What should socialists say about assisted dying?

Lynda McEwan

A bill has been passed through its first stage of the Scottish Parliament to legalise assisted dying, marking a significant and welcome shift in public conversation about life, death, and the role of the state.

Under the proposed legislation, terminally ill adults with less than six months to live would be able to request medical assistance to end their lives.

Framed in terms of “dignity” and “compassion”, the bill has received support from a cross-section of political parties, campaigners, and medical professionals.

But beneath the liberal veneer lies a more complex and troubling picture. In a capitalist system that fails to meet the basic needs of working class people in life, how can it be trusted to offer freedom or dignity in death?

The appeal of assisted dying cannot be separated from the stark reality of life, and death, in a neoliberal health and welfare system.

For working class people in Scotland and across Britain palliative care is increasingly inaccessible, fragmented, and underfunded. Hospices across Scotland are warning they may have to turn patients away due to a massive funding gap.

Community palliative care is patchy and overstretched. Cuts to local authority budgets mean social care is collapsing. NHS staff are leaving in droves, wages are falling behind inflation, and patients face waiting lists stretching into months or even years.

Meanwhile, private providers circle like vultures, ready to profit from people’s final days. Families are left to shoulder impossible burdens with little support.

In such a context, what does “choice” really mean? Starmer’s government is already attacking disability benefits, reducing disabled people’s living standards and severely impacting their ability to make informed choices.

When someone with a terminal illness faces the prospect of dying in pain, in poverty, or alone, the offer of assisted dying may appear as the only escape from suffering, not because it is truly chosen, but because other humane options have been systematically denied.

Disabled people’s organisations have raised deep concerns about the bill. Many rightly fear that legalising assisted dying in an austerity-ravaged society sends a dangerous message: that some lives are less worth living, and less worth supporting, than others. 

The value of human life should not be determined by economic productivity or bodily independence.
Experience from other countries, such as Canada and Belgium, has shown the very real risk of a “slippery slope”, where eligibility widens and economic or social desperation becomes a driver behind people’s decisions to die.

There have been cases in Canada of people with disabilities choosing assisted death not because of their illnesses, but because they could not afford housing or support.

And let’s be clear: this issue is inseparable from class. Wealthier people can pay for private care, choose the best hospices.

Working class people, especially in deprived areas, face far fewer choices, and die younger to begin with. In more affluent East Dunbartonshire, women live 5 years longer than their counterparts in socially and economically deprived West Dunbartonshire.

What appears as an act of personal freedom may in fact reflect structural injustice. For some, assisted dying may be promoted as the only compassionate option because the compassionate society we need does not yet exist.

Only a fully funded NHS and an reversal of all cuts, including a palliative care system that meets the needs of those who require it can offer real choice.

That means a planned, publicly owned economy run by and for the working class that can ensure everyone has the support and dignity they deserve in life and death alike.

We need socialist policies, not liberal smokescreens that let the state off the hook. A society that truly valued human life wouldn’t offer death as a solution to suffering, it would eliminate the suffering itself.

• This article is a contribution to the debate around assisted dying. If you’d like to write a contribution, please email us at [email protected]