Polly's pop at a "pitiless God" distorts my argument

There’s more than one argument for opposing assisted dying.

George Pitcher

George is a visiting fellow at the London School of Economics and an Anglican priest.

A hand rest gently on another outstretched hand.

Alexander Grey on Unsplash.

I hesitate to have a pop at the venerable Guardian columnist Polly Toynbee, partly because I like and admire her work. And partly, in this new media environment in which my enemy’s friend is my troll, I fear aligning myself with foam-flecked righties who use words like “Guardianista” and “wokerati”.

But she wrote a column late last week about assisted suicide that was just plain wrong. And, actually, I think she’s being profoundly illiberal on the subject, for reasons I’ll explain in a moment.

Assisted suicide – voluntary euthanasia, assisted dying, call it what you will – was a hobby horse of mine some 15 years ago when I wrote a book against it. Slightly more recently, Toynbee and I were on a broadcast interview together on an entirely unrelated subject when, to the bemusement of the presenter, she suddenly raised assisted dying to have a go at me. It was quite flattering.

Anyway, last week’s Toynbee column was of a kind, dismissing the anti-euthanasia case as the province of religious nutcases (presumably like me). Consider this massive straw man of a sentence: “Only God can decide how long we should suffer before death comes at a time of his pitiless whim, they say.”

I’m used to this, though not from Toynbee. Debating assisted suicide, it’s only a matter of minutes before someone will say that I shouldn’t impose my “sanctity of life” beliefs on other people. Eh? I’ve never used that phrase in this context (whatever it may mean). In fact, my views on assisted suicide are entirely secular, though informed by a faith that respects the primacy of compassion for and defence of the most vulnerable in our society.

I believe that a jurisdiction that enshrines in its legislature the principle that some lives are more worth living than others takes us into very dangerous moral territory. Related to that, a two-tier structure for the value of human life in the medical professions is abhorrent. That’s why I say that to despatch the weakest and most vulnerable among us is unacceptably illiberal.

The terminally ill, the disabled, the profoundly depressed and the aged and vulnerable really shouldn’t be treated as a nuisance to be helped on their way.

A bill will come back to parliament to change the law to allow assisted suicide this autumn. With new PM Keir Starmer in favour and a very different configuration of the House of Commons post-election, its chances of passing are said to be high.

But even Lord Falconer, the parliamentary poster-boy for assisted suicide, who convened a ludicrous “independent” commission in 2012 stuffed with euthanasia enthusiasts and useful idiots, has accepted that no so-called safeguards can entirely ensure that no lives will be lost to malfeasance or malpractice.

So, my question to Falconer and Toynbee is this: How many unnecessary lives lost to assisted suicide is enough to have what you want? 100? 50? One? Another number?

It’s commonplace for deeply distressing accounts of agonising deaths to be rehearsed in support of assisted suicide. Toynbee did so last week. But as Falconer must (or should) know, hard cases make bad law. The only focus here should be on how best to ensure that no one need die a bad death.

For Falconer and his supporters the solution is to legislate so that terminally ill patients can be helped to kill themselves. But speaking to end-of-life medical professionals, such as Baroness Finlay of Llandaff, many of whom claim that advances now mean that bad deaths are vanishingly few, it’s clear that the UK’s world-leading palliative care has in sight the day when no one need die a bad death.

That’s no comfort to someone who is suffering at the end of their life right now. But assisted suicide puts that palliative care target in jeopardy, when it makes death a form of medical treatment. Look at the record – the Netherlands now allows assisted suicide for those who are simply “tired of life”. That’s not where end-of-life care should go.

The burden of proof under the Suicide Act (1961) lies with the defendant, who currently faces a maximum jail sentence of 14 years for assisting or encouraging a suicide. Those who have demonstrated that they have acted with compassion and consent have in turn been treated with compassion and leniency in the application of the law. Invert that burden of proof, with the Crown needing to prove that an unscrupulous relative or friend coerced a victim into suicide, and we’re into a fresh hell of moral jeopardy.

The law works as it stands. The terminally ill, the disabled, the profoundly depressed and the aged and vulnerable really shouldn’t be treated as a nuisance to be helped on their way. Again, as we might expect Toynbee to know, that is wholly illiberal.

It looks like the assisted suicide lobby will get what they want this year. It will be hailed as a great liberal social reform. Doubtless they will find it in their hearts to forgive me if I continue to demur.

Article

Care

Comment

Economics

Ethics

2 December 2024

4 min read

NHS: How far do we go to feed the sacred system?

Balancing safeguards and economic expediencies after the assisted dying vote.

Callum Elwood

Callum is a pastor, based on a barge, in London's Docklands.

A patient eye view of six surgeons looking down.

