Article
Assisted dying
Care
Comment
4 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. Much as we all sympathise and feel the force of stories of agonising suffering, to put it bluntly, is it right to make such a fundamental shift in our moral landscape for the sake of the two per cent 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. 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. 

A 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 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. 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. 

Article
Comment
Economics
Sustainability
4 min read

Black Friday: don’t shop, try stewarding instead

We're so fallible to consumer culture. Here's how to counter it.

Rosie studies theology in Oxford and is currently training to be a vicar.

A phone screen is held up, showing a shopping page, behind a window displays a Black Friday Sale banner.
CardMapr.nl on Unsplash.

Have you noticed how many times in the last 24 hours you’ve been targeted or tempted by a Black Friday marketing campaign?  

It’s estimated that we can see anywhere from 50 to 400 adverts per day - on TV, billboards, online, and, more than ever, through social media. I’ve never felt more seen and known by the Instagram algorithm, and many of us have experienced items popping up on our feeds which we were talking about with friends only hours before. Is it possible to resist such incessant and elaborate marketing schemes? 

In the lead up to Black Friday this year, I’ve been looking out for a new vacuum cleaner (the rock-and-roll life of a thirty-something year-old). Having done all the research, I’m now poised to cash in on the discounts, regularly refreshing my Argos and Amazon tabs for the latest prices. 

But, as I’ve been comparing the relative pros and cons of cordless versus cylinder vacuums (and marvelling at the development of anti-hair wrap technology), it’s been difficult not to have my interest piqued by various other products being put under my nose by these websites, too.  

And difficult not to feel like, if I don’t act quickly, I’m going to miss out on an offer that’ll not come around again. It’s almost as if these marketing executives know how my brain is going work - even before I go online. But are we humans really as transparent as that? 

Netflix’s new documentary, Buy Now? The Shopping Conspiracy, says that we are. It profiles several ex-insiders from the world’s biggest brands, who expose the manipulative tricks used by these corporations to make us buy more, and the extent to which our desire for endless consumption has been cultivated and capitalised on by design.  

It seems that we humans, evolved and intelligent as we like to believe ourselves, are still fallible to serve the things which were designed to serve us. And the consequences are far-reaching. Online shopping may have dehumanised the consumer experience, but we remain connected to people around the world by global supply chains, and it is individuals and communities whose livelihoods are most dependent on the availability and quality of natural resources, and who live closest to the land, who reap the harmful effects of our incessant buying habits.  

Hazardous e-waste, for example (including discarded laptops, phones, and TVs), is rising by millions of tonnes annually. The UK is a particularly bad offender for illegally exporting toxic e-waste around the world, dumping it in landfills where it releases toxic substances such as mercury, zinc, and lead into local water and soil supplies. 

Back here in the UK, we can feel like such small cogs in such a huge, capitalist machine, that a lot of this seems beyond the realms of our human agency.  

There is certainly value in being savvy with our spending power as consumers. In doing the research to get the best Black Friday deals, as we tighten the purse strings and navigate what has become a protracted and painful cost of living crisis for many. It can be hard for Christmas not to feel like an unavoidably expensive time of year. 

But, perhaps there is also an opportunity to take small, subversive acts of resistance against this dehumanising consumer culture. Actions which reclaim our humanity and human agency, and which recognise our global interconnectedness. 

For example, maybe you could resist the urge to impulse buy something this weekend, by stepping away from the screen to make a cup of tea or go for a walk outside, before clicking ‘Pay Now’. 

Perhaps we could get better at comparing companies’ supply chains and ethical brand ratings, using our spending power to support those which align best with our values. 

And, when we’re making a purchase, let’s take a moment to be grateful for the things we already have, the items we’re buying, and the people who made them. 

The Christian faith invites us to reframe how we see our money and belongings through the lens of stewardship. It’s an underrated principle in today’s context. Stewardship goes beyond just thinking about how we spend our income, to the inherent responsibility we have as humans to look after the world around us, recognising that the earth’s resources are not ones we are entitled to, but are gifts which sustain life. 

The principle of stewardship makes it impossible to hide behind a screen and to ignore the impact which our spending decisions have on people and communities around the world, however far removed from our lives they seem. It invites us to use our money and resources to invest in things which will serve us - and others - well, and tells the world that it matters that we challenge systems which perpetuate economic and environmental injustice. 

And, if I happen to miss out on that vacuum cleaner while I’m out for a walk this weekend, at least it’s less than a month until the Boxing Day sales hit our screens.