Assisted dying poses risks for young people, especially women - we need to pay attention

Scotland and the UK should say "not yet" to assisted dying

Aurelia Brouwers was 29 years old when she died in 2018. Shanti De Corte was just 23 when she died in 2022. Zoraya ter Beek was 29 when she died in 2024.

Three young women under the age of 30 who did not have terminal illnesses. Three young women who were euthanised as a result of mental health conditions.

And they’re not the only ones. In 2016 it emerged that an unnamed woman in the Netherlands, in her twenties, was euthanised following mental health problems she had endured after experiencing sexual abuse as a child.

You might think almost a decade on from the details of that case alone being that we might all be a little more hesitant about the reality of assisted dying. Instead, here we are in 2024 locked in debate in the Scottish and UK parliaments as politicians prepare to vote on introducing assisted dying, and we are repeatedly told by the law’s supporters that cases such as these simply won’t happen here.

I’m going to take a wild guess that most people didn’t think they’d happen in any country where assisted dying is legal. But they did.

I have listened intently to arguments from those in favour of assisted dying, hoping that I might hear some snippet of information that absolutely assures me that the law won’t eventually become liberalised to the point that young people can effectively be helped by doctors and the state to commit suicide, but I remain worried.

Any legislation written today can be as robust as possible in terms of protecting vulnerable groups. It can ensure that the law only applies to terminally ill individuals. It can include requirements for individuals to be of sound mind when taking these decisions.

My concern, however, is that once the floodgates are open, the safeguards can be eroded. I don’t expect we’d see a sudden lurch from the law as intended today towards the worrying landscapes we see in parts of Europe and Canada. It would likely be a more gradual change, a loosening of definitions and what counts as terminally ill. It may widen to include the chronically ill. Eventually, arguments may be made that the existence of suffering alone should satisfy the criteria for assisted dying. Chronic pain, mental health conditions, poverty – the issue may no longer be about medical suffering and could instead encompass social suffering. It’s a far cry from where the debate began.

If you think I’m veering off into the realms of sheer provocation here, I am not. We already see evidence of this in Canada.

I have no doubt that the intentions of those who favour the introduction of assisted dying are good and merciful. They paint a picture of assisted dying that is comforting. They are coming from a place of compassion and it is genuine. Unfortunately, however, they can’t guarantee that their vision of assisted dying will be the one we ultimately end up with.

When it comes to matters as serious as assisted dying, it would be foolish to proceed with the blind faith that the best-case scenario is the one we’ll get.

Those against its introduction are campaigning fiercely to highlight the key inherent problem: the right to choose death within our medical, political and social climate is unlikely to be truly equal in reality when we consider the inequalities embedded within our structures.

The cases of the young women I mentioned at the beginning of this piece are the ones that leave me firmly opposed to assisted dying. These cases are most extreme examples of assisted dying gone wrong, and yet when I point them out to people, not only have they never heard of them, they initially have a hard time believing they actually happened.

Young women being euthanised for mental health problems is so low on our radar that it easily goes unnoticed. Even within the context of the current debate in the UK, at a time when members of the public are more engaged in these issues than they would typically be at any other time, the risks facing young people are not particularly high on the agenda. They should be.

Elsewhere in the news we hear constantly about the challenges facing young people. Lower wages, less security in employment, the impossibility of getting on the housing ladder, the sky-high rents of private landlords offering inadequate housing. The Labour government wants to get people back to work and deal with the numbers of economically inactive young people being signed off work with problems related to mental health or neurodiversity. It’s a great idea in theory but our mental health services are woefully inadequate. There is a lack of joined up thinking in this country. Services are fractured and barely fit for purpose.

We hear the voices of women who point out that there are inherent biases in the healthcare model that already leave their needs unmet. They feel that men are often taken more seriously when describing unusual physical symptoms, for example, whereas women are more likely to be written off with anxiety without proper physical assessment. The old tropes of hysterical women still persist in modern day medicine, many women argue, and as a result they are often not given appropriate help.

The NHS in general remains on its knees. Many areas of the country struggle to provide emergency care within reasonable timeframes. Waiting lists for non-urgent procedures are long. Paid carers and unpaid carers are endlessly highlighting the problems affecting care in the community. Hospices face a constant worry over future funding and the standard of palliative care in the UK.

To introduce assisted dying into this melting pot is a bold move.

In Scotland, I’m sad to say that I have concerns over whether our parliament is even competent enough to handle legislation of this gravity. The recent gender recognition reform legislation ended shambolically. Those in favour of gender recognition reform failed to fully address or engage with potential problems, whether they lay in legislation itself or in public perception. We ended up with two groups of people – women and trans people – who felt badly let down, misrepresented and misunderstood. It reflected an immaturity in our politics and in our parliament that needs further exploration.

To introduce assisted dying in this environment leaves me uneasy, to put it lightly. This is not something we can afford to do badly. There are too many people who can be let down if it goes wrong, if the safeguards fail further down the line.

Some people will always be in favour of assisted dying and some will always oppose it. For others, there is still another option: not yet. Recognising that this is not an optimal moment to introduce assisted dying means that we can eliminate the immediate risk of getting something terribly wrong but leave the debate open and with the intention to revisit it at a different time. While this may be a source of strong frustration for some, an issue as serious as assisted dying should be given as much time as it takes to ensure vulnerable people are protected.