A repeated claim made by politicians and a justification for the Health and Social Care Act 2012 is that the NHS is ‘unsustainable’ in its present form because the UK’s ageing population is increasing costs to levels that we can no longer fund from taxation. But this is a myth. While the proportion of the population aged over 65 years is increasing in most of the developed world as people live longer, there is no evidence for the claim that ageing itself will lead to a funding crisis. Rather, the NHS funding crisis is due to cuts in funding for the NHS and social services coupled with the high costs of marketisation and privatisation leading to service closures such that NHS funded services including GP services and out of hours services and hospital services are no longer meeting needs.

Reductions in funding and budgets for social services and long-term care and reductions in local authority provision add to the strain on NHS services. The volume of services provided is shrinking and these are not keeping pace with need. The amount spent on social care services for older people has fallen nationally by £1.4 billion (8.0%) from 2010-11 to 2012-13. The number of people receiving state-funded care fell from 1.8 million in 2008-9 to 1.3 million in 2012-13.

According to Age UK, in the three years between 2010-11 and 2013-14:

  • Numbers of older people receiving home care have fallen by 31.7% (from 542,965 to 370,630).
  • Day care places have plummeted by 66.9% from 178,700 to 59,125.
  • Spending on home care has fallen by 19.4% from £2,250,168,237 to £1,814,518,000.
  • Spending on day care has fallen even more dramatically by 30% from £378,532,974 to £264,914,000.

Older people are living longer, healthier and more productive lives

The extent, speed, and effect of population ageing has been exaggerated by the government because the standard indicator—the old age dependency ratio  ( The old-age dependency ratio is the ratio of people older than 64 to the working-age population, aged 15-64) — does not take account of the fact that people aged over 65 years are younger, fitter and healthier than in previous decades. In fact older people have falling mortality, less morbidity, and are more economically active than before. Some forms of disability are postponed to later years.

Currently over one million older people are still working, mostly part time, many with valuable experience or specialist knowledge. The spending power of the ‘grey pound’ has risen inexorably. Many do volunteer work vital to the third sector or look after grandchildren.

Older people aged over 65 contribute more to the economy than they take out. It is estimated that taking together the tax payments, spending power, caring responsibilities and volunteering effort of people aged 65-plus,older people contribute almost £40 billion more to the UK economy annually than they receive in state pensions, welfare and health services.

Most acute medical care costs occur in the final months of life, with the age at which these occur having little effect. It is not age itself, ‘but the nearness of death’ or health status of the individual in the ultimate period in the last few years or even months before death that matter most. According to this hypothesis health expenditure on older age groups is high, not so much because their morbidity or disability rates are higher, but because a larger percentage of the persons in those age cohorts die within a short period of time.

Similar findings have been reported in other European countries where by 2008 it was shown that ‘contrary to popular belief, ageing is not an inevitable and unmanageable drain on health care resources.’ Indeed one study suggested that the cost of death declines with age because older ‘people tend to be treated less intensively as they near death.’ In fact, it is those dying between the ages of 50 and 60 who cost the most. If the cost of death declines with age then an ageing society could lead to lower health care costs.

Life expectancy is an estimate of average expected life span, healthy life expectancy is an estimate of the years of life that will be spent in good health. The trend for healthy life expectancy at 65 in England for males and females has increased approximately in line with overall life expectancy at 65. For example, between 2006 and 2009, healthy life expectancy increased by 0.8 years for females and 0.5 years for males while overall life expectancy grew by 0.6 years for females and 0.7 years for males. This suggests that the extra years of life will not necessarily be years of ill health. There are important socio-demographic differences in healthy life expectancy. Not only can people from more deprived populations expect to live shorter lives, but a greater proportion of their life will be in poor health.

When measured using remaining life expectancy, old age dependency turns out to have fallen substantially in the UK and elsewhere over recent decades and is likely to stabilise in the UK close to its current level. It is not age but nearness to death that accounts for health expenditure.

Increased life expectancy means more years lived in good health.

