that a vote would be introduced to legalise assisted dying in Britain, with the Labour government saying it will not obstruct an MP from drafting a private members’ bill on the subject. While polling shows that assisted dying carries the support of most of the population, it remains a deeply divisive issue, with disagreements reaching across party lines. Prime Minister Keir Starmer is said to have a “strong opinion” in favour of allowing assisted dying, and has previously supported a change in the law.

It is likely a coincidence that the bill is being introduced just a week after the Office for Budget Responsibility (OBR) published its report showing the desperate state of Britain’s economy and finances. But in the future it may not be viewed that way, as the two issues are almost certain to become linked. One of the core problems highlighted by the OBR report was how an ageing population could put serious pressure on the Government budget between now and 2070, and it does not take much imagination to see how assisted dying might be seen by some — such as former MP and Times columnist Matthew Parris — as a “solution” to such a problem.

When a society ages, it has fewer working-age people to pay taxes and a growing elderly population which is reliant on the state. As older people age past the point of being able to take care of themselves, some of the workforce must leave their roles in the productive economy to become carers.

All of this puts a massive strain on resources. But because it is a simple numbers game, there is no obvious solution. Raising the retirement age can help at the margin, but as the older share of the population grows the effects of such manoeuvres do not last long. There is, however, one potential solution: eliminate some of the elderly population.

This may sound extreme, but the logic would probably not be that the state simply mandates a certain maximum age. Rather, we might imagine a society and healthcare system that finds itself under severe strain and starts putting pressure on the elderly and infirm to “take advantage” of euthanasia. Systems which are experiencing strains on their resources do everything possible to lower costs.

We can already see this logic at work in Canada. Since legalising euthanasia in 2016, the country now has some of the highest rates for assisted dying in the world. In 2022, 4.1% of people in Canada died through euthanasia — almost one in 20 deaths. There have been numerous reports of Canadian physicians putting pressure on ill or disabled people to allow themselves to be killed. Yet despite the enormous rates of euthanasia and the obvious abuses, the country is considering expanding services to people with mental illness. This is currently postponed, but it will likely become law at some point, thereby expanding the scope of the euthanasia programme further.

With an ageing society in the UK and an effectively bankrupt Treasury, to legalise assisted dying would be to play with fire. Proponents typically think of assisted dying as just a kind way to limit suffering, one choice among many in a consumer society characterised by abundance. But the reality is that Britain over the next 50 years will be one in which resource conservation will be key. Given this incentive structure, most of the liberal thought experiments about assisted dying become redundant — and human life becomes merely a liability on a balance sheet.


Philip Pilkington is a macroeconomist and investment professional, and the author of The Reformation in Economics

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j watson
j watson
23 days ago

Well the haters of immigration will have an alternative option in their dotage won’t they!
More seriously there is overwhelming support for more dignity in dying – c80% across all sections of our demographics. If the Govt allows a free vote it’s likely MPs will reflect this sentiment.
But the devil will be in the detail and some important lessons can be learned from likes of Canada, Netherlands, Switzerland etc. We can do it better.

Andrew R
Andrew R
23 days ago
Reply to  j watson

“…haters of immigration” (eye roll). JW if I said you had an immigration fet1sh, how would you feel about that?

Ian Barton
Ian Barton
23 days ago
Reply to  j watson

Spot on (except for the first sentence of course).

Caradog Wiliams
Caradog Wiliams
23 days ago
Reply to  j watson

It is amazing that younger people have always seen old people as stupid and boring. An arrogance which will continue for ever.

Peter B
Peter B
23 days ago

I don’t think that’s always been true in the UK. And isn’t the case in all countries and cultures today. For sure, I think the cult of youth has run too far in countries like the UK and experience and judgement are hugely underrated (one only has to look at recent prime ministers and many of the near juvenile MPs of the past 20 years). However, I think we may have passed the worst now.

Martin M
Martin M
23 days ago
Reply to  Peter B

Not only that, but some old people are stupid and boring.

Rasmus Fogh
Rasmus Fogh
23 days ago
Reply to  j watson

No, we cannot do it better. It is not possible. Once it is officially accepted that suicide is a) an individual right, b) supported as a good thing by society and the medical estabishment, the pro-suicide forces will in time push througth any temporary restraints. The state wants to save money. Lots of people want to kill themselves and demand that society validates and supports their decisions. If some dodgy case hits the media, well, the person concerned wanted it, and anyway is already dead, no need to make a fuss and make the doctors uncomfortable. People who want to maintain and enforce limits will be derisively ignored – much like those today who try to interfere with a woman’s right to choose abolrtion by enforcing the relevant laws.

