On 16 October. Kim Leadbeater MP announced her “choice at the end of life” Bill in the House of Commons. In the intervening days, many column inches have been allocated to the proposal. We’ve seen celebrity endorsement of the “right to die” by Dame Esther Rantzen, favourable comments from Prime Minister Sir Keir Starmer, and support from former chief prosecutors. On the other side of the debate, Health Secretary Wes Streeting has come out against a change in the law. We’ve also seen warnings from Paralympic champion Baroness Tanni Grey-Thompson, disability organisations, senior members of the clergy, and a body representing palliative doctors. Sparring on the issue is certain to continue in weeks to come, with Second Reading of Kim Leadbeater’s Bill scheduled for the 29th of November.

Everyone wants to see Britons receiving excellent care at the end of life. A desire to improve outcomes in this area is shared by supporters and opponents of Ms Leadbeater’s Bill. However, “assisted dying” — or physician-assisted suicide as it ought to be referred to — raises huge questions. Is it right for doctors to participate in the ending of patients’ lives or does this undermine the core values of the medical profession? Can we uphold the foundational idea that all human beings have intrinsic value and dignity whilst aiding the suicides of the seriously ill? And is legislating for the idea that some lives aren’t worth living a positive step for a society to take?

For me, the answer to these questions is “no”. I believe our existing approach — alleviating suffering whilst protecting the sufferer — is most conducive to human flourishing. This approach fosters a high regard for human life within our institutions, and acts as a guard to citizens, including people who are vulnerable to exploitation and abuse. It also ensures blanket suicide prevention. Not everyone shares this view. But interestingly, polling shows that many Brits who support “assisted dying” still have serious concerns about its potential implications. A slew of media reports on the experience of other nations may have something to do with this.

Evidence from overseas shows that people who die by “assisted death” are influenced by feeling like a “burden”, and because of social inequality. Abuses against vulnerable citizens have been noted. And in a number of countries across the world, mission creep is evident — “assisted dying” laws have become wider in scope or more permissive in practice over time. In light of all this — and regardless of their personal stance on “assisted dying” — UK politicians must ask themselves: “Can we prevent negative outcomes when other nations have failed to do so?”

To help answer this question, it’s worth looking across the pond to Canada, a country not dissimilar to our own, which legalised “assisted dying” for the terminally ill in 2016. Last week, a committee of experts in law, medicine and nursing published the first official report on the operation of Canada’s Medical Aid in Dying (MAiD) law in Ontario, the country’s most-populated province. Its findings are alarming.

The report’s authors noted that patients have accessed assisted death because they are poor and lack access to housing and said that vulnerable Canadians face “potential coercion” and “undue influence”. They also noted data showing that a disproportionate number of Canadians who died by “assisted dying” despite not being terminally ill (29 per cent) came from Ontario’s most deprived areas.

Individual cases cited in the report are disturbing. One depressed 50-year-old woman was allowed to access “assisted death” because the state could not offer her accommodation that adequately addressed the symptoms of her health condition. Another man who accessed the practice did so after previously attempting to end his life, and presenting to doctors with stomach ulcers, narcissistic personality disorder and suicidal thoughts.

The report also found evidence of “doctor shopping” by patients who were not initially approved for a state-assisted death. And instances of MAiD being offered solely on the basis of mental illness — which is illegal under Canada’s current law. Warnings about injustices were dismissed as scaremongering by many in Canada’s political class before the country’s law changed. They don’t appear quite so unrealistic today. 

Speaking last week, a member of the “MAiD Death Review Committee” that produced the report said it should serve as a warning to legislators in the UK. Dr Ramona Coelho, a family medicine practitioner in London, Ontario, said: “the UK should not assume it will manage [an ‘assisted dying’ law] better or avoid potential pitfalls”. 

The doctor added: 

When Canada legalised assisted suicide and euthanasia, Canadians believed it was intended to be a rare, last-resort measure, reserved for consenting adults enduring intolerable suffering at the end of life. However, lobbying efforts have steadily pushed for broader access and eligibility … British legislators have to consider how easily assisted dying can be expanded, how easily abuses can go undetected. 

It’s a striking, and timely, statement, and one that UK politicians ought to read and reflect on carefully before the debate next month.

 In my view, “assisted dying” is a change the UK mustn’t embrace. It’s unethical. Assessments by fallible doctors and judges could not rule out coercion and abuses against vulnerable people. And no “safeguard” could remove the invisible pressure people would feel to end their lives because they feel like a burden, lonely, or lacking sufficient support from the state. I hope MPs will oppose a change in the law and pursue alternative ways to support terminally ill people.