Politicians must stop blaming older people for their decisions to cut funding and close services

The false premises of the ageing hypothesis provide a technical rationale for starving the NHS of funds. In July 2013 NHS England warned of a funding gap ‘of around £30 billion between 2013-14 and 2020-21’. A Lords select committee , the Office for Budget Responsibility , the Nuffield Trust and the Institute for Fiscal Studies published health spending projections on the assumption that ageing is a main driver of cost rises. The studies mainly relied on simple population projections. The connection between ageing and costs and chronic illnesses was simply assumed. They did not consider the fact that people are living longer, healthier and more productive lives.

So the most remarkable thing about the ageing hypothesis or ‘demographic time bomb’ is its survival. The Canadian economist Robert Evans has described it as a ‘zombie theory’, one that refuses to die. It survives today only as a reason for explaining politicians’ bad policy decisions which have resulted in pressures on the NHS: as an alternative to the real reason which is the cutting of health budgets, and services for health care.

In the UK, both the Royal Commission on Long Term Care (the 1999 ‘Sutherland report’) and the Wanless Inquiry (2001-04) rejected the ageing thesis. The 1999 Royal Commission found that, even though ‘the population aged 80 or over is growing rapidly and appears likely to continue to do so’, the UK was not on the verge of a “demographic time bomb” as far as long-term care is concerned and as a result of this, the costs of care will be affordable.’

Wanless concluded: ‘Despite this significant ageing of the population, demographic changes have so far accounted for a relatively small proportion of the increase in spending on health care in the UK. While overall spending (between 1965 and 1999) grew by 3.8 per cent a year in real terms, the demographic changes alone required annual real terms growth of just 0.5 per cent a year. Less than 15 per cent of the growth in health care spending over the past 35 years can therefore be attributed to the cost of meeting the needs of an ageing population. This is in keeping with findings from other countries.’

In Canada the Evans paper on the Romanow report into future health care costs declared: ‘All studies come to the same conclusion. Demographic trends by themselves are likely to explain some, but only a small part, of future trends in health care use and costs and in and of themselves will require little, if any, increase in the share of national health resources devoted to health care.’

The European Commission report of 2010 found that it was ‘the health status of an individual (and – in aggregate terms – of the population), rather than age itself, which is the ultimate driving factor’ behind cost rises. Furthermore, ‘Over time, there is no clear link at the aggregate level between levels of spending on health care and the demographic situation of societies. In fact, several studies have found that the impact of ageing on increase in health expenditures is limited to as little as a few percentage points of this increase.’

The connection between ageing and health care costs has also been rejected in studies and parliamentary reports in the USA, Canada, Germany and Australia.

Examples of the ‘Zombie theory’ and how it is used to justify policy choices:

“We’ve got a growing and ageing population now and this is having a significant impact. It’s down to the policy-makers to decide whether to change the policy or not.”  Rupert Egginton, director of finance at the Nottingham University Hospitals NHS Trust

“An ageing population with more chronic health conditions, but with new opportunities to live as independently as possible, means we’re going to have to radically transform how care is delivered outside hospitals.” Simon Stevens, Chief Executive of NHS England

“However, if the NHS is to meet the needs of an ageing population we need it to be more efficient so it can provide more and better treatments.” Lord Howe, Parliamentary Under-Secretary of State for Health

Trends in numbers of people aged over 65 years and mortality rates and number of deaths:

ageing population

Figure 1: Age-Specific Mortality Rates, 1963 and 2013, England and Wales (Source: ONS24

Figure 2: Age-standardised mortality rates (ASMRs) in England and Wales, 1942-2012 (Source: ONS25)

Figure 2: Age-standardised mortality rates (ASMRs) in England and Wales, 1942-2012 (Source: ONS)

ageing population

Table 1: Number of deaths registered in England and Wales, 2004-2013 (Source: ONS)

Age structure of the UK: 2011 Census data

  • Aged 65 and over: 10.376 million
  • Aged 85 and over: 1.394 million
  • Total population: 63.183 million

This was first published by the Campaign for the NHS Reinstatement Bill

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23 Comments

  1. Alan Rogers says:

    Thank you Allyson. I am 77 and have been paying tax for 60 years with a two and a half year break to do military National Service (the pay of between ten bob(50p) and fifty bob (£2.50) per week didn’t require taxation). I am fit, walk several miles in the hilly country around my home every day. I see my GP once a year for routine checks, see a nurse once a year for ‘flu jabs and I plan to stay as fit as possible for as long as possible. I would like in the meantime for the religious bigots that oppose assisted suicide to be defeated so that I can make the miserable condition that sometimes ends one’s life as short as possible. I suspect that your analysis is much more realistic than the rubbish offered by Tory politicians aided by the despicable Tory press. That jerk of a Health Secretary can’t even get cause of the weekend mortality figures right.

