Explainer

Assisted dying

Comment

22 October 2024

9 min read

Assisted dying's language points to all our futures

Translating ‘lethal injection’ from Dutch releases the strange power of words.

Henna Cundill

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

A vial and syringe lie on a blue backdrop.

Markus Spiske on Unsplash.

In the coming weeks and months, MPs at Westminster will debate a draft bill which proposes a change in the law with regards to assisted dying in the UK. They will scrutinise every word of that bill. Language matters.

Reading the coverage, with a particular interest in how such changes to the law have been operationalised in other countries, I was struck to discover that the term in Dutch for dying by means of a fatal injection of drugs is “de verlossende injectie.” This, when put through the rather clunky hands of Google translate, comes out literally as either “the redeeming injection” or “the releasing injection.” Of course, in English the term in more common parlance is “lethal injection”, which at first glance seems to carry neither of the possible Dutch meanings. But read on, and you will find out (as I did) that sometimes our words mean much more than we realise.

Writing for Seen & Unseen readers, I explained a quirk of the brain that tricked them into thinking that the word car meant bicycle. Such is the mysterious world of neuroplasticity, but such also is the mysterious world of spoken language, where certain combinations of orally produced ‘sounds’ are designated to be ‘words’ which are assumed to be indicators of ‘meaning’. Such meanings are slippery things.

This slipperiness has long been a preoccupation for philosophers of language. How do words come to indicate or delineate particular things? How come words can change their meanings? How is it that, if a friend tells you that they got hammered on Friday night, you instinctively know it had nothing to do with street violence or DIY? Why is it that in the eighteenth century it was a compliment to be called ‘silly’, but now it is an insult?

Some words are so pregnant with possible meaning, they almost cease to have a meaning. What does “God” mean when you hear someone shout “Oh my God!”? Probably nothing at all, or very little. It is just a sound, surely? And yet no other sound has ever succeeded in fully replacing it. We are using the term “God”, as theologian Rowan Williams points out in his book The Edge of Words, as a “one-word folk poem” to refer to whatever we feel is out of our control.

Both of these first two interpretations look at death, in some sense, ‘from the other side’ – evaluating the end of someone’s life in terms of speculation over what will happen next.

This idea of an injection being verlossende seems to me to be the opposite. I find myself hearing it in four different (and not mutually exclusive) ways, each to do with taking control of this very uncertain question of dying. The first, releasing, sounds to me like an echo of the neo-platonic ideas that still infuse public consciousness about what it means to be dead. As we slimily carve our pumpkins for Halloween and the children clamour to cut eyeholes into perfectly good bedsheets, we see a demonstration of society’s latent belief that humans are made up of body and soul, and that at death the soul somehow leaves the body and floats into some unknown realm (or else remains, disembodied yet haunting). If we translate verlossende as releasing then we capture that idea – that of the soul, which longs to be at peace, trapped inside suffering, mortal flesh.

Google’s second suggestion for verlossende was redeeming. This could be heard theologically. Christians believe in eternal life, that the death of this earthly body is only the start of something new – a life where there will be no crying or pain, and people will live forever in the glorious presence of God. In the bible, the apostle Paul encourages those who follow Christ to trust that they have been marked with a ‘seal’, meaning that they are like goods which have been purchased for a price, and that God will ‘redeem’ this purchase at the appointed time. Death, therefore, is not a fearful entering into the unknown, but a faithful entering into God’s promises.

Both of these first two interpretations look at death, in some sense, ‘from the other side’ – evaluating the end of someone’s life in terms of speculation over what will happen next. But there is the view from this ‘side’ also. We do not need to speculate about what death means for some of those who experience acute suffering due to terminal illness, and who wish to hasten the end of their lives because of it. They too might want to speak of a releasing injection or a redeeming injection – given that both terms hint at the metaphor of life as a prison sentence. To be in prison is to have one’s rights and freedoms severely limited or entirely taken away. It is not uncommon to hear a sufferer refer to incapacitating illness as being ‘like a prison sentence’, and one can empathise with the desire to have the release date set, back within the sufferer’s control.

This is the strange power and pregnancy of words – verlossende is able to carry all these meanings or none of them. Until I began researching this article, I had always assumed that the English term, lethal injection, simply meant an injection of some substance that is deadly. This is how the term is commonly understood, therefore, in a sense, this is its meaning. Yet, when I came to consider the possible origins of the word, I realised its likely etymology is from the Greek word lēthē, meaning ‘to forget’. In the Middle Ages, if something was lethal it caused not just death, but spiritual death, placing one beyond the prospect of everlasting life. By contrast, something could be fatal, meaning only that it brought one to one’s destiny or fate.

With this in mind, as we try to speak clearly in the assisted dying debate, the term fatal injection might be a more precise way to describe this pathway to death that is in want of a name. After all, whether you believe in an afterlife or not, dying is everybody’s fate, and I can see that choosing to take control of one’s fate is, for anyone, an act of faith with regards to what comes next.

