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
During the nine weeks of intense committee work on the assisted dying bill there has been seemingly endless criticism of lack of proper scrutiny. Now that they are over the attacks have only grown. The bill’s sponsor, Kim Leadbeater, said in a letter to MPs this week: “I completely respect any MP who fundamentally objects to the principle of assisted dying, whether from a religious standpoint or any other. But what has been frustrating at times is to see opponents of the bill suggest that it has been debated and amended in a way that is anything other than thorough, rigorous and professional.”
It is indeed hard to distinguish fair-minded criticisms from those primarily made by people hunting for any stick with which to thrash the bill. Which heading should Cardinal Vincent Nichols’s letter to parishioners come under? The president of the Catholic Bishops’ Conference of England and Wales is urging parishioners to write to their MPs asking them to vote against the bill. In the letter, which will be read in the parishes of the Westminster archdiocese this weekend, he said: “At this point we wish not simply to restate our objections in principle, but to emphasise the deeply flawed process undergone in parliament thus far.
“We wish to remind you that it is a fundamental duty of every MP to ensure that legislation is not imposed on our society which has not been properly scrutinised and which will bring about damaging consequences.”
Is he right?
To get an unbiased take I’ve turned to the expert’s expert, Jill Rutter from the Institute for Government, which is neutral on the issue itself.
So what does she feel about that charge of a lack of scrutiny?
“I think the government has been quite irresponsible—if it really wants this change to pass—by trying to do it through private members’ legislation.
“But I don’t think it’s fair to say the legislation isn’t being properly scrutinised. That’s the wrong criticism. There are different issues with the way the government has approached this.
“We’re expecting Commons scrutiny to do far too much—things it simply can’t do. Partly because the government isn’t really taking responsibility for the bill, and we know it’s quite divided on the issue. So we’re understandably sceptical about how involved they really are.
“As a result, Commons scrutiny is being left to solve a whole range of problems it isn’t equipped to deal with—like how to produce legislation that most people would see as fair to those who want the option of dying. And that doesn’t necessarily just mean people with six months to live. If someone’s facing 12 months of unbearable pain, that could arguably be worse than six. Or it might be someone with a couple of years left, or whatever the timeframe, who simply wants to have some control over how and when they die but can’t physically end their life themselves. Then there are others who may feel under pressure—whether to preserve their inheritance, or because carers are, you know, pushing them to the edge. That kind of thing.”
So what would she have advised?
“What’s really missing in all this is that the government hasn’t clearly laid out the wider implications—particularly for the things it’s directly responsible for, like running the health service, but also potentially other areas too.
“Instead, what we’ve had is: Kim Leadbeater came top of the ballot, the bill was drafted for her, and no one saw it until it was published a week or so before second reading. So, in my view, we’ve ended up doing this the wrong way round.
“So, if you were trying to do something as potentially difficult as this—something that has momentum behind it but also needs serious safeguards, has major resource implications, and arguably changes the nature of both the NHS and palliative care, including questions about who does what—then I think the question is: what would a good process actually look like?
“If I were thinking about how to tackle this properly, what would I do?
“I’d probably have set up some kind of independent review—maybe a small panel, one person or three, commissioned to represent a range of perspectives. Give them time and some government resource to do the work, engage externally, and come back with proposals. Things like: how could this work in the UK? What does international experience tell us?
“If I didn’t want to go down that route, I might have put together a government green or white paper, setting out a range of proposals, and alongside that, some sort of impact assessment: what are the resource implications for the NHS? How would it fit within current structures?
“Then I’d put that out for consultation—which is normally at least 12 weeks. And because this isn’t especially contentious between parties—as opposed to within parties—you might even have had some pre-legislative scrutiny involving MPs and peers, like we saw with the Online Safety Bill.
“You would have still faced a difficult passage even if you’d done all that. But [it should have] involved much more proper attempts to do your thinking in public about how to do this—that’s basically what reviews, inquiries, consensus-building exercises and impact assessments are for. Which still hasn’t been done.”
Rutter pointed out some of the pitfalls back in November before MPs voted on the bill. But the strongest public criticism came when the judge scrutiny was scrapped and replaced by a committee. How would that have changed under her scenario?
“That’s a symbol of the bill coming in in an ill-thought-out form. So let’s imagine what happened there. I don’t know what happened there—but let’s imagine.
