AT Westminster earlier this month a ripple of compassion disturbed the business of contempt. Dr Liam Fox, the former defence secretary, introduced a bill that would give parity of esteem to people with Down’s syndrome with other minority groups whenever they encountered the state’s framework of care. It would require schools, social care services, NHS providers and local authorities to meet the specific needs of people with this condition.  

If passed, the bill will stand as a rebuke against the iniquitous social orthodoxy implicit in the modern world’s attitude to Down’s syndrome. When the condition is detected in pre-natal babies around 90 per cent are aborted in what has become a sort of informal programme of eugenics by stealth. The implications for people with Down’s who actually made it into the world are not exactly conducive to their sense of self-esteem.
As Dr Fox was proposing his bill the Scottish Parliament was moving in the opposite direction in terms of how we view infirmity and vulnerability. The introduction of a bill to legalise assisted dying by Liam McArthur, the Liberal Democrat MSP for Orkney is backed by a cross-party, Holyrood steering group. The legislation it seeks to enact seems well-intentioned and sincere and would provide terminally ill adults who are deemed to be of sound mind the right to an assisted death. 

Understandably, debate on this delicate issue has proceeded in an atmosphere of intense emotion. As such, some implicit dangers in how we begin to regard end-of-life choices for extremely vulnerable people are too easily overlooked as we get swept along by attitudes that seem compassionate.  

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Without questioning the sincerity of this bill’s most persistent proponents, to introduce it at this time seems to be entirely tone deaf. Others might describe it as callous. Where have they been these last 15 months? 
In these Covid days families all over the world have watched helplessly as their elderly relatives have succumbed in agony and alone to this disease. The most profoundly haunting images we have witnessed during this pale time have been of keening relatives trying to convey love through the walls of a care home to marooned and frightened parents and grandparents. 
During the pandemic the value we’ve attached to providing kindness and comfort to those reaching the end of their lives has never seemed greater. Nor has the commitment and compassion of NHS and care-home staff who have given everything of themselves to keep frail and elderly people alive and to provide them with a sprinkling of the love they’d otherwise be getting from their families.  

The law as it currently stands protects vulnerable people and their families from abuse and from exploitation by those who stand to benefit from an assisted killing. It also provides a degree of discretion for judges in those very few cases which might be regarded as in extremis. Only a tiny number of British citizens go abroad for assisted suicide – around 270 in 12 years. 

Making laws from numbers like these creates chilling precedents. It also fails to acknowledge the psychological pressure the state would inadvertently be applying on vulnerable people to end their lives as they imagine (or are encouraged to) that they have become an economic burden. This becomes a reality among those who suffer from depression, especially as a result of their illness.  

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The long-term economic and psychological distress caused by Covid will endure for a generation and will disproportionately affect our most marginalised communities. The people who live in these places, more than those in more affluent areas, will feel added pressure to end their lives as health and social care budgets reduce in the years ahead. 

In these circumstances sheer economic desperation will increase the likelihood of neglect and exploitation by some families at the very edge of their ability to cope. Inevitably, as we become desensitised to the effects of the new law its most implacable advocates will seek ways to chisel at the initial safeguards. You can only imagine what their chief motivations will be in a time when the writ of raw capitalism roams free. 

There is a reason why most of the UK’s largest disabled rights groups are opposed to any changes in the laws around assisted dying. They stem from their serious concerns – based on experience – that such a law will heighten prejudicial attitudes to disabled people and ramp up pressure on them to take their own lives. Much of this is rooted in naked financial imperatives.  

Many of those inclined to be persuaded by the arguments in favour of assisted suicide talk loosely about dignity in dying. Yet where is the dignity in this? Death is a messy, painful and unfair business but a government moved by compassion and a duty to care for all of its citizens at all stages of their lives – good times and bad – would find the money and resources to alleviate suffering with well-funded palliative and mental health care. The desire to commit suicide reduces greatly when people are being provided with proper care that honours their physical and psychological needs. 

It’s ironic that when it comes to dignity in death the eagerness to confer it outstrips our enthusiasm for providing it in life. Not so much time is spent discussing our duty of care to the many in our poorest communities who are stripped of dignity from the outset of their lives. Instead, in Scotland, more of them than any other country in Europe die of drug misuse. They are at the wrong end of the early mortality numbers. Long-term unemployment; lack of social housing and the scarcity of food and warmth will come to define their lives. 

Our political classes, through an absence of will and fear of electoral defeat, have failed to prevent capitalism preying on them with their zero-hours contracts and barely subsistent wages. What’s being proposed here is merely an artifice for our political elites to divest themselves of any responsibility to fund proper care packages by choosing the nuclear option: let them die instead. 

So, please spare me your lofty appeals to dignity in death when so many of our citizens are denied it in their wretched lives.