This article was part-inspired by Theo Boer’s original article Euthanasia of young psychiatric patients cannot be carried out carefully enough, in Dutch newspaper Nederlands Dagblad. Theo is a professor of health ethics at the Protestant Theology University, Utrecht.

Read the original article in Dutch or an English translation below. Reproduced by permission.

Euthanasia of young psychiatric patients cannot be carried out carefully enough

Theo Boer

How is it possible to determine that patients who have suffered from psychiatric disorders for five or ten years and who are between the ages of 17 and 30 have ‘completed their treatment options’, wonders Theo Boer. It also conflicts with perhaps the most important task of psychiatrists: ‘offering hope.’

The patients we are talking about now are not physically ill and therefore do not have the ‘comfort’ of an impending natural death.

A letter was recently leaked in which leading psychiatrists ask the Public Prosecution Service to investigate the course of events surrounding euthanasia of young psychiatric patients.

One death mentioned by name concerns seventeen-year-old Milou Verhoof, who received the redeeming injection from psychiatrist Menno Oosterhoff at the end of 2023. It will not have escaped many people's attention how much publicity the topic has received in the past year or so. Together with a colleague and a patient (who later also received euthanasia), Oosterhoff wrote the book Let me go.

The tenor was: it is good that euthanasia is possible for this group of patients, the taboo must be removed, their suffering is often terrible, they have already had to undergo countless 'therapies' without effect - can one time be enough?

Or would we rather have these patients end their lives in a gruesome way? And who really thinks that psychiatrists make hasty decisions when they decide to comply with a euthanasia request?

To be clear: we are talking about something completely different than what has been called 'traditional euthanasia' for years: euthanasia for physically ill patients with a life expectancy of weeks or months. Given the excellent palliative care that has become available, such euthanasia will actually be less and less necessary in 2024.

Panic

No, the patients we are talking about now are panicky, anxious, confused, depressed, lonely, often unemployed, poorly housed, without prospects. But they are not physically ill and therefore do not have the 'comfort' of an impending natural death.

I have heard several of them say: if only I were terminal, then euthanasia would not be necessary. The fact that there is now attention for this group of patients, with whom we in our hurried and solution-oriented society know so little how to deal, is a gain. At the same time, I am happy with the leaked letter. You can criticize Oosterhoff's procedural approach ('why not an ethical discussion instead of a legal one?'), the lack of collegiality, this perhaps underhanded action ('why did you go straight to the Public Prosecution Service?'). But in my opinion, the letter writers are definitely hitting the mark with this crooked stick. Firstly: how is it possible to determine that patients who have suffered from psychiatric disorders for five or ten years and who are between the ages of 17 and 30 have ‘completed their treatment options’ (a criterion from the Euthanasia Act)?

Review Committee

Nobody disputes that their suffering is unbearable. At the same time, I know from my time on a Regional Euthanasia Review Committee that an illness becomes unbearable when all hope is gone.

A psychiatrist who gives euthanasia to a young adult is also undeniably sending the signal that, like his patient, he has given up all hope of improvement. That is actually risky, because even patients who have suffered for years sometimes recover and, moreover, our brains are not fully developed until we are 25. But it also conflicts with perhaps the most important task of psychiatrists: offering hope. In their training, the risk of transference-counter-transference is consistently pointed out: a patient takes his therapist with him into despair, the psychiatrist transfers those feelings to this and other patients: ‘this kind of suffering is untreatable and cannot be lived with’.

In the recent NPO television documentary A Good Death we see an embrace between a psychiatrist and her emotional patient. In doing so, this psychiatrist offers a unique form of involvement. But does she provide sufficient resistance to the cynicism, despair and negative vision of the future that is also widespread outside psychiatry?

Sensible decisions?

That brings me to a second objection: is it sufficiently recognised how much a psychiatric illness can affect someone’s ability to make sensible decisions? The hallmark of many psychiatric illnesses is a deep desire to die and an inability to think about it in a relative way. As a result, many are unable to think in terms of a ‘possibly successful therapy’.

Boudewijn Chabot

The main character in the book Zelf heeft by Boudewijn Chabot, Netty Boomsma, responds to Chabot's suggestion that there might be a life after depression: 'Yes, but then I won't be it anymore.' She wants to go down with her depression. I know differences. The people with a death wish who remark about a possible therapy: ‘I hope it is not effective, because then I will have to go through it again.’

Another hurdle

If a second psychiatrist is consulted and, for example, suggests trying one or two more therapies, many patients see this as yet another hurdle on the road to euthanasia. They do not see it as a serious opportunity to be able to cope with life again. There are no easy answers here. Nor are pillories appropriate. But let euthanasia remain complicated here, and let us continue to look for hope.