    1. tomlondra says:

      I’m in a similar position to Alan – and I know quite a few people who are well into their eighties, healthy, and doing fine. What they’re not telling us is that the plan is to completely privatise all public services, including the NHS, but to do so gradually so that opposition can be managed. And it’s working.

      1. Win Gibson says:

        neat summation which tells it like it is – slowly slowly take over country?

  2. Peter Devlin says:

    The zombie hypothesis is indeed alive and well. However, your analysis that the funding gap is caused by cuts and privatisation takes no account of the real nature of the problem. The evidence I have seen clearly shows that both demand and cost is growing, and that this caused by a combination of increasing medicalisation of lifestyle risk, distress caused by increasing inequality, over-consumption leading to obesity and diabetes, and medical costs inflation.
    The problem will not be solved in the medium to long term by throwing more money at the NHS.

  3. Alan Rogers says:

    Peter, You are quite right about life-style impact on health and consequent health care costs. The smoking nettle was eventually grasped and after a great deal of persuasion and several decades of combat with commercial interests we have achieved considerable progress . The same needs to be done with diet and exercise. I think we have a real problem with the basic philosophy of medicine. We now need to distinguish between saving life and postponing death. A really tough issue but without resolving it we can expect to be maintaining many thousands of the “living dead”. Now it that doesn’t start a discussion this blog site is not doing its job.

    1. Martin Rathfelder says:

      Nobody’s life is ever saved. Only prolonged.

      1. Alan Rogers says:

        Right- but what constitutes life? Unconscious survival indefinitely? Conscious survival in pain or severe discomfort with little or no dignity?
        And remember we are talking about the last days, weeks or months or even perhaps years of life. And this probably after a long, active and happy life. Who makes the decision? The patient (perhaps in advance), the doctor, a Court of Law? Or will it be forbidden, even to the non-religious, because organised religion believes only their “God” can decide.

      2. Heather says:

        So my friends 6 year old girl who needed a heart transplant to live didn’t have her life saved?

        1. Martin Rathfelder says:

          Not for ever.

  4. Dr. David says:

    Not sure what organised religion has to do with this – plenty of people with a terminal disease but no religion want to hold onto life as long as possible, whilst some religious leaders openly support assisted suicide and yet many religious people don’t want their lives extending at all costs either.

    In any case what is really at stake here is the funding for people towards the end of life. Calls for assisted suicide at present are generally because people feel they are suffering excessively. Assisted dying is ultimately not going to help the small numbers of people with intractable suffering, so much as it will help society remove a much larger burden of mostly elderly people who are no longer economically useful and are costing the economy dearly with long term conditions. Especially the more that health and care is privatised, the more people will feel the cost directly to them or their families, and the greater the financial attraction of cutting life short once it stops being useful. Whether or not you agree with assisted dying for people with terminal illnesses, there is an overwhelming economic argument in favour of society introducing assisted dying once you reach a certain age or level of frailty to keep medical and care bills down.

    I’m just not sure how many of us want to live in that society.

    1. Alan Rogers says:

      Dr. David,
      Check with the Catholic Church, see what their position is on assisted suicide. I have a copy of a letter made available to the internet by an Anglican Canon who travelled to Dignitas with his wife who wished to end her life. The letter was a response to his treatment by the (then) Archbishop of Canterbury. It is very moving and demonstrates my point very clearly.
      There are two false arguments that organised religion uses (they rarely use the “God wouldn’t like it line” in public these days).
      1) It is just a way of getting rid of people.
      2) It would put unfair pressure on the disabled/terminally ill to end their lives.
      Both arguments are phoney. The people they put forward to argue this case say they wish to live… so they aren’t candidates for assisted suicide.
      I don’t think assisted suicide would make a great deal of difference financially. Most of the cost is inevitable if the cost of procedures and treatments grow – as they will with developments in scientific medicine. In the end it is a political choice which should be made by the citizens via their elected representatives about priorities. The best chance of controlling cost is to work on the causes of premature ill-health. There seem to be two and they are at opposite poles. Poverty and Affluence.

