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The future impacts are hard to think about ... but easy to see

All the scenarios in our ‘Future Impacts’ timeline video are grounded in clear experience from other countries where assisted suicide and euthanasia have been legalised.

2022

Assisted suicide legalised with ‘safeguards’

Mental capacity, terminal illness and only adults

  • These ‘safeguards’ are the key features of the ‘Oregon model’, as adopted in other US states (notably Washington and California), and proposed in Westminster for England & Wales.

2024

Fear of being a burden is involved in 59% of assisted suicides

Isolation and loneliness cause more Scots to consider it

  • 59% of those dying by assisted suicide in Oregon in 2019 cited feeling a ‘burden on family, friends, caregivers’ – a figure which has been rising.

 

  • The factors cited most often were being ‘less able to engage in activities making life enjoyable’ and ‘losing autonomy’ (90% and 86%).

2025

'State Assisted Dying'
deepens postcode lottery
for NHS medical treatments

  • There have been well-documented cases of patients being denied expensive, life-sustaining treatment while assisted suicide or euthanasia were offered – in Oregon (Barbara Wagner and Randy Stroup) and Canada (Roger Foley).

  • In California, Stephanie Packer was approved for a less toxic form of chemotherapy before the state adopted assisted suicide, but insurers pulled funding a week after the ‘End of Life Option Act’ became law.

  • Within the NHS, there have been many examples of tests, treatments and drugs being restricted on account of location, age or cost, and the individual cost of serious illness can be huge: research by Macmillan found 83% of people are, on average, £570 a month worse off as a result of a cancer diagnosis.

ECONOMIC PRESSURES WILL impact DECISION MAKING

£400 for lethal cocktail?

Or up to £90,000 for palliative care?

  • Following steep price rises for barbiturates used in American assisted suicides, physicians in Washington state devised alternative cocktails costing US$450-600 (£323-431) each.

 

  • A 2020 Canadian Parliamentary report found the total cost of a ‘completed case’ of euthanasia, including assessments, was C$2,327 (£1,323). The report also found that euthanasia deaths under the existing law would save health authorities C$86.9M in 2021, rising to C$149M under an expanded law.
 
  • Palliative care costs vary depending on diagnosis, prognosis, setting and other factors. Macmillan Cancer Support reported in 2013 that the cost of end of life care in the final few months of life can be as high as £90,000 per person, with many other studies indicating other five-figure sums

Sources: 

2027

Court ruling finds ‘safeguards’ to be discriminatory

New MSPs pass euthanasia for non-terminal illnesses, psychiatric conditions and disabilities

  • Canada’s requirement that death be ‘reasonably foreseeable’ to qualify for euthanasia was ruled an unconstitutional restriction by a Quebec Superior Court judge in 2019. The bill to comply with the ruling (C-7) will broaden the six-year-old federal law’s scope to include chronic illnesses and disabilities, and allow advance requests for those with conditions like dementia. The outgoing restriction failed to prevent the deaths of non-terminally ill patients with depression (cf Alan Nicholls) and eating disorders, and the Canadian Psychiatric Association has called the new bill’s stated exclusion of mental illnesses ‘stigmatizing.’

 

  • The law in Oregon requires that participants be terminally ill, but without any change in statute, officials also now consider patents to be eligible if they forego otherwise life-sustaining treatment: 2019 saw assisted suicides for patients with diabetes, arthritis and ‘complications from a fall.’

 

  • Concerning a shift from one form of ‘assisted dying’ to another: the Carter court case which prompted Canada’s law originally concerned assisted suicide, but the legislation which fulfilled the court’s mandate allowed both assisted suicide and euthanasia; just six of the 5,085 MAID deaths across nine Canadian provinces between June 2016 and October 2018 involved assisted suicide rather than euthanasia. Six years on, the terminal illness restriction has been struck down.

 

  • Prominent campaigners in the current push for a Scottish law change supported a Scottish euthanasia bill in 2010.

2028

Healthcare workers see their conscientious objection rights eroded

  • In 2019, the Ontario (Canada) Court of Appeal affirmed a College of Physicians and Surgeons (CPSO) policy requiring physicians unwilling to participate in euthanasia and assisted suicide to make ‘effective referrals’ to willing practitioners or clinics.

Hospice forced to close after funding is axed for refusal to offer euthanasia

  • British Columbia (Canada) requires all non-religious hospices in receipt of majority state funding to offer patients euthanasia, and the health authority is forcing the closure of one hospice which refused. In New Zealand, a judge ruled in 2020 that health authorities would have the right to defund hospices which similarly declined to offer euthanasia.

2030

MSP proposes bill to extend euthanasia to over-75s 'tired of life'

  • A bill currently before the Dutch parliament would allow for the euthanasia of healthy over-75s who feel their lives to be ‘complete’.

Elder abuse cases rise. Emotional & financial pressures mount on care givers.

  • Age UK reports that already in the UK, ‘almost half a million people aged over 65 will experience some form of abuse or neglect’ including physical, psychological and financial abuse.

 

  • Carers UK reports that one in eight adults across the UK provides unpaid care to older, disabled or seriously ill family and friends.

2032

Scottish teenager seeks the 'right to die'

Euthanasia extended to children of any age including newborns with disabilities.

  • The Belgian Act on Euthanasia of 28 May 2002 only permitted euthanasia for adults and emancipated minors, but was extended in 2014 to all terminally ill children.
 
  • Dutch law already provided for euthanasia for children as young as 12, as well as the euthanasia of disabled newborns by way of the ‘Groningen Protocol.’
  • In December 2016, Canada’s Ministers of Health and Justice ordered a review on the possibility of extending euthanasia to mature minors, prompting doctors associated with a Toronto children’s hospital to develop guidance on whether age or capacity should be the deciding factor, whether doctors should be required to bring euthanasia to young patients’ attention, whether children should be able to undergo euthanasia without their parents’ knowledge – much less their consent – and whether hospitals have a responsibility to normalise euthanasia.

PROPER FUNDING FOR PROPER CARE

PROPER FUNDING FOR PROPER CARE

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Palliative
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and euthanasia
Oppose assisted suicide
and euthanasia

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Promoting Care, Opposing Euthanasia

Care Not Killing was set up in 2006 as an alliance of individuals and organisations which brings together disability and human rights groups, healthcare providers, and faith-based bodies, with the aims of promoting more and better palliative care; ensuring that existing laws against euthanasia and assisted suicide are not weakened or repealed; and helping the public to understand the consequences of any further weakening of the law.

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