GEORGE FIELDING of Not Dead Yet will be rallying alongside a coalition of disabled people’s organisations outside Parliament tomorrow morning, asking MPs to vote against legalising assisted suicide.

Fielding, born with cerebral palsy, is convinced that should Kim Leadbeater’s End of Life (Terminally Ill Adults) Bill become law, disabled people’s lives will be at risk.

He set up two social care providers, currently caring for about 1,000 people a day, “because I was so distrustful of services... I knew how broke, how privatised they were. Nobody I knew could find the care and support they needed.” He no longer works for the organisations.

“So now I have to speak out. There are at least four services we should be investing in before we even consider the idea of state-sanctioned suicide.

“One is social care. Another is the welfare and benefits system — I don’t think it’s an accident that the cuts [to disability benefit] are running in parallel with the assisted dying legislation. Both will result in disabled people’s lives being shortened.

“Palliative care — only a third of palliative care is state funded. And therapy and bereavement counselling.

“These are foundational services. If we invested in them, redesigned them to make sure they work, and were truly personalised for people and their communities, then we wouldn’t be having this debate.

“We can’t be dreamers,” he says, appealing for people to look at the practical impact of the legislation rather than abstract principles. “This law has to apply to everybody. And what you see again and again [in the treatment of vulnerable people] is ableism, racism, misogyny.

“You are putting this Bill through in a society that’s rife with those discriminations, and you are placing it within services that are overburdened, overstretched, unsupported. There’s no new money.” 

Fielding fears a health service where “it will be cheaper and easier and more convenient to kill people” than to invest in making their lives more comfortable.

“The foundational principle of the NHS is to do no harm. The moment you give a doctor or any practitioner power to facilitate the end of someone’s life, that undermines that principle.

“This legislation is so consequential, a life and death decision.

“It will be the first time we’ve amended the Suicide Act since suicide ceased to be a criminal offence, and we’ll be amending it to enable medical practitioners to facilitate suicide.

“It’s anathema to the principles of good medical care, but particularly suicide prevention.”

That aspect of the Bill has raised alarm bells, with debate over whether capacity as defined under the Mental Health Act is adequate to determine an individual’s capacity to choose death, and amendments seeking to exclude patients with depression or mental illness from eligibility — amendments which were all rejected.

Fielding points to problems that arise when mental health is not taken into account — for example, any patient has the right to die by voluntarily stopping eating and drinking, but that needs to be distinguished from a mental illness like anorexia that might cause someone to stop eating and drinking, but needs treatment.

The Royal College of Psychiatrists, in its advice to MPs to reject the Bill, raised the question of a psychiatrist’s duty of care toward suicidal people and how a legalised suicide pathway might muddy that. The Royal College of Physicians and Royal College of Pathologists have also indicated they cannot support the legislation in its current form, though all three remain neutral on assisted dying in principle. Recently, a thousand doctors wrote to MPs asking them to oppose the Bill.

Have these professional interventions changed minds? “Well, they should have done,” Fielding says.

“If we’re not willing to listen to the medical professionals, then expertise has gone out the window. And remember that they are not against the principle. They are against this Bill. They don’t believe it’s strong enough to prevent abuse. And it isn’t.”

Some MPs backed the Bill at second reading despite misgivings, hoping that safeguards could be strengthened at committee stage. Have they been?

“No. It’s a weaker Bill than when it started. You were going to need sign-off by two doctors and a High Court judge.” The judge has gone, to be replaced by an “expert panel” that meets at the end of the process and, Fielding believes, is likely to consist of people ideologically committed to assisted dying who have applied to sit on such panels.

“The whole process has been designed to make assisted dying quick,” he says. “They’ve pre-designed the process to make it easier to facilitate the ending of someone’s life. And what we’ve seen in every other jurisdiction where this is legal is that those ‘safeguards’ soon get termed blockages to progress, infringements on someone’s individualised rights.

“Every amendment that could have made the Bill stronger or safer has been voted down.”

Disability rights groups have raised fears that people in vulnerable or dependent situations may feel pressure to choose death rather than feel like a burden on family or society, or face coercion. The Bill provides penalties for those found applying coercion or pressure, but Fielding isn’t impressed.

“It’s not easy to spot coercion, and medical professionals aren’t trained to do so,” he points out.

“Those in coercive and controlling relationships are often incredibly good at masking it.

“There are different forms of coercion too. There’s an internalised form where people are made to feel their lives aren’t worth living. We need to design a society in which every life is worth living.

“Why are people living in circumstances that they find intolerable? Poverty, inequality, pain?

“Why can’t we try to solve those things?”

We need to be alert to the reality of people’s lives: “people scared about how they can pay the rent, worried about a knock on the door from the bailiffs, pressure around Christmases and birthdays because of poverty.

“Carer’s allowance is a pittance, the environment people with disabilities are living in is a stressful one and it’s behind closed doors. The circumstances are often tinderboxes.

“Then there’s external coercion, and we will be looking at factors like the fact the NHS doesn’t have enough beds, to the cost of healthcare, and that it will be cheaper to kill somebody. And you can kill them without being investigated by a coroner.” The Bill disapplies a coroner’s statutory duty to investigate deaths by assisted suicide, so they will receive less scrutiny than other “unnatural” deaths.

“Is Covid so far back in history we’ve forgotten that a huge swathe of disabled people had Do Not Resuscitate notices put on them without their consent?

“This is the society this law would be implemented in. Will social attitudes to disabled people get worse? I’d have to ask — can they? Every one of us who lives with a disability meets somebody every week saying ‘oh, if I was in your position, I’d want to end my life.’

“There’s an awful lot of fear of disability, and people don’t want to live a life that I live joyfully. They don’t believe it’s possible. The greatest rebellion a disabled person can live is to live a joyful, ordinary life.

“People are scared, they don’t want to lose function, they don’t want to acquire something that may mean they are seen differently by society to the way they are. That’s what’s driving this.

“That, and if I may say so, an arrogance and a selfishness from people who don’t believe people with disabilities have the resource or the ability to object. Who has pushed this?

“You can judge a room by the people in it, but by the people who aren’t in it as well. Do we even believe in the social model of disability any more? The fact that society disables people? This Bill takes us backwards, to regressive social attitudes as to whose life should be valued and whose shouldn’t.”

What’s his message to MPs as they prepare to vote on the Bill’s third and final Commons reading?

“If you aren’t convinced it is watertight, vote against. If you think you haven’t had enough time, vote against.

“If you don’t want a disabled person showing up at your constituency surgery one day saying please, as my representative, help me to continue living because every system and advocate around me is telling me to die — vote against.

“If you’re doing this for position, for the metrics of internal party politics, please don’t. This is about society. It’s an irrevocable shift in society. Vote against.”