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. 

1,000th Article
AI
Creed
Death & life
Digital
6 min read

AI deadbots are no way to cope with grief

The data we leave in the cloud will haunt and deceive those we leave behind.

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

A tarnished humaniod robot rests its head to the side, its LED eyes look to the camera.
Nicholas Fuentes on Unsplash.

What happens to all your data when you die? Over the years, like most people, I've produced a huge number of documents, letters, photos, social media posts, recordings of my voice, all of which exist somewhere out there in the cloud (the digital, not the heavenly one). When I die, what will happen to it all? I can't imagine anyone taking the time to climb into my Dropbox folder or Instagram account and delete it all? Does all this stuff remain out there cluttering up cyberspace like defunct satellites orbiting the earth?  

The other day I came across one way it might have a future - the idea of ‘deadbots’. Apparently, AI has now developed to such an extent that it can simulate the personality, speech patterns and thoughts of a deceased person. In centuries past, most people did not leave behind much record of their existence. Maybe a small number of possessions, memories in the minds of those who knew them, perhaps a few letters. Now we leave behind a whole swathe of data about us. AI is now capable of taking all this data and creating a kind of animated avatar, representing the deceased person, known as a ‘deadbot’ or even more weirdly, a ‘griefbot’. 

You can feel the attraction. An organisation called ‘Project December’ promises to ‘simulate the dead’, offering a ghostly video centred around the words ‘it’s been so long: I miss you.’ For someone stricken with grief, wondering whether there's any future in life now that their loved one has gone, feeling the aching space in the double bed, breakfast alone, the silence where conversation once filled the air, the temptation to be able to continue to interact and talk with a version of the deceased might be irresistible. 

There is already a developing ripple of concern about this ‘digital afterlife industry’. A recent article in Aeon explored the ethical dilemmas. Researchers in Cambridge University have already called for the need for safety protocols against the social and psychological damage that such technology might cause. They focus on the potential for unscrupulous marketers to spam surviving family or friends with the message that they really need XXX because ‘it's what Jim would have wanted’. You can imagine the bereaved ending up being effectively haunted by the ‘deadbot’, and unable to deal with grief healthily. It can be hard to resist for those whose grief is all-consuming and persistent. 

Yet it's not just the financial dangers, the possibility of abuse that troubles me. It's the deception involved which seems to me to operate in at a number of ways. And it's theology that helps identify the problems.  

The offer of a disembodied, AI-generated replication of the person is a thin paltry offering, as dissatisfying as a Zoom call in place of a person-to-person encounter. 

An AI-generated representation of a deceased partner might provide an opportunity for conversation, but it can never replicate the person. One of the great heresies of our age (one we got from René Descartes back in the seventeenth century) is the utter dualism between body and soul. It is the idea that we have some kind of inner self, a disembodied soul or mind which exists quite separately from the body. We sometimes talk about bodies as things that we have rather than things that we are. The anthropology taught within the pages of the Bible, however, suggests we are not disembodied souls but embodied persons, so much so that after death, we don't dissipate like ethereal ‘software’ liberated from the ‘hardware’ of the body, but we are to be clothed with new resurrection bodies continuous with, but different from the ones that we possess right now. 

We learned about the importance of our bodies during the COVID pandemic. When we were reduced to communicating via endless Zoom calls, we realised that while they were better than nothing, they could not replicate the reality of face-to-face bodily communication. A Zoom call couldn't pick up the subtle messages of body language. We missed the importance of touch and even the occasional embrace. Our bodies are part of who we are. We are not souls that happen to temporarily inhabit a body, inner selves that are the really important bit of us, with the body an ancillary, malleable thing that we don't ultimately need. The offer of a disembodied, AI-generated replication of the person is a thin paltry offering, as dissatisfying as a virtual meeting in place of a person-to-person encounter. 

Another problem I have with deadbots, is that they fix a person in time, like a fossilised version of the person who once lived. AI can only work with what that person has left behind - the recordings, the documents, the data which they produced while they were alive. And yet a crucial part of being human is the capacity to develop and change. As life continues, we grow, we shift, our priorities change. Hopefully we learn greater wisdom. That is part of the point of conversation, that we learn things, it changes us in interaction with others. There is the possibility of spiritual development of maturity, of redemption. A deadbot cannot do that. It cannot be redeemed, it cannot be transformed, because it is, to quote U2, stuck in a moment, and you can’t get out of it.  

This is all of a piece with a general trajectory in our culture which is to deny the reality of death. For Christians, death is an intruder. Death - or at least the form in which we know it, that of loss, dereliction, sadness - was not part of the original plan. It doesn't belong here, and we long for the day when one day it will be banished for good. You don’t have to be a Christian to feel the pain of grief, but paradoxically it's only when you have a firm sense of hope that death is a defeated enemy, that you can take it seriously as a real enemy. Without that hope, all you can do is minimise it, pretend it doesn't really matter, hold funerals that try to be relentlessly cheerful, denying the inevitable sense of tragedy and loss that they were always meant to express.  

Deadbots are a feeble attempt to try to ignore the deep gulf that lies between us and the dead. In one of his parables, Jesus once depicted a conversation between the living and the dead:  

“between you and us a great chasm has been fixed, so that those who might want to pass from here to you cannot do so, and no one can cross from there to us.”  

Deadbots, like ‘direct cremations’, where the body is disposed without any funeral, denying the bereaved the chance to grieve, like the language around assisted dying that death is ‘nothing at all’ and therefore can be deliberately hastened, are an attempt to bridge that great chasm, which, this side of the resurrection, we cannot do. 

Deadbots in one sense are a testimony to our remarkable powers of invention. Yet they cannot ultimately get around our embodied nature, offer the possibility of redemption, or deal with the grim reality of death. They offer a pale imitation of the source of true hope - the resurrection of the body, the prospect of meeting our loved ones again, yet transformed and fulfilled in the presence of God, even if it means painful yet hopeful patience and waiting until that day. 

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