The careless conflation of independence, autonomy and dignity

As Jersey begins to legalise assisted dying, there’s keyword confusion.

Henna Cundill

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

A elderly women in a care home stands and places her hands on the shoulders of a seated woman.

Eberhard Grossgasteiger on Unsplash.

Reviewing Canada’s legislation on assisted dying, one article raises the concern: “Does it make dying with dignity easier than living with dignity?” This insightful question cuts to the centre of the debate: dignity. Or more particularly, the unwitting conflation of dignity with independence, and of independence with autonomy.

As Jersey becomes the first place in the British Isles to begin the process of legalising assisted dying, I feel that we should listen carefully as to how and where these terms are being used, both in the formal debate, and in the commentary that surrounds it. The States Assembly in Jersey voted to allow the development of assisted dying legislation for those with six months to live (or twelve months if their condition is neurodegenerative). A second vote to make assisted dying available more broadly to those who experience conditions that entail “unbearable suffering” was defeated by a narrower margin. Reading the flurry of press releases that followed the vote, these keywords, autonomy, independence, and dignity, are everywhere. But are we really thinking about what these words communicate?

People in positions of wealth and power have more independence and autonomy, more choices and freedoms, but it is we who ascribe dignity to those in that position.

The word dignity comes from the Latin word dignus, meaning ‘worthy’, and this is still the primary definition given to the English word dignity today. The OED dictionary has it as “the quality of being worthy or honourable”, immediately followed by reference to “honourable or high estate”. If this is so, then dignity is not something that can be bought, nor assumed – it is a status conferred upon someone by the esteem in which other people hold them. The haughtiest person in the world can still be esteemed undignified, as can the richest. Moreover, the opposite is also true: we are never prevented from conferring dignity upon, and esteeming the worthiness of, those who live the humblest of lives.

And yet, if we are honest with ourselves – do many of us not quietly associate the idea of becoming rich and powerful with becoming dignified? Do we not tend to assume the worthiness of those in high office – at least until we meet them and realise pretty quickly that they all put their trousers on one leg at a time, the same as the rest of us. This association happens because we have such a tendency to conflate dignity with independence (the ability to live without assistance from others) and autonomy (the ability to make one’s own decisions, and not have those decisions limited or interfered with). People in positions of wealth and power have more independence and autonomy, more choices and freedoms, but it is we who ascribe dignity to those in that position. It is society who sees the autonomy of those in high status, and esteems it as dignified.

Does this not unwittingly suggest that choosing to live in a state of extreme dependence on palliative care is, by implication, undignified?

Repeatedly ancient wisdom, in the Bible, warns us not to assume that dignity comes with the freedom of wealth or power. All the great ‘heroes’ of that book suffer their indignities. Fresh from the success of his Ark project, Noah gets drunk and exposes himself. Elated from a victory against an enemy, King David dances half-naked through the streets. These are just two examples of the catalogue of embarrassments and mishaps that beset nearly all the kings and leaders whose stories are told as part of the Christian story. One after another, they stumble and struggle with life and leadership. The apostle Paul explains that this is because God uses the foolish things of this world to shame human pride, “for even the foolishness of God is still wiser than human wisdom.” Therefore, Paul argues, God chooses to speak to us through the weak and the lowly things and people of this world. Never was this demonstrated so clearly as when Jesus was born in a draughty stable, lived a life of poverty, and died a criminal’s death on a cross.

But what has all this to do with the debate over assisted dying? Well, I am struck by how often the idea of losing one’s independence (through disabling or terminal illness) is conflated with losing one’s dignity, and so dying through personal choice (autonomy) is presented as regaining it. One campaign group that speaks to this debate even calls itself ‘Dignity in Dying’ – but does this not unwittingly suggest that choosing to live in a state of extreme dependence on palliative care is, by implication, undignified?

Independence is not possible for everybody, or not possible to the same degree. And dignity? Well, dignity is possible for anyone.

The Dean of Jersey, the Very Reverend Mike Keirle, has spoken of his concern that the change in legislation will make vulnerable people feel pressured to end their lives. Examples from Canada, where physician assisted dying is already available, show that his concern is not unfounded. In 2022, Canadian veteran and Paralympian Christine Gauthier phoned her caseworker to chase up the over-due installation of her new wheelchair ramp. She then describes how she was horrified to find herself being advised to consider assisted dying instead.

"It is remotely just what they're doing,” says Gauthier, “exhausting us to the point of no return. […] I was like, 'Are you serious?' Like that easy, you're going to be helping me to die but you won't help me to live?"

