Article

Assisted dying

Care

Comment

Politics

6 February 2025

6 min read

Assisted dying’s problems are unsolvable

There’s hollow rhetoric on keeping people safe from coercion.

Jamie Gillies

Jamie is a freelance writer.

Members of a parliamentary committee sit at a curving table, in front of which a video screen shows other participants.

A parliamentary committee scrutinises the bill.

Parliament TV.

One in five people given six months to live by an NHS doctor are still alive three years later, data from the Department of Work and Pensions shows. This is good news for these individuals, and bad news for ‘assisted dying’ campaigners. Two ‘assisted dying’ Bills are being considered by UK Parliamentarians at present, one at Westminster and the other at the Scottish Parliament. And both rely on accurate prognosis as a ‘safeguard’ - they seek to cover people with terminal illnesses who are not expected to recover.

An obvious problem with this approach is the fact, evidenced above, that doctors cannot be sure how a patient’s condition is going to develop. Doctors try their best to gauge how much time a person has left, but they often get prognosis wrong. People can go on to live months and even years longer than estimated. They can even make a complete recovery. This happened to a man I knew who was diagnosed with terminal cancer and told he had six months left but went on to live a further twelve years. Prognosis is far from an exact science.

All of this raises the disturbing thought that if the UK ‘assisted dying’ Bills become law, people will inevitably end their lives due to well-meaning but incorrect advice from doctors. Patients who believe their condition is going to deteriorate rapidly — that they may soon face very difficult experiences — will choose suicide with the help of a doctor, when in fact they would have gone on to a very different season of life. Perhaps years of invaluable time with loved ones, new births and marriages in their families, and restored relationships.

Accurate prognosis is far from the only problem inherent to ‘assisted dying’, however, as critics of this practice made clear at the – now concluded – oral evidence sessions held by committees scrutinising UK Bills. Proponents of Kim Leadbeater’s Terminally Ill Adults (End of Life) Bill and Liam McArthur’s Assisted Dying for Terminally Ill Adults (Scotland) Bill have claimed that their proposals will usher in ‘safe’ laws, but statements by experts show this rhetoric to be hollow. These Bills, like others before them, are beset by unsolvable problems.

Coercion

Take, for example, the issue of coercion. People who understand coercive control know that it is an insidious crime that’s hard to detect. Consequently, there are few prosecutions. Doctors are not trained to identify foul play and even if they were, these busy professionals with dozens if not hundreds of patients could hardly be counted on to spot every case. People would fall through the cracks. The CEO of Hourglass, a charity that works to prevent the abuse of older people, told MPs on the committee overseeing Kim Leadbeater’s Bill that "coercion is underplayed significantly" in cases, and stressed that it takes place behind closed doors.

There is also nothing in either UK Bill that would rule out people acting on internal pressure to opt for assisted death. In evidence to the Scottish Parliament’s Health, Social Care and Sport Committee last month, Dr Gordon MacDonald, CEO of Care Not Killing, said: “You also have to consider the autonomy of other people who might feel pressured into assisted dying or feel burdensome. Having the option available would add to that burden and pressure.”

What legal clause could possibly remove this threat? Some people would feel an obligation to ‘make way’ in order to avoid inheritance money being spent on personal care. Some would die due to the emotional strain they feel they are putting on their loved ones. Should our society really legislate for this situation? As campaigners have noted, it is likely that a ‘right to die’ will be seen as a ‘duty to die’ by some. Paving the way for this would surely be a moral failure.

Inequality

Even parliamentarians who support assisted suicide in principle ought to recognise that people will not approach the option of an ‘assisted death’ on an equal footing. This is another unsolvable problem. A middle-class citizen who has a strong family support network and enough savings to pay for care may view assisted death as needless, or a ‘last resort’. A person grappling with poverty, social isolation, and insufficient healthcare or disability support would approach it very differently. This person’s ‘choice’ would be by a dearth of support.

As Disability Studies Scholar Dr Miro Griffiths told the Scottish Parliament committee last month, “many communities facing injustice will be presented with this as a choice, but it will seem like a path they have to go down due to the inequalities they face”. Assisted suicide will compound existing disparities in the worst way: people will remove themselves from society after losing hope that society will remove the inequalities they face.