“Kim Leadbeater cobbles together a bill quite quickly, says we need to reassure people, we need to have a judge. Interesting—do you really want a judge? Other countries do it differently. But anyway—we're going to have a judge process, because everybody’s always reassured by judges.
“So they put in a judge. Then the Justice Department says: ‘We don’t have enough judges to do this. This is going to tie up a huge amount of judicial time. Haven’t you noticed we can barely get any trials going at the moment? We have massive backlogs, blah blah blah. We don’t have the resources for that. You’ll have to think of a different process.’
“Those are the sorts of issues you should have resolved through either an external policy process going into government, or through an internal process within government. You should have resolved those issues before the legislation was written. So you shouldn’t be making these very big changes because you’re hitting resource worries within government.
“Maybe Kim Leadbeater really thinks, ‘Actually, I’ve heard about this, I think this is a better process now—a commission or whatever…’ Maybe she genuinely thinks that’s better. But those are the sort of issues that should have come up before the legislation was written.
“You shouldn’t be making really huge changes as the thing’s going through. And it shows the problem.”
But it is hardly Kim Leadbeater’s fault?
“It’s not really Kim Leadbeater’s fault, in the sense that she was responding to this issue seriously.
“The trouble is, she is not a completely new MP, but she hasn’t been around that long. She suddenly discovers she’s top of the private members’ ballot in July. She’s got to get a bill. She decides she’s going to go for this. It’s not a government handout bill, as far as we can see. It’s not one where the government said, ‘Here’s one—we can’t find space in the legislative programme.’
“So she gets someone to help her draft it, gives some instructions, and that’s fine. But Kim Leadbeater’s never done legislation before. She doesn’t have a chance to consult widely and do a big public policy process. She doesn’t have access to loads of officials in the Department for Health and Social Care or the Ministry of Justice or whatever to talk her through all the implications.
“She has to produce a bill, drafted up against really tight deadlines to be the first private members’ bill debate of the year. So when that’s introduced, she publishes it just a bit beforehand.
“It’s a very compressed process compared to norms, and she doesn’t have government lawyers to help her draft, to give instructions and so on.
“So yeah, I think it’s wrong to criticise Commons scrutiny. I think the problems with Commons scrutiny are a by-product of the fact that this is being done through a private members’ bill.
“And knowing, you know, Kim Leadbeater will probably never come top of the ballot again—it’s quite possible that somebody who introduces this bill will never come back.
“And that’s why some people say, ‘Well actually, the moment it got second reading, the government should have said: ‘Clearly, there’s a view in parliament that we want to do this—but we now need to make this government legislation and take it through as such, with ministers involved and in a much more official way.’
“Maybe even take the bill—or a government version of the bill—into some sort of pre-legislative scrutiny and do it in the next session.”
And you think that should have happened?
“Yes. I agree with a lot of people who say they support the principle but aren’t convinced by the process. And you might well end up—either the government will be forced to come back in a year or two and remake the bill, or you’re leaving lots of secondary legislation where people will say that’s effectively the government making the bill behind closed doors.
“I mean, you would have still faced a difficult passage even if you’d done all that. But something which had involved much more proper attempts to do your thinking in public about how to do this—that’s basically what reviews, inquiries, consensus-building exercises and impact assessments are for. Which still haven’t been done.
“The government had the chance to back it—but didn’t. To put, if you like, the courage of its convictions behind it by doing it as government legislation.
“And you can do government legislation and still allow votes of conscience. They did that on same-sex marriage.”
You wrote originally that because Keir Starmer wanted the best of both worlds, he might end up with no bill at all. Do you think that’s going to happen?
“I don’t know. Because people said they were voting for it, but may want to look again when it comes back from committee. And I think quite a lot of those will be concerned about losing some of the protections, like the judge, etc. Some people who were a bit queasy about it but thought it would be all right may have second thoughts.
“I don’t know how the votes will go, but compared to first reading, I think it may move the other way.
“I say that even as some who supports the bill, as I do, the lack of an impact assessment is a concern and it does seem extraordinary to have not set out how this is going to be provided by the NHS in general or a separate, specialist service within it. Or what the limits on public providers are. All that would have been sorted out in the way you suggest.
“And the role of hospices, or whether you’d have ‘dying hospices’ or not. I mean, I’ve just been in Australia, got friends in Canada.
