Article
Assisted dying
Death & life
4 min read

Behind the data: the social messages physician assisted suicide sends to the autistic

If intense suffering caused by society drives autistic people to seek assisted death, then society has failed.
A hand rest gently on another outstretched hand.
Alexander Grey on Unsplash.

Statistically speaking, autistic people are far more likely to die by suicide than non-autistic people. They are also, statistically speaking, far more likely to die by physician assisted suicide than non-autistic people, in countries where this is allowed.  

For example, in a study of 927 people who sought physician assisted suicide in the Netherlands (where this is legal) 39 of them were autistic. That’s about four per cent, but the prevalence of diagnosed autism in the Netherlands is only one to two per cent. The researchers go on to note that 21 per cent of these 39 people cite autism or intellectual disability as the “sole cause of suffering” that had prompted them to request assistance to die.  

I don’t like speaking statistically. For a start, 21 per cent of 39 people is 8.19 people, which raises obvious questions. A little digging reveals that what the researchers mean really is eight people. Eight people with eight unique stories that include an account of autistic suffering so intense that they asked for help to end their lives.  

But we do not have those stories, not really. Included in the report are carefully anonymised excerpts from the physicians’ notes, and this is the nearest that we can get.  

‘The patient suffered from his inability to participate in society [ … ] [He] was not able to live among people, because he was easily overstimulated. This made him isolated’ (2019 (22), male, 70s, ASD) 

‘The patient had felt unhappy since childhood and was persistently bullied because he was just a bit different from others [ … ] [He] longed for social contacts but was unable to connect with others. This reinforced his sense of loneliness. The consequences of his autism were unbearable for him [ … ] The prospect of having to live on in this way for years was an abomination to him and he could not bear it’ (2021 (26), male, 20s, ASD) 

The debate about legalising physician assisted suicide in the UK is ongoing, and the British Medical Association have provided a helpful guidance document which sets out the main arguments, both for and against, without making a recommendation either way. In the document, they observe that the reasons people ask for assisted suicide are predominantly personal and social, not clinical, and also that “laws send social messages.” I agree that laws do that, and I also think that those seeking assisted suicide send social messages too.  

For example, even just from these two tiny excerpts, I hear that a life worth living is one where people can participate in society and have social contacts, even if they are a “just a bit different from others.” It would be good to hear more. It would be good to sit down over a cup of coffee with each of these two men and ask them all my questions about their lived wisdom when it comes to autism.  

I could ask “2019 (22), male, 70s, ASD”: 

What causes the overstimulation - are there places where you don’t feel that?  

Can we create more such places for autistic people to socialise?  

And I could ask “2021 (26), male, 20s, ASD”:  

What makes you feel different?  

What kind of social contacts and connections do you think that you are looking for?  

But of course, I can’t do that, because these two men have been assisted to die.   

The word ‘welcome’ is striking to me here. What does it mean to welcome someone, not to merely include or tolerate, but to really welcome someone. 

When approached for comment, autistic theologian Claire Williams said:  

‘There is something of a personal and social tragedy reflected in these cases. If we understand that much of the difficulty that autistic people suffer is caused by society – as per the neurodiversity paradigm – then it is the case that these two nameless men were failed by society. They felt that their lives could not find a place in an unwelcoming world. It is, of course, their choice to end their lives but I do also think that God chose to start their lives and finds them to be infinitely valuable. They were both made in God’s image and reflect something of it. That they felt there isn’t a place for them that is suitable is a tragedy because society should do better to welcome them.’ 

The word ‘welcome’ is striking to me here. What does it mean to welcome someone, not to merely include or tolerate, but to really welcome someone, even if they seem ‘a little bit different from others’? Dr Léon van Ommen, another theologian who writes about autism, suggests that it is a matter of making oneself and one’s resources fully available to that person, to the point where they feel that you belong to them. This is not to promote relationships with unhealthy power dynamics, but to highlight that when a person feels truly welcomed by another, they feel the opposite of owing a debt or being a burden – they feel they are of value, that you would be lacking something without them.  

I feel we are lacking something without you, “2019 (22), male, 70s, ASD”. And I feel we are lacking something without you, “2021 (26), male, 20s, ASD”. Not to forget the 37 others who are a little like you. We can pause to reflect on the social messages that you have sent, what you are teaching all of us about what it means to live a “good” life. But I am sorry that you have all died now and we cannot hear more.   

Whether people in the UK should be able to choose physician assisted suicide, I, personally, am not yet sure. Like the BMA, I see and respect the very good arguments both for and against. But eight people have chosen physician assisted suicide due to autism or intellectual disability, and when it comes to the social messages that sends, I feel compelled to sit down and listen.  