Politicians should also assess the claim that assisted deaths are “compassionate”. The rhetoric of campaigners vying for a change in the law have led many to believe that it is a “good death” — a “gentle goodnight”, compared to the agony of a prolonged natural death from terminal illness. However, senior palliative medics underline the fact that assisted deaths are accompanied by distressing complications. They can also take wildly different amounts of time: one hour; several hours; even days. Many people would not consider a prolonged death by drug overdose as anguished family members watch on to be compassionate.

Suicide prevention

It is very important to consider the moral danger involved with changing our societal approach to suicide. Assisted suicide violates the fundamental principle behind suicide prevention — that every life is inherently valuable, equal in value, and deserving of protection. It creates a two-tier society where some lives are seen as not worth living, and the value of human life is seen as merely extrinsic and conditional. This approach offers a much lower view of human dignity than the one we have ascribed to historically, which has benefited our society so much.

Professor Allan House, a psychiatrist who appeared before the Westminster Committee that’s considering Kim Leadbeater’s Bill, described the danger of taking this step well: “We’d have to change our national suicide prevention strategy, because at the moment it includes identifying suicidal thoughts in people with severe physical illness as something that merits intervention – and that intervention is not an intervention to help people proceed to suicide.”

Professor House expressed concern that this would “change both the medical and societal approach to suicide prevention in general”, adding: “There is no evidence that introducing this sort of legislation reduces what we might call ‘unassisted suicide’.” He also noted that in the last ten years in the State of Oregon – a jurisdiction often held up as a model by ‘assisted dying’ campaigners – “the number of people going through the assisted dying programme has gone up five hundred percent, and the number of suicides have gone up twenty per cent”.

The evidence of various experts demonstrates that problems associated with assisted suicide are unsolvable. And this practice does not provide a true recognition of human dignity. Instead of changing the law, UK politicians must double down on existing, life-affirming responses to the suffering that accompanies serious illness. The progress we have made in areas like palliative medicine, and the talent and technology available to us in 2025, makes another path forwards available to leaders if they choose to take it. I pray they will.

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Review

Culture

Film & TV

Politics

War & peace

7 March 2025

6 min read

Bonhoeffer: how to rouse a deaf world to moral action

Comparing today to the past is risky, a new biopic helps us do it well.

Theodore Brun

Theodore is author of the historical fiction series The Wanderer Chronicles.

A man dressed in 1930s clothing, sits with others at a table looking pensive.

Angel Studios.

Historical analogies are a dangerous, and often inaccurate, way of interpreting the times in which we live. “This is just like that” has a habit of making us react and respond to “that” - which we think we understand so well - when really, we should be taking time to appreciate the nuances of the problems which “this” uniquely poses us now.

That said, I don’t suppose ever, in the last 80 years, have analogies abounded in our media with such ubiquity that we find ourselves in a historical moment facing similar threats to our freedoms and way of life to those arising across Europe in the 1930s.

Thus, the movie Bonhoeffer, Todd Komarnicki’s fantastic new biopic of the dissident German theologian and Christian martyr, appears to come at an opportune moment in our culture.

As writer and director of this two-hour-long epic, Komarnicki’s admiration for his subject shines through like a faithful sun breaking through an overcast sky. And whether you are a Christian or not, there is undoubtedly much to admire in Dietrich Bonhoeffer’s life and the way he lived it.

It's a story worth hearing - which, given its Christian overtones, still has the power to break out of the boundaries of Christian sub-culture to a wider audience, with its message of courage in the face of overbearing evil.

Born in 1906, Bonhoeffer was still a young man when Hitler and his newly formed Nazi party rose to power. He trained as a Lutheran pastor, was an accomplished theologian, and became a key founding member of the Confessing Church – the remnant of the German church who did their best to withstand Hitler’s ideological take-over. (For which, many paid with their lives.) By the early 1930s, Bonhoeffer had already perceived the dangers which few others in the German church seemed able to see or else willing to call out. And after abandoning a short stint of study in the US, he returned to his native Germany to do what he could to call the church back to herself before it was too late. No easy task.

A close up of a 1930s man wearing wire-rimmed glasses, looking pensive.

Dietrich Bonhoeffer (colourised).