Peter B
Peter B
23 days ago
Reply to  Rasmus Fogh

This isn’t correct.
There is nothing in proposals for assisted dying – or actual implementations in other countries – that “supports as a good thing” assisted dying by either society or the medical profession. It is strictly a medical exception and not a preferred option.
If you look at abortion, this is not preferred or promoted by the NHS. Nor is it seen as a good thing by society as a whole. It’s seen as a necessary evil in some cases and tolerated in others.

Rasmus Fogh
Rasmus Fogh
23 days ago
Reply to  Peter B

Regrettably, I think *you* are not correct.

As abortion and assisted suicide are implemented they are not seen as exceptions, nor as evils, necessary or otherwise. They are supported as perfectly equal choices, something that society not only allows, but facilitates and approves of. Abortion is in many situations the recommended default option: Imagine a pregnant seventeen-year-old. Will social workers pressure her – gently, of course – to keep the baby, or to get an abortion? Assisted suicide will similarly become the standard option in a number of cases – as has already been seen in Canada, and any limits on when it is allowed will gradually wither away. As has been seen for abortion everywhere, and for assisted suicide too.

Once there are no clear moral barriers practicality will do the rest. Babies and old people are demanding, messy, and expensive, and reduce your freedom to do what you like. Why would you *not* work to get rid of them, when society clearly supports the idea?

Martin M
Martin M
23 days ago

While polling shows that assisted dying carries the support of most of the population….” In light of that, what is the problem? Far better to just get it done.

Helen Nevitt
Helen Nevitt
23 days ago
Reply to  Martin M

I would like a full discussion first.

Steven Carr
Steven Carr
23 days ago

The population is ageing rapidly, and it is hard for taxpayers to fund pensions for them all.
For example, the British Medical Journal recently reported that just in Tower Hamlets alone, there are 300 people over the age of 105.
Extrapolate that over the country, and you can see the problem.

John Robertson
John Robertson
23 days ago
Reply to  Steven Carr

Thats likely mostly made up of bogus benefit claimants, same in other areas in london with high transient and migrant populations.

E Wyatt
E Wyatt
23 days ago
Reply to  John Robertson

Yes, has anyone checked they’re still alive in recent years?

Drew Gibson
Drew Gibson
23 days ago
Reply to  Steven Carr

Interesting piece of research. Looks like most people over 100 are actually dead 🙂 div > p > a”> div > p > a”>https://theconversation.com/the-data-on-extreme-human-ageing-is-rotten-from-the-inside-out- div > p > a:nth-of-type(2)”>ig div > p > a:nth-of-type(3)”>- div > p > a:nth-of-type(4)”>nobel div > p > a:nth-of-type(5)”>-winner-saul-justin-newman-239023?utm_medium=email&utm_campaign=Latest%20from%20The%20Conversation%20for%20September%2013%202024%20-%203097031576&utm_content=Latest%20from%20The%20Conversation%20for%20September%2013%202024%20-%203097031576+CID_3824f6c14c82ca536166e017af5d7d6e&utm_source=campaign_monitor_uk&utm_term=The%20data%20on%20extreme%20human%20ageing%20is%20rotten%20from%20the%20inside%20out%20%20Ig%20Nobel%20winner%20Saul%20Justin%20Newman

Billy Bob
Billy Bob
23 days ago

How many of those Canadians were terminally ill or simply at the end of their lives? Without that number (and many others) it’s hard to say whether the system is being abused as much as is being claimed

UnHerd Reader
UnHerd Reader
23 days ago
Reply to  Billy Bob

According to credible reports Trudeau has abused ot a lot.

Billy Bob
Billy Bob
23 days ago
Reply to  UnHerd Reader

He’s personally bumped them off?

Martin M
Martin M
23 days ago
Reply to  Billy Bob

That is absurd! I’m sure he has people to do that for him!

Thomas Wagner
Thomas Wagner
23 days ago
Reply to  Martin M

Plausible deniability. Or deniable plausibility. Take your choice.

Helen Nevitt
Helen Nevitt
23 days ago
Reply to  Billy Bob

There are verifiable cases of how this is routinely abused in Canada. A military vet, a woman, needed a new wheelchair and was offered assisted suicide as an alternative.

Imagine what that would do to you psychologically.