  5. Hazel Seidel says:

    Of course an ageing population should not be used as an excuse for saying that the health service is unsustainable. We can afford it if we want to. That’s got that out of the way.

    However, I find the arguments put forward to suggest that an ageing population does not increase health care costs are unconvincing. Possibly acute care for the episode of illness leading to death is less costly than for younger people. But what about the cost of treating chronic conditions over increasing years of life, and of chronic conditions associated with old age like certain eye conditions, arthritis, and dementia; and the cost ovet a greater number of years of other acute episodes not leading to death such as infections and injuries.

    A study published in 1999 is quoted: ‘Wanless concluded: ‘Despite this significant ageing of the population, demographic changes have so far accounted for a relatively small proportion of the increase in spending on health care in the UK. While overall spending (between 1965 and 1999) grew by 3.8 per cent a year in real terms, the demographic changes alone required annual real terms growth of just 0.5 per cent a year. Less than 15 per cent of the growth in health care spending over the past 35 years can therefore be attributed to the cost of meeting the needs of an ageing population. This is in keeping with findings from other countries.’

    Sorry, but 0.5% increase in real costs per annum is not nothing (and that figure is out of date anyway). Other factors may be more important in inxreasing costs (alcohol and obesity to name two), but that does not mean that the impact of an ageing population on health costs is a ‘myth’. The ‘demographic time bomb’ may be more significant in terms of pension and social care costs (the latter impacting on the NHS becauase of bed-blocking), but it does also affect health care.

  6. What you have all said shows actually that the ‘demographic time bomb of aging ‘ is a myth and that the factors contributing to the costs of healthcare are many.i am frustrated by the accusation that somehow the over 65’s are taking all the money when we all know that there is increased interest in more risky sport, that medical procedures are often taken for more than just ‘life saving reasons’ (IVF,plastic surgery etc etc and Medical science is now able to address early life threatening illnesses with long term outcomes that involve extensive treatment and monitoring..whereas before we just died…None of those conditions involve over 65s.It is the final years illnesses and they have always been present that are experienced by all of us at some stage…..In the past… perhaps they just did not bother to treat us.. whatever.. I am sick of ‘taking the blame’ My generation paid for the earlier generations ills and pensions and care… that is how National Insurance works or it did whilst they were deducting it from me

  7. John says:

    We do have an ageing population but we also have a growing population.
    It is the increased numbers of people – and the failure of government to plan for them – which is at the bottom of the current “problem”.
    Increased numbers of people means increased amounts of tax revenue receipts too – so why are the government failing to fund the NHS?
    The only real answer is that they choose to divert the available funds elsewhere, for example into tax cuts for wealthy people and firms.
    That and the ridiculous situation whereby PFI-built healthcare facilities are costing the NHS a small fortune over the lifetimes of their contracts.
    Add to that continuing outsourcing of services and estates management, all at inflated prices to match grossly obscene salaries being paid to senior NHS personnel – and it becomes apparent that we are all the victims of a government that knows the price of everything and the value of nothing.
    If they were minstrels, it might be amusing.
    But they are not; they are just bungling wastrels.

  8. Paula says:

    My feeling is that if Assisted Suicide is legalised, it won’t be long before elderly and chronically ill people are being advised that the most reasonable and economically responsible way to deal with their ‘problems’ is to end their lives.
    Many women who have terminations do so because they are advised it’s. it ‘s not the ‘ right time ‘ ;to have a .baby .Isn’t it more sensible to wait until
    your job, or relationship is more secure etc etc
    Similar arguments will apply with older people. Isn’t it better for your hard earned savings to be spent paying for your darling grandchild to go to University rather than to fritter it away on paying exorbitant charges for your residence in a Residential Home that will ask you to leave if your care needs become too burdensome for them?
    Personally I prefer to have help to carry on living as well as I can for as long as I can. After all I’ve already paid my taxes!

