What’s in a name?

The assisted suicide Bill is back before Parliament. So, too, is the elite insistence on not calling it assisted suicide.

In Britain, the campaign for legalisation has settled on the euphemism “assisted dying”: a phrase whose gentleness depends on its imprecision. To the uninitiated (or incurious) ear, it might seem to denote almost anything done for somebody approaching death — pain relief, hospice care or even the withdrawal of burdensome treatment.

Indeed, in a 2021 poll, only 43 per cent understood “assisted dying” to mean providing lethal drugs to somebody with less than six months to live. Almost as many thought it meant allowing a dying person to stop life-prolonging treatment; another 10 per cent thought it referred to hospice care.

A majority, in other words, took “assisted dying” to mean ordinary end-of-life care rather than deliberately helping someone to kill themselves.

Yet Labour MP Lauren Edwards has now announced that she is reintroducing Kim Leadbeater’s failed Bill: a proposal under which terminally ill adults who wished to die would be supplied with lethal drugs to take in order to kill themselves. That act already has a precise name — one acknowledged even by the NHS. It is assisted suicide.

Kim Leadbeater nevertheless repeatedly rejected that description of her bill, insisting that it concerned “assisted dying” instead. “We need to be really careful about the language we use around suicide,” she said. The irony was obvious: whatever its sponsor chose to call it, the criminal-law exemption on which the assisted suicide regime depended had to be written into the Suicide Act 1961.

The euphemisms did not end there. The bill would also have required the resulting death to be recorded as an “assisted death” rather than an assisted suicide. Even the lethal drugs it contemplated were described merely as an “approved substance”. At each stage, the plain description of the act was replaced by something smoother and stiflingly administrative.

“Approved” is an especially industrious little word. Under the Bill, it meant only that the substance had been specified in regulations by the Secretary of State. It bore soothing authority, although no drug or combination of drugs has been approved by any medicines regulator specifically for assisted suicide. Nor is there any settled regimen for causing death. Different jurisdictions use different cocktails of sedatives, barbiturates, opioids and cardiotoxic drugs, administered orally or intravenously under locally developed protocols. “Approved”, in other words, supplied the reassurance that the evidence could not.

This is no mere matter of verbal fastidiousness. We have to get language right not just for its own sake but because language shapes our thought. Here, for example, it determines which questions politicians have to answer. The Government’s current strategy for England promises to reduce suicide rates, and it has committed up to £3.6 million over three years to projects intended to prevent middle-aged men from committing suicide. Meanwhile, Parliament is being asked to authorise doctors to assist another particular class of people in killing themselves.

Call the policy assisted suicide, and the state must explain why one person’s intention to kill themselves demands intervention while another’s merits medical assistance. It must explain why suicide is regarded as a tragedy in one citizen and an exercise of autonomy in another.

Call it “assisted dying”, however, and the argument passes smoothly to eligibility, safeguards and access, obscuring the moral contradiction. This week, France’s National Assembly approved a bill creating a “right to aid in dying”, having rejected amendments that would have named what it legalises: assisted suicide and euthanasia. The acts may enter the law; their names, apparently, may not.

Canada is also revealing. Its Criminal Code groups euthanasia and assisted suicide under the neutral-sounding category of “medical assistance in dying”, or MAiD, while Ontario’s medical regulator calls the lethal drugs “medications”. Although the procedure is documented and separately reported, MAiD itself does not appear on Ontario’s medical certificate of death: the underlying illness is entered as the cause, while reference to MAiD or the substances administered is prohibited.

Both sides in the assisted suicide debate may invoke compassion, dignity and choice yet neither is entitled to dispense with accuracy. A campaign that cannot describe its policy without burying the act in euphemisms has already exposed something about the confidence it feels towards its own moral case.

Parliament is not being asked whether dying people should be cared for, comforted or spared needless suffering. It is being asked whether doctors should be permitted to provide lethal drugs so that patients may kill themselves. Supporters are entitled to defend that proposition. They should not, however, disguise it. If the policy sounds harsher when stated plainly, the harshness lies in the policy, not in the English language.