Assisted Dying: A Duty to Care or a Slippery Slope to Killing?

The moral and political clash of the autumn. On one side, Labour MP Kim Leadbeater is ready to introduce a private member’s bill to Parliament that seeks to change the law on assisted dying in England and Wales. On the other, Cardinal Vincent Nichols, the UK’s highest-ranking Catholic bishop, has made a rallying cry to the faithful, urging them to lobby MPs against the proposed changes. Nichols’s warning? A “slow change from a duty to care to a duty to kill.”

The stakes couldn’t be higher. We’re talking about life and death—literally. And not just in the abstract, philosophical sense that bishops love to chew over, but in the practical, deeply personal realities that terminally ill patients, their families, and medical professionals face daily.

Nichols’s Apocalyptic Vision: A Culture of Death?

Cardinal Nichols, in a letter to be read in churches across his diocese, pulls no punches. He warns that legalising assisted dying would open a Pandora’s box, leading to a gradual erosion of the sanctity of life. In countries where assisted dying has been legalised, Nichols argues, the circumstances under which it is permitted have been “widened and widened.” This, he believes, could lead to a situation where patients feel pressured to end their lives to relieve family members of the “burden of care,” avoid pain, or—darkly—"for the sake of inheritance.”

It’s a terrifying dystopia if you take Nichols’s vision to its logical conclusion. You can almost hear the clock ticking towards a future where medical professionals, once sworn to the Hippocratic oath, morph into reluctant executioners. Today, they care. Tomorrow, they kill—slowly, incrementally, but inevitably. The language is apocalyptic, the stakes existential.

But Nichols goes further, framing suffering itself as an intrinsic part of human dignity. In his words, “The suffering of a human being is not meaningless... It is an intrinsic part of our human journey.” One can almost hear the Catholic echo of centuries of martyrdom, suffering embraced as a gateway to eternal glory. Pain, in this view, is not to be alleviated at any cost, but to be endured, even celebrated.

Leadbeater’s ‘Unbelievably Cruel’ Reality

Kim Leadbeater, meanwhile, offers a rather different perspective. For her, and for many who support reform, the current law on assisted dying is “not fit for purpose.” In a world where medical advances have prolonged life well beyond what nature once intended, the idea of living with unbearable suffering, without the legal option to end one’s life on one’s own terms, seems archaic and “unbelievably cruel.”

Leadbeater’s proposed bill aims to change that, offering terminally ill patients the option to die with dignity, free from unbearable pain, and with control over their final moments. The bill’s supporters argue that the existing legal framework condemns some patients to die in agony, with no recourse but to travel abroad—if they have the resources—or to take their own lives in secret, a tragic last resort.

Earlier this year, before he ascended to the premiership, Keir Starmer threw his support behind changing the law. He even made a personal promise to Esther Rantzen, the beloved TV presenter now battling terminal lung cancer, that he would back her campaign for reform. For many, this is not about undermining the sanctity of life but about offering compassion and autonomy to those for whom modern medicine offers only pain and despair.

Insight 1: Assisted Dying Laws—Where is the Line Drawn?

The crux of the debate isn’t just about assisted dying but where, if anywhere, we draw the line on what constitutes legitimate suffering. Cardinal Nichols’s concerns over a slippery slope are not entirely unfounded. Countries that have introduced assisted dying, such as Belgium and the Netherlands, have indeed expanded the scope of who qualifies—sometimes including those with mental illnesses or severe disabilities, and in extreme cases, even minors. The question is, once you open the door to legalised death for some, how do you justify denying it to others who may also be suffering but fall outside the originally defined criteria? The "widening and widening" Nichols warns of isn’t just a scare tactic; it's a reflection of how difficult it is to set clear ethical boundaries once the principle of assisted dying is accepted.

Insight 2: The Psychological Toll on Medical Professionals

One of the most profound yet often overlooked consequences of legalising assisted dying is the impact it could have on doctors and healthcare professionals. While much of the public debate focuses on the rights of patients, we should also consider the psychological toll on those tasked with administering these laws. As Nichols points out, there’s a real fear that doctors may find their role shifting from one of care to one of enabler, or worse, executor. Studies from countries where euthanasia is legal suggest that medical professionals sometimes struggle with the moral implications of ending a life, even when it is consensual. Are we risking a burnout epidemic among doctors who go into medicine to save lives but may increasingly find themselves asked to end them?

Insight 3: The Influence of Societal Pressures

One of the more uncomfortable aspects of the assisted dying debate, raised by Nichols, is the potential for societal pressure to influence vulnerable people into making choices they wouldn’t otherwise consider. For the elderly, the terminally ill, or those with chronic conditions, the mere existence of assisted dying laws could create an implicit expectation to 'do the right thing' and relieve their family or the state of the burden of care. This isn’t hypothetical scaremongering—there are documented cases from Canada and Belgium where patients expressed concerns about being a financial or emotional weight on their families, influencing their decision to opt for assisted death. The psychological pressure to not be a ‘burden’ can be subtle but powerful, particularly in a society that increasingly equates value with productivity.

Autonomy vs. the Sanctity of Life: Who Decides?

At the heart of this debate lies a fundamental clash of values. For Nichols, the sanctity of life is paramount, and suffering—even intense suffering—can have meaning, purpose, and dignity. It’s a view rooted deeply in Catholic doctrine, where life is seen as sacred from conception to natural death, and where human suffering can be redemptive.

For Leadbeater and her supporters, the issue is about autonomy—about the right of individuals to make their own choices regarding their death, particularly when facing unbearable suffering. They argue that the law should allow people to avoid unnecessary pain, to exit life on their own terms, rather than be forced to endure indignity and agony.

And, in the middle, sit the medical professionals. Nichols worries about a “duty to kill” creeping into the profession, but for many doctors, the ethical debate is already a difficult one. They witness the suffering of their patients firsthand, and for some, the inability to help their patients die with dignity feels like a failure of care, not a protection of life.

A Nation Divided

As MPs prepare to vote on the issue on November 29, the public debate is likely to intensify. Polls consistently show that a majority of the British public supports the legalisation of assisted dying under strict conditions. But support from the public is not the same as consensus in Parliament, where strong opposition—especially from religious leaders like Nichols—remains influential.

Whether the bill will pass remains to be seen. But one thing is certain: the debate around assisted dying is not going away. It strikes at the heart of our values—about life, death, suffering, and the role of the state in regulating these most personal of decisions.

For some, like Leadbeater and Rantzen, the law’s change represents compassion and progress, a step towards a more humane society. For others, like Cardinal Nichols, it’s a step too far, a dangerous and irreversible shift towards a culture that devalues life and sees death as a solution.

Ultimately, the question is this: do we trust individuals to make their own decisions about their death, or do we, as a society, believe that life must be preserved at all costs, even when it’s painful and degrading? It’s a question that MPs, medical professionals, and voters alike will grapple with in the weeks to come.