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.

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Music

Sustainability

17 October 2024

4 min read

What’s the point of celebrating the harvest?

We reap what we sow: a once young man’s guide.

George Pitcher

George is a visiting fellow at the London School of Economics and an Anglican priest.

A soot stained burnt-out harvester sits in a recently harvested field.

A burnt-out harvester, Lonesome Farm, Oxfordshire.

Nick Jones.

I plan next week to visit a small nursery school, called Young Haymakers, for their Harvest celebration where toddlers to five-year-olds will sing songs about tractor wheels going round and round, with vigorous manual actions as they shake, shake, shake the apple tree.

We’ll have a Harvest snack at tiny tables, a prayer and then they’ll give me the Harvest gifts from their families for those who may be hungry.

It is, of course, a delight, one of the happiest duties of a parish priest and I’ll miss it terribly as I hand it over to a new Rector. But, while I take nothing away from the sheer joy of thanksgiving of these children for the fruits (and vegetables) of this harvest and for those who farm them, I can’t help but wonder what Harvest, as a festival, really means for grown-ups.

The metaphor has been just too rich to avoid this season. We reap what we sow – and we witness that from Ukraine to Gaza and Lebanon, from Sudan to a United States that teeters on the brink of self-destruction as the world’s beacon of democratic values.

One might add to this sorry list the longer-term grim gathering-in from the world’s reliance on fossil fuels, a failed harvest of biblical-scale abomination as we destroy our planet’s natural capacity to host us. Truly, we have sown a wind and, in so many areas of human endeavour, we look like we reap a whirlwind (literally, in the case of weather crises such as Hurricane Milton).

There are prophetic voices that cry out in our human wilderness, from those who foresee the demise of the US at the hands of a shallow nationalism to those few on the political stage who predict an all-out war in the Middle East as the only possible conclusion to the escalation of revenge attacks between Israel and its neighbours.

The ancients saw famine and failed harvests as judgments for their sin, their divergence from the divine will. It’s unlikely that our world is going to accept such culpability any time soon. To do so would require a humility that we have lost, along with losing our religion.

We need to be careful of ascribing too much of a prophetic voice to Young. This was, after all, a fairly bombed-out singer-songwriter of the start of the Boomer generation.

Setting aside the reaping of whirlwinds from millennia ago, I’m going to invoke a popular folk song from a little over half a century ago. I do so because, in 1972, we lived in a more innocent world, before we knew how industrialisation could destroy our human species and when a western hegemony in democracy was taken for granted. Little did we know the precipice on which we were perched.

The song is by the folk-rock colossus Neil Young and is called, appropriately enough, Harvest. It is, lyrically, one of his more obscure works and to listen to it now is to struggle to get past a strangulated hippy voice that verges on self-parody.

But it repays the effort. Young’s lyrics are infused with religious reference and imagery, but no claim should be made for his affirmation of the Christian faith. Nonetheless, we’re entitled to view art through the prism of what informs us and, as such, Harvest yields its fruits. Young may well be singing about his lover, but it’s in love that all truth is explored.

Listen to it. Young’s Harvest opens with the lines “Did I see you down in a young girl’s town/ with your mother in so much pain?” Through a scriptural lens, this sounds like the pain of incarnation, the sharing of Mother Mary’s agony in visceral human experience.

It continues: “Will I see you give more than I can take”; for the confessing faithful, we’re at the foot of the cross here. “Will I only harvest some?”; we can, all of us, only harvest a little of the mystery of that event. “As the days fly past, will we lose our grasp?”; of course we will – time is finite. “Or fuse it in the sun?”; an uncanny pre-echo of climate change worthy of Nostradamus.

We need to be careful of ascribing too much of a prophetic voice to Young. This was, after all, a fairly bombed-out singer-songwriter of the start of the Boomer generation. But it’s also true that we should be careful of where we look for prophetic voices.

For Young, the Harvest is indeed a cruel and painful event, which we can only understand in part. We do indeed reap what we sow, but there may be purpose to be found in that. And the Harvest is indeed bitter, but in it we may glimpse a plan: “Dream up, dream up, let me fill your cup/ With the promise of a man”.

Or, okay, it’s just a song, harvesting a good deal of cash for its writer and singer. I’m no big fan of Young. But it might just have told me more about the Harvest than singing All Things Bright and Beautiful.