LONDON — Keir Starmer’s in-tray already looks daunting if he becomes U.K. prime minister July 5. And that’s before he has death to deal with.
The U.K. Labour leader — odds-on to enter Downing Street next month — has buoyed the hopes of campaigners pushing for a rethink of decades-old assisted dying laws.
Starmer set hares running earlier this year when he said he’s “personally committed” to changing laws that those pushing for change argue inflict unnecessary suffering on the terminally ill and their loved ones.
“The commitment that Keir’s made to find parliamentary time for a proper legislative debate is absolutely critical and it transforms the position,” former Labour MP Paul Blomfield, who stepped down at the election after helping lead the all-party parliamentary group for choice at the end of life, told POLITICO.
Blomfield has a deeply personal reason for backing change.
His father took his own life aged 87 after a terminal lung cancer diagnosis — and Blomfield has spoken about how a more humane system could have given his family more time together. “He’s one of very many people who are let down by the current law or have been let down by the current law and taken things into their own hands,” Blomfield said of his father.
Helping someone to end their life is currently illegal in the U.K. — and punishable by up to 14 years behind bars. British laws on the issue haven’t been updated since the Suicide Act of 1961 — despite the country’s population growing older in profile.
Not just the usual voices
And it’s not just the usual liberal voices now calling for change.
A petition started by the Daily Express, a Conservative-supporting right-wing tabloid which launched its own punchy campaign fighting for assisted dying for terminally ill adults, recently bagged more than 200,000 signatures and forced a debate in parliament.
“Terminally ill people who are mentally sound and near the end of their lives should not suffer unbearably against their will,” the petition said.
Veteran broadcaster and campaigner Esther Rantzen — who has terminal lung cancer — has also been lobbying British lawmakers hard for a rethink. “We can offer our beloved pets a pain-free death but we can’t offer it to our beloved family,” she said earlier this year.
Shifting sands
The House of Commons last voted on assisted dying nine years ago. A Private Members’ Bill introduced in 2015 by then-Labour MP Rob Marris was comfortably defeated, by 330 votes to 118.
But one of its chief supporters was an up-and-coming MP named Keir Starmer.
Starmer, who served as Britain’s top prosecutor between 2008 and 2013, told MPs he’d overseen around 80 assisted dying cases in that role — and decided no prosecution should be brought in 79 of them.
“We have arrived at a position where compassionate, amateur assistance from nearest and dearest is accepted but professional medical assistance is not, unless someone has the means and physical assistance to get to Dignitas,” Starmer said, referencing the Swiss clinic which offers assisted dying.
“That to my mind is an injustice that we have trapped within our current arrangement.”
Under Starmer’s leadership in 2010, the Crown Prosecution Service issued guidance which included six factors that could mitigate against prosecuting someone who has aided another’s suicide — including being “wholly motivated by compassion.”
Campaigners are keen to seize on support for a debate from Starmer — and believe public appetite for a change has increased since the last time MPs got a chance to vote on the matter. “The backdrop has changed enormously and increasingly people … have spoken out very powerfully,” Blomfield says.
Opinium polling for the pro-assisted dying organization Dignity in Dying earlier this year showed 75 percent of respondents supported making it lawful for dying adults to access assisted dying. Medical opinion also appears to be shifting, with the British Medical Association (BMA) union dropping its opposition in 2021 and adopting a neutral stance.
“The pressure for change is growing irresistible and the dam is breaking,” said Dignity in Dying Chief Executive Sarah Wootton, adding that she is optimistic assisted dying will receive attention in the next parliament. “There is a real movement towards people being able to control how they die.”
Starmer has already promised MPs a free vote on the issue in the next parliament if Labour takes office.
Such a vote would allow MPs to side with their conscience rather than on party lines. Shadow Health Secretary Wes Streeting, who also backed the 2015 bill, has described himself as open to reform, saying “as long as the law gives people the freedom to choose, I’d be minded to support it,” although he has admitted to feeling “genuinely conflicted” due to fears people could be coerced into ending their lives.
