With assisted dying back in the headlines, Madeleine Pennington shares her take on recent Theos polling on the topic. 30/01/2024

Assisted dying returned to centre stage in the public conversation over Christmas, as journalist Esther Rantzen revealed that she has joined the Dignitas clinic in Switzerland and plans to end her own life if a “miracle” treatment cannot cure her stage 4 lung cancer.

The UK public is broadly sympathetic. A poll from The Mirror commissioned in response to Rantzen’s comments back in December found that 71% were in favour of legalising assisted dying for those with a terminal illness, while just 13% were opposed. Other polls have found similar levels of support for legislative change (though it’s worth noting that the campaigning group Dignity in Dying’s own polling has found this support cooling in recent years, from a high of 84% in 2019 to 78% last summer).

The circumstances in which someone would choose to end their own life are always tragic and painful, and the ethical debate around this issue often comes down to a disagreement about how to respond to human suffering with kindness (though its moral implications go far beyond this, especially to the limits of autonomy when balanced against the common good). Campaigners on both sides are often personally affected by the issue; those on both sides frame their arguments in terms of the desire to see a more merciful, more dignified society.

It is for this reason that the experience of other countries should give us pause. Above all, in Canada, which already has some of the most liberal laws on this issue in the world, euthanasia was the cause of 4.1% of all Canadian deaths in 2022. Already, Canadians can seek medical assistance to end their life even without a terminal illness if their physical condition is deemed “grievous and irremediable”, and political debates are still ongoing over plans to expand ‘MAiD’ (Medical Assistance in Dying) to cover those suffering from mental illness. Last year, polling found that 28% of Canadians were also in favour of including homelessness as a reason to seek medical assistance in dying (and 27% for poverty). More alarming still, this number jumped to 41% of people aged between 18 and 34. This is quite a departure from the current tone and focus of public debate in the UK, on assisted dying for the terminally ill.

Rantzen’s own perspective is shaped by her personal circumstances, and above all, the security of a loving family: her daughter has said publicly that she would “want to ground the plane [to Switzerland]” if it were up to her, though is supportive of her mother’s right to choose. To her, compassion means choice. Yet ultimately, legislation must work not just for individuals but for communities and the population as a whole – meaning that compassion must also (and arguably more so) mean protection for those who are at their most vulnerable, without hope, or without loved ones reassuring them their lives are still precious. As Canada slides further down the proverbial slippery slope, it is clear that the two are not always the same.

It was partly with this in mind that Theos commissioned YouGov to conduct similar polling in the UK last summer, asking 2,569 people whether they would support a change in the law to allow assisted dying under a range of circumstances.

As expected, in line with existing polling, we found high support for legalised assisted dying in cases of terminal illness: 78% across the whole population. But the debate can’t end with an appeal to public support alone. Ours is a society that generally does death badly; we conducted this research as part of a wider stream of work on death and dying which has highlighted our lack of exposure to death in normal life. And just as we have found this hiddenness can negatively impact how we come to terms with our own deaths and those of our loved ones in ordinary circumstances, the unspoken assumptions in the debate around assisted dying can diminish our sense of what is truly at stake.

For example, we found that support for assisted dying for the terminally ill was generally slightly higher in the older age categories: some 65% of respondents aged 18–24 were in favour of legalisation compared to 79% of respondents aged 55 and over (and 85% aged 45–54 – the most supportive group – raising questions about why support in fact slightly tails off in older age, even when religious respondents, who are likely to be older, are removed from the sample). Meanwhile, the oldest respondents were least likely to support a change in the law in cases of old age: 30% of respondents aged 55 and over were in favour of legalised assisted dying for old age, compared to 36% of the general population and a high of 45% among 25–34–year–olds.

Might it be the case that respondents who felt supportive of legislative change when imagining themselves as suffering from unbearable terminally illness were less supportive when imagining themselves as an unwanted burden, soon facing pressure to die?

How we perceive our own stake in the issue seems to matter. And for groups with less voice in the mainstream conversation, it matters further still. To this end, we also found that 62% of respondents supported the legalisation of assisted dying for people who are chronically disabled; nearly half (49%) supported legalisation for those suffering from dementia; 10% supported it for those suffering from extreme poverty; and 9% for those who are homeless.

These figures are not as high as the Canadian poll, but they still imply stark judgements about whose lives are imagined to be hopeless, unbearable, irredeemable. In the real–world context of an ageing population, straining public services, and an unrelenting housing crisis, they also point to a potentially growing proportion of people who may feel that their lives are no longer valued by those around them, or by society as a whole – perhaps even that they may too be better off dead.

Dignity in Dying is explicit that it is not campaigning to legalise assisted suicide for any of these groups, but any public debate inevitably takes on a life of its own, subliminally shifting our sense of what is morally acceptable or politically possible. Where this masks unexamined judgements about whose lives are worth living, or whose situations are hopeless, we must pay particular attention; Canada is a cautionary tale of the alternative.

As the conversation around assisted dying continues, and legal change grows ever more likely, the need for greater attention to these nuances therefore grows ever more urgent. It is, literally, a matter of life and death.

You can view the full data tables here.

Background

All figures, unless otherwise stated, are from YouGov Plc.  Total sample size was 2,569 adults. Fieldwork was undertaken between 19th – 21st July 2023.  The survey was carried out online. The figures have been weighted and are representative of all UK adults (aged 18+).

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