Article
Assisted dying
Care
Comment
Death & life
Suffering
5 min read

Why end of life agony is not a good reason to allow death on demand

Assisted dying and the unintended consequences of compassion.

Graham is the Director of the Centre for Cultural Witness and a former Bishop of Kensington.

A open hand hold a pill.
Towfiqu Barbhuiya on Unsplash.

Those advocating Assisted Dying really have only one strong argument on their side – the argument from compassion. People who have seen relatives dying in extreme pain and discomfort understandably want to avoid that scenario. Surely the best way is to allow assisted dying as an early way out for such people to avoid the agony that such a death involves?  

Now it’s a powerful argument. To be honest I can’t say what I would feel if I faced such a death, or if I had to watch a loved one go through such an ordeal. All the same, there are good reasons to hold back from legalising assisted dying even in the face of distress at the prospect of enduring or having to watch a painful and agonising death.  

In any legislation, you have to bear in mind unintended consequences. A law may benefit one particular group, but have knock-on effects for another group, or wider social implications that are profoundly harmful. Few laws benefit everyone, so lawmakers have to make difficult decisions balancing the rights and benefits of different groups of people. 

It feels odd to be citing percentages and numbers faced with something so elemental and personal and death and suffering, but it is estimated that around two per cent of us will die in extreme pain and discomfort. Add in the 'safeguards' this bill proposes (a person must be suffering from a terminal disease with fewer than six months to live, capable of making such a decision, with two doctors and a judge to approve it) and the number of people this directly affects becomes really quite small. Much as we all sympathise and feel the force of stories of agonising suffering - and of course, every individual matters - to put it bluntly, is it right to entertain the knock-on effects on other groups in society and to make such a fundamental shift in our moral landscape, for the sake of the small number of us who will face this dreadful prospect? Reading the personal stories of those who have endured extreme pain as they approached death, or those who have to watch over ones do so is heart-rending - yet are they enough on their own to sanction a change to the law? 

Much has been made of the subtle pressure put upon elderly or disabled people to end it all, to stop being a burden on others. I have argued elsewhere on Seen and Unseen that that numerous elderly people will feel a moral obligation to safeguard the family inheritance by choosing an early death rather than spend the family fortune on end of life care, or turning their kids into carers for their elderly parents. Individual choice for those who face end of life pain unintentionally  lands an unenviable and unfair choice on many more vulnerable people in our society. Giles Fraser describes the indirect pressure well: 

“You can say “think of the children” with the tiniest inflection of the voice, make the subtlest of reference to money worries. We communicate with each other, often most powerfully, through almost imperceptible gestures of body language and facial expression. No legal safeguard on earth can detect such subliminal messaging.” 

There is also plenty of testimony that suggests that even with constant pain, life is still worth living. Michelle Anna-Moffatt writes movingly  of her brush with assisted suicide and why she pulled back from it, despite living life in constant pain.  

Once we have blurred the line between a carer offering a drink to relieve thirst and effectively killing them, a moral line has been crossed that should make us shudder. 

Despite the safeguards mentioned above, the move towards death on the NHS is bound to lead to a slippery slope – extending the right to die to wider groups with lesser obvious needs. As I wrote in The Times recently, given the grounds on which the case for change is being made – the priority of individual choice – there are no logical grounds for denying the right to die of anyone who chooses that option, regardless of their reasons. If a teenager going through a bout of depression, or a homeless person who cannot see a way out of their situation chooses to end it all, and their choice is absolute, on what grounds could we stop them? Once we have based our ethics on this territory, the slippery slope is not just likely, it is inevitable.  

Then there is the radical shift to our moral landscape. A disabled campaigner argues that asking for someone to help her to die “is no different for me than asking my caregiver to help me on the toilet, or to give me a shower, or a drink, or to help me to eat.” Sorry - but it is different, and we know it. Once we have blurred the line between a carer offering a drink to relieve thirst and effectively killing them, a moral line has been crossed that should make us shudder.  

In Canada, many doctors refuse, or don’t have time to administer the fatal dose so companies have sprung up, offering ‘medical professionals’ to come round with the syringe to finish you off. In other words, companies make money out of killing people. It is the commodification of death. When we have got to that point, you know we have wandered from the path somewhere.  

You would have to be stony-hearted indeed not to feel the force of the argument to avoid pain-filled deaths. Yet is a change to benefit such people worth the radical shift of moral value, the knock-on effects on vulnerable people who will come under pressure to die before their time, the move towards death on demand?  

Surely there are better ways to approach this? Doctors can decide to cease treatment to enable a natural death to take its course, or increase painkillers that will may hasten death - that is humane and falls on the right side of the line of treatment as it is done primarily to relieve pain, not to kill. Christian faith does not argue that life is to be preserved at any cost – our belief in martyrdom gives the lie to that. More importantly, a renewed effort to invest in palliative care and improved anaesthetics will surely reduce such deaths in the longer term. These approaches are surely much wiser and less impactful on the large numbers of vulnerable people in our society than the drastic step of legalising killing on the NHS. 

Explainer
Creed
Death & life
Monsters
Paganism
5 min read

Will the owner of ‘Halloween’ please come and collect it?

