Defining assisted suicide as medical treatment

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I have been writing about euthanasia and assisted suicide for almost 30 years. During that time I have taken the clear position that killing is not caring and euthanasia and assisted suicide are not medical treatment.

The outcome related to defining medical treatment as including killing is substantial.

Dan Hitchens was published in compactmag.com on March 31, 2025 explaining: How assisted suicide will undo the NHS. The NHS refers to the National Health Service in the UK. Hitchens writes:

Last week, the MPs examining Britain’s assisted suicide bill voted through a very remarkable subclause. A single sentence, tabled by the bill’s chief architect Kim Leadbeater, quietly altered the definition of the National Health Service. The NHS’s original legislation in 1946 laid down that it must “secure improvement in the physical and mental health of the people of England…and the prevention, diagnosis and treatment of illness.” None of which really includes assisted suicide. If Leadbeater’s bill manages to pass its future votes in the Commons and Lords, this might have opened the government to a legal challenge.

I personally consider this change to the assisted suicide bill as revolutionary. Hitchens explains the significance of the amendment to the assisted suicide bill:

Hence the subclause, which allows the Health Secretary to declare that “commissioned VAD [voluntary assisted dying] services” are in fact part of the NHS’s legislative charter. The subclause doesn’t explain why: It just ensures that the government can say so. Which, as the Tory MP Danny Kruger observed, effectively admits that the National Health Service would turn into a different kind of institution. It would, through this tweak to its founding legislation, become the National Health and Assisted Suicide Service. But the alarm was loudest on the other side of the Commons. Labour MPs tend to regard the NHS as their party’s definitive achievement, the greatest edifice of the postwar welfare state built by Clement Attlee’s government. After the subclause went through, six Labour MPs signed a letter calling the bill “irredeemably flawed and not fit to become law,” noting—among a dozen other issues—that it makes “a change to the founding language and purpose of our NHS.”

Professor Sir Louis Appleby, who leads the National Suicide Prevention Strategy for England responded that they work on the principle that:

“Of protecting people at their lowest point, helping them find something worth living for, however bleak life looks.”

“Once the principle behind suicide prevention has been set aside, once any part of the ground has been ceded—not only to allow suicide but to assist it—we have lost something we may not get back.”

Hitchens explains that Kit Malthouse, a Tory MP argues that assisted suicide is not suicide. Hitchens makes reference to Australian MP Alex Greenwich who referred to assisted suicide as:

"an important form of suicide prevention.”

Hitchens explains that defining assisted suicide as part of medical treatment, with relation to the NHS will take the heart out of the NHS especially since Kim Leadbeater, the sponsor of the assisted suicide bill stated that trying to persuade a loved one from assisted suicide may qualify as “coercion.” Hitchens writes:

To recap: Taking your own life isn’t suicide, the provision of lethal drugs is suicide prevention, begging a loved one to stay alive is coercion, and the rejection of a safeguard “creates safeguards.” It is sometimes worth asking, in the words of WS Graham, what is the language using us for? This kind of language, this style of thought, uses us to obliterate what we thought we knew about our duties to each other.

Hitchens comments on how legalizing assisted suicide changes palliative care.

Palliative care, and more specifically hospice care for those nearing the end of life, is one of the signal achievements of modern medicine. Both in removing physical pain, and in addressing the complex emotional needs of the terminally ill, it can be transformative. But in jurisdictions with assisted suicide, it begins to hold a more brutal meaning. One Oregon nurse has lamented that “There is an attitude among many of our clients that ‘If I go into hospice, they’re going to kill me because that’s what a hospice does.’”

Hitchens continues by presenting data from a New Zealand study of healthcare professionals who work within a Hospice setting. The study by Dr Sinéad Donnelly indicates that the legalization of assisted death in New Zealand has changed the nature of hospice care. Hitchens comments on the change in attitude in New Zealand by writing:

Again, knock out the universal principle—we will care for you until the very end—and the atmosphere shifts decisively. There are two kinds of existences: those worth living, and those not worth living. A colder, more impatient, more utilitarian logic begins to work its way into our relationships.

Hitchens concludes his article by stating:

Stepping back a little, it is hard not to see a connection between the assisted suicide bill and the national condition in 2025: our crumbling public services, bewildered government, and extractive rentier economy. Hospices are struggling to stay open. The care sector survives on superhuman self-sacrifice and poverty wages (“a miracle sitting on top of a disgrace,” as one care manager has said.) Working-age parents are squeezed for every last penny and every last minute. There isn’t enough to go around—not enough cash, not enough time, not enough attention. And every one of those problems makes itself felt in the NHS, where waiting lists have hit record highs, 30 per cent of staff feel burnt out, and hospitals are so swamped that one hospital recently advertised for a “corridor care” doctor. Health and social care is perhaps the defining challenge for the current generation of politicians, and officially they all want to solve it. But wouldn’t it be easier, a voice seems to whisper, to just give up?

I believe that the problem goes further than described by Hitchens. When assisted suicide is considered to be medical treatment, the outcome is a requirement to inform everyone who may qualify for it based on the fact that people have a right to know about all medical options.

The reality is that assisted suicide is not medical treatment and in fact, it does not have a medical purpose. It does cause death, but death is not an intentional medical outcome, rather it is a reality of life.

Once assisted suicide is defined as a medical treatment, the legislation will be forced to expand. It becomes discriminatory to limit medical treatment to persons over the age of 18 and you cannot limit medical treatment to someone who is not dying, based on equality, when it can be offered to someone who is dying.

If euthanasia and assisted suicide are defined as medical treatment, then death becomes a treatment for conditions that require excellent care.