Reproduced by kind permission

Article

Creed

Death & life

Easter

Film & TV

14 April 2025

9 min read

Harry Potter and the mysteries of death

Horcruxes and our digital consciousness

Jonny Torrance

Jonathan is a priest and theologian who researches theology and comedy.

Hermoine rests her head on the shoulder of Harry Potter.

Harry and Hermione at the grave of his parents.

Warner Bros.

A couple of years ago I had a conversation with some friends that has stuck with me. One of them is a palliative care doctor, and we were discussing medical trends which seek the extension of life at all costs. My friends are Jewish, and we as were comparing religious notes, it was unsurprising that they asked me: "well what do Christians think about death?"

I replied, without really thinking: "Well, death is the enemy that is defeated." Somewhat to my surprise, their response was quite negative. "Oh, I don't like that idea. That pushes us towards denying our mortality, and trans-humanism, and the inability to let aged relatives go. We need to become better at welcoming death, at recognising it as part of our humanity."

And as I groped to try and explain why that wasn't quite what I meant, the best analogy I could find for articulating what Christians think about death came from Harry Potter. And in the years since that conversation, it is still the best analogy that I can find to talk about mortality.

So, here is the version of what I wish I had said.

The Harry Potter books have many themes, but above all they are about death. That may sound unlikely for a series of books apparently aimed at children, but the evidence stacks up...

The main character is an orphan, and the majority of people he comes close to will die across the seven books. (Now seems as good a time as any to mention that the rest of this article will basically all be spoilers, so maybe stop now if you've been putting off reading the books for the last 20 years. I'm also going to assume you are at least reasonably familiar with the plot).

Harry's life is defined by the death of his parents and his own close shave with mortality as a baby, and as the books continue the body count gets almost ludicrously high.

Indeed, the author J.K. Rowling has said that Harry is "the prism through which I view death in its many forms."

Unsurprisingly, given how central the theme is, there is a certain amount of explicit reflection on death, even if it is somewhat vague. Thus, we find that: "to the well organised mind, death is but the next great adventure." Dying hurts not at all, but is "quicker and easier than falling asleep." Those who die can "go on," perhaps by "boarding a train."

If all of this sounds a touch sentimental and the sort of thing that might appear in bad funeral sermons, it is paired with descriptions of grief that are visceral and deeply moving. (I may have cried more than once whilst doing the "research" for this article).

But where the discussion of death gets really interesting, at least to me, is in the plot, and the metaphysics that underpins it. By metaphysics I just mean the whole picture of the structure of reality that makes the world of Harry Potter work.

And in this metaphysics we find that death is indeed an enemy. This becomes clear partly through the sheer excruciating depiction of loss that runs through the books - how could something that causes this much pain be anything but an enemy? - but in book seven it is also made explicit.

In one of my favourite moments of the whole series, Harry stands before his parents' gravestone, and reads the epitaph:

'"The last enemy that shall be destroyed is death"... A horrible thought came to him, and with it a kind of panic. "Isn't that a death Eater idea? Why is that there?"

"It doesn't mean defeating death in the way the Death Eaters mean it, Harry," said Hermione, her voice gentle. "It means... you know... living beyond death. Living after death."'

In Harry and Hermione's reaction to the quote on his parent's tombstone we find that there are multiple ways for death to be an enemy.

The Deathly Hallows sounds eerily like a current technological advancement: the rising trend of griefbots.

Book seven, in fact, presents three ways to defeat death, and they are highly illuminating.

Firstly, there are Horcruxes. This is Voldemort's project for immortality: the division of his soul via murder and the darkest magic, and the implantation of those parts of the soul into objects which guarantee that, even should he die, he will live on.

This is, I think it's fair to say, not a vision of the death's vanquishing which the books present as appealing - Voldemort is the darkest wizard of living memory, and the creation of his Horcruxes takes him deeper into evil than anyone has ever gone. Yet it has strange parallels to various current attempts at death defiance. Dividing your soul up and placing it in objects sounds pretty similar to me to uploading your consciousness into a computer.

Now I'm not saying that all transhumanists are evil wizards whose projects rely on murder, but I do wonder if the same impulse lies behind Horcruxes and downloaded consciousness.

There is, in both, the same fear of death, the same refusal to accept that my life might end. And there is the same default assumption that the body doesn't really matter - that the centre of my being is somewhere else, and that I can separate it from this inconvenient vessel which is so subject to injury and decay. The inevitability of bodily death is acknowledged, but life can go on even if my body fails, because I can place myself into objects. What matters is my consciousness, and that can be made eternal.

The second option is a little more complex: the Deathly Hallows. These are three strange, mysterious objects, possession of which promises to make the bearer "master of death." The wand that gives murderous power. The stone that brings back the dead. The cloak that conceals.

