The careless conflation of independence, autonomy and dignity

As Jersey begins to legalise assisted dying, there’s keyword confusion.

Henna Cundill

Henna is a researcher with the Centre for Autism and Theology at the University of Aberdeen.

A elderly women in a care home stands and places her hands on the shoulders of a seated woman.

Eberhard Grossgasteiger on Unsplash.

Reviewing Canada’s legislation on assisted dying, one anonymously authored article raises the concern: “Does it make dying with dignity easier than living with dignity?” This insightful question cuts to the centre of the debate: dignity. Or more particularly, the unwitting conflation of dignity with independence, and of independence with autonomy.

As Jersey becomes the first place in the British Isles to begin the process of legalising assisted dying, I feel that we should listen carefully as to how and where these terms are being used, both in the formal debate, and in the commentary that surrounds it. The States Assembly in Jersey voted to allow the development of assisted dying legislation for those with six months to live (or twelve months if their condition is neurodegenerative). A second vote to make assisted dying available more broadly to those who experience conditions that entail “unbearable suffering” was defeated by a narrower margin. Reading the flurry of press releases that followed the vote, these keywords, autonomy, independence, and dignity, are everywhere. But are we really thinking about what these words communicate?

People in positions of wealth and power have more independence and autonomy, more choices and freedoms, but it is we who ascribe dignity to those in that position.

The word dignity comes from the Latin word dignus, meaning ‘worthy’, and this is still the primary definition given to the English word dignity today. The OED has it as “the quality of being worthy or honourable”, immediately followed by reference to “honourable or high estate”. If this is so, then dignity is not something that can be bought, nor assumed – it is a status conferred upon someone by the esteem in which other people hold them. The haughtiest person in the world can still be esteemed undignified, as can the richest. Moreover, the opposite is also true: we are never prevented from conferring dignity upon, and esteeming the worthiness of, those who live the humblest of lives.

And yet, if we are honest with ourselves – do many of us not quietly associate the idea of becoming rich and powerful with becoming dignified? Do we not tend to assume the worthiness of those in high office – at least until we meet them and realise pretty quickly that they all put their trousers on one leg at a time, the same as the rest of us. This association happens because we have such a tendency to conflate dignity with independence (the ability to live without assistance from others) and autonomy (the ability to make one’s own decisions, and not have those decisions limited or interfered with). People in positions of wealth and power have more independence and autonomy, more choices and freedoms, but it is we who ascribe dignity to those in that position. It is society who sees the autonomy of those in high status, and esteems it as dignified.

Does this not unwittingly suggest that choosing to live in a state of extreme dependence on palliative care is, by implication, undignified?

Repeatedly ancient wisdom, in the bible, warns us not to assume that dignity comes with the freedom of wealth or power. All the great ‘heroes’ of that book suffer their indignities. Fresh from the success of his Ark project, Noah gets drunk and exposes himself. Elated from a victory against an enemy, King David dances half-naked through the streets. These are just two examples of the catalogue of embarrassments and mishaps that beset nearly all the kings and leaders whose stories are told as part of the Christian story. One after another, they stumble and struggle with life and leadership. The apostle Paul explains that this is because God uses the foolish things of this world to shame human pride, “for even the foolishness of God is still wiser than human wisdom.” Therefore, Paul argues, God chooses to speak to us through the weak and the lowly things and people of this world. Never was this demonstrated so clearly as when Jesus was born in a draughty stable, lived a life of poverty, and died a criminal’s death on a cross.

But what has all this to do with the debate over assisted dying? Well, I am struck by how often the idea of losing one’s independence (through disabling or terminal illness) is conflated with losing one’s dignity, and so dying through personal choice (autonomy) is presented as regaining it. One campaign group that speaks to this debate even calls itself ‘Dignity in Dying’ – but does this not unwittingly suggest that choosing to live in a state of extreme dependence on palliative care is, by implication, undignified?

Independence is not possible for everybody, or not possible to the same degree. And dignity? Well, dignity is possible for anyone.

The Dean of Jersey, the Very Reverend Mike Keirle, has spoken of his concern that the change in legislation will make vulnerable people feel pressured to end their lives. Examples from Canada, where physician assisted dying is already available, show that his concern is not unfounded. In 2022, Canadian veteran and Paralympian Christine Gauthier phoned her caseworker to chase up the over-due installation of her new wheelchair ramp. She then describes how she was horrified to find herself being advised to consider assisted dying instead.

"It is remotely just what they're doing,” says Gauthier, “exhausting us to the point of no return. […] I was like, 'Are you serious?' Like that easy, you're going to be helping me to die but you won't help me to live?"

Gauthier is not alone – she spoke out when she learned that four other Canadian veterans had reported similar experiences. In these unhappy moments, one can see how dangerous the assumption can be – the assumption that no one would want to live a life of needing help. Here are disabled people who do want to live, and this assumption, this careless conflation of independence, autonomy, and dignity, leaves them fighting for their right to do so. Why should anyone have to fight or even speak for their right not to commit suicide? It is little wonder that disabled actress, Liz Carr, describes assisted dying legislation as “terrifying” for disabled people.

I respect that there are terminally ill people, and those who love them, who speak from a desire to end their suffering; it is clear that people on all sides of the debate need to have this difficult and emotionally charged conversation. But whatever the eventual outcome in terms of legislation, we must be careful that it is not based on careless assumptions, or on the conflation of one thing with an entirely different other. Independence is not possible for everybody, or not possible to the same degree. And dignity? Well, dignity is possible for anyone – it is a state that can be conferred whenever, and upon whomever society chooses to confer it. Autonomy is the matter in question – we are talking about autonomy in dying. And whatever happens, we should by no means legislate in a way that leaves disabled people esteemed unworthy, left open to the indignity of fighting for their right to live.