“It doesn’t seem to be a huge deal. Actually, places that have it don’t seem to make a huge meal of it. A friend of mine’s mother is in a residential place in Canada. The woman in the next room is scheduled for assisted dying quite soon. My friend’s mother thought she’d go round and see her, because she’s obviously a bit depressed and things like that.
“I mean, it’s not a massive deal for them.
“But I think it’s the process of getting from here to there—by thinking through how to do it. That’s why I don’t blame Kim Leadbeater at all. I think she’s been slightly unfairly dumped on by Keir Starmer.”
1st April
At first glance, Joseph Awuah-Darko’s Instagram account is full of pictures that spell contentment: ducks gliding gracefully over sparkling water, him cuddling up to a fluffy white dog, jumping for joy at scoring Kendrick Lamar tickets.
Like a lot of 28-year-olds on social media, there’s also lots of evidence of pleasure in his twin love of food and travel, from orange rice in Ghana to a classic English fry up in Mayfair, as well as giant prawns in Lamu and pear and ricotta bruschetta in Crete.
So far, so ordinary.
But Awuah-Darko’s Instagram account is far, far from ordinary. And so is he.
Not just because in the world’s eyes he is a bit of a superstar. Joseph Nana Kwame Awuah-Darko, aka Okuntakinte, has been remarkably successful at anything he turns his hand to: music, art, philanthropy and acting, although he says writing is his first love.
No, it is not his achievements that make this account remarkable, but because Awuah-Darko is tracing his journey towards a legal assisted death. Not because he is dying of a terminal illness, but because he finds life intolerable.
His account is headed “I AM NOT IMPORTANT. This instagram is basically a scrapbook and public requiem of my demise.”
He is bi-polar, and on 9th December told the world: “Two days ago I announced my decision to legally end my life due to my struggles with treatment resistant bipolar disorder. And now, my fiancé has left me. And I don’t blame him. We’re still friends, but the pain is still quite real. I often find that romantic love and the pressures that come with it can sometimes be all too consuming. I’m healing and I am trying to connect in a different way. Even as I pursue my path with assisted euthanasia, the idea I have is called the Last Supper project. Basically, for the next few months, I’d like anyone who is willing to invite me over to prepare their favorite meal for dinner. We’ll break bread with friends and loved ones and I’ll bring post-its, board games, origami and fellowship with no judgement. I want to find meaning again with people while I have times to live on earth.”
Judging by the huge success of the project he seems to have done so, he shows no sign of changing his mind about dying. There is something profoundly sad and disturbing in such a man wishing to extinguish himself, not least because worldly success has not eluded him.
He was born in London in 1996, but when he was five, his family moved back to Ghana.
In 2016, he released his music video “Melanin Girls”, which was not only a hit but also started a social media campaign encouraging dark-skinned girls to celebrate and express pride in their appearance. It became an anti-bleaching campaign.
Three years later, he held a solo exhibition at Gallery 1957, which included paintings and sculptural pieces.
He was selected as one of the 21 emerging African contemporary artists by the Mastercard Foundation, and became the youngest person in history to be recognised by the West African Business Awards. He was also awarded “Most Promising Social Entrepreneur” in May 2018.
In 2019, Forbes magazine named him among the “30 Under 30” creatives on the African continent, recognising his contribution to the contemporary art sector.
I’ve been aware of his story since the autumn of 2024 but felt slightly awkward about writing about his decision without talking to him, partly because I was concerned that I’m taking his words at face value (I’ve asked him for an interview twice, but had no response.) Now he has spoken to the Times I feel less concerned.
His very personal story intersects quite directly with the policy concerns of those who are opposed to the notion of assisted dying. They fear that if assisted dying—or “assisted suicide”, as they prefer to call it—becomes legal, then death becomes, to use an inappropriate turn of phrase, a lifestyle choice, perhaps even a whim, rather than something that happens to you inevitably.
This is why Kim Leadbeater has gone out of her way to stress that her bill is only available for the terminally ill, with a very definite diagnosis and a short time to live.
The Netherlands has no such strictures, and recent figures indicate that the number of euthanasia deaths rose from 9,064 in 2023 to 9,958 in 2024. While the vast majority of people—86 per cent—had an advanced physical disease such as cancer, 219 people died for psychiatric reasons, compared with 138 in 2023. In 2010, there were only two such cases.
This appears to have alarmed one of the bodies set up to monitor such processes. The Regional Review Commission for Euthanasia notes “the great caution that a doctor must observe if the euthanasia request (largely) arises from suffering resulting from a mental illness.”
