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
11th March
Whichever side of the divide they come down on, MPs have to remember one simple fact about assisted dying: the public seems overwhelmingly supportive. According to every single reputable opinion poll in recent years, the support has been consistent and strong at around 66 per cent.
But at the best of times opinion polls are tricky things.
I arrived at the BBC when John Birt was director general and soon discovered he was mildly obsessed with opinion polls. I have a vivid memory of bounding into the newsroom one Saturday night, clutching one of the Sunday papers. I was convinced that we had a decent lead story for the next morning, with an opinion poll giving somebody or other a particular lead. The details are hazy, but the lesson learned is not.
The news editor told me “no”. There had been a diktat from the very top: never lead on a single poll because opinion polls don’t “show” anything; they only “indicate” something. It was the direction of travel that was important rather than the headline figure, the news editor said. And above all, check the question. My script was abandoned and these prescriptions were branded on my mind.
You have to ask questions when such slippery things are used in this contested debate about assisted dying.
So I was interested when Kim Leadbeater welcomed a letter from 63 MPs backing her amendment to scrap the oversight by a High Court judge and added that “it was encouraging to see a poll published this week showing that 67 per cent of those questioned supported the change to a multidisciplinary panel.”
How on earth do random members of the public have the knowledge to answer such a question? How many had been following the story closely enough to have an opinion? The survey was of 2,023 British adults, conducted by polling firm Walr for Humanists UK on 19th February. Results were weighted to be representative of the UK population by gender, age and region.
So far, so good.
But what about the question? This is it: “Parliament is deciding who should have the power to grant an assisted death. Right now, the bill requires two independent doctors to conduct an assessment, which is then submitted to a High Court judge for final sign-off. Campaigners have argued that this causes delays and puts considerable pressure on the judicial system. No other country where assisted dying is legal requires court approval; instead, the decision is made between doctors and patients.
“MPs are currently considering replacing the High Court sign-off with an expert panel that includes a legal expert, a psychiatrist, and a social care professional. To what extent do you agree that the High Court should be replaced by a panel of legal, psychological, and social care experts to grant assisted dying requests?”
A bit wordy, and quite a lot to absorb—but it is rigorously fair and accurate.
This just got me thinking about opinion polls in general on this subject and sent me scurrying to a little book called The Reality of Assisted Dying, which is a sort of primer for those opposed to the bill and all its consequences. I’ve been sent a review copy, and I will get around to discussing it more broadly in time.
But I remembered there was a chapter called “The Polls on Assisted Suicide: The Misuse of Public Opinion” by Andrew Hawkins, founder and CEO of polling company ComRes.
He is very critical of the way polls have been carried out. He admits that YouGov’s regular polls generally show extensive support for what he calls assisted suicide. YouGov’s core question is simple and straightforward: “Do you think the law should or should not be changed to allow someone to assist in the suicide of someone suffering from a terminal illness?”
Hawkins admits this support has varied between 64 per cent and 71 per cent, but he then makes an immense leap. He claims that if one were to take much of the published polling on assisted suicide at face value, “one might mistakenly believe much of the British public had taken to heart the kind of large-scale extermination described in The Children of Men, where those reaching 60 are deemed no longer useful and are forced to take part in state-sanctioned mass drowning.”
I do not see how the simple wording of the question justifies this absurd claim. But it goes a long way to explain his next contention, that pollsters often pose questions that contain within them dangerous assumptions.
For instance, he argues that assumptions about assisted suicide providing an immediate, pain-free and peaceful option are misleading, as evidence suggests this is simply not the case—death can take hours, and in some horrific cases, patients regain consciousness and die days later.
He then goes on to state that the public are highly susceptible to excessively emotive language.
It seems to me that rather than argue for as neutral a question as is possible, he’s arguing for polls to be deliberately skewed in favour of the argument he supports. Perhaps not that surprising from a man who thinks that if you answer “yes” to the question, “Do you think the law should be changed to allow someone to assist in the suicide of someone suffering from a terminal illness?”, then it can be assumed you back the mass murder of the over-60s.
But he’s not a lone maverick in calling for deeply biased polls. In a persuasive and emotional article, published just before the debate on the assisted dying bill, Gordon Brown wrote: “According to the Focaldata poll I have seen, more than half the country’s non-homeowners worry they will be unable to pay for their end-of-life care, while 52 per cent think assisted dying would discriminate against those who cannot afford end-of-life support. For these reasons, 70 per cent of the public want to prioritise social and end-of-life care before thinking about assisted dying.”
That 70 per cent is a hefty and persuasive figure—until you know how it was obtained. After a little digging, it turns out that this was an opinion poll commissioned by the anti-bill pressure group Care Not Killing. Respondents were first given 10 reasons why assisted dying was a bad idea and were asked to consider a number of statements. They included:
- “Some countries have extended the law on assisted dying to include children under 12. Does this argument make you reconsider your opinion?”
- “The UK has spent years trying to reduce suicide rates. By legalising assisted dying, are we at risk of normalising suicide?”
- “There is evidence from other countries that some people feel pressured into choosing assisted dying because they feel like a burden on their loved ones.”
- “Introducing assisted dying while the NHS and social care budgets are under huge pressure may lead to reductions in palliative care spending.”
At the outset 72 per cent said they supported the bill. Of the 10 negative statements about assisted dying the most effective in denting support was “some people would be likely to request assisted dying because they cannot afford social care”. Forty-five per cent said in light of this they would not support the bill. It is the only statement that causes support to dip below 50 per cent.
While it doesn’t appear people were asked if they still supported assisted dying having read all 10 statements, only 10 per cent didn’t change their mind because of any of the highly biased statements, and answered all 10 points with “still support”.
There are then a series of further statements, the most important being: “Labour should prioritise sorting out palliative, social, end-of-life care first, before even thinking about assisted dying.” Thirty-four per cent strongly agree and 32 per cent somewhat agree. That makes 66 per cent, rather than the 70 per cent in Brown’s article. But this isn’t a question of sloppy polling; it’s a case of deliberately skewing a poll for a particular agenda.
Indeed, in this post, the company admits that this was exactly what they were trying to do. “The poll assessed which arguments and messages are most likely to prevent The Terminally Ill Adults (End of Life) Bill passing through the House of Commons this month.”
The company can’t be blamed—they did the job they were hired to do, and did it well. But the results should not have been used to suggest a majority really wanted palliative care improved before assisted dying was allowed. But it does explain why those opposed to the bill have raised the profile of palliative care to unprecedented heights.
10th March
Kim Leadbeater is working on an amendment that would ensure that, if her bill becomes law, assisted dying would be free and available on the NHS. A week ago the Times ran an intriguing story (with a follow-up the next day) suggesting that the government was considering outsourcing the service to private contractors “in an effort to ease pressure on NHS clinics while dealing with doctors’ insistence that a separate service is needed to help patients to end their own lives.”
If this was ever considered I understand it is not part of any current plan. So would private provision be banned? I’m told not, because the bill’s supporters feel “it would be unfair and unworkable to expect somebody who has always gone private to have to go into the NHS for this particular service alone.” But the amendment wouldn’t allow private companies to make money out of assisted dying, although they will be able to make “a reasonable charge”. What is considered “reasonable” we don’t know, as the amendment is still being written.
