This is Prospect’s rolling coverage of the assisted dying debate. This page will be updated with the latest from our correspondent, Mark Mardell. Read the rest of our coverage here
21st November
12pm
What is your torment ?
I have now finished Sigrid Nunez’s novel What Are You Going Through, on which the new award-winning Almodóvar film is based. I began reading it out of a sense of duty, to you, this blog and the debate, abandoning everything else I was reading. I’m delighted to report that my work ethic was repaid in delight at discovering such a terrific book and new (to me) author.
I confess Nunez had never crossed my radar before, even though she won the 2018 National Book prize for her seventh novel The Friend and has written a memoir of her time working for Susan Sontag as she recovered from cancer, which describes how Nunez ended up dating the writer’s son.
This 2020 novel revolves around the decision of a woman with terminal cancer to end her own life and her request to an old friend to support her. The unnamed narrator and the dying woman used to be very close but have rather lost that intimacy.
The notion of assisted dying isn’t mentioned until halfway through and isn’t really what the book is “about”. It is about women’s friendship, mothers and daughters, loss and loneliness.
The writing is unexpectedly brisk and unadorned, while the story is told discursively as the narrator recalls other stories—among them an attempt to befriend an isolated elderly woman who is not only going gaga but Maga too, a gym freak’s despair at ageing, and even a tale told by a cat (by definition an unreliable narrator). A constant refrain as the main character meanders through these tales is “the saddest story ever told”. These are the opening lines of Ford Madox Ford’s The Good Soldier—yes, it is one of those books that is in part about writing and the books that furnish a life.
These anecdotes are tangential to the plot, but are the sparse brush strokes which obliquely hint at a wider picture. One review I read suggested the novel fell down because the main character isn’t likeable: I rather think that it takes a subtle skill to draw with such precision a picture of a rather unlovable, lonely woman through tangential stories and a brisk inner monologue.
While a tremendous read, it must have been very hard to turn into a film, given the predominance of ideas and lack of action—and what little there is seems rather out of focus and off-screen.
So, does this novel contribute to the debate? It does without being preachy or definite. One passage struck me forcefully: when the woman with cancer reflects on other people’s determination that she should “fight” and not “lose” to the disease.
“People ought to be able to understand that this is my way of fighting,” she says. Cancer can’t get me if I get me first. And what’s the sense in waiting, she adds, when “I’m ready to go”.
Then there is the book’s title, a quote from Simone Weil: “The love of our neighbour in all its fullness simply means being able to say to him, ‘What are you going through?’’’ Nunez points out that in the original French “the great question sounds quite different : ‘quel est ton tourment?’”
Which couldn’t be more relevant. Perhaps on both sides of the debate we need to ask each other: “what is your torment?”
20th November
3pm
Wes Streeting’s number two, health and care minister Stephen Kinnock, won’t be joining his boss in the lobbies in nine days’ time. The senior minister said: “I think that assisted dying is the right thing to do from the point of view of compassion. Hundreds of people a year are taking matters into their own hands in uncontrolled environments. It’s not safe, it’s not compassionate, and I think it’s also right that people should have the choice to die a good death in the warm embrace of the people that they love.”
Given that Streeting caused a bit of a storm when he suggested palliative care wouldn’t be able to cope with the strain an assisted dying law would place on the system, the comments from the man in charge of it are particularly significant. Kinnock told ITV News: “I will be voting for the bill on November 29. I don’t think it’s an either/or question on hospices and palliative care but evidence shows that often countries and places that go with assisted dying actually see improvements in palliative care coming from that.” There is no suggestion that his vote is anything at all to do with his mother’s peaceful and natural death from Alzheimer’s in 2023, but personal experience are important. So it is worth recalling his words a few months later.
“One of the lovely things that happened after Mum died is we heard those lovely tributes,” he said. “They were very moving and really helped me to deal with the grieving process. You access memories from before that horrible illness took hold, because for the last three or four years she was a very, very different person to before. That change is so all-consuming you find it quite difficult to remember what she had been like.”
He said the disease meant grieving twice. “Once when they die, but once when they’re still standing in front of you. A lot of deep, deep sadness came when Mum started slipping away mentally and suddenly wasn’t able to do all the things she used to do, from baking a cake to reading a book to being really engaged in conversations. You could see she was desperately trying to but she just couldn’t get the connections in her brain to work.”
