The Assisted Dying Bill is a compassionate step forward but peers must bolster safeguards for true dignity and choice

It is the final debate on the most consequential change to Britain’s moral and legal framework since the abolition of capital punishment.

Members of Parliament have already deliberated the principle with care and compassions, on both sides of the debate, and chosen to allow assisted dying. That decision now stands.

Peers are not asked to reopen the argument but to ensure that the law’s safeguards are as strong, as detailed, and as humane as possible. Because if they fail, the stakes could not be higher.

And one area demands more scrutiny: social isolation.

When people are cut off from relationships, housing, or care, loneliness can become a reason to die. That possibility should chill us all.

I write as a Canadian, where medical assistance in dying (MAID) was legalized in 2016 and expanded in 2021 to those not facing imminent death. Public support remains strong, but the lessons are complex.

A recent review of deaths in Ontario found several cases in which people qualified not because of untreatable medical decline but because of “unmet social needs”, such as isolation, poverty, or fear of homelessness. One anonymized case involved a man in his 40s with bowel disease and mental illness, described as “socially vulnerable and isolated.” Another was a woman with severe chemical sensitivities who sought MAID because she could not find safe housing.

These stories aren’t an argument for or against assisted dying per se. They are warnings. Social disconnection is a truly agonising experience. If a society legislates for assisted dying without addressing the epidemic of, some people will feel pushed toward a fatal choice.

The United Kingdom already knows it has a chronic loneliness problem. In 2018 it appointed the world’s first minister for loneliness. The NHS has pioneered social prescribing (link workers who connect patients to community groups, nature, the arts, or exercise) and it works.

But demand for belonging far outpaces supply. From young carers to disabled people, from bereaved men to older adults living alone, too many remain unseen. Chronic isolation harms both body and mind, fuelling inflammation, anxiety, and premature death. It frays trust and corrodes democracy. No humane end-of-life policy can be built on a foundation that leaves people feeling invisible.

The Belonging Barometer, an annual survey of 10,000 UK adults, conducted by my organisation, the Belonging Forum, shows a stark truth: when people feel they belong, they report better health, resilience, and civic trust. When they don’t, loneliness and despair soar.

If Parliament proceeds with assisted dying, it must do so in tandem with a national mission to strengthen belonging. That means embedding social connection into the clinical pathway, expanding social prescribing so no one waits months for support, investing in the community infrastructure where relationships actually form, and measuring loneliness with the same urgency we measure physical pain.

I hold both Canadian and British citizenship. I also hold two convictions that can, and must, coexist. First, adults deserve compassion, agency, and honesty at the end of life.

Second, dignity is not only about how we die. It is about how we live together. The Canadian experience shows how quickly a society can normalise assisted dying while still neglecting the infrastructure of belonging. Britain must not repeat that mistake.

Led by Luciana Berger, the Labour peer and chair of the Maternal Mental Health Alliance, a group of peers is calling for more time to scrutinize the bill and its potential pitfalls. The must be listened to.

In an open letter, the peers point to concerns raised by the Royal College of Physicians, the lack of clarity on how the law would be implemented in practice, the reliance on non-binding codes of practice for safeguards, and the absence of provisions to ensure that medically assisted deaths are reliably recorded and investigated.

Clearly, more can be done to make this legislation safe.

When peers rise to speak on Friday, I hope they also ask a simple question alongside the legal ones: Have we done everything possible to ensure people are choosing in the presence of connection, not the absence of it?

Because a just society does not offer death to those it has left alone. It widens the circle, so that everyone has reason to stay.

Kim Samuel is the founder of the Belonging Forum and long-time campaigner for disability rights.

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