Chris Milburn
Chris Milburn
22 days ago
Reply to  Billy Bob

I’m a doc working in Canada. And I can tell you it is VERY disturbing to watch the people choosing to be offed. The catch-22 is that they have to do it before they are incapacitated. Once incapacitated, they don’t qualify. So people are choosing suicide long before their quality of life is zero, in many cases years before. Very, very disturbing. My plea to you Brits is not to be as naive as I was.
https://pairodocs.substack.com/p/assisted-suicide-suffering-and-slippery

UnHerd Reader
UnHerd Reader
23 days ago

Clearing the way for the onquerors.

Douglas Redmayne
Douglas Redmayne
23 days ago

Hysterical. Assisted dying offets more freedom of choice and reports from Canada are hyperbole. It is also not “deeply divisive” as most of the public support it as they do with abortion. As for helping fiscal sustainability it would require millions of deaths in tbe next 10 years which won’t happen.

Arthur G
Arthur G
23 days ago

It doesn’t offer more “freedom”. You’re free to commit suicide whenever you’d like.
It falsely medicalizes killing, which has nothing to do with medicine.

John Tyler
John Tyler
23 days ago

Seems to me you are hysterically complaining about anyone with whom you disagree! You might perhaps be more persuasive were you to stop hurling personal accusations of hysteria.

Chris Milburn
Chris Milburn
22 days ago

I’m a doc working in Canada, and can say very definitively that you’re wrong about the reports on Canada being hyperbolic. It’s even worse than you could imagine.

Peter B
Peter B
23 days ago

So why do they want to completely outlaw smoking ? This method worked pretty well culling off the old for decades and required no government or doctor intervention. Being a little facetious (and neglecting the suffering of the smokers), but there is an element of reinventing the wheel here – if we take the premise of the article as true (I’m not sure I do actually).
But the Treasury is not “effectively bankrupt”. I’ll give you that it’s intellectually bankrupt and economically incompetent. However, there is no real shortage of money. They’re just spending more than they earn. It’s all fixable, given the will.
One final thing: wake me up when Mathew Parris reaches the qualifying age.

Chipoko
Chipoko
23 days ago
Reply to  Peter B

Good points!

Dennis Roberts
Dennis Roberts
23 days ago
Reply to  Peter B

Different Govt Depts have different priorities

Jeremy Bray
Jeremy Bray
23 days ago
Reply to  Peter B

Indeed and why did we trash our economy trying to keep the elderly from being carried off a few months or years ahead of time with covid.

The problem is never a shortage of money; it is its misapplication and waste and the multiple incentives to idleness rather than desired productivity.

Perhaps special widow and widower state pension boosts to the surviving relatives of the euthanised should be available to really generate enthusiasm for euthanasia. We will certainly then have come a long way from the relatives of suicides being deprived of inheriting and the deceased being buried at the crossroads In unhallowed grounds.

Andrew Martin
Andrew Martin
23 days ago
Reply to  Peter B

I would agree with you on the point of being economically incompetent. Who in their right minds would but index liked debt bonds when our interest rates went out of control due to Bailey being asleep at the wheel.

Francisco Menezes
Francisco Menezes
23 days ago
Reply to  Peter B

Lefties want to forbid. They do not want you to enjoy yourself. Now they do not want you to live. It is all about nasty personalities denying things to others. Driven by resentment.

Judy Johnson
Judy Johnson
22 days ago

Lefties don’t particularly want euthenasia and more than the right; it is more to do with religious faith.
The lefties want us to do as we please which includes both euthenasia and enjoying ourselves!

Brett H
Brett H
23 days ago

When the time comes i’ll do it in exchange for a house for my grandchildren. There’ll be a price for my body.

Andrew Buckley
Andrew Buckley
23 days ago

The devil will be in the detail.
I am 66, I have cancer (should be fine long term). I have some substantial life insurance. This doesn’t pay out if I commit suicide. Should I choose assisted suicide/euthanasia would the insurance pay out?
This policy runs until I am 70. Extraordinary pressure if I am ill at 69!

Brett H
Brett H
23 days ago
Reply to  Andrew Buckley

Bye bye life insurance then if there’s no payout on euthanasia. And bye bye insurance companies. See, there’s always a silver lining.

David Peter
David Peter
23 days ago
Reply to  Brett H

They always have been the unacceptable face of capitalism!

Dennis Roberts
Dennis Roberts
23 days ago
Reply to  Brett H

How do you insure against something you’ve chosen to do? Insurance is to cover unexpected events.

Steven Carr
Steven Carr
23 days ago
Reply to  Andrew Buckley

wow!