  9. Alan Rogers says:

    Paula,
    You put a plausible case for an elderly person to terminate their life in order to benefit others. But that is their decision to make. You would not want to do this you say – so you will not consider assisted suicide. Why does that mean you must refuse others that choice? Why do you want to deny to others a choice which (you assert yourself) you will never take?
    Are you a registered organ donor?

  10. Dr. David says:

    But there is very strong social pressure to terminate pregnancy under certain circumstances – and strong social pressure not to admit to having qualms about termination of pregnancy, perhaps even more so in left-of-centre (or across the Pond, US Democrat) political circles than the right of centre. It is entirely plausible that in a generation’s time it will be considered the norm to choose assisted dying once someone has decided they are a burden to their family or to wider society, and that someone choosing to want to life regardless, or a family choosing to pay for someone’s care costs when they could “just put the person out of their misery” and spend the money on themselves would be considered frankly selfish.

    There was a feature on the BBC website the other day about a lady from Guatemala who is a designer and is one of the BBC’s 100 Most Inspirational Women. She also has Down’s Syndrome. After seeing the article I couldn’t help but ask myself why we have a national screening program to detect such people before birth to prevent them being born, and why our society is so accustomed to this that pregnant women in the UK who refuse to be screened for carrying a Down’s syndrome baby are often viewed with a degree of incredulity for refusing to be tested.

    http://www.bbc.co.uk/news/world-latin-america-38132503

    My point here is less the rights and wrongs of abortion for foetal abnormalities but that something that not so long ago was illegal is now both commonplace and expected, and that to expect anything less should assisted dying be introduced as a “solution” to the increasing cost of caring for the elderly is frankly implausible.

  11. So you think killing off the old so the rich can have more is ethical? The only culture that sanctioned that approach that I know of was the Ick. They were not quiet the same, though as it was some time ago and they were in extremis, and couldn’t support their old – and nobody was hogging the wealth/food supply. When things improved the custom stopped I don’t think you have actually understood the power of manipulation…its not someone choosing to die, its someone being manipulated to agree to something they don’t want, but coming to believe it is their choice – that is how maniipulation works, and how people get away with abuse both physical and mental. Of course nobody would admit to doing it. I was warned by a professional my father was being so manipulated so took him to live with me for 6 more happy years – including a trip to Burma, where he had been stationed, for Remembrance Day. He was so proud, and wrote a piece for a magazine on it which was published. I hope to God you are wrong. The manipulaters can have bereft siblings, and we have had years to love the parents who cared for us when we were helpless. I would give everything to have my parents with me just for a few hours or minutes more of love. I hate to see people regarded as disposable, at the behest of a few manipulative wealthy people, taking a tiny minority of extreme cases and presenting them as a norm.. Its what they did to persuade us care in the community was a great thing. Turned out it really meant neglect in the community. I just hate to think you, or anyone, could forsee telling your parents to kick the bucket with a clear conscience and a happy mind. It makes dementia sound like a fantastic option. You will be betrayed by those you thought loved you most, and to whom you had given your lives, but at least you won’t know it. I am not much impressed with the notion that there is any corelation between an older person, and a bunch of cells. Its a faux argument. Even my mum, who had dementia, had a joy in living. I guess I will never understand someone who thinks its OK to normalise killing, and wouldn’t fight to protect people who are likely to suffer from it. In the case I mentioned, the lady involved was left in freezing conditions with a wide open window and no food or drink until she died. She pleaded for her life and her son (not the heir) is bereft, All for a small business. I haven’t heard of anyone actually wanting to die until their last few hours and not even then, sometimes. It isn’t a norm, unless palliative care has failed. Can’t we just get that better? Why is it selfish to stay alive and cost the state, but not to dodge taxes and cost the state? We are at risk of turning money into our ethical driver. Shouldn’t that be empathy and mutual support? That is the socialist way. Who else do we kill off because they are a drain on the state, how much more can we dehumanise people – that isn’t a civilisation, is it?

