Canada seen by some as cautionary tale for U.K.’s assisted dying bill

Esther Rantzen says she doesn’t have the strength to fly to Canada to seek lasting relief from her ever-advancing cancer, but she would if she could.

“I love Canada, but I think I will go to Switzerland and seek an assisted death if the illness starts to progress faster,” Rantzen, 84, said from her cottage in the New Forest in southern England. 

“It was named the New Forest a thousand years ago by one of William the Conqueror’s sons. So we are quite a conservative country…. If we regard a thousand years as being quite new, you can see why it’s taking us a bit of time to reform our current law.”

Rantzen is referring to what’s being called a once-in-a-generation political and moral decision for the United Kingdom’s members of Parliament.

On Friday, MPs will have the opportunity to debate and vote on whether terminally ill adults in England and Wales with fewer than six months to live and the assistance of a doctor should have the right to end their lives. 

Bill 12, or the Terminally Ill Adults (End of Life) Bill, says anyone who wants to end their life must be older than 18, have the mental capacity to make that choice and be expected to die within six months. From there, interested adults must make two separate declarations, witnessed and signed, about their wish to die and receive approval from two independent doctors.

A High Court judge would then hear from at least one of the doctors and be permitted to question the dying person before making their ruling, at which point a doctor would prepare a substance for the individual, who would administer it themselves. 

Currently, assisted suicide, as it’s called in the U.K., is illegal and punishable by up to 14 years in prison.

Learning from Canada’s example

Despite Bill 12 being modelled extensively after assisted dying laws in the state of Oregon, Canada has found itself being held up as a prime example of what not to do by those who oppose the legislation. 

Some people see Canada’s expanding provisions for medical assistance in dying (MAID) as an example of what they feel could go wrong if the legislation is passed. Others are saying the strictness of the language in the British bill will safeguard England and Wales against going the way of Canada’s experience.

“We’ve got the benefit in this country of looking at what other countries have done,” Labour MP Kim Leadbeater told ITV’s Good Morning Britain. 

“And I’m not looking at the model that is going on in Canada. I’m looking at those other jurisdictions where this is done well and in some cases it’s been done for a long time, very well, and the criteria have never been extended.”

MAID was legalized across Canada in 2016 for those whose death was “reasonably foreseeable.”

Expanded in 2021, the law as Canadians know it today no longer requires the person applying to have a terminal diagnosis in order to be eligible. 

For critics of the U.K.’s bill, which has divided opinions across the political spectrum, the concerns range from a lack of safeguards to lawmakers not being given enough time to review its language.

Leadbeater introduced the bill to the House of Commons on Oct. 16 and published its full text on Nov. 11.

“At the heart of this is choice, it’s autonomy. It’s addressing a status quo which is not fit for purpose and it’s the rights of those terminally ill people who do not have long left to live just having the choice that I believe they deserve,” Leadbeater told the BBC on Nov. 12.

Recently, U.K. Justice Minister Shabana Mahmood wrote a letter to constituents calling it a “slippery slope to death on demand” and strongly voiced her plans to vote against the bill, despite calls from Prime Minister Keir Starmer for cabinet neutrality. 

Tanni Grey-Thompson, a Paralympic athlete and member of the House of Lords, says her concerns lie with the message she believes this legislation will send to the disabled community, should it pass.

“I worry about the impact on disabled people who don’t feel they will have a choice but to end their lives because the U.K. is not necessarily a great place for disabled people to live,” says Grey-Thompson.

People with disabilities in the U.K. continue to face discrimination, according to a 2023 report by the Equality and Human Rights Commission (EHRC), which found persistent barriers to access to transport, the justice system and sporting and cultural venues.

The language in the law being proposed specifies assisted dying would only be afforded to the terminally ill, which does not include someone with a mental disorder or physical disability.

But Grey-Thompson says laws can be changed. 

“We’ve seen in places like Canada, it’s changed quite a lot…. It’s possible for a huge number of people to potentially ask for this.”

She adds the widening of the law in Canada is concerning. 

Currently, Canada’s Bill C-14 does not require a terminal diagnosis and is open to those plagued by “physical or psychological suffering.”

However, expansion of Canada’s MAID program for those with a mental illness has been delayed until March 2027.

WATCH | Health minister says Canadian government is seeking delay to MAID expansion: 

Government wants to wait on expanding medical assistance in dying

The federal government has announced it’s hitting the brakes on expanding medical assistance in dying to those suffering solely from mental health issues, saying Canada’s health system is not ready.

“I think we just have to be careful what we wish for,” said Grey-Thompson. “I don’t want people to suffer. I watched my parents die, it was pretty miserable. But their experience has made me think about how we need to do things in a better way.”

When will it take effect?

Ahead of the U.K.’s general election this past summer, a poll by a London-based research consultancy showed that when asked to choose the top priorities for the new Labour government, only four per cent included “legalizing assisted suicide.” 

And yet, a public opinion poll conducted in the weeks following the publication of Britain’s Bill 12 demonstrated “73 per cent of Britons believe that — in principle — assisted dying should be legal in the U.K.” 

MPs will vote in the House of Commons on Friday, at which point, if the bill passes, it will be forwarded to a public bill committee for consideration. Evidence could be submitted for or against the proposed legislation from campaign groups, religious organizations and medical professionals.

Further obstacles to the bill take shape in the form of a third reading, followed by a vote in the House of Lords, all of which means it could be years before the first person in the U.K. is able to legally apply for assisted dying. 

It’s a timeline that Rantzen fears will outlive her.

Rantzen, who set up a health line for children in 1986, stepped down from her post as president of Childline in 2023 after being diagnosed with Stage 4 lung cancer.

She said she supports this bill because it gives people who are terminally ill the right to a “good death.”

“Choice is what it’s all about, whether you have a choice to shorten your death. Not your life, but your death.… That choice is what Canadians have.”