Explainer

Art

Culture

Identity

2 August 2024

5 min read

Controversial art: can the critic love their neighbour?

What to do when confronted with contentious culture.

Jonathan Evens

Jonathan is Team Rector for Wickford and Runwell. He is co-author of The Secret Chord, and writes on the arts.

Two people run though a darkened art gallery towards a body lying amongst photography paraphanalia

Audrey Tautou and Tom Hanks, The Da Vinci Code.

Sony Pictures.

In the wake of the controversy over the Olympic opening ceremony, based as it was on a fundamental misunderstanding on the part of Christians as to what was being portrayed, you may be perplexed or confused by the different ways Christians respond to controversial art or media portrayals that are perceived to be an attack on core Christian beliefs. If that is you, here are some thoughts as to why it is that Christians react in a range of different ways.

Our responses are always underpinned by depth of relationship with and commitment to Jesus, the one who has turned our lives upside down and filled us with his Spirit. Our sense of what it is that Jesus has done for us and what it is that relationship with Jesus means to us is the determinative factor affecting our response when we perceive the One we love and who loves us to have been maligned or mocked.

For some, we feel a need to stand with or defend Jesus whenever we perceive that he is under attack, and we have seen that instinctive response apparent in reactions to the Olympic opening ceremony. However, instinctive emotive responses run the risk of pre-empting more reasoned or reflective responses. That has certainly been the case here, as what many Christians perceived to have been a parody of the Last Supper was not actually that at all. Instead, the sequence was a portrayal of the feast of Dionysius, so had nothing to do with the Last Supper at all.

Christians, as here, are often too quick to make allegations of blasphemy without actually understanding what is being portrayed. I have, unfortunately, seen many similar examples within my lifetime. In the 1970’s and 80’s films like Monty Python’s Life of Brian and Martin Scorsese’s The Last Temptation of Christ resulted in thousands of Christians demonstrating outside cinemas, while Christian organisations, like the National Viewer’s and Listener’s Association headed by Mary Whitehouse, lobbied for those films to be banned.

God does not need human beings in order to be defended, particularly from perceived mockery.

However, interestingly, the release of The Da Vinci Code in 2006, although it dealt with similarly controversial material for Christians, did not result in mass protests. Instead, through seeker events, bible studies, websites and booklets, churches encouraged discussion of the issues raised by the film while clearly contesting the claims made about Christ and the Church.

The protests against such films often did not tally with the content of the films themselves and displayed a lack of understanding of them, their stories and meaning. As Richard Burridge, a former Dean of King’s College London, has said of Life of Brian, “those who called for the satire to be banned after its release in 1979 were ‘embarrassingly’ ill-informed and missed a major opportunity to promote the Christian message”. Life of Brian portrayed the followers of religions as unthinking and gullible and the response of Christians to that film reinforced that stereotype.

As a result, the Church had to learn again that the way to counter criticism is not to try to ban or censor it but to engage with it, understand it and accurately counter it. The Da Vinci Code events, bible studies, websites and the like that the Church used to counter the claims made in The Da Vinci Code featured reasoned arguments based on a real understanding of the issues raised, making use of genuine historical findings and opinion to counter those claims. These created a conversation with the wider community that was far more constructive than the kind of knee-jerk reactions we have seen to the opening ceremony of the Olympic Games.

Some of these knee-jerk reactions derive from a sense, in the West, that the dominant place Christianity used to have in society has been eroded leading some to think that our values and beliefs are under threat. This reveals an underlying insecurity which it is surprising to find in those who believe that God is all-powerful and in control of human history. God does not need human beings in order to be defended, particularly from perceived mockery.

Indeed, the reverse is the case, as, in Jesus, God deliberately entered human history to experience human life in all its facets, including real mockery and suffering, to show that such experiences are not defining and can be transcended through love and sacrifice. Such a God does not require those who follow to become defensive themselves when the path of mockery is actually the path to resurrection and renewal.

Cultural comment is as much about love for neighbour as any other aspect of Christian life.

So, what might a more constructive and productive response to controversies entail? Taking time to reflect and to understand what it is we are experiencing would be a much better place to start. The Olympic opening ceremony was a celebration of French culture, which highlighted images from the Louvre in particular. Leonardo da Vinci’s ‘Last Supper’ is in Italy and does not include a blue Dionysius. With some reflection and investigation, that would quickly have become apparent. Similarly, the scene to which Christians objected in The Last Temptation of Christ was just what it said on the tin, the last temptation Jesus faced. It was a temptation that he rejected, and the film was all the more powerful as a depiction of the incarnation as a result.

Then, we can see that what the Christ who embraced human life through the incarnation calls us to is a charitable hermeneutic (how we interpret), when it comes to receiving, understanding and commenting on the culture around us. Cultural comment is as much about love for neighbour as any other aspect of Christian life. Our charitable hermeneutic was summed up for us by St Paul when he wrote of going through life looking for “whatever is true, whatever is honourable, whatever is just, whatever is pure, whatever is pleasing, whatever is commendable”. Sister Wendy Beckett, the cultural commentator who most recently has best exemplified this charitable hermeneutic achieving huge popularity as a result, wrote of “a beautiful secret … that makes all things luminous … a precious gift in this confused and violent world”.

With the beautiful secret of a charitable hermeneutic, we might, perhaps, look again at the Olympic opening ceremony and appreciate the intent of Thomas Jolly, the artistic director behind the ceremony, when he said that religious subversion had never been his intention: “We wanted to talk about diversity. Diversity means being together. We wanted to include everyone, as simple as that.”