We welcome the detailed report from the Commons Health and Social Care Committee, which catalogues the dangers of legalising assisted suicide or euthanasia, however given the evidence the MPs heard is disappointing that they have not come down firmly against changing the law.

The committee recognises about the huge problems in patients accessing good quality palliative care [Conclusions 13-15]. It heard about the struggle many face with getting the right social care and how disabled people, the vulnerable and elderly find it tough to pay their bills or suffer from isolation and feel like they have become a burden. Indeed, one expert told the Committee about the clear evidence of the pressure on people who were seen as no longer 'a useful member of society" [Par 140] and that this pressure could be nonintentional. This is exactly what we see in places like Oregon, where a majority ending their lives cite burden on their families as a reason for ending their lives or Canada where 1,700 people cited loneliness as a reason for allowing the state to kill them.

The Committee also heard the about the difficulty to 'to accurately assess capacity, and safeguard the person, in every case' [Conclusion 7] and acknowledged that a small number of places have only recently changed their laws to allow state sanctioned killing of the terminally ill, vulnerable and elderly. And that over time deaths from assisted suicide or euthanasia increase [Conclusion 12].

There are many problems with changing the law to legalise state sanctioned killing. As we saw in the Netherlands and Belgium limits on who qualifies for an assisted death have been swept away. No longer is state aided killing with death row drugs limited to those with less than six months to live, but routinely includes disabled people, those with chronic non-terminal conditions and individuals with mental health problems, such as patients with dementia, treatable depression, anorexia even a victim of sexual abuse.

We were disappointed that the Committee, failed to pick up that those countries which have changed the law, have celebrated savings they have made, or failed to increase spending in palliative care at a similar rate to neighbouring jurisdictions [Conclusion 7] or that changing the law is increasingly linked to an increase in suicides rates in the general population, based on extensive data from the US and Europe.

The Mathews et al Study, a peer reviewed study from 2020, interviewed palliative care physicians and nurses who practiced in healthcare settings where patients could access Medical Assistance in Dying (MAiD) in Southern Ontario. This report concluded the negative impact that MAID has on palliative care in Canada, while studies from the UK's Anscombe Institute show the growing body of evidence linking increases in suicide to legalising assisted suicide and euthanasia:"

At a time when we have seen how fragile our health care system is, how underfunding puts pressure on services, accessing specific treatments and when the UK's amazing hospice movement faces a £100 million funding crisis, MPs could have decided to firmly close the door on assisted suicide and euthanasia, and say the current law which protects everyone, regardless of whether they are young or old, able bodied or disabled should remain. They failed.

Dr Gordon Macdonald is head of Care Not Killing, a group of organisations campaigning against the legalisation of euthanasia and assisted suicide. To donate to the Stepping Up, Speaking Out campaign, visit https://www.carenotkilling.org.uk/donate/