Assisted Dying logic makes perfect sense but imposes a dreadful dilemma

The case for assisted dying appeals to choice and autonomy, yet not all choices are good. It means vast numbers of people will face a terrible choice as their life nears its end.

Graham Tomlin

Graham is the Director of the Centre for Cultural Witness and a former Bishop of Kensington.

A black and white picture shows a woman head and shoulders, she is looking up and to the side in an unsure way.

Anastasiya Badun on Unsplash.

Two broad cultural trends have led us to our current debate over assisted suicide.

One is the way consumer choice has come to be seen as the engine of successful economies. Emerging from Adam Smith’s theories of rational choice based on self-interest, given a boost by Reaganomics and Thatcherite thinking in the 1990s, the provision of a range of choice to the consumer is usually argued, with some logic, as key to the growth of western economies and the expansion of freedom.

The other is the notion of individual autonomy. Articulated especially in the past by figures such as John Locke and John Stuart Mill, the idea that individuals should be free to choose to dispose of their property, their time and their talents as they choose, as long as they don’t harm anyone else, has become standard moral fare in the modern world.

Put these two together, and the logic of assisted dying makes perfect sense. What can be wrong with offering someone a choice? Why should the state restrict individual freedom to end your life in the way you might decide to do so?

Yet expanding choice is not always good. Forcing an employee to choose between betraying a colleague or losing their job is not a fair choice. There are some choices that are unfair to impose upon people.

Assisted dying will lead us to this kind of choice. Imagine a woman in her eighties, living in a home which is her main financial asset, and which she hopes to leave to her children when she dies. She contracts Parkinson’s or dementia, which will not kill her for some time, but will severely limit her ability to live independently (and remember about of third of the UK population will need some kind of longer-term care assistance as we get older). At present, her only options are to be cared for by her children, or to sell her house to pay for professional care.

With the assisted suicide bill, a third option comes into play – to end it all early and save the family the hassle - and the money. If the bill passes, numerous elderly people will be faced with an awful dilemma. Do I stay alive, watch the kids’ inheritance disappear in care costs, or land myself on them for years, restricting their freedom by needing to care for me? Or do I call up the man with the tablets to finish it soon? Do I have a moral duty to end it all? At present, that is not a choice any old person has to make. If the bill passes, it will be one faced by numerous elderly, or disabled people across the country.

Even though the idea may have Christian roots, you don’t have to be religious to believe the vulnerable need to be protected

Of course, supporters of the bill will say that the proposed plan only covers those who will die within six months, suffering from an “inevitably progressive condition which cannot be reversed by treatment.” Yet do we really think it will stay this way? Evidence from most other countries that have taken this route suggests that once the train leaves the station, the journey doesn’t end at the first stop - it usually carries on to the next. And the next. So, in Canada, a bill that initially allowed for something similar was changed within five years to simply requiring the patient to state they lived with an intolerable condition. From this year, there is a proposal on the table that says a doctor’s note saying you have a mental illness is enough. In the same time frame, 1,000 deaths by assisted dying in the first year has become 10,000 within five years, accounting for around 1 in 20 of all deaths in Canada right now. Some MPs in the UK are already arguing for a bill based on ‘unbearable suffering’ as the criterion. Once the train starts, there is no stopping it. The logic of individual choice and personal autonomy leads inexorably in that direction.

Of course, some people face severe pain and distress as they die, and everything within us cries out to relieve their suffering. Yet the question is what kind of society do we want to become? One where we deem some lives worth living and others not? Where we make numerous elderly people feel a burden to their families and feel a responsibility to die? In Oregon, where Assisted Dying is legal, almost half of those who opted for assisted dying cited fear of being a burden as a factor in their decision. Or would we prefer one where the common good is ultimately more important than individual choice, and where to protect the vulnerable, we find other ways to manage end of life pain, putting resources into developing palliative care and supporting families with dependent members – none of which will happen if the option of assisted dying is available.

Even though the idea may have Christian roots, you don’t have to be religious to believe the vulnerable need to be protected. Changing the law might seem a small step. After all, doctors routinely administer higher doses of morphine which alleviate pain and allow a natural death to take its course. Yet that is a humane and compassionate step to take. To confront numerous people, elderly, disabled and sick with a dreadful dilemma is one we should not impose upon them.

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General Election 24

Politics

5 July 2024

5 min read

What happens when you lose an election?