Gauthier is not alone – she spoke out when she learned that four other Canadian veterans had reported similar experiences. In these unhappy moments, one can see how dangerous the assumption can be – the assumption that no one would want to live a life of needing help. Here are disabled people who do want to live, and this assumption, this careless conflation of independence, autonomy, and dignity, leaves them fighting for their right to do so. Why should anyone have to fight or even speak for their right not to commit suicide? It is little wonder that disabled actress, Liz Carr, describes assisted dying legislation as “terrifying” for disabled people.

I respect that there are terminally ill people, and those who love them, who speak from a desire to end their suffering; it is clear that people on all sides of the debate need to have this difficult and emotionally charged conversation. But whatever the eventual outcome in terms of legislation, we must be careful that it is not based on careless assumptions, or on the conflation of one thing with an entirely different other. Independence is not possible for everybody, or not possible to the same degree. And dignity? Well, dignity is possible for anyone – it is a state that can be conferred whenever, and upon whomever society chooses to confer it. Autonomy is the matter in question – we are talking about autonomy in dying. And whatever happens, we should by no means legislate in a way that leaves disabled people esteemed unworthy, left open to the indignity of fighting for their right to live.

Article

Climate

Comment

Politics

27 November 2024

7 min read

Neighbours, nimbys, and politician power plays

Is there a politics that takes both love of the land and climate concerns seriously?

Joel Pierce

Joel Pierce is the administrator of Christ's College, University of Aberdeen. He has recently published his first book.

A sign protesting a proposed wind farm stands on flat moorland.

A Scottish wind farm protest sign.

Richard Webb, Wikimedia Commons.

It was easy to forget the fury of the past few winters in the gentle light of the golden autumn which enveloped our corner of rural Aberdeenshire over the past month. The scars Storm Arwen tore through the landscape three years ago, toppling whole hillsides of trees, and the flood-soaked fields of last winter were hard to conjure when faced with the thousand colours that painted the landscape. The smoky green of pine forests in twilight, the shocking scarlet of apples my daughters picked from our neighbour’s tree, the little violet fireworks of elderberry clusters hanging above the path to our house, these chased away worries about the future and the past and demanding attention to the present. Amid this array, it was easy to see why Queen Victoria chose our corner of Scotland for her rural retreat over a century and a half ago. The changing of the season has something of the eternal, sacred, and inviolable in it. “Let the field be joyful and all that is therein; then shall all the trees of the wood rejoice,” sang the ancient Psalmist. Surely, if ever a land was obedient to this command, it was our valley’s, this October. Surely too, it is our duty to preserve it so that it can sing out for a thousand more such autumns?

This drive to preserve is evident in the signs that appear regularly on fences as you drive through our valley. “STOP MONSTER PYLONS” and “NO WINDFARM ON HILL OF FARE” they say in capital letters large enough to communicate their creators’ anger. Our valley, which connects the Highlands to the sea, is prime real estate for the sorts of development necessary to transform the UK economy, which still gets 77 per cent of its energy from burning fossil fuels, into one built on renewable energy. Our hills are ideal for turbines and our land must be crossed if transmission lines are to carry electricity from wind farms in the north to population centres like Edinburgh, Glasgow, Manchester, and London. To many of my neighbours this sort of construction amounts to an industrialisation of the countryside, an irreversible scarring of pristine land in service of interests far away which care little for them. This view is common enough that almost all of the local village councils have expressed opposition to the developments. When my neighbours are characterised by senior government ministers as “the blockers, the delayers, the obstructionists”, I suspect it only hardens their resolve.

It is not hard to imagine Adam the gardener or Abel the shepherd attending to their land and animals with similar care to that of my neighbours.

Sometimes I wonder if what politicians have in mind when they think of my neighbours are the sorts of toffs featured in Rivals for whom the countryside is a playground of upper-class indulgence. I am not rich. Neither are most of my immediate neighbours, many of whom rely on waiting tables at the local farm shop or cleaning holiday lets to make ends meet. My understanding is that most of the local farmers consider themselves lucky if they turn any profit at all from their long and exhausting hours. Every year we wonder if there will be enough pupils to keep our local primary school open. Every winter we prepare for the inevitable interruptions caused by power cuts, school closures, and unplowed roads.

