Are you kind and empathetic enough to support the legalisation of assisted dying? Following the announcement of Labour MP Kim Leadbeater’s private member’s bill, one could be forgiven for thinking this is the only way to understand the issue.  

“I will stand four square with Kim,” tweeted the Conservative’s Kit Malthouse, “as will millions of people who are on the side of compassion and humanity. The law must change in the name of love.” Leadbeater, claims Sarah Wootton, CEO of Dignity in Dying, is “tough as well as compassionate … exactly the sort of woman able to unpick the cruel, unsafe and unfair mess that this country’s blanket ban on assisted dying has created”. 

One doesn’t have to be oversensitive to detect a message here about the sort of people who might have misgivings about assisted dying. They are positioned as, if not exactly mean, then morally inferior, naïve, or even paranoid. Maybe they haven’t witnessed someone dying slowly and in agony; maybe they lack the ability to imagine such suffering; maybe they are deluded about palliative care, or have some knee-jerk attachment to life at any cost. Concerns about a ‘slippery slope’ smack of fear and moral panic. What kind of person puts their own squeamishness about death ahead of alleviating the pain of another? 

If you can’t see that there is a real risk of a slippery slope, then you make it all the more likely that such a thing will exist

I’d like to think I’m not that kind of person, but some people might disagree. Assisted dying is one of those issues where, given the chance, I am not quite sure how I would vote. I know what I would want in an ideal world — that no one should be forced to suffer unnecessarily at a stage beyond all hope. I would like a good death, at a time of my choosing; I’d like that for others, too. Nonetheless, whenever I see advocates for assisted dying declaring themselves representatives of Team Kindness and Compassion, my doubts increase. If you can’t see that there is a real risk of a slippery slope, then you make it all the more likely that such a thing will exist. 

There’s an irony in the way in which opponents — or even mere doubters — of the safety of legalising assisted dying are positioned as lacking in imagination, or even basic experience of the human lifecycle. It is as though we inhabit some rarefied space in which none of our relatives have ever died, or none of our loved ones have gone through years of intolerable suffering, or if they have, well, then, we must be too cold-hearted to have cared. As though anyone who fears negative consequences, or the kind of expansion of terms witnessed in other countries, must have been given some weird bypass when it comes to ordinary human experiences and responses. As though we need the reality of suffering explained to us again and again, because how could we possibly witness it and not find the issue perfectly straightforward? 

Yet there is more than one way to be squeamish and naïve. Yes, one can read about the horrors of end of life and agree that assuming morphine will solve it is not enough. But if people do not like talking about death, they also do not like talking about control and abuse in carer and cared-for relationships (people do not like talking about abuse in general). Underpinning the UK’s assisted dying debate I cannot help seeing a vast underestimation of just how pervasive familial abuse can be and the way in which it can play out under the guise of caring. I am not imagining resentful or inheritance-greedy relatives here, but something far more subtle. We need to think long and hard about how a change in law will influence what people tell one another about their own worth, even if in the short term, the conditions seem relatively restricted. It is not paranoid to acknowledge that boundaries will be pushed. 

All too often, we make carers into saints, not because they are, but because we need them to be in order to feel less ashamed about the absence of broader support networks. When some carers kill their charges, including their own children, there can be a liberal impulse not to judge in order to demonstrate one’s understanding of how hellish these people’s lives must have been. When elderly men — but far less frequently elderly women — kill their sick wives it is often accepted that these acts did not take place as part of an abuse continuum (this includes one instance where a husband cut the throat of his wife as “an act of love” and another in which a man pushed his wife downstairs to prevent her becoming “a decrepit old hag”). One can argue that such events would be less frequent, and issues of consent less ambiguous, were assisted dying to be legalised. What I would counter is that there is a particular danger in denying the prospect of a slippery slope, particularly in situations of coercive control, in a world where such events already take place. 

It’s also a world in which not worrying about safeguarding, or assuming bad actors will exploit loopholes, is increasingly worn as a badge of honour. Why, ask the performatively bewildered, can’t the naysayers just be kind? Identifying risk and complexity — whether it is about assisted dying, or commercial surrogacy, or the legalisation of prostitution — is dismissed as a cover for prejudice. It’s an attitude which reduces the possibility of minimising harm by demonstrating how easy it is to refuse to see it at all. 

“Yes, there is an enormous risk here — here’s what we will do to mitigate it” would be a far more convincing argument than “there’s no risk, and anyone who thinks there is lacks compassion”. That’s if the objective is to persuade rather than shame the doubters. Most people on both sides are kind. I genuinely believe this — but let’s not be squeamish about all that is at stake.