Spare a thought (and prayer) for the defeated.

Ross Hendry

Ross leads CARE, a Christian social policy charity.

A mayor reads an election result as a despondent candidate looks on.

Penny Mordaunt loses in Portsmouth.

BBC News.

Friday morning, 6 May 2005 I awoke wondering whether the past few months had been a bad dream, and contemplating what my future might hold. It was the day after the general election. ‘My’ party had won, but my result, while respectable, was a distant second place. So, in the wake of this election, I know what the vast majority of the 4,379 candidates who ran are feeling, which is why I would encourage us all to spare a thought and prayer for them.

Few people apart from close family and friends and the most ardent party activists will give much attention to the candidates who lost. Perhaps a few prominent politicians will be interviewed alongside pictures of the ex-cabinet member who lost their seat to a fresh-faced young candidate. But in general, life moves swiftly on, and those who lost will be quickly forgotten about.

It's understandable. We want to know what a new Government will do – who will be the leading figures shaping our lives over the next few years. If we do think about those who lost it will be in the context of the next competition – party leadership. Will there be a change in party leaders? Which ‘faction’ will come to dominate their party, and so on. This is an important consideration.

There will be hundreds if not thousands of candidates who will need to be reminded that their identity and worth is not in politics, being a candidate, or seeking the approval of local voters.

Of the 3,729 candidates not elected to sit in Parliament for the next five years many will face a similar mixture of emotions as I did on that morning in 2005. There may be regret and anger. I know for a long time I wondered whether there were things I could have done differently. Things I did not say or do that could have made a difference. “If we had planned to do this… if we could have avoided that…, should I have…” will be questions on the lips of many on Friday morning.

Personally, I also felt that there were things said and done against me that were deeply unfair, so I was also angry that the unjust had seemed to prevail. I could identify with the ancientthe ancient writer of the Psalms poetry who cried “why do the wicked prosper?” Politics is unfair and cruel. That is the reality. Too often it is not a meritocracy. Candidates lose, not because they are less able but because voters preferred another party or leader.

In these days following the election, I suspect there will be hundreds if not thousands of candidates who will need to be reminded that their identity and worth is not in politics, being a candidate, or seeking the approval of local voters. For me, I was immensely grateful for close friends and teachers who reminded me that my identity was in Jesus Christ. I was part of a holy nation, a royal priesthood and God’s special possession. God knows how those former candidates and MPs without that security will cope, which is why they need our prayers.

Being a candidate is hugely costly. Some do it for fun, others might be motivated by spite, but the great majority run because they want to serve others.

I also needed to learn what it meant to forgive. I felt that untrue claims and accusations had been made against me during the campaign, and tactics deployed that were designed to intimidate and mislead. I did feel that the result was unfair, and I was angry that my opponent and his team would stoop very low to win, But I also needed to learn how to forgive. To this day I believe I ran an honourable campaign, giving more respect than I received; and I would like to think I would have made a good MP. I believed God called me to run but I do not feel he let me down. That does not mean he still needed to teach me how to forgive my opponent. That is an ongoing process I am learning over time.

There will be many like me who will need to learn forgiveness in the weeks, months and years after the election. Like me, they may need to learn how to forgive opponents that hurt or wronged them, or learn how to forgive themselves, the electorate, or even God for not giving them their hearts desire.

And I'll pray that those who were defeated in this election will still have sense of calling to public service, despite their loss, if this is right for them. Being a candidate is hugely costly. Some do it for fun, others might be motivated by spite, but the great majority run because they want to serve others. We need to remember this in an age where people are increasingly cynical about politics and politicians.

I lived in the constituency I was running in for over four months before the election. The Monday after polling day I was back at the desk I had not seen for months. It took several months for me to slowly work out that God could still have a calling for me into the public square and that his plan was good.

There is evidence that in the current environment, good people are staying out of politics and public life because of the cost and the emotional toll it has on the individual and their family. I know firsthand some of what that means. But if good people are deterred, they leave a vacuum that will be filled by others of less capability and virtuous character. That would be a tragedy for our national life.

So, in the days after the election, I will intentionally remember how I felt nineteen years ago and send a card or text message to those who I know have lost, thanking them for their service and reminding them that God may still be calling them into public life and service, just in a different way. And I will pray for them, as I also pray for the new government, and the peace and prosperity of the UK in the next five years.