  12. Alan Rogers says:

    Jean
    Sorry- but you defeat your own argument by making it.
    Your mother suffered dementia but enjoyed life. Assisted suicide was clearly not required. You seem to believe that because this was the case for your mother it must be true of all other human beings … you must try to be more realistic. To try to misrepresent assisted suicide as forced extermination either reveals a lack of imagination (and true compassion) or a deliberate attempt to deceive.

  13. You seem a tad confused. One minute your argumnent is that older people should be “assisted” to end their lives, and it will be normalised – which of course it would be – the Netherlands example shows that clearly – and the next minute you are saying that if you are enjoying life it isn’t applicable. My argument is that, given a choice, a really free choice, I have never met anyone who wants to go a minute before they must. Yes there are a very few for whom the best palliative care might not work, but history teaches us laws made on exceptions are bad laws. The choice is clear. We either do right by the huge majority, or wrong them by listening to a far right argument using a tiny minority as a trojan horse, as they did for care in the community. I think we should be putting our efforts into the best palliative care for all, so that everyone has a gold plated death. We need to ensure that we can also do that for the tiny number of people who have conditions that make a good death unlikely without the best palliative care, and more research. You think its OK that quite a few people will be coerced into an early death in order to be unselfish, by their very selfish offspring. And you also seem to think my mum is unusual. Does that mean you have a specific case around those with dementia? Are you by any chance extrapolating from your own fears of losing control, to thinking it applies to all those with the condition? My mum lived with dementia for well over 15 years, we think more like 20. I cared for her, and met many others like her. Yes, they were not easy to care for – like having a giant and bossy toddler – but they all seemed to be very much alive and enjoying being so…pretty much like a toddler in that way too. If you don’t believe that your idea would turn into forced suicide, please listen to someone who has much wider experience, not just one family issue of a bad death (Baroness Findlay), and look at how the numbers of suicides have hugely increased in countries where it was mistakenly made into law. People are being misled into thinking its a painless option, sadly not always the case it can be more painful than the death people were trying to avoid. At the moment we have laws which do allow us to hurry a painful death to an end, but still protect the vulnerable. I have seen just how easy it is to coerce the vulnerable myself – not to mention the testimony of real experts on the subject – and I rather think it is someone who thinks its OK to let this happen, who is lacking in imagination and compassion. There was a programme on a while ago, in which a young man was taken to dignitas. He kept saying he wanted to do x, y and z before he died, to see more and do more, but his parents, and dignitas, ignored that he was signalling he just wasn’t ready, and basically had him put down. You are never going to see the true picture while you ignore that we can do a lot more to protect the vulnerable and still help those who will have a difficult end. We choose not to put our momey into that. In fact you were intimating it should be normalised that older people be persuaded that we simply can’t afford them, so they should see sense and go as a burden on the young. Dangerous thinking, blaming the “other”, will seep into our world view of the disabled, unemployed, ethnic minorities, and so on. It is the far right way. Compassion would be clamouring for prioritising palliative care, which is so very much neglected. When I gave evidence to Baroness Neuuberger the whole room, packed with relatives, was very much against your view. They thought they had seen your version of assisted suicide in action, and were traumatised. But as Baroness Findlay said, there is so often one person who will take advantage and try to end a life, for money, much more often than you seem to want to believe, or simply because they can’t cope. That is why we work as a society. I work with hospices and palliative care experts. I wish that more effort was spent in that field, and less in the trendy idea that assisted death is the way to go. Just as well your idea isn’t normalised or they would have got rid of Steven Hawking a long time ago. Funny thing you should accuse someone of lack of compassion when I spent a full 2 weeks in hospital 24/7 with my dying dad, in a ward full of dying people. Funny thing you should accuse someone of lack of compassion when my wish is to see gold plated and expert palliative care for all, so that nobody suffers a bad death. I work with the self same vulnerable groups you seem to think should be made even more vulnerable. As I said, please read or talk to an expert who has been working in this exact field for over 40 years. I also talk to academics in Canada on the subject, so it isn’t just a UK viewpoint. If someone really cares they get out there, talk to people, and do what they can to ensure the best for everyone, not just a few. I have found, sadly, that minority voices are only listened to by the powerful, when there is another agenda going on – and usually the people used also lose, along with a great many others, who were the real target. I still remember the propaganda around care in the community showing an elderly woman who had been institutionalised for being a bit simple as they said back then. I wonder just how many people like her there actually were in these hospitals, as the real reason was for the Thatcher government to sell the land, and drive down costs. I got taken in that time, but am a bit more politically savvy now. The frail elderly can either be properly and caringly looked after, which will cost, or driven to want to end it all by neglect and lack of compassion, by manipulation, physical and mental abuse and so on. Given the lack of funding for social care, and the NHS, is this really the time for an idea that will make it easy to end life, and normalise it. You will notice Terry Pratchett stopped talking about suicide booths pretty darned quick, and certainly didn’t go down the route of suicide – easy enough if you have money, or even without. i suspect this has more to do with your own inner fears about not controlling your own end, than any actual feelings of compassion. Death is a frightening thought, and somehow doing it yourself seems less scary (its human psychology). Normalising assisted suicide until it is seen as a way of getting rid of the expensively lingering (for the state or an individual or family) is going to achieve the exact opposite of putting the power in the hands of the individual, and i am sad you can’t see its not the compassionate way to go. It isn’t even the empowered way to go – have a look at the NCPC site and see what can be done to maintain control. As an ethicist I am not very positive about what people can be brought to think of as normal, even to the point of persuading ordinary members of the public into inflicting excruciating pain (a Canadian experiment). We know that mass death can be normalised in whole populations from history. Be careful what you wish for, it may come back to bite you. It won’t help then to say “but that is not what I meant”.

