Assisted dying: in praise of being a burden

It's not a reason to end a life, it's the very possibility of our being human.

Jonathan Rowlands

Jonathan is a theology lecturer and Liverpool FC fan.

A younger hand holds a wrinkled older hand of someone in a bed.

A lot has been said already about assisted dying. In the raging bonfire of public discourse, there has been a lot of heat, but not a lot of light. But amid all the noise surrounding Parliament’s upcoming discussion around assisted dying, a recent conversation hosted by Prospect between Brenda Hale (former President of the Supreme Court) and Rowan Williams (former Archbishop of Canterbury) served as a reminder that we are, despite everything, still capable of having meaningful and fruitful discussion about even the most divisive of issues.

The conversation is earnest and hard-won throughout; both Hale and Williams each push and probe the other for more detail, more nuance, more outworking of implications. And yet their tenor remains respectful. There is no cheap point scoring, no trite comments or easy aphorisms. These are two people working to understand the other, in full recognition of the gravity of the topic.

One particular moment, however, was frankly spine-chilling. As the conversation progresses, Hale is asked the following: “How do you deal with the pressure questions – pressure from family or financial pressures? What safeguards can you build in?” Her response – in full, for context – is as follows:

“Well, you can build in the safeguards that the decision must be made without undue influence, coercion, duress or fraud. But in the end, it’s a matter of evidence, isn’t it? One of the things I find most difficult is that I don’t think it’s necessarily irrational for somebody to take into account the suffering their suffering is causing to the people dear to them, or the burden that looking after them is placing upon the whole community.

I wouldn’t call that “undue influence”, but it’s one of the questions I find most difficult about all of this. You know, obviously there’s duress, there’s financial abuse, there are all of those sorts of things that have got to be checked against, and there ought to be objective evidence of absence of that. But when it comes down to somebody thinking, “I don’t want to be a cause of others suffering,” that seems to me to be a reasonable thing for somebody to take into account.”

The idea that my dependency or burdensomeness might factor into decisions about whether I continue to live, seems to me to be contrary to the very notion of the Christian message. Let me explain why.

We are made to be a burden, then. To depend on others, to be burdensome to them, is to be human.

We are, whether we like it or not, now rapidly approaching Christmas. At this time of year, Christians celebrate the birth of Jesus; the divine Son of God made flesh and born of a virgin. As the divine Son of God, Jesus lived the perfect human life of joy, grace, and faithfulness; the kind of life I can only aspire to.

Because of this, as a Christian, I look to Jesus’ perfect life of faithfulness as a model for what a truly healthy human life looks like. And I am often surprised by what I find there. For example, it turns out true human flourishing does not involve getting married, having sex, or having children; Jesus’ perfect life of flourishing featured none of these things.

But crucially, Jesus’ perfect life often involved depending upon others; upon being a burden to those around him. As an itinerant travelling teacher, Jesus relied on the financial support of his followers to make his ministry possible. He relied on being made and given food to eat, and a roof to sleep under. He was far from self-sufficient. Rather, he gladly made himself a burden to others in service of his ministry.

But more than this, we often overlook the radical significance of the Christian claim that, at Christmas, we celebrate God’s becoming a baby. For the first years of his perfect life, Jesus was entirely – entirely – dependent upon his parents for all his needs. Here we see God, in the person of Jesus, depending upon Mary and Joseph to feed him, to clothe him, to cuddle him, to clean up his sick and his excrement. This is what human flourishing looks like.

This is mirrored at his glorious death, too. Prior to his arrest, Jesus asked his friends for support; to stay awake while he prays for comfort. The Gospels go on to tell us that, having been mercilessly tortured, beaten, stripped, and interrogated, Jesus had his cross carried by a man named Simon of Cyrene. After his death, having no tomb of his own, Jesus was buried in the family tomb of his follower Joseph of Arimathea. And this, too, is what human flourishing looks like.

Throughout his entire life Jesus lived the perfect life of human joy and faithfulness. And this often involved depending upon others and being a burden to them in every way conceivable. We are made to be a burden, then. To depend on others, to be burdensome to them, is to be human.

To think, then, with Baroness Hale, that my dependency and burdensomeness upon others might somehow serve to underwrite a decision to end my life, is fraught with difficulty for me as a Christian. I simply cannot reconcile her words with the life I see Jesus living in the Bible: a life of joyful, difficult burdensomeness.

There may be many other reasons why people decide they want their lives to end. But a sense of burdening others ought not to be one of them. Being a burden is not a reason to bring one’s life to an end, because it is the very possibility of our being human in the first place. To need others, to place ourselves into their care, does not make us less human, it makes us more human. And therein lies its glory.

