Assisted dying: UK can easily learn from Canada’s mistakes, think tank says

Ahead of Kim Leadbeater’s bill text being introduced, new briefing shows lessons UK can learn on eligibility and safeguards from failures in Canadian assisted dying policy.

The Social Market Foundation – a cross-party think tank – said that Canada’s experience need not deter the UK from a carefully controlled and compassionate approach to assisted dying. The SMF emphasises that there are other jurisdictions (in the US, Australia and New Zealand) which allow for some form of assisted dying in a tightly controlled manner.

The research comes the same week that Labour MP Kim Leadbeater will introduce the full text of a bill to legalise assisted dying in England and Wales, before a vote among MPs on November 29. The Times reported that both sides of the debate believe the vote is “far too close to call”, and that when “you ask about the detail, changes quite a lot”. Concerns about the state of UK palliative care, the impact on disabled and disadvantage groups, and a ‘slippery slope’ of loosening eligibility standards, have all been raised.

The Social Market Foundation urges UK policymakers to approach the policy with the aim of attaching robust safeguards to protect vulnerable populations, which can help avoid the same fate as Canada. Jake Richards MP, a proponent of the bill, stated in the SMF report foreword: “…it’s essential we approach this policy with caution, putting safeguards in place to protect against potential misuse.”

The Canadian example has dominated discourse, as a prominent example of loose eligibility restrictions and minimal safeguards. Physicians in some provinces were expected to make life or death judgements with only a four-page pamphlet for guidance. Later in 2021, a judicial decision based on Canada’s constitution led the government to scrap requirements that applicants be terminally ill, which has led to a number of questionable cases that human rights organisations and disability advocates have warned about.

The SMF briefing delved deeper into the Canadian assisted policy dying landscape and technicalities, to understand how best UK can avoid its mistakes.

Based on the assessment, key recommendations for the UK include: restricting assisted dying to individuals with terminal illnesses; developing clear procedural guidelines for healthcare providers, establishing oversight committees to verify those guidelines are followed; and making oral medication the default method for those who wish to end their lives. In addition, crucially, alternatives should be available including high-quality palliative care so no one accepts assisted dying before they wish.

With 75% of respondents expressing support for assisted dying legislation (according to an Opinium poll), UK policymakers have a chance to act on public will while implementing clear guidelines for both eligibility and physician responsibilities, the SMF noted. Gideon Salutin, Senior Researcher at Social Market Foundation, said:

“Advocates for assisted dying in the UK should confront concerns about Canada head on, discussing them compassionately and demonstrating that they have learned the necessary lessons about protecting the most vulnerable. Many issues, such as those related to our palliative care system, are authentic, significant and practical.

At the same time, they cannot allow Canada to dominate the debate. There are numerous examples that demonstrate that there is no inevitable slippery slope, and that there are better models to study and learn from.”

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