More members of the cabinet have been saying how they will vote—by my rough and ready reckoning that makes it eight to five in favour, if we include the prime minister, which I think we must. Starmer has told the BBC: “I dealt with it for five years when I was chief prosecutor, so I saw every single case that was ever investigated, so I know what the issues are. And I also really do appreciate just how strongly people feel. Obviously, people will see the way in which I will vote. I will vote, and I’ve set out my views previously in relation to this.” According to the LabourList tracker, as of this morning 59 Labour MPs are for the bill, with the exact same number undecided. Twenty-six will vote against.
19th November
11:30am
The master of flamboyant, funny and freaky film, the Spanish director Pedro Almodóvar, has made his first English language picture—and the plot revolves around assisted dying. I loved his last work, which pulled off that particularly Spanish trick of combining compelling personal stories with reflections on historical memories. But his latest work, The Room Next Door, has had very mixed reviews. There’s universal praise for the acting by two great performers, Tilda Swinton and Julianne Moore, but a general sense that the script is a bit clunky and that an indefinable something doesn’t quite work. One film magazine, Little White Lies, reckons: “It’s an elegant film, reckoning empathetically with an extremely complex topic, but there’s a slight sense that something is missing, keeping The Room Next Door from ever really becoming truly great.” The Independent says it is “didactic, strained and unsure of itself”. The Spectator argues: “Tilda Swinton’s character is selfish and tiresome and you’ll wish she would hurry up and die.” Ouch.
Based on the 2020 novel What Are You Going Through by the American author Sigrid Nunez, the film is set in the US but in part filmed in Spain, which according to some is plain awkward, but for others adds to an unreal atmosphere.
The Guardian loved it: “extravagant and engrossing and doggedly mysterious as anything [Almodóvar] has done recently, with... an undertow of darkness”. “The ideas are fiercely and absorbingly invoked,” it added. “Saying goodbye is what we will all have to do someday. We have to prepare.”
And the FT also finds sophistication: “In the face of the urgent real-world debate around assisted dying, Almodóvar again doesn’t do quite the expected. Rather than editorialise, he treats the act as simply something people may choose to do, with potential for awful misuses and slapstick mishaps.”
I can’t wait to see it and make up my own mind—it is in arthouse cinemas right now but I don’t know when I’ll get a chance. In the meantime, I’m reading the novel—so far it is terrific.
Oh, and it’s not only the acting that gets plaudits from all the critics: the knitwear is said to be sensational, too.
18th November
5pm
A leading expert on the ethics of assisted dying has attempted to perform a demolition job on the main arguments behind the Leadbeater bill. Indeed, in his very first footnote Professor John Keown calls even the phrase “assisted dying” “a vague and tendentious euphemism”. From that moment on, he pulls no punches. The report, for the conservative-leaning thinktank Policy Exchange, is subtitled “Improving the Quality of Debate”, which the author thinks is sorely needed. He looks in detail into the second reading of a previous (and obviously unsuccessful attempt) to pass such a law. He argues this matters because the Meacher bill from October 2021 is substantially the same as Leadbeater’s.
Keown argues three fatal flaws were revealed in a 2021 debate that was “superficial” as well as erroneous and exaggerated. The speeches by four eminent judges are dismissed as “of disappointing quality”. Then there’s “the failure of the supporters of the bill to follow the obvious logic of where the principles informing the bill led”, which was “one of the most striking omissions in their speeches”.
And that’s just the first page.
The three flaws he identifies are:
1. The main argument is about preventing suffering, but the bill does not require that patients are suffering, and many who are suffering would be excluded from it. Baroness Meacher’s speech (“confusing”) failed to draw the logical conclusion that this would inevitably lead to an extension of the law.
2. The suggestion that the law, in particular the Suicide Act of 1961, effectively “condoned” suicide was an error, and therefore the argument that it was illogical to stop some helping with suicide was “misguided”.
3. There was an exaggerated respect for the principle of autonomy but little or no stress on “the principle of the sanctity of life”. This made the disabled and elderly vulnerable in a society that “prizes youth, appearance and productivity.”.
While the middle point is largely irrelevant wordplay, the first does identify a glaring problem and a logic deficit in the bill. Although I agree with his argument here, I’m coming at it from the opposite direction. His third and last point raises some very interesting issues, and I suspect why the report gets such enthusiastic backing from disability campaigner and former Paralympian athlete, Baroness Grey-Thompson. She writes that it “shows clearly the practical and moral difficulties that this drastic departure from current ethical norms on the sanctity of human life will entail”.
