Why is legalising assisted dying so controversial?

Where is assisted dying legal?

Legal frameworks surrounding assisted dying vary around the world.

Belgium, Canada, Colombia, Luxembourg, the Netherlands, and Switzerland have all legalised some form of assisted dying, permitting it under strict regulatory frameworks.

Generally, these countries require a potential patient to be of sound mind, experiencing unbearable medical suffering, and facing a terminal illness for some time before they can request assistance in ending their life.

In the United States, legislation differs from state to state. Assisted dying is currently permitted in states like Oregon, Washington, and Vermont, but other states remain engaged in constant moral, ethical, religious, and social debate about whether or not the service should be available.

Meanwhile, countries like Australia, New Zealand, and several European nations –including the UK – continue to engage in conversation over potential legalisation, with strong support on either side of the debate.

“If I know that I can take control at the end… that will give me some comfort whilst I’m living with cancer"@sophieRblake, who has incurable breast cancer, talks to @MrDanWalker about how she welcomes Keir Starmer's plans to change the law on assisted dying if he becomes PM. pic.twitter.com/qJap5uIhbd

— Channel 5 News (@5_News) March 13, 2024

What moral and ethical questions emerge?

Central to the assisted dying debate rests a major clash between morals.

Its advocates argue that individuals have the right to exercise autonomy over their own bodies, particularly in the face of excruciating pain and terminal illness. They say that the service stands as a compassionate option for those whose suffering has become unbearable.

At the same time, opponents raise concerns about the erosion of the sanctity of life as well as the unintended consequences that may arise from legalisation. They warn that it could lead to diminished trust for healthcare professionals all while kickstarting a slippery slope towards euthanasia without consent.

Though advocates of assisted dying reiterate that strict safeguards would be put in place, critics remind lawmakers that abuse of power, coercion, and manipulation can take place whether these measures exist or not.

Bit nervy about the whole”assisted dying” thing tbh. Whilst freedom of choice is something necessary I sense the whole “large aging population” thing & this agenda aren’t coincidental topics

— Disappointed Optimist (@disappoptimism) March 13, 2024

In places where assisted dying is legal, reports of elderly and marginalised patients feeling pressured by family members or caregivers to end their lives have emerged.

Such cases stand as a reminder of the murky area between individual autonomy and pressure from outside sources behind the scenes.

Then, there is the worry about its potential for misuse. In countries where assisted dying is legal, requests have come from people who cite feeling like a burden to society, their families, or their peers.

This scenario presents a serious ethical challenge because the line between genuine autonomy and societal pressures is blurred.

It also ushers in the debate over whether assisted dying should be granted only in cases of extreme physical suffering or when a patient is experiencing chronic psychological challenges.

I admit I’m opposed to assisted dying in any case, but in the current climate of austerity and shortages of social care and pressure on the health service, this is really dangerous. Look at what’s happened in Canada – killing people is cheaper than supporting them… https://t.co/X8T2CQaNE5

— Dr Jo Kershaw (@mthr_jo) March 13, 2024

The economics of it all

Access to end-of-life care often depends on numerous combined factors including economic status, education, and geographic location.

In general, disparities in access to healthcare and medical resources have seen marginalised populations face barriers to accessing any form of end-of-life options. This is especially the case for living where the healthcare sector is privatised.

Taking this into account, the cost associated with undergoing legal procedures and obtaining medical approval for assisted dying could worsen socioeconomic disparity even further.

If assisted dying becomes allowed, I wonder where insurance companies will stand on this, because they don't usually pay out for death by suicide to do they, so would they put it under the same banner?

— ⚒Nicola⚒ COYI (@PrettyBubbles65) March 13, 2024

To legalise or not to legalise?

As the global conversation on assisted dying continues, maintaining the balance between compassion and caution involves walking a thin line.

If it goes ahead, it’s clear that countries will need robust regulatory frameworks in place.  Continuous dialogue to safeguard and protect the rights of patients is also central to ensuring legislation moves forward in the right way.

It seems that the intricacies of this debate are not just heightened by complex law-making processes or differing social, philosophical, and religious perspectives, but because it involves the one thing that we all have a shared stake in: what it means to live and die with dignity.

For that reason, legalising assisted dying will likely continue to be a long road in countries where ideologies vary from person to person.