Our crumbling NHS would make assisted dying a disaster for Britain

The UK’s broken welfare state will turn personal tragedy into a Canada-style national catastrophe

It is a horrible, unbearable reality that so many people, most of them very old, many afflicted with debilitating, terminal diseases, must live out their last days in excruciating pain, with minimal relief. The prospect of legalising doctor-assisted dying for such people, with safeguards to protect the vulnerable, seems not just humane but in fact the only civilised, the only libertarian approach truly respectful of our individual autonomy. 
There are conditions worse than death, and MPs hope to soon start debating legalising assisted dying for competent adults with less than six months left to live. If the bill is given Government time, it will surely be passed with a massive majority of Labour MPs, becoming one of the most ethically consequential pieces of legislation ever introduced. 
It is a campaign supported by the wonderful Dame Esther Rantzen; she has signed up to the assisted dying clinic Dignitas in Switzerland due to her stage 4 lung cancer. Thousands of terminally ill people may soon be in a position to decide when and how to end their lives.
Yet while the case for legalisation is compelling, I hesitate to embrace it. I worry that it would soon be grievously abused as a result of our pathologically broken welfare state. I fear the safeguards wouldn’t last. I am terrified of the cultural impact of eliminating one of the last taboos emphasising the sanctity of life at a time when all other traditional restraints are dissolving, of racing down a slippery slope towards institutionalised senicide, of human life becoming a fiscal matter to be treated as a “cost”. 
There is an essential difference between do-not-resuscitate (DNR) orders or doctors agreeing to withdraw treatment, and physicians actively ending a life, breaching the Hippocratic Oath’s injunction that says: “I will not give a drug that is deadly.” 
Legal reforms of this magnitude inevitably unleash waves of social change, and this one is bound to shift the way we perceive not just the very old, but also the very ill, the disabled and other vulnerable groups. It would send a signal, if subliminally, that euthanasia is now an option of last resort for anybody who is struggling or deeply unhappy. Pushy families desperate for an inheritance would look at relatives in a darker light. The dehumanisation would be corrosive, and risks ending in moral armageddon. 
Canada’s courts legalised assisted dying in 2015, before massively widening its scope. Eligibility now includes anybody who “experiences unbearable physical or mental suffering from your illness, disease, disability or state of decline that cannot be relieved under conditions that you consider acceptable”. 
The subjectivity of the latter point is striking. Applicants “do not need to have a fatal or terminal condition to be eligible”. The floodgates have been not just opened but blown to smithereens; from 2027, adults suffering from mental illnesses will become eligible. 
Shockingly, the number of deaths from euthanasia are rising 30 per cent a year, hitting 4.1 per cent of the total. 
The authorities appear content: Canada’s Parliamentary Budget Officer infamously published a report explaining that assisted death costs thousands of dollars less than paying for patients’ healthcare costs. Some of those who have taken advantage of the policy cited the fear of becoming a burden on their families; one claimed that they were threatened with bankruptcy if they didn’t sign up; and some disabled people are choosing to opt for death, arguing that they are “suffering intolerably” in a psychological sense. People who could have been nursed back to health are dying unnecessarily. 
Canada, a hideously woke society under the abject Justin Trudeau, is veering dangerously close to welcoming a cull of the weak, sick, poor and vulnerable. Many past societies practised geronticide, the killing of the elderly. In some cases, the elderly and infirm were abandoned; in others, they were clubbed to death or thrown off cliffs, especially when food was scarce. We were meant to have moved beyond such barbarism, even if dressed up in the language of compassion, technology and fiscal accounting. 
Assisted dying may work in Switzerland, a country with a strong individualist streak and an excellent, private insurance-based healthcare and retirement system. It may work in countries with a strong attachment to the sanctity of life, including those where religious observance remains high, guarding against abuse. 
But will it not backfire catastrophically in collectivist, post-Christian Britain, where we worship the dysfunctional NHS, where social care is decrepit, where the fiscal pressures on the state are immense, where intergenerational warfare is increasingly rife? Wouldn’t the rules be gradually loosened? Wouldn’t some older people be guilt-tripped into ending their lives prematurely? In Belgium and the Netherlands, dozens of people with eating disorders have been granted an assisted death. Wouldn’t this happen here too?
Wes Streeting, one of the best Labour ministers, who would doubtless be doing a lot more to reform the NHS were he allowed to do so, has been characteristically thoughtful. He worries Britain doesn’t have the right palliative and end-of-life care, and wants to make sure that “people aren’t coerced into exercising [any] right to die” because of a lack of support. 
I would go much further. The problem is that Sir Keir Starmer seems keener to change the public’s behaviour than he is to truly change the NHS. He thinks that it is the public’s duty to save the NHS, not the NHS’s mission to save the public; we must be more healthy, not for our own sake but for that of the Exchequer. 
This collectivist mindset is incompatible with navigating the complexities of assisted dying: it risks inadvertently putting moral pressure on the old and ill to sacrifice themselves for the greater good, for “our NHS”. The logic is brutal: death is cheaper than spending years in social care. Some grandparents may offer themselves up for the sake of younger generations saddled with a crippling tax burden and national debt. We will be plunged into a utilitarian nightmare, where one life is traded off against another. 
This is the most difficult of subjects. I reserve the right to change my mind, and I care deeply about the suffering of the terminally ill. But one thing is sure: it would be madness to rush into legalising assisted death without the mother of all national debates.