Article
Assisted dying
Comment
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. 

Article
Comment
General Election 24
Politics
5 min read

The tale of two Hindu Prime Ministers

June 4th told a brief but bold story of Modi’s India. July 4th will reveal the mind of the UK.

Rahil is a former Hindu monk, and author of Found By Love. He is a Tutor and Speaker at the Oxford Centre for Christian Apologetics.

official surround an open case containing an electronic voting terminal and cables.
Indian election officials unpack a voting machine.
@BruceDGilley on X.

After 44 days of voting across India, 640 million people entered 5.5 million election booths to choose who would be their next Prime Minister.  

Finally, on June 4th the result was announced, and India had chosen the devout Hindu incumbent PM Narendra Modi.  

But wait for the twist! Mr Modi announced way ahead of the elections that his ruling BJP party would win a significant majority of 400 seats out of the 543 in the Lower House. Many of the pollsters felt this was possible, among them Axis My India, the country’s most prominent polling company. Data-driven pollsters and an action-filled mass-media told the world that Mr Modi would have his thumping majority for a third consecutive term. Bafflingly not… 

When the results were counted on June 4th it turned out that Mr Modi’s BJP managed a disappointing 292 seats, dropping it short of the majority needed to continue the status quo of Indian governance.  

Pradeep Gupta, Founder and CEO of Axis My India, wept in front of media cameras, revealing to the hundreds of millions of voters that even after accurately predicting so many national and state elections, he can also get things terribly wrong.  

The world media was largely shocked but couldn’t hide its glee. The Economist told readers on its front cover that Modi’s ethno-nationalist shortfall was a “triumph for democracy.” The Financial Times told its readers that Modi was “weakened”, and other headlines across the globe revealed that even the “most popular world leader” can be humbled. 

Even though it was startling to most of those who kept an eye on this mammoth undertaking of democracy I was strikingly surprised to notice that no one claimed that the election was “rigged” or that there was “Russian interference” (or Chinese in the case of India)! It was simply accepted…alliances were struck and, within a day, 1.4 billion people in India moved ahead with Mr. Modi still as its PM, now heading the National Democratic Alliance parliamentary grouping. The smoothness of the political system after such a seismic surprise is quite astonishing to a “westerner” like me. In our “sophisticated” part of the world we seem to be confused as to who has won an election or even a referendum for that matter. 

“Democracy” to many millions in India simply means, “elections” and in some towns and cities people queued for six hours to vote. 

Mr Modi lost in the city of Ayodhya! This is where he consecrated the controversial Hindu temple on top of the ruins of a sixteenth century mosque that Hindu nationalists demolished in 1990. A disapproval by the people of the Hindu hub of Ayodhya is like saying that the Taliban have now decided to wave the rainbow flag… or that the state of Texas is now officially going full on vegan. 

It’s interesting that no politician or media outlet echoed the chants and mantras of western elections or referendums in recent years and roared, “the people don’t know what they’ve voted for…so let’s do the vote again!” Quite strange for a nation whose GDP per capita is only $2,300… 

350 million people in India live below the poverty line and I would go as far as to argue that 450 million of its inhabitants do not even know what the United Nations is let alone what it stands for. “Democracy” to many millions in India simply means, “elections” and in some towns and cities people queued for six hours to vote. Human Rights, Freedom of Expression or Religion are alien ideas when all you need is a meal.  

It is humbling not just for Narendra Modi as the mass media have said in the west but even for keen observers here such as myself. That’s the first lesson. 

The second lesson from this stunning outcome is to never ignore the people you think you can easily ignore… 

It was the poor (even Hindus) whose homes were blatantly demolished to build the Hindu Temple in Ayodhya that went against Mr Modi. It was the farmers who protested for months for their financial security that decided that their leader is not really a man of the commoner but of the corporates. At least that’s the image Mr Modi gave them. About 55 per cent of India’s population receives an income related to the agriculture industry.  

Finally, the Dalit (lowest caste) community didn’t vote the way the BJP expected. Even though their PM is from the lower Ghanchi caste they didn’t see in him any action suggesting that he is one of them. 

At the beginning of his decade of rule Mr Modi cunningly utilised the fact that he is from a low caste background, a simple tea-selling family and not educated at Oxford or Stanford. And it worked. 

But now the very people he cast a net over are beginning to peer through his fickle facade. “The axe convinced the trees in the forest that because its handle was made of wood it was one of them” is a Turkish proverb that comes to mind. Eventually, the trees catch on. When you fool people time and again, eventually they get the antibodies.  

UK Prime Minister Sunak is also a devout Hindu who often uses the Hindu term dharma when he talks about ‘duty to his nation.’ And yet he is quite the opposite on many other accounts. Sunak is from a very educated and wealthy background. He went to Winchester School and then on to Oxford and ran a hedge fund before entering politics. He is liked by many world leaders and admired by HM Treasury, the government department he used to run. A ‘technocrat’ in every sense of the word and yet he is facing the same doubts and demands from the electorate – about integrity. I do not wish to isolate PM Sunak on the integrity chart but leaders and those with tall responsibilities attract a higher demand. Wisdom in the Christian Bible says, “to whom much is given, much will be required.”  

June 4th told a brief and bold story of PM Narendra Modi’s India. July 4th will reveal the mind of the United Kingdom. How will we treat the people or politicians we disagree with? Dutch theologian and professor Benno Van Den Toren once told me that the minute you laugh at an idea you disagree with, is the exact moment you lose access to understanding what the individual or idea is trying to say. Will we seek to understand? Or simply win? The ruling class in India won for a decade whilst ignoring their opponents and as a result eventually lost their majority. As important as the result on July 4th in the UK is what happens after, how we steer our hearts and treat those who didn't vote as we did.  

That is the humbling lesson to learn from the 640 million voters of India.