This column first appeared in Malta Today

England and Wales have just passed a Bill which will make assisted dying legal.

The historic vote in Parliament saw the Bill passing by 314 to 291 votes, which will legalise the procedure for terminally ill people. It will give those with less than six months to live in England and Wales the right to an assisted death, after approval from two doctors and a panel including a psychiatrist, a social worker and a senior lawyer. There will be safeguards and protections and criminal action will be taken against any family member found to be coercing someone to choose to hasten their own death.
The very close result indicates just how divided MPs were on this very sensitive issue. One Labour MP who was initially against it because of his Christian beliefs, eventually changed his mind, “I believe in choice and while I believe assisted dying is not for me, it should be a choice for others.”

Locally, this result will be viewed with interest as the discussion on whether to introduce a similar law to allow assisted dying (which is being called assisted voluntary euthanasia), has been no less emotional and fraught with personal appeals from both sides of the debate. Public consultation on this delicate topic is open until 2 July 2025.

It is one of those topics about which I am torn, and I cannot decide whether I would vote for or against. Like everyone else, I have had relatives with a terminal illness in both my immediate and as well as my extended family. Was it easy watching them deteriorate month by month (and sometimes even years), seeing the anguish in their eyes, knowing that they are aware of their own imminent mortality, and witnessing their silent plea to be rid of the pain and suffering? Of course not. In some cases they have even verbalised their wish: “This is not living, I am just existing, and if I cannot be cured, I don’t want to live like this any more.”

The deep depression and sense of dispair which sets in when one is facing death cannot be explained and I can understand that feeling of wanting it to be all over, rather than to linger for who knows how long, without any hope.

And yet, I am sure we also know of people who thought they would not survive an illness, and yet they did, for many years after the initial diagnosis. Those additional years were precious gifts, and had they chosen assisted dying, both they and their families would have been deprived of more invaluable memories. Should we be the ones to “play God” and decide our own fate, or should we let nature take its course, as has always happened, for better or worse?

It’s a thorny, ethical dilemma which, unsurprisingly, arouses very passionate reactions. Yet, I feel we are jumping the gun in so many ways. Before discussing Euthanasia, would it not make more sense to discuss living wills first – for which no provision under the law exists as yet?

According to the definition by the Mayo clinic: “Living wills and other advance directives include written, legal instructions that state the treatment you want for medical conditions when you’re unable to make decisions for yourself. Advance directives guide choices for healthcare professionals and caregivers in certain situations. For example, a medical team may use advance directives when you’re unable to talk and are terminally ill, seriously injured, in a coma, in the late stages of dementia or near the end of life.”

The importance of advance directives is that they are not only for older adults. Anyone at any age can have an unexpected accident, illnesses or end-of-life situations, so putting a living will in place is crucial.

When sudden illness or accidents hinder a person’s ability to speak up for themselves, the decision making falls on the family and other caregivers. If these scenarios have never been discussed (and let’s face it, people rarely do talk about, ‘what if?’) it can be very difficult in times of crisis to know whether one is doing the right thing and respecting the wishes of the person concerned.