Column

Assisted dying

Care

Comment

14 November 2024

4 min read

Proposed euthanasia safeguards insult our NHS

We must defend a collective sense of care and generosity.

George Pitcher

George is a visiting fellow at the London School of Economics and an Anglican priest.

A gable end mural depicts a nurse in scrubs and a mask turning and looking towards the viewer.

A mural of an NHS nurse during COVID, Manchester.

Mural Republic

It was, I believe, the late political satirist Simon Hoggart who coined the Law of the Ridiculous Reverse, which held that, if the opposite of a statement is plainly absurd, then it was not worth making in the first place.

This law comes to mind when Labour MP Kim Leadbeater promises that her Assisted Dying Bill will have the “strictest safeguards in the world”, one of which is that those patients who have ordered their fatal dose “would be allowed to change their mind at any time.”

Where, exactly, has it ever been suggested that an individual, having asked for an assisted death, would not be allowed to change their mind? I’m just wondering which legislator or medical professional has proposed that once a lethal draught has been prescribed then there is no turning back.

I’m struggling to picture the circumstance in which a terminally ill patient is pinned down and killed, the last words that they hear being: “I’m sorry Mrs Simpkins, but everyone’s gone to a lot of trouble. You asked for it and you’re jolly well going to get it.”

This is important because, apparently, being able to change your mind about asking for help to kill yourself is one of the strictest safeguards in the world. I hope Ms Leadbeater will forgive me for pointing out that this doesn’t really stack up.

And what’s serious about it is that it’s also a massive straw man argument. The clear and rather devious implication is that one of the arguments being made against the introduction of an assisted suicide law is that patients won’t be able to change their minds about it, which I think we can all accept simply isn’t a fact at all. It’s absurd – a Ridiculous Reverse.

So I’ll defend the NHS with a religious fervour. To my mind, healthcare is a holy mission. We meddle in law with the Hippocratic Oath at our very deep peril.

It’s also hugely contemptuous of the medical profession in general and rude to the NHS in particular. That’s because there’s a snide impression behind Leadbeater’s comment there may be hundreds of budding Harold Shipman out there, but her powerful safeguards are going to protect us from them.

We’re in danger of becoming inured to this kind of insult from politicians directed at the NHS. And it’s worth exploring why they might think we need to be protected from unscrupulous doctors and nurses. In this case, one possible reason is that the NHS isn’t being particularly helpful in giving the euthanasia enthusiasts what they want.

Doctors and their staff have plenty of ethical objections to assisted suicide. But leave those aside for a moment. At the practical level, the NHS has made it clear that it doesn’t have the infrastructure to operate a policy of assisted deaths safely. And it can’t afford to set one up. So a government that introduces assisted suicide is going to have to organise and regulate its own assisted death agency.

“Oh,” the assisted dying lobbyists seem to exclaim, “we’d presumed you’d do as you’re told.” Just hand out the hemlock. Take your instructions from the legislature.

But the NHS is better than that. And it’s that kind of high principle that so infuriates feckless politicians. It was the late Nigel Lawson who said, somewhat ruefully, that the NHS “is the closest thing the English have to a religion”. The right wing of politics regularly tells us it’s time to renounce that religion.

To worship the NHS as a religion would, literally, be idolatrous. But it’s not so to acknowledge its religious qualities. Just look at the word – the Latin religio means something like “good faith”, the essence of who we are, what makes us good.

The NHS, in its post-war incarnation, has been central to who we are as a people and what defines us. It’s something to do with our collective sense of care and generosity to one another. Its members, like our national Church, make up a single body.

This is not to co-opt the NHS as the medical wing of the Church. It’s no part of the NHS’s brief to proselytize – rather the reverse; Christian medical staff have been in deep disciplinary trouble for evangelising. It is a profoundly secular organisation.

So the NHS emphatically isn’t in the business of propagating the gospel. But that’s not to say that we can’t be in the same business. Many priests have stories of their most affirming work being in the company of people of other faiths or of none.

The NHS’s proud heritage is to offer treatment free to anyone at the point of access. Put another way, it will seek to heal anyone who comes to it. I make no apology for saying that sounds familiar.

So I’ll defend the NHS with a religious fervour. To my mind, healthcare is a holy mission. We meddle in law with the Hippocratic Oath at our very deep peril.

And when NHS professionals tell us where we can stick our assisted suicides, I respectfully suggest we give it our solemn attention, rather than patronisingly offering a Law of the Ridiculous Reverse.