    1. John says:

      What is needed for an informed debate is some facts.
      It is sometime since I read any literature on assisted suicide but I know it is permitted in a number of US states and the evidence there is that people live longer and better lives because they have the reassurance that if their health problems become too painful to bear they can end their lives legally.
      I believe Canada is going down the same road as a result of the good results from the USA.
      As an over 70s person, I do not favour bumping off the elderly for the common good – where might that project begin and end?
      I still continue to make my contribution to my local and national – and international? – society, so why should I cash in my chips now?
      As an individual, I believe I am entitled to be able to make my own decisions about my own body and mind, and to be able to exercise my own individual freedom to be allowed to decide when I have had enough of life.
      Like Terry Pratchett, that day may come in the dark of the night while I am asleep. If so, that is fine by me too.

      1. Dr. David says:

        The enlightened healthcare system in the US that permits physician assisted suicide includes:

        * insisting that patients funded by Medicare (the Government health insurance safety net for the elderly) abandon taking curative drugs if they wish to receive palliative care
        * offering assisted suicide under Medicare whilst not covering drugs used in treatment or pain relief.

        Thus whilst wealthier patients can afford not to take up the offer of assisted suicide, some poorer patients cannot afford to avoid it. If that’s not discrimination against some of the poorest and most vulnerable in our society then I don’t know what is. And the vast majority of disability rights organisations oppose assisted suicide for reasons already rehearsed.

        It’s easy to cite individual examples of patients whose emotive circumstances tug at our heartstrings and make us wish that were we in their position we could choose the option of assisted dying; but place such a choice in front of an increasingly frail and elderly population and the results for individuals become anything but a free choice. The combination of increasing privatisation of healthcare services, moves towards insurance and and ageing demographic means that any well-intentioned attempt to legalise assisted dying for “compassionate” reasons will inevitably become sooner or later the de facto means of caring for our ageing population and those who think differently will before long be viewed with the same combination of bewilderment and contempt that medics who oppose abortion are often held in.

  14. Ken Johnson says:

    The often heard story that life expectancy at birth has doubled since 1917 is actually true, but few seem to understand why it has doubled. The reason is that children no longer die in infancy and women no longer die in childbirth. Death in infancy used to be horrifically common, but life expectancy at age 18 has not changed much in 100 years. It is at age 18 that one starts paid work. Therefore, people have about as long to earn their pensions and about as long to draw them as they have at any time during the life of the National Insurance Scheme. The reason for raising the pension age is – what else – to pay for Tory indulgences like nuclear weapons, tax avoidance and tax cuts for millionaires.

    Please sign my E-Petition to Parliament for free pensions at age 60:
    https://petition.parliament.uk/petitions/185661/sponsors/yOLF7ucjsGAChNvzYHq

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