Article
Awe and wonder
Comment
Holidays/vacations
Monastic life
Psychology
5 min read

You can find the awesome in the everyday not just on holiday

The sources of awe are not scarce, but we do overlook them
A colourful street food van
Awesome in Singapore.
Swaroop Satheesh on Unsplash.

Are you starting to think about holidays? Have you heard yourself trotting forth the old clichés?  

“We’re looking forward to getting away from it all.”  

“We’re planning something special to take us out of ourselves.”  

“Well, it might not be that relaxing with the *kids/dogs/relatives* – but a change is as good as a rest!”  

Even if going for the budget-friendly ‘staycation’ this year, there is something about stepping out of our everyday busyness and chores that we find distinctly appealing. We hope that a change of routine, if not a change of place, will afford us some kind of renewal. On holiday we are freed to move to the edges of our lives, even if we can’t escape them entirely, and gain the view from the terrace over the box-hedge-maze of all things quotidian.    

But would it help us to visit that terrace a bit more often? This has long been the recommendation of scientists, poets and prophets alike. Most recently, a 2025 study from Yale University researched experiences of “awe” in the everyday. They recruited Long Covid patients and instructed them over a three-month period to slow down several times a day, paying attention to something that they valued or found amazing, whilst breathing and noticing any tangible responses or reactions in their body. The researchers called this process “awe”: Attention, Wait and Exhale. Amongst the participants in the study, the practice of AWE induced a measurable improvement in mental health.  

Of course, there have always been people who pause multiple times per day to turn their thoughts away from the mundane. In the Sixth Century, an Italian monk known as Benedict devised a “rule” for those living the monastic life, wherein brothers were required to pause for prayer eight times in every 24 hours – including in the middle of the night! This connected the members of the order not only with God but also with each other. Even if a brother found himself temporarily outside the cloister, going on a journey or working with the poor in the wider community, he was still expected to “join” his community in prayer at the regular hours, stopping whatever he was doing to pray in solidarity.  

There are still Benedictine orders today, and others who seek to “pray the hours” based on brother Benedict’s rule. But for most of us, our lives are far from this monastic ideal of community and regularity, even if we do practise the Christian faith. Within a busy schedule, stopping once or twice per day to pray can be a challenge, let alone eight times and regardless of convenience! No matter how much the scientists tell us that it will lift our spirits and do us good, such timefulness is the medicine that the modern life denies. But perhaps this is where the poets can supply deficiencies?  

In her great work, Aurora Leigh, Elizabeth Barrett Browning once wrote: 

“Earth’s crammed with heaven, 
And every common bush afire with God; 
But only he who sees takes off his shoes— 
The rest sit round and pluck blackberries.” 

It’s a brilliant reminder that sources of awe are not scarce, even if we are prone to overlooking them. In speaking of “he who sees” Browning suggests that there are some people who see the world in a way that anticipates moments of wonder, and that such people are willing to “take off their shoes”. This is an allusion to the story of Moses in the Bible, who, when he encounters the miraculous mystery of the burning bush in the desert, is commanded by God to take off his shoes because the ordinary desert has now become sacred and holy ground – a place of awesome encounter.  

Perhaps we should take our cue from brother Benedict, and simply stop and kneel where we are, by the side of the path, in amongst the box-hedge.

This type of atunement is available to any of us, no matter how full the schedule. Even as I write – and you read – this article right now, any of us might pause to take in our surroundings and be able to find something to value and find amazing, a little bit of heaven crammed into earth. It might be a large thing, like the view from the window, or small thing, like the curling steam rising from a cup of coffee on the desk. Anything can become meaningful if we choose to observe its meaning; anywhere can become holy ground if we make it a place of encounter with all that is awe-inspiring and that transcends our daily lives.  

What stops us, I wonder? Is it that for me writing this article, and for you reading it, this is just another task that we feel we must finish so that we can hurry along to finishing something else? We must keep pressing on, threading our way through the box-hedge-maze today, because the time for visiting the terrace is not now, it’s later – in a few weeks’ time, when the schools break up and we can finally “get away from it all”. 

Perhaps we should take our cue from brother Benedict, and simply stop and kneel where we are, by the side of the path, in amongst the box-hedge. If we look closely, we might even notice that it is made up of a thousand million tiny leaves, each with its own little leafy life to live, each patterned with tiny, intricate veins. Beautiful, and for no obvious reason. Most people will never notice this – but we have seen it now. In the middle of all things quotidian, here is a common bush, and it is afire with God. There is nothing to stop us noticing this, and when we have done so, we can get up, take off our shoes, and continue to walk.

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