Article
Assisted dying
Care
Comment
Politics
6 min read

Assisted dying’s problems are unsolvable

There’s hollow rhetoric on keeping people safe from coercion.
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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Article
Comment
Economics
Politics
Trust
5 min read

Tariffs destroy trust so where do we go next?

Blunt weapons cause a mess in markets and lives.

Paul Valler is an executive coach and mentor. He is a former chair of the London Institute for Contemporary Christianity.

A gold coin with the DOGE dog on it, lies over the face on a $50 bill.
So doge-y.
Kanchanara on Unsplash

‘When America sneezes the rest of the world catches a cold’ quipped economists almost a century ago after the Wall Street crash.  A comment that might equally apply to the more than 10 per cent drop in stock markets caused by President Trump’s sudden raised tariffs on imports to the USA.  The impact of the American economy on the world is inescapable.  It represents almost a quarter of global GDP and the dollar is the leading reserve currency, accounting for around 60 per cent of international foreign exchange reserves.  Size is what enables America to bully the rest of the world. 

For decades the American trade deficit has been an elephant in the room and Trump is to be applauded for recognising it and addressing the problem. Unfortunately, the way he has gone about it has caused another, bigger problem. Changing the direction of the global economy is like turning a tanker, it cannot be done easily or quickly, but Trump’s style is to attack, like hammering at a nail.  Every issue in geopolitics looks like another nail, waiting for him to hammer out a negotiated deal.  Full marks for courage, but not for wisdom. The blunt weapon of trade tariffs is designed to bring wealth and power back towards the USA, but blunt weapons often cause a mess, and sure enough a global mess is what we now have.  A US/China trade war with higher prices that could end up stoking inflation and a government own goal.   

Panic selling of government bonds signalling a loss of confidence following Trump’s dramatic tariff boost is reminiscent of the impact of Liz Truss’ sudden and radical UK tax cuts, which were also driven by an ideology, but ended up as a wrecking ball.  Even some of Trump’s backers have warned of an economic nuclear winter.  In the long run, Trump has done the world a favour by highlighting a structural issue that needed correction, but his economically violent methods of addressing it look increasingly unwise.  If a global depression does happen on the back of all this, then coupled with the rise of autocratic and belligerent leadership, we would face a worrying parallel to what happened in the 1930s when the world eventually slid into war.   

Tariffs are like walls, barriers to cooperation and the epitome of economic selfishness.  Make America Great Again is selfishness writ large - a society pursuing wealth and power without the cohesive framework of values that are so essential to cooperation and community wellbeing.  A psychology of self-centredness that damages relationships at the national level.  This is what I find most concerning about Trump’s approach; not just the economics but the long-term legacy of relational damage that could last well beyond his Presidential term. 

Our fears reveal just how much we trust in wealth above everything else, and how much the fear of scarcity affects our mental health.

Michael Schluter in his book The Relational Lens defines five principles, or measures, of relational health.  They are directness, parity, common purpose, continuity and breadth.  Applying those five measures helps us see why Trump’s tariffs are the polar opposite of relational.  He introduced these escalating penalties remotely and not in face-to-face negotiations.  Exploiting the power of America instead of showing respect for the status and needs of other nations.  Tariffs have no common purpose with other countries, only a selfish agenda.  There is no continuity with previous trading protocols.  And it is all purely financial, with no reference to the broader holistic impact.  All in all, a relational disaster.   

Despite living in the ‘first world’ we remain gripped with fear of loss.  Our fears reveal just how much we trust in wealth above everything else, and how much the fear of scarcity affects our mental health. Markets are not entirely rational; they are driven by algorithms that stem from this psychology of greed and fear.  Emotions and trading swing wildly with a herd instinct that often drives behaviour.  As Rabbi Jonathan Sachs said:  

‘Markets have no moral compass; we have outsourced morality to legislation by the State.’   

But the worry now is that the current US administration shows signs of ignoring morality and even riding roughshod over the courts.  No wonder people feel afraid. 

Where can we find hope in all this turmoil?  Is there a better response than gritted teeth and the mantra: ‘this too shall pass’?  I think so.  There is life beyond the market.  Jesus said: ‘life does not consist in an abundance of possessions.’  We can choose to step back and look at all this with the true perspective that money isn’t everything.  We can cultivate gratitude for what we do have.  We can learn contentment.  Yet I feel for those who have experienced financial loss, and don’t want to minimise the reality of hardship.  In fact, something important and practical all of us who are privileged can and should do is to be vigilant in watching out for those who are poor and disadvantaged.  To look after those with a real need for the basics of life and help them through this tough time when economic disruption could make life even harder.  For those with a faith this is part of working out how our faith makes a positive difference where we are. 

Perhaps the supreme irony of this crisis is President Trump’s insistence that Americans must trust him.  Ironic, because the one thing that his tariff actions seem to have undermined more than anything else is trust.  The trust that is essential to the functioning of both markets and civilisation as a whole.  Face to face discussions must be the way forward now, to rebuild trust and find more nuanced, mutual approaches to solving America’s trade deficit.   

There is one person we can always trust though, and his name is written clearly on the American One Dollar bill.  In God we trust.  Let’s pray that Trump and his America returns to that imperative and turns back to a more Christ centred philosophy of loving our neighbour as ourselves, reflected in more bilateral diplomacy and agreements. 

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