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
Belief
Creed
Identity
Truth and Trust
5 min read

Calls to revive the Enlightenment ignore its own illusions

Returning to the Age of Reason won’t save us from post-Truth

Alister McGrath retired as Andreas Idreos Professor of Science and Religion at Oxford University in 2022.

In the style of a Raeburn portrait, a set of young people lounge around on their phones looking diffident
Enlightened disagreement (with apologies to Henry Raeburn).
Nick Jones/Midjourney.ai.

Is truth dead? Are we living in a post-truth era where forcefully asserted opinions overshadow evidence-based public truths that once commanded widespread respect and agreement? Many people are deeply concerned about the rise of irrational beliefs, particularly those connected to identity politics, which have gained considerable influence in recent years. It seems we now inhabit a culture where emotional truths take precedence, while factual truths are relegated to a secondary status. Challenging someone’s beliefs is often portrayed as abusive, or even as a hate crime. Is it any surprise that irrationality and fantasy thrive when open debate and discussion are so easily shut down? So, what has gone wrong—and what can we do to address it? 

We live in an era marked by cultural confusion and uncertainty, where a multitude of worldviews, opinions, and prejudices vie for our attention and loyalty. Many people feel overwhelmed and unsettled by this turmoil, often seeking comfort in earlier modes of thinking—such as the clear-cut universal certainties of the eighteenth-century “Age of Reason.” In a recent op-ed in The Times, James Marriott advocates for a return to this kind of rational thought. I share his frustration with the chaos in our culture and the widespread hesitation to challenge powerful irrationalities and absurdities out of fear of being canceled or marginalized. However, I am not convinced that his proposed solution is the right one. We cannot simply revert to the eighteenth century. Allow me to explain my concerns. 

What were once considered simple, universal certainties are now viewed by scholars as contested, ethnocentric opinions. These ideas gained prominence not because of their intellectual merit, but due to the economic, political, and cultural power of dominant cultures. “Rationality” does not refer to a single, universal, and correct way of thinking that exists independently of our cultural and historical context. Instead, global culture has always been a bricolage of multiple rationalities. 

The great voyages of navigation of the early seventeenth century made it clear that African and Asian understandings of morality and rationality differed greatly from those in England. These accounts should have challenged the emerging English philosophical belief in a universal human rationality. However, rather than recognizing a diverse spectrum of human rationalities—each shaped by its own unique cultural evolution—Western observers dismissed these perspectives as “primitive” or “savage” modes of reasoning that needed to be replaced by modern Western thought. This led to forms of intellectual colonialism, founded on the questionable assumption that imposing English rational philosophies was a civilizing mission intended to improve the world. 

Although Western intellectual colonialism was often driven by benign intentions, its consequences were destructive. The increasing influence of Charles Darwin’s theory of biological and cultural evolution in the late nineteenth century led Darwin’s colleague, Alfred Russel Wallace, to conclude that intellectually and morally superior Westerners would “displace the lower and more degraded races,” such as “the Tasmanian, Australian and New Zealander”—a process he believed would ultimately benefit humanity as a whole. 

We can now acknowledge the darker aspects of the British “Age of Reason”: it presumed to possess a definitive set of universal rational principles, which it then imposed on so-called “primitive” societies, such as its colonies in the south Pacific. This reflected an ethnocentric illusion that treated distinctly Western beliefs as if they were universal truths. 

A second challenge to the idea of returning to the rational simplicities of the “Age of Reason” is that its thinkers struggled to agree on what it meant to be “rational.” This insight is often attributed to the philosopher Alasdair MacIntyre, who argued that the Enlightenment’s legacy was the establishment of an ideal of rational justification that ultimately proved unattainable. As a result, philosophy relies on commitments whose truth cannot be definitively proven and must instead be defended on the basis of assumptions that carry weight for some, but not for all. 

We have clearly moved beyond the so-called rational certainties of the “Age of Reason,” entering a landscape characterized by multiple rationalities, each reasonable in its own unique way. This shift has led to a significant reevaluation of the rationality of belief in God. Recently, Australian atheist philosopher Graham Oppy has argued that atheism, agnosticism, and theism should all be regarded as “rationally permissible” based on the evidence and the rational arguments supporting each position. Although Oppy personally favours atheism, he does not expect all “sufficiently thoughtful, intelligent, and well-informed people” to share his view. He acknowledges that the evidence available is insufficient to compel a definitive conclusion on these issues. All three can claim to be reasonable beliefs. 

The British philosopher Bertrand Russell contended that we must learn to accept a certain level of uncertainty regarding the beliefs that really matter to us, such as the meaning of life. Russell’s perspective on philosophy provides a valuable counterbalance to the excesses of Enlightenment rationalism: “To teach how to live without certainty, and yet without being paralyzed by hesitation, is perhaps the chief thing that philosophy, in our age, can still do for those who study it.” 

Certainly, we must test everything and hold fast to what is good, as St Paul advised. It seems to me that it is essential to restore the role of evidence-based critical reasoning in Western culture. However, simply returning to the Enlightenment is not a practical solution. A more effective approach might be to gently challenge the notion, widespread in some parts of our society, that disagreement equates to hatred. We clearly need to develop ways of modelling a respectful and constructive disagreement, in which ideas can be debated and examined without diminishing the value and integrity of those who hold them. This is no easy task—yet we need to find a way of doing this if we are to avoid fragmentation into cultural tribes, and lose any sense of a “public good.” 

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