By Oli Dugmore

Copyright newstatesman

If you have motor neurone disease you know how the story ends. It’s a medical, biological, philosophical certainty – lights out. Not even shuffling off the mortal coil because, for all the inner grit, you can no longer gruntingly slide one foot before the other. So instead of that, for yourself but also your loved ones’ final precious pictures of you, you take a pharmaceutical exit.

It’s a doctor’s job to make sure no one dies too early, but do some of us die too late?

Assisted dying is the term used to describe a choice over the manner and timing of death after a terminal diagnosis. It is the lowest rung of a moral ladder that climbs past assisted suicide – buying someone’s ticket to Switzerland – toward euthanasia: the soldier who ends the suffering of a catastrophically wounded mate with one of his own bullets or, in a slightly less dramatic context, a lethal injection administered by a doctor.

Religious arguments are not persuasive. They can inform us about the alleged sacred value of a life but British democracy should be secular. I do not believe in the big man in the sky or that his opinions are relevant to this or most other matters of government. What you choose to do in the privacy of your thoughts is your own business. But two others are (persuasive). The first is ugly and pragmatic, the second moral.

Starting with distasteful pragmatism, the UK population is ageing. We’re getting older and our birth rate is declining. And if we don’t maintain high levels of immigration, ironically opposed by most older people, then it’s hard to overstate the demographic problem. The taxable workforce is shrinking while the welfare bill is increasing thanks to the big fat juicy triple lock on pensions (reminder: which no other benefit is afforded) but also the increasing bill for the NHS and care sectors. We are living longer and that means more medical needs and more care needs. Most of the money spent on your healthcare by the state will fall in the final months of your life. Assisted dying would appear to mitigate some of those problems, curbing the pensions bill, the NHS bill and the care bill.

I know many, many people in their middle age who, when conversation turns to older age, and death, sing the refrain: “Just let me go, I don’t want to be a burden.” They view it as a simple economic equation, many of them having put their own parents through care homes, and then hospitals and hospices, as their estates and lifeforce drain away. It’s an interesting parental reflex: would you rather spend the significant wealth accrued in your house on palliative care and extensive medical treatments or, instead, end your life early and guarantee an inheritance for your progeny? That parental instinct to provide, certainly not encumber, is powerful. Even the last queen worried that though she wished to die at Balmoral it would make her funerary arrangements more difficult.

Secondly, and more importantly, no one else knows what’s best for you. You are the single greatest arbiter, the one who should decide your future, lack of it, and means for getting there. I wouldn’t dream of telling you how to live your life, so why should I tell you how to end it? It’s your decision.

If you were conscious, a doctor would consult you about treatment options. Surgery, drugs, physio. A lethal dose of sedatives or muscle relaxant is an extension of that conversation.

Consider an older person who collapses in a care home but has a Do Not Resuscitate order. Their life could possibly be saved with CPR. Instead, you do not start chest compressions. There is not a moral difference. And we could just about stretch our earlier definition of controlling the timing and method of death in the context of a terminal illness to fit this scenario.

Tory historian Andrew Roberts recently stood to address the House of Lords and argue that assisted dying would represent the greatest advance in the reduction of human suffering since the discovery of penicillin. It was a nice rhetorical touch, to invoke in Alexander Fleming an irrevocable adjustment to the course of human history, but he was wrong to do so. John Logie Baird is a better point of reference. His inventions do more to alleviate the misery of the elderly.

All over the country our elders sit in cell blocks bathed in the stupefying light and sound of Bargain Hunt, Location, Location, Location, Tipping Point, unvisited by relatives who are preoccupied by the rhythm of their lives, or perhaps unable to summon the courage to witness the degeneration of the once totemic figures of their lives, their mum and dad. Let them die.

[See also: Your Party’s existential spat over trans rights]