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.

Henna Cundill

Henna is a researcher with the Centre for Autism and Theology at the University of Aberdeen.

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.

Review

Culture

Music

Politics

25 July 2025

6 min read

As the congregation gathers Bruce Springsteen leans hard into hope

Chords of confrontation and communion

Elizabeth Wainwright

Elizabeth Wainwright is a writer, coach and walking guide. She's a former district councillor and has a background in international development.

Bruce Springsteen crouches down and holds a hand out to a sea of outstretched hands

Springsteen plays Manchester.

Brucespringsteen.net.

I finally got to experience a Bruce Springsteen concert recently. Which is to say, for three hours, I touched a land of hope and dreams.

We walked along a canal to get to the arena – my husband, my father-in-law, and me –Manchester shimmered with the arrival of summer, and light bounced off red brick and still water. We neared the arena and the air felt dense with anticipation. T Between us we carried heartbreaks, elections, hopes, failures, and a collective return to music that had accompanied and clarified it all. We were drawn by loyalty and nostalgia and joy, but also I sensed by a hope that Bruce would meet the moment — the frayed, furious, anxious now — with something that mattered.

We found our seats and gripped our drinks as the lights dimmed. Thousands of people stopped individual conversations, and hushed, and then joined voices into a deep and reverent chant. “Bruuuuuuuce”. To my right, the glow of a screen, the woman holding it sending a text – “yes babe, 1pm, lovely” – and it seemed incongruent and true. In the tension before the release, in the dark before the light, we hold our breath even as the ordinary carries on. The ordinary carries on even as the world fractures and glows. The ordinary is what Bruce often sings of, it is one reason why fans feel heard and seen by him. That night though, all the ordinaries he sang of formed something extraordinary.

Then there was light, and Bruce walked slowly from the side to the front of the stage, his guitar suspended across his body, his face a relaxed, broad smile, his bandmates and companions beside and behind him. Then there was music. No videos, no pyrotechnics; just old songs that felt as if they existed for the now. My City of Ruins, Death to My Hometown, Land of Hope and Dreams, The Promised Land. The song Long Walk Home was introduced as a “prayer to my country”. It is a country that he embodies, despairs of, and loves. He sings of his home with fury, sorrow, tenderness, and love.

Riffs and rhythms that were decades old were being made urgent again. Springsteen’s music holds both grit and glory, and hard-won joys leave space for sorrow. I write this and lines by Mary Oliver come to mind: “We shake with joy, we shake with grief / what a time they have these two / housed as they are in the same body.” What a time they had, joy and grief, that night with Bruce.

The evening unfolded not as spectacle but as liturgy; all of us involved in something like devotion – in part to Bruce, but also to moral clarity, to the power of poetry, to the promise of who we could be. At times the crowd seemed silent, ushered into something deeper – not entertainment or escapism, but something like confrontation and communion. We were being offered the joy of music and memory, but also an opportunity to reckon with who we are.

Between songs, Bruce spoke. He apparently rarely does so in his gigs. His voice slowed and deepened – not chit chat, not to entertain, but to bear witness and stand defiant and call us to the best versions of ourselves. “I’ve spent my life singing about where we’ve succeeded and come up short in pursuit of our civic values,” he said. “I just felt that was my job.” He proceeded to describe how those values are being torn apart, and why they matter. The crowd roared. He was making civic values shine, speaking about them with urgency. He acknowledged both the dream and the failure, but still he believes in the promised land and he asks us to as well. Before he belted out Rainmaker, he said, “when conditions in a country are right for a demagogue, you can bet one will show up.” He spoke of America, and really of the world – what it is, what it is becoming. His honesty and poetic rage situated us, then became a map for how to keep going.

We can be glad to be alive even while we are honest about sorrow, injustice, broken politics, fractured families, and tired hearts.

I found myself wondering: why is it that Bruce can sing and speak about justice, warped politics, and who we are becoming, and be met with cheers, while so many churches avoid doing so, preferring instead to whisper in neutral tones while the world burns? That night, I stood in a crowd of thousands and I heard a kind of moral clarity that orientates the soul and made me cry. It wasn’t partisan, it was human. Why can it feel riskier to speak specifically and prophetically in a sermon than in a stadium? I wonder if it’s because Springsteen has always rooted his politics in people’s real lives – in work, family, grief, memory. He doesn’t gesture toward abstract ideologies for fear of alienating people, or in the hope of retaining fans: he tells stories and gives names to problems and injustices, singing about crooked institutions, boarded-up factories, buses that never come, lovers who don’t come back.

The evening felt, for me, like the kind of church I long for and sometimes touch: no tidy answers, no insincere lyrics, no vague calls for justice, but rather honesty and specificity and the chance to stand alongside strangers and feel something challenging, beautiful, true.

I scribbled a question as the music soared: can a chord be mystical? Because that’s how it felt. As if there are progressions – minor then major, dissonance into harmony – that can reach past language and speak directly to the part of us that longs for love more than cynicism, to the part of us that still dares to hope even when there is very little obvious reason to do so, to the part of us wondering how to be truly alive.

Near the end, Bruce quoted the American writer James Baldwin:

“In this world, there isn’t enough humanity as one would hope. But there’s enough.”

There’s enough. It was a small phrase but it hung in the air like incense. For Bruce, there is enough humanity to keep singing for, and about. Now, he seemed to ask the crowd, what will you do with that enoughness, with that humanity?

In the final stretch, Bruce leaned hard into hope with songs like The Rising and Born to Run. The energy in the room felt like resistance – not against something, but for something. He didn’t pretend everything’s fine, but he sang anyway. “It ain’t no sin to be glad you’re alive.”

We can be glad to be alive even while we are honest about sorrow, injustice, broken politics, fractured families, and tired hearts. Gladness is being asked to stand its ground now, and to do something with our improbable aliveness. For the final song, Bruce played Bob Dylan’s Chimes of Freedom. It is a song about lightning and exiles and freedom, about the trembling of the soul and about a sky that “cracked its poems in naked wonder.” He sang it slowly, tenderly, like a prayer – which can also be a trembling of the soul, a song of naked wonder. Perhaps he prayed to God, perhaps to some other sacred thing: our better angels, or the fragile hope of who we might yet become.

In a BBC documentary about Bruce Springsteen’s history with the UK, someone says “there’s something in Bruce fans, you know you can implicitly trust them.” As we filed out of the arena, it felt like 25,000 of us briefly knew each other, trusted each other, could take on the world together. Perhaps we just had.

Soon it was just me, my husband, my father-in-law, and the silent dark canal as we walked back into the night. We were tired, we were awake. I thought of Bruce’s belief in the promised land, and of Baldwin’s line: there’s not enough humanity, but there’s enough. These are beliefs that can feel risky. So can belief in God. But enough is plenty. Enough can turn up the volume and let the spirit be our guide. With 25,000 other people, I’d turned that volume up and I could hear the spirit defiant, unifying, guiding. It is – has always been – time to go and sing of it, despite everything.