A mutant festival of saints, spirits, and supermarket costumes resists belonging to anyone
A witch, a priest and a druid stand in a store and look quizzically towards a halloween pumpkin
Nick Jones, Midjourney.ai

The trouble with modern Halloween is that it’s hard to say who it really belongs to. Our contemporary public holiday – 31 October, when people dress up as skeletons, light jack-o-lanterns, and go ‘trick-or-treating’ – has a few prospective owners.  

Perhaps Christians could claim it. The term “Halloween” is a shortening of ‘All Hallow’s Eve’, which is the day before All Saint’s Day (1 November) in the Church calendar.  

But this doesn’t fit with a few things. Don’t Christians dislike all that dressing up as evil spirits, and summoning up misrule and revelry? Instead, the case is made for a pagan ownership of Halloween: it was all due to a Celtic festival called Samhain (pronounced ‘sow-in’). This was a day for appeasing evil spirits, contacting the dead, and acts of mischief – all better fits for modern Halloween, surely? 

Sadly, we just don’t know enough about Samhain to say. We only have evidence about it from centuries after the Christian era, and in limited scraps like: “Samhain, when the summer goes to its rest”. It is unlikely the Christians invented this, to be sure – but none of the data tells us how it was celebrated.  

In fact, there is no evidence at all that All Saints Day was a churchy attempt to ‘take over’ a pre-existing pagan festival. From the get-go, Christians commemorated their dead on the basis that they were still alive in heaven, and able to bring prayers to God. A quick peek at the Book of Revelation (the final book of the Bible) gives a behind-the-curtain look: “and the smoke of the incense, with the prayers of the saints, rose before God from the hand of the angel”.  

Over time, it became more official which ‘holy ones’, or saints, should be honoured at which times. This was not about making dead Christians into gods, though. A famous theologian called St Augustine explains the proper view of the early Christians as they kept hold of bones and clothing from their dead: “We do not build temples, and ordain priests, rites, and sacrifices for these same martyrs; for they are not our gods, but their God is our God”.  

Gradually, a date was set to celebrate all those great men and women in heaven – from this came All Saints, or All Hallows Day. A tradition in northern Europe set this on the 1 November: “As a jewel worn on the brow sparkles time and again, so November at its beginning is resplendent with the praise given to all the saints” reports an English calendar from around 800AD.  

It is all well and good celebrating those who have made it to heaven. But what about the majority of Christians? Those who had died unrepentant and lukewarm – what on earth could be done for them? Here came another separate development: offering prayers and worship on behalf of those who had died as forgiven sinners, but who were still, if you like, serving their time for their bad choices.  

It gradually became the norm to tack that practice onto the pre-existing All Saints Day, so that the souls of regular Joes could have powerful heavenly intercessors close by. And so, All Souls Day became an established part of the Church’s year too, falling on 2 November.  

 

But here’s the twist. This season of ‘Hallowtide’ (All Saints and All Souls together) carried on for centuries, until England suddenly and violently abandoned it all in the sixteenth century. Seemingly overnight, the Reformations of the Tudor monarchs ended All Souls Day by scrapping all mention of a purgatory for the dead, and attempts to pray for them there. All Saints Day limped on in the new Established Religion as a remembrance of Christian exemplars – but they were not to be thought of as in radio contact from heaven anymore.  

Some people tried to carry on as usual, in illicit gatherings on hilltops, where they would burn straw, and gather to ask for help from great saints and pray for loved ones. But the majority followed the new religious settlement and tried to forge new communal rituals as best they could. The night still had a ‘supernatural’ afterglow thanks to centuries of the now-absent All Saints and All Souls. 

Then, in the nineteenth century, there was a comeback. Irish immigration to the USA and Great Britain plonked a fully formed Hallowtide into English-speaking culture again. It took like a duck to water. Perhaps this was to be expected. Here was a civilisation which had been rapidly deprived of its ordinary way of expressing connection to their deceased loved ones, as well as a sense of protection from heavenly guardians. They were clearly starving for some way to communicate feelings about ‘the beyond’, and to find hope in the darkening, colder days.  

‘Halloween’, really a modern döppleganger of All Hallow’s Eve, quickly became a popular national custom – a world custom, indeed, due to US influence. It took from Christianity that otherwordly atmosphere – but it did not jettison any of the customs that had arisen since the Reformation, and which were themselves continuations of folky responses to the coming of Winter; Samhain is almost certainly a part of that background here, even if it is not a direct connection, as we have seen. 

This Halloween mystery has a twist, then. Here is really a mutant of a festival that belongs to no one in particular - and that is the point. One could really call it one of modern pluralistic society’s great achievements. It has taken over management of this eerie season from the church, and arguably made a successful shared custom out of it. On the other hand, it is arguably consumeristic, tacky and frequently immoral: it was only a few years ago that supermarket costumes allowing people to dress as ‘mentally ill’ showcased this shallowness. 

So, as a Christian, I have some regrets that Christianity does not really ‘own’ modern Halloween, anymore. Because the original All Hallows, as well as All Souls, seem to me to be a historic high point of confidence about our human fate. Here was a whole civilisation that seemed to announce to itself, every November, that death, human wickedness, and the Devil, were not in charge here – those who had died in Christ were now more fully alive; that no one is so beyond hope that they are not worth praying for. The darkening nights and colder air must have seemed less daunting to them.  

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