One existing photograph of Bonhoeffer shows a young, earnest face in steel-rimmed glasses, an expression of wisdom beyond his years weighing heavy on his brow. But for all the seriousness of his situation, he was, by Komarnicki’s account, an ebullient character. Persuasive, playful and able to find joy even in the darkest of times.

In Bonhoeffer, he is played brilliantly by Jonas Dassler, a native German actor who brings an intensity and intelligence to the role which must be a fair reflection of the man himself, as well as allowing room for a levity of spirit, especially in his friendships and family ties.

There’s a scene early in the film, foreshadowing much that was to come. Dietrich the boy plays the Moonlight Sonata at his older brother Walter’s funeral wake. The piece was Walter’s favourite, but none of the mourners pay the slightest attention. Dietrich slams the piano shut and runs off in frustration. “No one listened,” he tearfully complains to his mother. “No one cared.” This theme of rousing a deaf or unfeeling world to moral action runs through the whole movie.

We can all agree that Bonhoeffer is a man to emulate in our own times. The question is where would his instincts lie in the political and cultural landscape of today.

Komarnicki has done a solid job unfolding Germany’s inexorable descent into darkness, often marking key moments as Bonhoeffer the man makes his stand against the state with actual quotations from his work. The most famous serves as the movie’s strapline:

“Silence in the face of evil is itself evil. Not to speak is to speak.”

The script is peppered with such exhortations, which seems directed as much to the audience of today as they do to Bonhoeffer’s own, eighty-or-ninety-odd years ago. Such injunctions seem all the more arresting as Bonhoeffer’s story pursues its arc from pastor to martyr, and the noose awaiting him at Buchenwald concentration camp just days before Germany’s final capitulation.

It is no doubt hard to frame a movie around the moral courage and conscientious stand of a single man, however admirable that man may be, particularly when so much of the struggle is happening inside his own head. Perhaps that is why much of the less historically accurate material has been included. The thriller subplot – of Bonhoeffer’s involvement in a plot to assassinate Hitler – brings some necessary forward propulsion to the story, but seems the least congruent with what we know of the man. Much of this more thrusting narrative is intercut with scenes of Bonhoeffer’s last days before his execution, the wrestling with his faith and his fate, before a final resolution of peace, even joy in his final moments. “Eternity, eternity, eternity,” he murmurs. A word he used to repeat endlessly with his twin sister as they whiled away the time smoking cigarettes. But a word which ultimately gives him the focus and the spiritual strength to hold his courage to the end. Although slower, these provide a more convincing and compelling portrait of a man who deserves to be remembered as a hero, not only of his own age, but of any age where evil is determined to silence truth at any cost.

As a modern audience, this is where the hazard lies. To return to my original point, it is all too easy to tar one’s political or cultural opponents with the label of “fascist” or “Nazi” – merely because they happen to disagree with you. (And sadly I’ve seen this done by otherwise mild-mannered English theologians over this very film.) Some have said this is akin to shunning another child in the playground because they have “cooties”. It’s over-simplistic and facile. If anything, it reveals the casual propagandising of a suggestible mind.

Few would watch this film and associate themselves with its antagonist (Hitler) over its heroic protagonist. We can all agree that Bonhoeffer is a man to emulate in our own times. The question is where would his instincts lie in the political and cultural landscape of today.

Jesus had harsh words to say to the pharisees and scribes who build tombs for the prophets and decorate the monuments of the righteous. “You say, ‘If we had lived in the days of our fathers, we would not have been partners with them in shedding the blood of the prophets.’”

How easy it is to assume we would have been on Bonhoeffer’s team.

And this is my one criticism of the film: its portrayal of the bishops and clergy who did succumb to Hitler’s ideology seems too blunt-edged. They rail from the pulpit in the manner of the Fuhrer himself, marking them as ravening ideologues; they bark out Party platitudes, red in the face. I imagine the reality of how Nazi ideology infiltrated and captured the church – as it did many other institutions – was far more subtle, far more insinuating and insidious. More boiled frog than scalded cat.

So it surely is in our day. While National Socialism has passed away, the totalitarian instinct which animated it has sadly not. My prayer is that we have the wisdom, courage, and above all discernment, to learn Bonhoeffer’s lesson and pass the tests of our time.

Komarnicki’s excellent movie may just help us to do that.

Bonhoeffer is out in UK and Irish cinemas from 7th March 2025. For more information and to book tickets visit the film's site.