Article
Assisted dying
Care
Comment
Politics
4 min read

Assisted dying is not a medical procedure; it is a social one

Another vote, and an age-related amendment, highlight the complex community of care.
Graffiti reads 'I miss me' with u crossed out under the 'mem'
Sidd Inban on Unsplash.

Scottish Parliament’s Assisted Dying bill will go to a stage one vote on Tuesday 13th May, with some amendments having been made in response to public and political consultation. This includes the age of eligibility, originally proposed as 16 years. In the new draft of the bill, those requesting assistance to die must be at least 18.  

MSPs have been given a free vote on this bill, which means they can follow their consciences. Clearly, amongst those who support it, there is a hope that raising the age threshold will calm the troubled consciences of some who are threatening to oppose. When asked if this age amendment was a response to weakening support, The Times reports that one “seasoned parliamentarian” (unnamed) agreed, and commented: 

“The age thing was always there to be traded, a tactical retreat.”  

The callousness of this language chills me. Whilst it is well known that politics is more of an art than a science, there are moments when our parliamentarians literally hold matters of life and death in their hands. How can someone speak of such matters as if they are bargaining chips or military manoeuvres? But my discomfort aside, there is a certain truth in what this unnamed strategist says.  

When Liam McArthur MSP was first proposed the bill, he already suggested that the age limit would be a point of debate, accepting that there were “persuasive” arguments for raising it to 18. Fortunately, McArthur’s language choices were more appropriate to the subject matter. “The rationale for opting for 16 was because of that being the age of capacity for making medical decisions,” he said, but at the same time he acknowledged that in other countries where similar assisted dying laws are already in operation, the age limit is typically 18.  

McArthur correctly observes that at 16 years old young people are considered legally competent to consent to medical procedures without needing the permission of a parent or guardian. But surely there is a difference, at a fundamental level, between consenting to a medical procedure that is designed to improve or extend one’s life and consenting to a medical procedure that will end it?  

Viewed philosophically, it would seem to me that Assisted Dying is actually not a medical procedure at all, but a social one. This claim is best illustrated by considering one of the key arguments given for protecting 16- and 17- year-olds from being allowed to make this decision, which is the risk of coercion. The adolescent brain is highly social; therefore, some argue, a young person might be particularly sensitive to the burden that their terminal illness is placing on loved ones. Or worse, socially motivated young people may be particularly vulnerable to pressure from exhausted care givers, applied subtly and behind closed doors.  

Whilst 16- and 17- year-olds are considered to have legal capacity, guidance for medical staff already indicates that under 18s should be strongly advised to seek parent or guardian advice before consenting to any decision that would have major consequences. Nothing gets more major than consenting to die, but sadly, some observe, we cannot be sure that a parent or guardian’s advice in that moment will be always in the young person’s best interests. All of this discussion implies that we know we are not asking young people to make just a medical decision that impacts their own body, but a social one that impacts multiple people in their wider networks.  

For me, this further raises the question of why 18 is even considered to be a suitable age threshold. If anything, the more ‘adult’ one gets, the more one realises one’s place in the world is part of a complex web of relationships with friends and family, in which one is not the centre. Typically, the more we grow up, the more we respect our parents, because we begin to learn that other people’s care of us has come at a cost to themselves. This is bound to affect how we feel about needing other people’s care in the case of disabling and degenerative illness. Could it even be argued that the risk of feeling socially pressured to end one’s life early actually increases with age? Indeed, there is as much concern about this bill leaving the elderly vulnerable to coercion as there is for young people, not to mention disabled adults. As MSP Pam Duncan-Glancey (a wheelchair-user) observes, “Many people with disabilities feel that they don’t get the right to live, never mind the right to die.” 

There is just a fundamental flawed logic to equating Assisted Dying with a medical procedure; one is about the mode of one’s existence in this world, but the other is about the very fact of it. The more we grow, the more we learn that we exist in communities – communities in which sometimes we are the care giver and sometimes we are the cared for. The legalisation of Assisted Dying will impact our communities in ways which cannot be undone, but none of that is accounted for if Assisted Dying is construed as nothing more than a medical choice.  

As our parliamentarians prepare to vote, I pray that they really will listen to their consciences. This is one of those moments when our elected leaders literally hold matters of life and death in their hands. Now is not the time for ‘tactical’ moves that might simply sweep the cared-for off of the table, like so many discarded bargaining chips. As MSPs consider making this very fundamental change to the way our communities in Scotland are constituted, they are not debating over the mode of the cared-for’s existence, they are debating their very right to it.   

Article
Climate
Comment
Sustainability
5 min read

What “drill baby drill” really means for the world’s poor

Climate jargon pales in comparison to hard, hot and harsh realities.

Jane Cacouris is a writer and consultant working in international development on environment, poverty and livelihood issues.

forest tree-tops break a mist.
Forest in Cameroon.
Edouard Tamba on Unsplash.

“Drill, baby, drill,” declared Donald Trump during his inauguration speech in January to roars of Republican approval, going on to sign executive orders to “unleash” the American oil and gas industry to do just that: drill. This, even though the United States is already the largest crude oil producer of any other nation, according to its own Energy Information Administration, and has been for the past six years in a row. 

