Why Assisted Dying Is a State Responsibility

 

Why Assisted Dying Is a State Responsibility

The question of assisted dying is a deeply personal and difficult one. It's an issue of autonomy and dignity in the face of suffering. In the UK Parliament's debate on this topic, a core argument emerges from a fundamental inconsistency in how the state treats personal health decisions. While getting sick or old are personal processes, the state is heavily involved in assisted healing. Therefore, the same logic dictates that the state should also be involved in assisted dying.

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The Core Inconsistency

The state already plays a massive role in our healthcare. We have a National Health Service (NHS) that provides a wide range of treatments and care, all designed to help people heal and prolong life.¹ This includes everything from simple medications to complex, life-saving surgeries. We spend billions of pounds each year on doctors, hospitals, and medical research.² This is a form of state-assisted healing, and we collectively agree that it's a necessary and moral function of government.

This state involvement is not seen as an intrusion; rather, it's a fundamental duty to support the health and well-being of citizens. We don't say that treating cancer is a personal matter and should be left to the individual and their family alone. Instead, we have a public system in place to assist.

If the state is so deeply involved in assisting people to live, why does its responsibility stop at the point where a person, facing incurable and unbearable suffering, wishes to die? The decision to end one's life under these circumstances is just as personal as the decision to seek treatment for an illness. To deny assisted dying is to say that the state can help you live but cannot help you die, even when living has become a burden that a person no longer wishes to bear. This creates a moral and ethical imbalance in our healthcare system.

Addressing Concerns

Of course, there are significant concerns about assisted dying. The risk of foul play, pressure on vulnerable individuals, and ethical issues are very real and must be addressed. However, these concerns are not insurmountable. Many countries have already implemented assisted dying laws with strict safeguards, including:

• Multiple physician approvals: Requiring more than one doctor to confirm the patient's terminal diagnosis and mental capacity.

• Waiting periods: Ensuring the decision is not made impulsively.

• Patient self-administration: In some cases, the patient must be the one to take the final dose, ensuring the act is truly voluntary.³

• Mental health evaluations: To confirm the patient is not suffering from treatable depression or other mental health conditions that may be influencing their decision.

These safeguards demonstrate that it is possible to create a system that respects individual autonomy while protecting the vulnerable. The debate should not be about whether to allow assisted dying, but how to implement it safely and compassionately.

In conclusion, if the state's role is to assist its citizens in their most vulnerable moments, then that responsibility must extend to both living and dying. To provide a public service for assisted healing but not for assisted dying is a logical and ethical contradiction that the UK Parliament should resolve.

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Quality of Life vs. Longevity: Time to Rethink What Truly Matters in Aging Societies

Quality of Life vs. Longevity: Time to Rethink What Truly Matters in Aging Societies

In modern society, longevity is often celebrated as a triumph of civilization. Governments track rising life expectancy as a sign of progress, and families boast of elders living to 90 or even 100. But is living longer always better?

Dr. Bi Liuying, a seasoned physician in Taiwan, offers a deeply personal and thought-provoking challenge to this assumption. When her 83-year-old mother—suffering from advanced cerebellar atrophy—could no longer move, eat, or use the bathroom independently, she expressed a persistent desire to be released from her suffering.

After reading “The Art of a Good Death” by Japanese doctor Jinichi Nakamura, Dr. Bi introduced her mother to the concept of voluntary fasting—a conscious, natural way to conclude life without aggressive medical intervention. Her mother agreed, and together they embarked on a 21-day journey toward death through fasting. During this period, no artificial feeding was administered. It was a quiet, peaceful, and voluntary end, accompanied by love and respect.

Dr. Bi later dreamed of her mother—young, healthy, and free. “She’s no longer trapped in that bed,” Dr. Bi said. “I feel glad, not sad.”

This powerful story reminds us that quality of life and length of life are two different things—and they should not be conflated.

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Why This Matters Now

Modern medicine can prolong life, but at what cost? Tubes, monitors, pain, and indignity—these are the hidden costs of life-extension at all costs. As Dr. Nakamura argues in his bestselling book, many people don’t die from cancer or age itself—they die from the painful treatments imposed on them in their final days.

Japan and Taiwan, both rapidly aging societies, have seen a rise in over-medicalization and unnecessary end-of-life suffering. In response, movements advocating for “natural death” are gaining traction.

In Taiwan, legislation already supports “natural death” and the refusal of futile treatments. However, social and cultural pressures still lead many families to overextend aggressive care in the name of filial duty, while the real act of love may be doing nothing—just being there.

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Letting Go as a Human Right

We need to shift the question from "How long can we keep someone alive?" to "What kind of life do they want to live—and how do they want to die?"

This is not a call for neglect, but for choice. Not everyone should fast to death. But every person should have the right to define what a “long enough” and meaningful life looks like—without being shackled by society’s obsession with longevity statistics.

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A Wake-Up Call for the Baby Boomer Generation

As the largest aging demographic in history, baby boomers across the globe are in a unique position to reshape this conversation. Rather than striving for extreme longevity, it’s time to champion policies that empower individuals to make thoughtful, dignified end-of-life decisions.

This issue deserves to be a major topic in upcoming elections, not just a niche concern for the elderly or terminally ill. From healthcare funding to family caregiving rights, voters need to ask: are we building a society that forces suffering in the name of “more time”? Or one that respects autonomy and the natural cycle of life?

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Conclusion: Less Heroics, More Humanity

As Dr. Nakamura writes, "Sometimes the kindest thing is to do nothing at all." Quality of life is not about how many years we accumulate, but how those years are lived—and how they end.

Let us stop chasing immortality and start crafting policies and cultures that honor the dignity of aging, illness, and death.

A long life isn’t necessarily a good life. But a good life, no matter its length, is always enough.