The introduction of a bill to legalise assisted dying for terminally ill people

The introduction of a bill to legalise assisted dying for terminally ill people in England and Wales raises profound concerns for me, both ethically and theologically. Having studied medical ethics as part of my nurse training, I am deeply aware of the principles that guide medical decision-making, particularly the balance between autonomy—the right of individuals to make decisions about their own lives—and beneficence—the duty to promote wellbeing and protect life. However, my professional and personal experience as a nurse, Salvation Army officer, and relative journeying with those who are dying has shown me that the practical application of these principles is fraught with complexity, especially for vulnerable individuals.

Autonomy and Vulnerability

Advocates for assisted dying often frame the issue as one of personal autonomy: individuals, especially those suffering from terminal illness, should have the right to choose the timing and manner of their death. This seems compelling on the surface, as it speaks to a deeply human desire for control. However, my personal and professional experience with people facing terminal illness, suicide, and poor mental health shows that autonomy is not always as clear-cut as it appears.

I have journeyed with individuals with vulnerabilities who felt as though they had no other option than to end their lives. These experiences reveal that choices around life and death are rarely made in a vacuum. Economic pressures, the feeling of being a burden, societal expectations, life experiences, and the inadequate support from a struggling health and social care system can deeply impact a person’s sense of agency. When people feel isolated, unsupported, or undervalued, autonomy can become a coercive force, pushing them toward decisions they may not make under better circumstances.

This is particularly concerning in the current state of our health and social care system, which, as I have witnessed, is already failing to adequately safeguard vulnerable people. We are unable to properly protect children and adults in need, as social workers, healthcare professionals, and community resources are massively underfunded and overstretched. In this context, can we truly ensure that the choice for assisted dying will be a free and informed one, unclouded by the pressures of inadequate care and support?

Beneficence and Non-Maleficence

The principles of beneficence and non-maleficence in medical ethics guide healthcare professionals to act in the best interest of the patient, promoting wellbeing and avoiding harm. Assisted dying places these two principles in tension. While some may argue that helping someone end their life to alleviate suffering is an act of kindness, my experience with palliative care shows that suffering is multi-dimensional—physical, emotional, spiritual—and can often be managed with the right support and care.

Unfortunately, our end-of-life and palliative care systems are chronically underfunded, under-resourced, and understaffed. Too often, people in need of comfort and support at the end of life do not receive the care they deserve. In this context, the introduction of assisted dying could lead to a dangerous shift: rather than focusing on improving palliative care, there may be a temptation to see assisted dying as a quicker, less resource-intensive option. This could further erode the quality of care for those nearing the end of life.

As someone who has walked alongside people in their final moments, I know that good palliative care is essential. It enables people to die with dignity. The solution to end-of-life suffering should be more comprehensive care, not the legal option to end one’s life prematurely.

Theological Reflection: The Sanctity of Life and Care for the Vulnerable

From a theological perspective, the sanctity of life is central to my belief system. All human life is a gift from God, created in His image and with inherent dignity. My role as a Salvation Army officer and nurse has further deepened my commitment to caring for those who are most vulnerable. In my ministry, I have encountered many people who feel they have no choice but to end their lives because of pain, illness, or poor mental health. This is where we, as a society, must step in—not to offer them a way out through death, but to stand with them in solidarity, offering them the care, support, and compassion they need to continue living with dignity.

Suffering, while painful, is not without meaning. Theologically, suffering can deepen relationships and foster spiritual growth, not only for the person suffering but for their community as well. The Christian tradition emphasises the importance of caring for the marginalised, including the sick and dying. In Matthew 25:40, Jesus reminds us, “Whatever you did for one of the least of these brothers and sisters of mine, you did for me.” Assisted dying, by contrast, risks isolating those who suffer, sending a message that their lives are less valuable and that death is preferable to the complex, communal process of caring for one another.

The Slippery Slope

There is also the very real concern of the slippery slope. In other countries where assisted dying has been legalised, the eligibility criteria have widened over time to include people with disabilities and those suffering from mental health conditions. As someone with personal and professional experience of poor mental health and suicide, I know how fragile the human spirit can be when faced with despair. Assisted dying could become an option that is chosen not out of genuine autonomy, but out of hopelessness, loneliness, or a sense of burden. In a system already failing to safeguard the vulnerable, this legislation risks normalising the idea that some lives are worth less than others.

Conclusion

As someone who has both personal and professional experience with end-of-life care, suicide, and working vulnerable people, I am deeply concerned about the implications of this bill. While autonomy is important, it must be understood within the broader context of vulnerability, care, and community. We must focus on improving palliative care, adequately resourcing health and social care services, and standing in solidarity with those who suffer. As a society, our ethical and theological mandate should be to protect the vulnerable, uphold the sanctity of life, and provide compassionate care for all, especially at the end of life.