The Guardian wrote: “The NVVE, the Dutch right-to-die society, said the overall figures matched demand. ‘The figures increase slightly each year,’ said the group’s chair, Fransien van ter Beek. ‘This shows the option of euthanasia is increasingly accepted and used.’”
Which is—I repeat—exactly the worry of opponents: that having someone kill you becomes seen by society as a legitimate choice. They fear that it will rapidly be accepted that people will mandate their time to die for whatever reasons they fancy—not just terminal illness or depression, but simply because they choose to leave the stage at that point.
Like so much in the debate about assisted dying, this fear seems overblown. Indeed, many arguments against offering people a moral choice—one judged immoral by others—are coloured by a peculiar anxiety. It’s the strange conviction of the concerned moralist that choices such as gay marriage, homosexuality, abortion, or transgender identity are so irresistibly alluring that, given the option, most people will seize them.
This may say more about the psychology of the worried moralist than anything else. But it seems particularly off-beam when applied to assisted dying. Even in the Netherlands, there are numerous hoops to jump through. Awuah-Darko is still waiting for a confirmed date—he had to undergo a rigorous process of psychological assessment before that was even possible.
But Awuah-Darko himself welcomes the debate it has prompted. After he told the South African news site IOL about his plan, it wrote: “Okuntakinte‘s journey is a wake-up call. It forces us to ask: Why do we still struggle to talk about mental illness openly?
“Why do we dismiss invisible suffering as ‘not serious enough’? How many people in South Africa feel the same way Okuntakinte does but have no one to talk to?”
It continued: “Okuntakinte will take his final steps in the Netherlands, where his request for non-violent assisted death has been approved after four years.
“But before that day comes, he will continue to sit at tables filled with laughter, stories, and warmth. He will continue to remind us that even in the darkest moments, human connection matters.
“His story is not just about death, it’s about what it means to truly live. As people, we must learn from his journey. We must break the silence around mental health. We must create spaces where people feel seen, heard, and understood.
“Because in the end, all anyone really wants is to be held in love before they go.”
31st March
One of the assisted dying bill’s most vocal critics on the committee, Naz Shah, has savaged the whole process and said she hopes it fails when it returns to the House of Commons at the end of April.
In an interview in the New Statesman magazine, she says she feels “disheartened that I will not be able to vote for the bill, because it’s just not fit for purpose”.
The Statesman’s associate editor, Hannah Barnes, writes that the Labour MP for Bradford West is clearly suffering after the gruelling committee sessions yet “though clearly sleep-deprived, remained sharp.” “The one thing that is glaringly obvious is that this is not how we do legislation,” Shah tells her.
Shah is frustrated that no impact assessment has yet been published for the committee to examine. “How can you legislate on something that you don’t even know what the impact is going to be?”
She also discussed the difficulties of scrutinising a bill without having much detail on how it will be implemented. “We have no idea what the [assisted dying] service will look like. We don’t have a model. We don’t know who could provide this service, who couldn’t provide the service. Is it going to be hospices? Is it going to be charities? Is it going to be for-profit? That’s not good enough.”
Shah also spoke to the Independent about what she calls the “fundamentally flawed” bill. The newspaper says her comments come “as data shows that 393 amendments were put forward by MPs who opposed the bill at its second reading. Of these, 330 were rejected by the committee, 31 were withdrawn before going to a vote and another 32 were accepted”.
Shah said: “When there’s this narrative of ‘we have listened’, no: that’s not true. The evidence is there in black and white. The biggest changes to the bill… all of these big-ticket items—the ones that have weakened it, in my opinion—have come from the bill sponsor.”
One of the mysteries, at least to me, of this bill is whether the full-scale assault on it—by critics, heavily amplified by the right-wing press, will have the intended impact on MPs when they come to vote.
In a fair-minded and balanced editorial, the Sunday Times argues the government gave Leadbeater a “hospital pass” by not taking over the process, and has made the passage of the bill look “messy” and “chaotic”, particularly with the recent change which could delay implementation to 2029. “For supporters of the bill, this is the equivalent of kicking it into the very long grass, from which it may never emerge. For those who oppose it, and there are many, including disability campaigners, it provides an opportunity to dump a flawed piece of legislation.”
So what does Shah, one of those opponents, think? Will her colleagues dump it as she urges? “I genuinely don’t know,” she said. “I don’t want it to go through as it is.”