Nell Clover
Nell Clover
23 days ago
Reply to  Andrew Buckley

Many life insurance policies pay out after suicide after a short qualifying period. They insure aggregate risk of death across a population, not individuals, and suicide is just another (comparatively very small) risk of death for them.

What euthanisa would do (is doing in Canada) is shorten life expectancy and so reduce the net premiums paid. In turn this would make the cost of life insurance more expensive or make the insured sum smaller.

Another effect euthanasia will have is to reduce research into end of life health conditions. Conditions that were once untreatable and – in an alternative universe – best dealt by euthanasia are – in our universe – entirely manageable if not curable thanks to research inspired by suffering. Take away the suffering and what motivation is there to invest in and invent better palliative care?

Lennon Ó Náraigh
Lennon Ó Náraigh
23 days ago
Reply to  Nell Clover

100% There’s a market out there for dementia and cancer cures. Hence the billions invested yearly by big pharma in research and development into these diseases. With assisted suicide this market will dry up. As a species we will stop striving to prolong longevity. This is a literal dead-end.

Max More
Max More
23 days ago
Reply to  Andrew Buckley

Andrew: Have you checked your policy? Here in the USA, most life insurance does pay out for a suicide so long as it happens at least two years after taking out the policy.

Lindsay S
Lindsay S
23 days ago

If we legalise assisted dying then what was the point of the Covid lockdowns? The amount of elderly and sick that could’ve been allowed to pass by way of nature (if we assume the Chinese didn’t have a hand it), no our government prefers to save them from one demise so the can inflict their own miserable endings on them. Whether it’s by freezing them, starving them or injecting them with a cocktail of drugs.
Before anyone feels the need to point out that it was the previous government, I am very aware, I’m also very aware that Labour fully supported lockdowns, practically rubbing their hands with glee over it!

UnHerd Reader
UnHerd Reader
23 days ago
Reply to  Lindsay S

Because lockdown meant relatives could not visit (and therefore keep an eye on) the elderly in nursing homes, where the residents’ lives were being shortened through many different avenues, e.g. inappropriate drug protocols, returning the sick from hospitals to the nursing homes, denying hospital to sick residents, putting DNR orders on residents who were quite well and leaving them alone, lonely and frightened. See the Scottish Covid Enquiry for more details.

UnHerd Reader
UnHerd Reader
23 days ago
Reply to  Lindsay S

The US solved that problem by putting covid positive elderly back into group living , ie nursing homes and wiped thousands off the books.

Andrew Martin
Andrew Martin
23 days ago
Reply to  UnHerd Reader

My 92 year old Mother in Law survived Covid in a Care Home despite having virtually every conceivable comorbidity you could think of. And she’s had the full course of the mRNA pseudo vaccines. And yet so many young people passed away after taking them. I think there’s a lesson to be learnt here.

Judy Johnson
Judy Johnson
22 days ago
Reply to  Andrew Martin

Why do you describe the mRNA vaccines as pseudo vaccines?

El Uro
El Uro
22 days ago
Reply to  Judy Johnson

The undeniable fact is that these vaccines were killing young people. Those who had almost no chance of dying from COVID

Douglas Redmayne
Douglas Redmayne
23 days ago

Assisted suicide would yield the greatest value for money if it was permissively ( but voluntarily) applied in prisons as the cost of keeping an offender incarcera is £50,000 a year. The value for money would be greater still if those on life sentences chose assisted death as the avoided cost would be greater.

John Tyler
John Tyler
23 days ago

Hysterical nonsense?

UnHerd Reader
UnHerd Reader
23 days ago

slippery slope they may consider euthanasia for the disabled or bringing back the death penalty to save money

John Tyler
John Tyler
23 days ago

I recall there was some German guy in the 1930s and 40s who started assisting those with mental and physical handicaps to die. They are very small steps between free choice, encouragement and the state choosing for you. When the state starts playing God we can all forget about democracy let alone liberal democracy.

Do we give murderers the option of assisted suicide? Why can’t paedophiles have assisted castration? Should we assist kleptomaniacs to cut off a hand? Perhaps the solution for clinically depressed subjects is to end their suffering once and for all. I must remember not to remind my dementia-suffering mother to eat. I broke my neck in an accident and want to die before you offer me any treatment or advice. A can of worms? No! A nest of vipers!

Douglas Redmayne
Douglas Redmayne
23 days ago
Reply to  John Tyler

Hysterical nonsense.