Two things struck me about this clear and interesting report. The first was its tone—parliamentarians might take umbrage at the scorn he pours on the debating skills of their colleagues in the Lords, and the contempt he feels for their intellectual grasp of the subject. The politics of this is all in the big(ish) name endorsements, not in the arguments made in the paper—which are more likely to bolster existing convictions than make converts.
Which brings me to that second thing. It is a shame Policy Exchange omits a few words from its blurb about the author. It says he “holds the Rose Kennedy Chair in the Kennedy Institute of Ethics at Georgetown University”. According to his university, the full job title is “Rose F Kennedy Professor of Christian Ethics”. Nothing wrong with that, of course, but it is nice to know. In a current job advert for the post what that means is laid out starkly—the successful candidate will “have a solid background in the study and development of Catholic thought and tradition applied to medicine, biology, human development, and related issues, … [and] demonstrate an appreciation of, and broad support for, the Catholic and Jesuit mission of Georgetown University”. If you want to apply you’ve got until the 10th December. I don’t think I’ll bother: I could do the scorn, but not the rest.
4pm
I’m told more than 100 Labour MPs are undecided how to vote on Friday 29th November. This week both sides in the debate will be stepping up the pressure, polishing their best arguments and deploying their big guns. A very useful tracker, published by Labour List, suggests that of the 402 Labour MPs only 70 have declared how they will vote (48 for, 22 against).
Some of the most intense pressure is on Wes Streeting for sticking his neck out. The prime minister is said by the Sunday Times to have personally rebuked his overbold health secretary: “Senior Whitehall sources claim Starmer was irritated that Streeting had ignored the cabinet secretary’s instructions and his explicit appeal to cabinet ministers not to try to influence the vote.”
Intriguingly, there is also a suggestion some civil servants are “dismayed”. The paper says: “There have been some informal discussions where staff have expressed their views... Staff have flagged that the call for a review does seem to cut across routine process. There are some concerns about Streeting the secretary of state expressing a view, rather than Streeting the MP.”
Hefty political stories, particularly in the Sundays, are often weaved out of such thin material, and it is a matter of judgement whether to trust them. This one has the ring of authenticity.
After all, Starmer has previously been on the record quite clearly in favour of assisted dying and sees this debate as honouring a promise to Esther Rantzen. But he made it clear this week that because of his position he shouldn’t and wouldn’t be trying to influence the debate. And now former interim Labour leader Harriet Harman has doubled down on her previous criticism of Streeting.
This morning, speaking on the Today programme, Harriet Harman said that he had “crossed a line”. She told the Observer: “I think it is really important that the government is neutral on this and the two people whose neutrality is most important are the prime minister and health secretary. Keir has stuck to that—but Wes has not.”
She has called on him to scrap the investigation into the impact the bill would have on the NHS.
“By commissioning work to assess the cost of facilitating assisted dying—which he will have to publish—he will then out of necessity have to balance that against the cost of the person staying alive. That leads you to the awful prospect that the research could find that it is cheaper for people to be doing assisted dying rather than staying alive, and that would really contaminate the argument.
“I think he should not go ahead with this research because either way it is problematic, especially if it finds that it is cheaper for the NHS for people to have assisted dying. That will taint the decision with the idea that people who voted for it are voting for it to save money.
“The most important thing is for him to cancel the work he has commissioned and henceforth… to say absolutely nothing.”
Will the voluble and media savvy Streeting be able to hold his tongue?
He can at least rest assured fellow opponents have been wheeling out some of their prominent supporters over the weekend. They are backing a very critical report of the Leadbeater bill by a top ethics professor for Policy Exchange. More on that later, but it all adds to the sense that “make-your-mind-up time” is fast approaching.
We are very used to colourful, often apocryphal, stories of the whips twisting the arms of MPs to get them into the right lobby, but with a free vote it isn’t like that. Obviously, both government and opposition whips have to ostentatiously sit on their hands, dark arts undeployed, while the rival teams gently stroke or poke their colleagues’ consciences. For one side this is all about raising fears, for the other calming and quelling worries. Persuasion with little room for pride or prejudice.
Kim Leadbeater’s team says she is having dozens of conversations every day—she can barely walk down a Commons corridor without being questioned about the bill’s implications. The early assumptions that this bill would pass easily have evaporated, but Leadbeater is buoyed up by the nature of her colleagues’ questions—detailed policy-driven concerns, suggesting they are thinking of voting for the bill but want reassurances. There’s no question that the next 10 days will be vital. When I suggest to a member of Leadbeater’s team that a defeat is on the cards, they sound horrified. “If we lose this the debate is over for another 10 years,” they said.
