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.

Conviction politics is changing morality

Political dialogue gives way to animal-like culture war.

Barnabas Aspray

Barnabas Aspray is Assistant Professor of Systematic Theology at St Mary’s Seminary and University.

A severed doll head, resembling Donald Trump, lies on dirty ground.

Max Letek on Unsplash.

“We're gathering 100 MILLION signatures to OVERTURN Trump's wrongful conviction!”

I received this SMS message, along with a link, on Monday 10th June. It was the fourth message of its kind I’d received since the verdict convicting former US President Donald Trump of felony. This time, out of curiosity I followed the link. I found a lot of words in capital letters conveying a sense of extreme urgency, but I did not find any evidence or argument for the injustice of the verdict.

Trump’s conviction has been met with a torrent of reactions from people across the political spectrum. Everyone sees the event as an episode in the upcoming US election in which Trump plans to run for president. For those on the left, it’s final and conclusive proof that he is unfit for office; the evidence is clear, the courts have decided, end of story. For those on the right, it’s a further sign of the depraved depths to which the Democrats will go to discredit him; the jury was rigged, and the whole thing was a political stunt to win the election. The legitimacy of the court ruling is something nobody on the left questions and nobody on the right admits.

To me, these responses are another sign of the ever-widening gap between left and right that eats up all common ground, even the rule of law. Political victory now takes priority over truth or justice – or perhaps more accurately: victory for my side is identical with truth and justice. To concede anything to the opposing side is seen, not as praiseworthy, but as betrayal.

My comments in what follows are nonpartisan: I want to point to what is true of both sides equally: the failure of dialogue and its replacement by a warfare mentality. This change affects even what we consider moral and admirable behaviour. It is not only a problem in the US. Ever since Brexit, things have become increasingly polarised in the UK as well.

That is what “culture war” means. War and dialogue are opposites; war is what happens when dialogue has failed.

Formerly in Western nations, rival political parties offered different means to achieve the same end: a flourishing society of justice, peace, prosperity, and freedom. Politicians disagreed but they respected each other. They had faith in the political process in which they all participated. Consider as an example the letter George Bush Senior left Bill Clinton after losing the 1992 US election.

“Your success now is our country’s success,” he wrote. “I am rooting hard for you. Good luck.”

The fact that he was now president was more important than which political party he belonged to.

In such a cohesive society, the legal system was a trusted arbitrator whose decisions would be accepted by victor and loser alike. This does not mean the system was perfect. Everyone knew that justice could sometimes miscarry. But the public did not see themselves as qualified to judge that either way. How could they expect to know more than the jury?

What we are witnessing now is a return to a more animal-like state in which the goal is that my team wins no matter what. If the arbitrator rules in favour of my tribe, they are seen as executing justice. If they rule against my tribe, their ruling must by definition be unjust.

That is what “culture war” means. War and dialogue are opposites; war is what happens when dialogue has failed because both sides have been unable even to “agree to disagree.”

Reasoned debate is seen as no longer effective in light of the vile underhanded tactics of the other side (but not, of course, of my side).

In dialogue, both sides aim to uncover the truth even if the truth turns out not to be what I wanted or thought. Prioritizing the truth means that I might realise I was wrong and concede the point, even at some material cost. For example, in a property dispute, I might become persuaded of the truth of my opponent’s case and give up my claim. That may be painful, but winning was less important than justice being done. In dialogue, both ‘sides’ are really on the same side because they both ultimately want the same thing.

In war, on the other hand, the goal is to defeat the enemy and it makes no difference whether they are right or wrong – or rather, it is assumed without question that they are wrong. If words are used in war, they are weapons in disguise, not meaningful communications.

This transformation from dialogue to war changes morality itself. You are now judged, not by the sincerity of your pursuit of truth, but by how loyal you are to your tribe. Even to take seriously the opposing position is viewed like reading a propaganda flyer dropped from a Nazi airplane: don’t even read it, it will only twist your mind!

Even seven years ago, fans of Jordan Peterson were fond of the phrase “all I want is to have a reasoned debate.” Regardless of your opinion of Peterson or of whether he exemplified this, those who used this phrase revealed a desire for dialogue rather than war. But today, many of those same followers no longer say that. Now they say, “the left is out to get us and must be stopped” and their counterparts say, “the right is out to get us and must be stopped.” Reasoned debate is seen as no longer effective in light of the vile underhanded tactics of the other side (but not, of course, of my side).

What do we want from our political opponents? We want them to listen to us and to take our arguments seriously.

What role can Christianity have in this polarised society? Sadly Christians are often seen as part of the problem rather than the solution: sold out to one political party. But we should be clear that Christianity does not sit neatly on either side of the divide. That does not mean Christians should be moderate or “centrist,” as if none of the issues matter much. Christianity comes down strongly on many things, but those are spread across the political spectrum. The way Christians vote depends on which issues they judge to be the most important or pressing in the current circumstances.

Second, Christians are called to make peace in time of war. “Blessed are the peacemakers,” Jesus said, “for they will be called children of God.” Christians are called build bridges rather than burn them, to seek common ground rather than trying to obliterate their opponents. This can start with showing love and respect for the person behind the argument; by celebrating our common humanity before trying to argue a point.

Third, it means exemplifying the kind of attitude we want to see in our opponents. “In everything do to others as you would have them do to you,” Jesus told his disciples. What do we want from our political opponents? We want them to listen to us and to take our arguments seriously. We want them to stop making cheap caricatures of us and represent us at our best. We want them to break out of their echo chambers and read news from a variety of political leanings. We want them to open themselves to persuasion and be prepared to change their minds. Jesus suggests leading by example and doing those things first.

Fourth and finally, the Christian’s allegiance is to truth and justice above any tribe, any agenda. The real political situation is almost certainly complex, with much to be said for and against both sides. There are awkward facts that don’t fit our own political position; let’s admit them. The Christian commitment to truth means being ready to acknowledge the weaknesses, failings, and faults on our own side before we point the finger. It’s hard, I know. I am not perfect at it myself. But it’s a more Christlike moral standard to aim for than that of the culture warrior who excels at demolishing the enemy.

Restoring dialogue won’t be easy and may come at a high personal cost. But the cost is greater if we don’t try. My own desire is to see Christians taking the lead in the restoration process and showing the world what Christlike peacemaking can accomplish.