John Tyler
John Tyler
23 days ago

Probably best to put me down 🙂

UnHerd Reader
UnHerd Reader
23 days ago
Reply to  John Tyler

A certain president jn the US said at a certain age we just make grandma confortable and stop spending health care money on her

John Tyler
John Tyler
23 days ago
Reply to  UnHerd Reader

And the same is probably true in plenty of nations around the world.

Francisco Menezes
Francisco Menezes
23 days ago
Reply to  John Tyler

Never forget it were not the Nazi’s who murdered the psychiatric patients, the Down syndrome children, the lung patients, the heart disease patients. It were the ordinary doctors and nurses. By 1938 the job was finished. They even calculated to the last pfennig how much money that had saved the Reich on an annual basis.

Chipoko
Chipoko
23 days ago

I cannot take seriously that notion advanced in this article that legalising euthanasia would corrupt into a cynical process to cull elderly people in UK society to relieve the burden on budget and related resources. That is an extreme evil more appropriate to some dystopian novel than the UK of the future should this much-needed law be enacted.

Chris Milburn
Chris Milburn
22 days ago
Reply to  Chipoko

As a doc working in Canada, I assure you that you are wrong. We are already living in a dystopian novel.

Chipoko
Chipoko
17 days ago
Reply to  Chipoko

Judging by all the downticks, I can only assume there are people out there who believe that legalised euthanasia will become a legitimate process for governments to exploit in order deliberately to murder swathes of old people to ease budget pressures. Sorry, I just cannot take that perspective seriously.

Rocky Martiano
Rocky Martiano
23 days ago

‘the logic would probably not be that the state simply mandates a certain maximum age.’ Thank goodness for that! It would not be euthanasia but eugenics.
However, the author conflates assisted suicide with euthanasia. They are not the same and there should be strict definitions and safeguards in law to ensure that both are properly administered.

Brett H
Brett H
22 days ago
Reply to  Rocky Martiano

I think suicide and euthanasia are both the same, we just view them differently through social norms.

Max More
Max More
23 days ago

People should have the right to end their lives, with adequate protections against abuse. However, this becomes dangerous in a society with a state-run or state-dominated health system. Such a system always has limited resources and needs to cut costs rather than increase supply as would happen in a market.

Francisco Menezes
Francisco Menezes
23 days ago

A nation that bumped off a king so that it could be reported in the proper newspaper can be trusted to take care of a herd of non-productive crunchies. Look what could be achieved with midazolam and morphine in 2020. Between now and 2070 all trees will be gone so nan can burned in the biomass electricity plants. Speaking of killing two birds with one stone. McKinsey eat your heart out.

Simon Blanchard
Simon Blanchard
22 days ago

There will inevitably be a “Rwanda scheme” for the elderly, where care can be administered at reduced cost, in a nice warm climate, maybe even by people from cultures that respect and value the elderly.

Edward De Beukelaer
Edward De Beukelaer
21 days ago

the difficulty of the subject of assisted dying is partly due to the type of medicine we have which is very good a stopping people dying but not so good at making them feel better in the sense of enjoying a degree of health where they can cope with things of life (see Huber definition of health in BMJ). Because we are not good at fostering health or to use the better term healing (term frowned on by many : see Iain McGilchrist) there is more suffering than needed and due to a perceived lack of option, Euthanasia for relieving suffering crops up.
There are solutions proposed in current Integrative Medicine trends and in the One Health definition. But even people who promote these trends miss that it is necessary to engage with all current and historical knowledge relating to health and disease to make the highly needed progress in medcine (we still bellve in the future promises of technology in medicine which more than often does not deliver…. covid? souns familiar?) .
The problem is that the pharma industry has made us sooo addicted to their products and services that we cannot (do not want to) see and accept this. Hence NHS crisis … bad food … slowly reducing health of the population.. chronic illness… If we do not change our societal model and start valuing what makes a population healthy and resilient and continue to prefer to just pop pills to eliminate symptoms, the euthanasia debate will remain an issues : it is logic that many see it as a good solution for relieving the suffering for some but deep down we may sense it is not quite right,….. this deep down is our instinct that tell us that maybe what our brains are convinced off is not necessarily so right (agan see McGilchrist)

Nancy Kmaxim
Nancy Kmaxim
21 days ago

The field of medical ethics is quite aggressively populated by a line of discourse that advocates for withholding medical care from patients who aren’t materially worthwhile. There are existing formulas for calculating the worth of the patient. I noticed that unheard recently hosted Peter Singer. More on this topic please.

Dr. G Marzanna
Dr. G Marzanna
21 days ago

I totally support assisted dying and would choose it myself if necessary