ARI SHAPIRO, HOST:
Tomorrow, British lawmakers will vote on an assisted dying bill. As Willem Marx reports, the proposal's language and the way it's been introduced are attracting criticism and dividing Parliament.
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UNIDENTIFIED PERSON #1: I have the presentation of the bill - Kim Leadbeater.
UNIDENTIFIED PERSON #2: Hear, hear.
WILLEM MARX, BYLINE: Kim Leadbeater, a not particularly powerful lawmaker in the governing Labour Party, first introduced this legislation last month.
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KIM LEADBEATER: Terminally Ill Adults (End of Life) Bill.
MARX: The Terminally Ill Adults (End of Life) Bill was designed to help people avoid what Leadbeater called a horrible, harrowing death and would include what she termed the strictest safeguards anywhere in the world. It's not a law the government itself officially supports. And, in fact, several senior ministers, including Britain's health secretary, have said they oppose it.
The new legislation will require applicants to be an adult living in England or Wales with a terminal diagnosis and less than six months to live. They must have sufficient mental capacity to make this choice, with a clear, informed desire that's free from coercion. To pressure a person into making a declaration could prompt a stiff prison sentence, but spotting coercion is not always so simple, says Akiko Hart, the director of the British human rights and civil liberties advocacy group, Liberty.
AKIKO HART: People feel like a burden because of unspoken pressure from their family members or because, like in the U.K., there is huge pressure on the health service. What we're worried about is those people being inadvertently approved in this process and the safety around that just not being in place.
MARX: Hart says her organization supports the idea of assisted dying in principle, but this kind of rapid-fire legislating through what's known as a private members' bill is not appropriate for such a seismic shift for society.
HART: Essentially, it's a very contracted process, which means that there hasn't been the level of scrutiny required or the level of public consultation required for a matter of this importance.
MARX: Under the new law, two separate doctors must agree on a patient's eligibility over a span of seven days, and a doctor must administer or supply the fatal medication. But some experts say this essentially makes it a form of medical treatment. That, in turn, could soon lead to expanding eligibility, as has happened elsewhere, says Matthew Dore, honorary Secretary for the Association for Palliative Medicine in Great Britain and Ireland.
MATTHEW DORE: As soon as you make this a medical treatment, you instantly get patients who say, well, why can't I access this medical treatment based on an arbitrary criteria? If you're say, 17 opposed to 18, why can't I have it? Therefore, it becomes an argument of a quality of access.
MARX: A high-profile and highly popular TV presenter called Esther Rantzen kick-started the campaign for this practice nearly two years ago when she was diagnosed with lung cancer. She's planning to die at a time of her choosing inside a Swiss clinic but has argued that option should be available in Britain, too. Switzerland has allowed assisted suicide for more than 80 years, and, each year, a few dozen U.K. citizens go there to die. But proponents have assisted dying say, annually, hundreds more terminally ill Brits take their own lives, and this bill offers the best chance yet for British lawmakers to introduce what's already available in Austria, parts of Australia, Canada, Columbia, and 11 U.S. states. In fact, for a medically supported death in Luxembourg, Belgium or the Netherlands, no terminal diagnosis is even necessary. But, as a result, the quality of palliative care for those close to death has fallen in those jurisdictions, says Mari Lloyd-Williams, a professor of palliative and supportive care at John Moores University in Liverpool.
MARI LLOYD-WILLIAMS: We do know that there has been some research. And that has revealed that in countries which have allowed assisted dying, that actually the palliative care services in some cases sort of disintegrated, but more commonly have deteriorated.
MARX: Lloyd-Williams and many other clinicians argue Britain's poorly funded palliative care system should be improved, instead of leaving decisions over life and death, as the new U.K. law intends, to individual senior judges. Despite the Labour government's large parliamentary majority, the prime minister, Keir Starmer, says legislatures can, on this occasion, vote with their consciences. And since the issue seems to cut right across party lines, Friday's initial vote tally for or against this bill is still currently too close to call.
For NPR News, I'm Willem Marx. Transcript provided by NPR, Copyright NPR.
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