If I had to guess at what keeps my neighbours here it is the land itself, watching and admiring it, caring for it, aligning the rhythms of their life to it. Autumn can be wonderful, but so too is spring. I drive to work past newborn lambs trying out their stilt-like legs, anticipate the sudden return of house martins to their nests under our eves, and enjoy weekend walks up the hillsides amid the sun-yellow mazes of coconut-scented gorse bushes. Each season land presents itself to us, demands our attention, calls for our admiration.

In the two creation stories of Genesis, what it is to be human is to be made in the image of God and to be given the task of tilling and keeping the land, respectively. A way of reading these together is that humans are to be priests to creation, recognising and praising its beauty and caring for it in a way which reflects God’s love for it. In my last article for Seen & Unseen, I discussed philosopher Alasdair MacIntyre’s concept of practices and how the human activities he identifies as practices can order and give meaning to our lives and communities. Another way of thinking about these practices is that they are all, in some way, an expression of this original edenic imperative, to see, to respond to, and to care for God’s creation. If this is true of any practice, it is perhaps most transparent in rural ones. It is not hard to imagine Adam the gardener or Abel the shepherd attending to their land and animals with similar care to that of my neighbours.

The practices we engage in have a way of becoming enmeshed with our identity in such a manner that it can be hard to imagine ourselves without them. That is why, I believe, opposition to wind farms and pylons runs so deep here, and why, as geographer Patrick Devine-Wright has demonstrated, attempts to offset the financial downsides of developments through local grant programmes and other compensation do very little to swing public opinion in favour of development. As he demonstrates, at the root of such opposition is an affective attachment to the land, one that money cannot buy away and which resists even the most well-reasoned arguments which attempt to ignore it.

And yet, I know, my neighbours know, that all is not well with the land. Although we draw sizable crowds on Easter and Christmas, the most packed I’ve ever seen our parish church was when a locally born climate scientist came to present his research on Antarctica. He walked us through what it is like to live there, how scientists survive the winters, and what they eat, but all anyone was interested in the Q&A that followed is what can be done about climate change. It is hard to ignore it. It is there in the good and the bad: in the pleasant, nearly tropical breeze that ushered my children from house to house on Halloween; in a mild winter making ticks and Lyme’s disease a regular visitor; and in the onslaught of storms felling fifty year old forests in a single night and cutting road and railway connections to the rest of Britain for days on end. If we are to keep these changes from becoming more extreme, if we are going to bequeath to our grandchildren a countryside with the beauties admired by Queen Victoria and countless others, we need to slow this change. We need to move away from fossil fuels and to renewably generated electricity and given that, as I said above, 77 per cent of our energy is still made by burning carbon, we need to produce not just a little more electricity, but a lot. The answer to the oft repeated question, “Wouldn’t these be better, if they were built somewhere else?” is that, yes, they will need to be built somewhere else and here, and in many other places, if we are going to get anywhere close to a carbon-free future.

The land will be changed either way. Our choice is some scarring now, or a terminal decline later.

What might a politics look like that both took my neighbours’ attachment to the land and these realities seriously? What it shouldn’t be is one that castigates my neighbours for that attachment. That only feeds suspicions that what is really at play is an exploitation of the countryside to feed the excesses of the cities. Such exploitation runs deep in the folk memory of Scotland. The Clearances only lightly touched our valley, but a little travel here or there takes one by abandoned villages. Those who resisted then, clinging tightly to their land, also might have been called blockers, delayers, and obstructionists by modernising absentee landlords the sitting rooms of their Edinburgh townhouses, intent on replacing them with more profitable sheep.

However, the possibility exists for drawing my neighbours’ attachment to the land into the conversation about why these developments are needed. The land, the planet, is sick, and sometimes the scars of a necessary surgery are a price worth paying for survival. The alternative to roads rising up our hills to turbines and to transmission lines cutting through now fertile fields is a future of longer droughts, hotter heat waves, and more extreme storms, bringing with them infertile fields, forest fires, and landslides. The land will be changed either way. Our choice is some scarring now, or a terminal decline later.

But for such a rhetoric to work, politicians need to be serious about everyone bearing someone of the burden of climate solutions, both here in the UK and across the world. It can be tempting to give up hope in this regard. More than one article about our area has cited farmers complaining about how what we do won’t really matter anyway since China and India will burn away any positive effects of renewables here. But there are problems closer to home too. When UK governments and traders gush about the possibilities of new, power-hungry technologies like AI and cryptocurrency it can give any discussion of net-zero an air of unreality. Turbines and transmission lines can be part of caring for the land and can be shown to be in continuity with those other practices of care, but if other changes aren’t made, they will be as useful as a keyhole surgery on a patient who is bleeding out.