Fossil fuel combustion is undeniably the largest source of greenhouse gas emissions worldwide says the IPCC, with oil accounting for about 34 per cent of global CO2 emissions from fossil fuels. And World Economic Forum statistics show that the lowest income countries produce only one-tenth of emissions but are the most heavily impacted by climate change.  

Something doesn’t seem very fair here.  

Many of us are aware of the statistics and policies and rhetoric around climate change. It is all buzzing around in the background of our lives, in the news, on social media and in opinion pieces like this one. But if we’re honest, it is all still theory for most of us living in the Global North.  

On a recent work assignment, involving research in remote communities in Southern Cameroon, I found the true extent of climate crisis is hard hitting and very real. According to the IMF, Cameroon is ranked 16th in the world in terms of countries most vulnerable to the impacts of climate change, partly due to its geographical location. 

High levels of rural poverty and the country’s economic dependence on agriculture, which employs over 70 per cent of the population adds to this climate vulnerability. But the government statistics and climate jargon, worrying as it is, paled as I discovered the reality of rural Cameroonians’ lives. Lives that depend almost solely on the productivity of the land, and therefore on the weather. Lives that have no Plan B when the climate is unpredictable.  

The communities we studied live in rural villages many kilometres from any urban centre, and rely entirely on natural resources for their livelihoods. They depend on traditional rain-fed agriculture, hunting for bush meat, and collecting non-timber forest products such as tropical fruits, insects, medicinal plants, herbs and honey from the dense forests near their dwellings to survive.  

The effects of the changing climate have been felt by them for some time. During periods of water scarcity, which is becoming more unpredictable and prolonged, local streams dry up, meaning crop yields fail, such as corn, groundnuts and cassava, and families go hungry. Fishing yields dwindle. The work burden for women rises, as they have to travel further to collect water for drinking, washing and cooking. Poor roads with inaccessible tracks during heavy rain events, or non-existent roads, prevent communities from accessing markets, health care and external support, making them isolated and more vulnerable to climate impacts. 

With the science predicting rising future temperatures and higher seasonal variability in their region, these communities will only become more vulnerable, mirroring the story of millions of other people around the world. They must adapt to survive. The alternative is not surviving. Devastatingly, this is a very possible future outcome.  

I’d say the UK is standing on the side lines in the playground, looking on.  

Why should wealthy, powerful nations mostly responsible for global carbon emissions, not only refuse to compensate those at the receiving end of resulting climate change, but actively seek to cause more damage? It echoes of a bully in a school playground, inflicting suffering on a smaller child, gaining in popularity, power and self-confidence as a few egg them on, others stand by, whilst the receiver of the abuse summons all their remaining strength simply to survive and make it through another day.  

So where does the United Kingdom stand in the playground?  

In terms of domestic climate policy, the UK must meet net zero by 2050, in line with the target set out in UK legislation, i.e. in twenty-five years from now, total greenhouse gas (GHG) territorial emissions must be equal to the emissions removed from the atmosphere. On paper, it seems the UK is on track to achieve this. GHG emissions have halved since 1990, driven by investing in renewable power and phasing out coal in the electricity sector. However, as WWF and others have pointed out, this figure has a glaring omission. Products including clothing, processed foods and electronics imported into the UK are counted as the “manufacturing country’s emissions,” not the UK’s. This is known as “offshoring.” And according to WWF, between 1990 and 2016, emissions within the UK’s borders reduced by 41 per cent, but the consumption-based carbon footprint only declined by 15 per cent, mainly due to goods and services coming from abroad.  

In terms of climate finance for the world’s poorest nations, the UK pledged to spend £11.6 billion between 2021 and 2026, and the government recently said it remains committed to meet this pledge. However, the pot from which this climate finance must come, the UK’s overseas aid budget, was slashed in recent months from 0.5 per cent to 0.3 per cent of national income to prioritise defence spending. Meanwhile, climate experts and charities are warning that what the world needs now is stronger global solidarity in the face of the climate crisis, rather than national self-interest. I’d say the UK is standing on the side lines in the playground, looking on.   

Trump professes to be a practicing Christian… I wonder what would Jesus have to say about the way America and other wealthy nations have dealt with the climate crisis? One of Jesus’ most well-known and powerful teachings was to love your neighbour. The parable of the Good Samaritan in the Bible demonstrates the way we should treat our neighbours; acting with love, compassion and mercy, not only towards those we know or who live in our friendship network, community or country, but towards every human being, regardless of nationality, background or social group. In the context of climate change, Christians are called to love our global neighbours. This includes supporting the world’s poorest communities to thrive, speaking up on their behalf, demonstrating love through political and social action. Jesus certainly doesn’t teach us to put ourselves “first.”  

Imagine a world where every nation signed up to Jesus’ teaching on how to treat our neighbours. Would climate change abruptly halt, human suffering stop and global peace prevail? In truth, probably not, because humanity is imperfect and we get things wrong even when we mean well. But if the intention was there, and if world leaders looked to Jesus’ lead on this, there is little doubt we would be many steps closer.  

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