The Hallows dress up their promise in esoteric garb - they offer a quest for the initiated that requires a certain embrace of mystery, and they certainly seem friendlier than Horcruxes, since no one has to die to make them.

But in the end, as Dumbledore admits, they are not really that different from the Horcruxes, for those who seek them also respond to the temptation to defy death, just like Voldemort. And if Horcruxes are about preserving the soul in the face of the inevitability of bodily death, the Hallows tease the possibility of avoiding death altogether, through the exercise of power.

The wand gives the power of invincibility and conquest: the avoidance of death through the murder of all who might threaten to kill.

The cloak gives the power to hide, to keep out of trouble, to evade death by escape.

And the stone? The stone overcomes the loss of death by bringing its victims back, by refusing to accept that those we love might leave us.

Again, the Deathly Hallows sounds eerily like a current technological advancement: the rising trend of griefbots. There is the same attempt to respond to grief by clinging to simulations of those whom we mourn, and the same despair at the end of the line. For the dead do not belong with the living, we are told, and legend has it the first owner of the stone was driven to suicide.

The Hallows attempt to deny death through power, and this is why Dumbledore found them so alluring, and so destructive: they promised to wind back his own loss while giving him the victory he thought would give his life meaning.

And yet, in reality, even when Harry unites them all, they don't give what they promise. Indeed, they only work to their full power when they are used for humbler ambitions: to hide friends from danger, to perform wondrous magic without boasting in the glory of the wand, or to face death with the comforting presence of those who have gone before.

For the stone only becomes available to Harry when he finally embraces the third way to defeat the death. The way his parents believed in.

Death, in the Potter books, is defeated by dying. Or perhaps more specifically, by dying for love - love of children, love of friends, love of a world gone tragically wrong.

Harry's mother protected her son from dying multiple times, through the power of her sacrificially loving surrender. Dumbledore, in a complex way, protects Malfoy and saves the Elder Wand from Voldemort, thereby protecting the whole wizarding world, through his voluntary death. Even Snape, in the bitterest and most twisted story of them all, ends up giving Harry what he needs to win and finding a measure of redemption, in and through his own murder.

And, in the climax of this long, convoluted story, Harry avoids death by going willingly to die. Because he loves his friends. Because he hates others dying for him. Because he recognises the terrible duty he faces, the terrible path Dumbledore has laid out for him, and he loves too much to run.

Voldemort is wrong. Love does conquer death.

The parallels to the Christian vision of death are stark. The quote on the tombstone which sparks these reflections for Harry (and for me) is in fact from the Bible. "The last enemy that shall be defeated is death" is a profoundly Christian idea.

Yet my friends were right to react negatively to what they thought I meant by death being an enemy.

For, just like the good guys in Harry Potter, Christians have traditionally been suspicious of attempts at immortality on our own terms. The Bible, I would suggest, knows nothing of a technological defeat of death, whether through downloading our consciences, or radical life extension, or technologies of power. Death cannot be staved off by any of our own work.

But this does not mean that death is a good thing, simply a part of human existence which we would do well to welcome and learn to get along with (though I do think we would do better to think about death more, and be more honest about its existence).

Death is an enemy. It is the final enemy. We are right to rage against it. To grieve those whom we lose. To feel its existential weight.

Yet, perhaps paradoxically, we should not fear it. For death is an enemy that has been vanquished, but vanquished through Jesus' death.

Immortality is not, for Christians, something we achieve, but something that is given to us. We believe in the Saviour who dies, and who rises again, and in whose resurrection, as strange as it may sound, we also will be raised. Death is defeated by love, but it is not our love, it is God's love for us.

This gift, according to the early Christian writers, can only be received by going through death, not by avoiding death. Indeed, Paul's letters, which make up most of the New Testament, are full of the insistence that the pattern of Christian life is always death first, then life. Death in baptism, to new life in Christ. Death to sin, to life in freedom. Bodily death, to bodily resurrection.

And so, what I should have said to my friend, is that Hermione is right. Death is the final enemy to be defeated, but this does not mean the ways of the Death Eaters. It does not mean projects of immortality, whether rooted in science, or a mystery cult, or power over others.

Rather it means it life after death - a life that is given to us, by our saviour who has been through death and defeated it.

Death is the enemy but it is not our enemy to defeat. That victory was won for us, on Easter Sunday 2000 years ago, in a cemetery near Jerusalem, when Jesus rose again.

Celebrate our 2nd birthday!

Since Spring 2023, our readers have enjoyed over 1,000 articles. All for free. This is made possible through the generosity of our amazing community of supporters.
If you enjoy Seen & Unseen, would you consider making a gift towards our work?
Do so by joining Behind The Seen. Alongside other benefits, you’ll receive an extra fortnightly email from me sharing my reading and reflections on the ideas that are shaping our times.
Graham Tomlin
Editor-in-Chief

Give now