The next parliament will contain a large number of new MPs, with more than 100 incumbents standing down and polls suggesting the ruling Conservatives are on course for a drubbing. Blomfield is optimistic that the shake-up at Westminster could work in favor of change. “I’m pretty confident that they will more accurately reflect public opinion in their approach to the issue,” he says of Britain’s incoming MPs.
Wootton says her organization will aim to “ensure that the new MPs coming into Westminster are very clear about the weight of support for this issue.”
Urging caution
The assisted dying campaign in Westminster is also closely watching developments further afield. Scottish Lib Dem MSP Liam McArthur has introduced a bill to the Scottish Parliament allowing terminally ill adults to lawfully request assistance by health professionals to end their lives. British Crown dependency Jersey recently approved plans to allow assisted dying for those with a terminal illness “causing unbearable suffering.” The Isle of Man, also a dependency, is debating similar legislation on assisted dying.
“It would be a great injustice if there was a postcode lottery depending on what jurisdiction you lived in within the U.K.,” Blomfield warned.
But questions remain over how big a priority a Labour government would really place on an assisted dying overhaul given the many other demands it would face.
“Governments come in with huge agendas and a legislative timetable that can barely cope with all the things that they want to do,” said Desmond Swayne, a Conservative MP before the election who is standing again this time around. He strongly opposes changes to the law, and spoke out against moves to overturn it in a debate earlier this year.
Legalizing assisted dying is, Swayne argued, “the thin end of a very thick wedge.” He believes a change in the law could result in terminally-ill people’s wishes being sidelined. “I think you very quickly move from providing choice to an expectation,” he said.
Swayne supports letting MPs have a say on the issue again — but isn’t phased by the polling on the public’s views, arguing politicians in a representative democracy shouldn’t be beholden to this. “You give an immediate answer without having to go through the whole process of thinking through of all the consequences,” he said of opinion surveys.
That concern echoes strong opposition to altering the law on religious grounds. In 2021, Archbishop of Canterbury Justin Welby, Cardinal Vincent Nichols and Chief Rabbi Ephraim Mirvis signed a joint letter to members of the House of Lords warning that assisted dying threatened the “precious gift of life.” Instead, they want the U.K. to prioritize better palliative care.
And unease remains among some in the medical profession too.
Backbench action
A 2020 BMA survey of its members found just 10 percent of palliative care doctors — the type most likely to be involved with terminally ill patients — would prescribe drugs to assist death, while 76 percent would not.
Objections to reform cut across party lines during an emotional Westminster Hall debate earlier this year, highlighting just how tricky it would be to pass any legislation.
“Legalizing assisted dying would impose a terrible dilemma on frail people, elderly people and others when they are at the most vulnerable point in their lives, especially on conscientious frail people who do not want to die but do not want to be a burden,” said Labour backbencher Stephen Timms during the debate. “I do not think that there is any way to avoid imposing that dilemma.”
If a Starmer government does end up too snowed to prioritize the issue, a backbench MP could still try to force assisted dying up the agenda. Legislation enacting social change has often been sparked by backbenchers, including moves to decriminalize homosexuality and abortion.
Swayne remains unconvinced that another private members’ bill on the subject could actually become law, however. He points out opponents to these backbench bills are well-versed in tactics to talk out ideas they don’t agree with. “The enemy of the private members’ bill is time,” he says. “You just need to turn up on a Friday and speak at length about what a wonderful bill it is until it runs out of time.”
But Blomfield is still optimistic change might be on the cards, saying the Labour leader’s personal promise offers his side its best chance to push for change yet.
“We need to give everybody the opportunity for choice at the end of their lives and the right to die in dignity,” he says.
“The debate is reaching a crescendo and dying people’s voices are refusing to be ignored,” says Wootton.