National Cancer Institute via Unsplash.

“Die cheaply, protect the NHS” It sounds extreme, but it could become an unspoken policy. With MPs voting on 29th November to advance the assisted dying bill, Britain stands at a crossroads. Framed as a compassionate choice for the terminally ill, the bill raises profound ethical, societal, and economic concerns. In a nation where the NHS holds near-sacred status, this legislation risks leading us to a grim reality: lives sacrificed to sustain an overstretched healthcare system.

The passage of this legislation demands vigilance. To avoid human lives being sacrificed at the altar of an insatiable healthcare system, we must confront the potential dangers of assisted dying becoming an economic expedient cloaked in compassion.

The NHS has been part of British identity since its founding, offering universal care, free at the point of use. To be clear, this is a good thing—extraordinary levels of medical care are accessible to all, regardless of income. When my wife needed medical intervention while in labour, the NHS ensured we were not left with an unpayable bill.

Yet the NHS is more than a healthcare system; it has become a cultural icon. During the COVID-19 pandemic, it was elevated to near-religious status with weekly clapping, rainbow posters, and public declarations of loyalty. To criticise or call for reform often invites accusations of cruelty or inhumanity. A 2020 Ipsos MORI poll found that 74 per cent of Britons cited the NHS as a source of pride, more than any other institution.

However, the NHS’s demands continue to grow: waiting lists stretch ever longer, staff are overworked and underpaid, and funding is perpetually under strain. Like any idol, it demands sacrifices to sustain its appetite. In this context, the introduction of assisted dying legislation raises troubling questions about how far society might go to feed this sacred system.

Supporters of the Assisted Dying Bill argue that it will remain limited to exceptional cases, governed by strict safeguards. However, international evidence suggests otherwise.

In Belgium, the number of euthanasia cases rose by 267 per cent in less than a decade, with 2,656 cases in 2019 compared to 954 in 2010. Increasingly, these cases involve patients with psychiatric disorders or non-terminal illnesses. Canada has seen similar trends since legalising medical assistance in dying (MAiD) in 2016. By 2021, over 10,000 people had opted for MAiD, with eligibility expanding to include individuals with disabilities, mental health conditions, and even financial hardships.

The argument for safeguards is hardly reassuring, history shows they are often eroded over time. In Belgium and Canada, assisted dying has evolved from a last resort for the terminally ill to an option offered to the vulnerable and struggling. This raises an urgent question: how do we ensure Britain doesn’t follow this trajectory?

The NHS is under immense strain. With limited resources and growing demand, the temptation to frame assisted dying as an economic solution is real. While supporters present the legislation as compassionate, the potential for financial incentives to influence its application cannot be ignored.

Healthcare systems exist to uphold human dignity, not reduce life to an economic equation.

Consider a scenario: you are diagnosed with a complex, long-term, ultimately terminal illness. Option one involves intricate surgery, a lengthy hospital stay, and gruelling physiotherapy. The risks are high, the recovery tough, life not significantly lengthened, and the costs significant. Opting for this could be perceived as selfish—haven’t you heard how overstretched the NHS is? Don’t you care about real emergencies? Option two offers a "dignified" exit: assisted dying. It spares NHS resources and relieves your family of the burden of prolonged care. What starts as a choice may soon feel like an obligation for the vulnerable, elderly, or disabled—those who might already feel they are a financial or emotional burden.

This economic argument is unspoken but undeniable. When a system is stretched to breaking point, compassion risks becoming a convenient cloak for expedience.

The Assisted Dying Bill marks a critical moment for Britain. If passed into law, as now seems inevitable, it could redefine not only how we view healthcare but how we value life itself. To prevent this legislation from becoming a slippery slope, we must remain vigilant against the erosion of safeguards and the pressure of economic incentives.

At the same time, we must reassess our relationship with the NHS. It must no longer occupy a place of unquestioning reverence. Instead, we should view it with a balance of admiration and accountability. Reforming the NHS isn’t about dismantling it but ensuring it serves its true purpose: to protect life, not demand it.

Healthcare systems exist to uphold human dignity, not reduce life to an economic equation. If we continue to treat the NHS as sacred, the costs—moral, spiritual, and human—will become unbearable.

This moment requires courage: the courage to confront economic realities without compromising our moral foundations. As a society, we must advocate for policies that prioritise care, defend the vulnerable, and resist the reduction of life to an equation. Sacrifices will always be necessary in a healthcare system, but they must be sacrifices of commitment to care, not lives surrendered to convenience.

The path forward demands thoughtful reform and a collective reimagining of our values. If we value dignity and compassion, we must ensure that they remain more than rhetoric—they must be the principles that guide our every decision.