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Assisted dying
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Life & Death
5 min read

The careless conflation of independence, autonomy and dignity

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

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Education
Leading
5 min read

Why I teach over my students’ heads

Successful teaching is a work of empathy that stretches the mind.
A blackboard covered in chalk writing and highlights.
James's chalkboard.

I’ve been teaching college students for almost 30 years now. As much as I grumble during grading season, it is a pretty incredible way to make a living. I remain grateful. 

I am not the most creative pedagogue. My preference is still chalk, but I can live with a whiteboard (multiple colors of chalk or markers are a must). Over the course of 100 minutes, various worlds emerge that I couldn’t have anticipated before I walked into class that morning. (I take photos of what emerges so I can remember how to examine the students later.) I think there is something important about students seeing ideas—and their connections—unfold in “real time,” so to speak.  

I’ve never created a PowerPoint slide for a class. I put few things on Moodle, and only because my university requires it. I’ve heard people who use “clickers” in class and I have no idea what they mean. I find myself skeptical whenever administrators talk about “high impact” teaching practices (listening to lectures produced the likes of Hegel and Hannah Arendt; what have our bright shiny pedagogical tricks produced?). I am old and curmudgeonly about such “progress.”  

But I care deeply about teaching and learning. I still get butterflies before every single class. I think (hope!) that’s because I have a sense of what’s at stake in this vocation.  

I am probably most myself in a classroom. As much as I love research, and imagine myself a writer, the exploratory work of teaching is a crucial laboratory for both. I love making ideas come alive for students—especially when students are awakened by such reflection and grappling with challenging texts. You see the gears grinding. You see the brow furrowing. Every once in a while, you sense the reticence and resistance to an insight that unsettles prior biases or assumptions; but the resistance is a sign of getting it. And then you see the light dawn. I’m a sucker for that spectacle.  

This is how the hunger sets in. If you can invite a student to care about the questions, to grasp their import, and experience the unique joy of joining the conversation that is philosophy. 

Successful teaching is, fundamentally, a work of empathy. As a teacher, you have to try to remember your way back into not knowing what you now take for granted. You have to re-enter a student’s puzzlement, or even apathy, to try to catalyze questions and curiosity. Because I teach philosophy, my aim is nothing less than existential engagement. I’m not trying to teach them how to write code or design a bridge; I’m trying to get them to envision a different way to live. But, for me, it’s impossible to separate the philosophical project from the history of philosophy: to do philosophy is to join the long conversation that is the history of philosophy. So we are always wresting with challenging, unfamiliar texts that arrive from other times that might as well be other planets for students in the twenty-first century.  

So successful teaching requires a beginner’s mindset on the part of the teacher, a charitable capacity to remember what ignorance (in the technical sense) feels like. To do so without condescension is absolutely crucial if teaching is going to be an art of invitation rather than an act of alienation. (The latter, I fear, is more common than we might guess.) 

Such empathy means meeting students where they are. But successful teaching is also about stretching students’ minds and imaginations into new territory and unfamiliar habits of mind. This is where I find myself especially skeptical of pedagogical developments that, to my eyes, run the risk of infantilizing college students. (I remember a workshop in which a “pedagogical expert” explained that the short attention span of students required changing the PowerPoint slide every 8 seconds. This does not sound like a recipe for making students more human, I confess.) 

That’s why I am unapologetic about trying to teach over my students’ heads. I don’t mean, of course, that I’m satisfied with spouting lectures that elude their comprehension. That would violate the fundamental rule of empathy. But such empathy—meeting students where they are—is not mutually exclusive with also inviting them into intellectual worlds and conversations where they won’t comprehend everything.  

This is how the hunger sets in. If you can invite a student to care about the questions, to grasp their import, and experience the unique joy of joining the conversation that is philosophy, then part of the thrill, I think, is being admitted into a world where you don’t “get” everything.  

This gambit—every once in a while, talking about ideas and thinkers as if students should know them—is, I maintain, still an act of empathy.

When I’m teaching, I think of this in a couple of ways. At the same time that I am trying to make core ideas and concepts accessible and understandable, I don’t regret talking about attendant ideas and concepts that will, to this point, still elude students. For the sharpest students, this registers as something to learn, something to be curious about. Or sometimes when we’re focused on, say, Pascal or Hegel, I’ll plant little verbal footnotes—tiny digressions about how Hannah Arendt engaged their work in the 20th century, or how O.K. Bouwsma’s reading of Anselm is akin to something we’re talking about. The vast majority of students won’t be familiar with either, but it’s another indicator of how big and rich and complicated the intellectual cosmos of philosophy is. For some of these students (not all, certainly), this becomes tantalizing: they want to become the kind of people for whom a vast constellation of ideas and thinkers are as familiar and present as their friends and cousins. This becomes a hunger to belong to such a world, to join such a conversation.  

This gambit—every once in a while, talking about ideas and thinkers as if students should know them—is, I maintain, still an act of empathy. To both meet students where they are and, at the same time, teach “over their heads,” is an invitation to stretch into new terrain and thereby swell the soul into the fullness for which it was made. The things that skitter just over their heads won’t be on the exam, of course; but I’m hoping they’ll chase some of them for a lifetime to come. 

  

This article was originally published on James K A Smith’s Substack Quid Amo.