Article
Assisted dying
Care
Comment
Ethics
6 min read

It's a dreadful thing when we regard the disabled, the dependent, and the different as disposable

A MND sufferer reflects on the historic vote to legalise assisted dying
A crowded House of Commons awaits a vote.
MPs await the result.
Parliament TV.

I can’t say I’m surprised, but I am disappointed. The euthanasia juggernaut has been gathering momentum throughout the western world. In this country it appeared as the Voluntary Euthanasia Society, to be later rebranded as the richly endowed Dignity in Dying. It’s been beavering away for decades, with well publicised personal stories and legal cases which have been very effective in persuading general opinion that dying is frequently nasty and that we should have the right to choose when and how to die. That organisation resisted using the term ‘suicide’, which is what they advocate, realising that it opens up the accusation of devaluing life. So, I’m not surprised that MPs have, after an impassioned debate, by a narrow majority, eventually given way to the pressure.

A fortnight ago, I had my annual check-up at the motor neurone disorder clinic and subsequently received the GP letter.

“Date seen 02/06/2025…  Diagnosis (this visit) Primary Lateral Sclerosis…  Symptom onset 2000”.

I well remember the year 2000, my voice deteriorating, my balance starting to fail me, resulting finally a year later in the consultant’s verdict, “You have a motor neurone disorder.”

I knew what that meant as at the time Diane Pretty, backed and publicised by the Voluntary Euthanasia Society, was fighting through the courts as far as the European Court of Human Rights for the right for her husband to take her to commit suicide in Switzerland in the Dignitas “clinic”. It was a frightening time to receive an MND diagnosis, and it still is today. The normal progression is both swift and relentless. However, the Motor Neurone Disease Association does say “in the majority of cases, death with MND is peaceful and dignified”.

At that time I could have been depressed; I could have known how much care I would need, how much it might eat into our savings; I could have feared the physical and emotional toll it would take on my wife; I could have been desperate about the future. Certainly I was vulnerable. Fortunately, I was of an optimistic nature and had plenty of reasons for living.

But it could easily have been otherwise. I might well have panicked and opted for a doctor to help me die, if the law debated in the Commons today was in effect. Then I wouldn’t have seen two sons getting married nor grandchildren being born and growing up. I would have missed out on twenty years of an increasingly restricted but paradoxically fulfilled life.

Of course you might argue that I’m ‘lucky’ to have, as became clear over the years, my exceptionally rare and slow form of MND, but I wasn’t to know that, as indeed none of us do despite our doctors’ best predictions. Indeed I am lucky to be alive.

However it was my experience that brought me face to face with the fact of my own mortality and the issue of assisted dying. There seemed to me to be four main drivers. First, the desire for autonomy; second, the insistence of independence; third, a sort of compassion, and fourth, finance. There were two further factors: fear of death and fear of being “a burden”.

Autonomy

It’s a modern western concept that humans are by nature autonomous beings, meaning that choice is an inalienable right. I once co-wrote a book with the title, I Choose Everything, based on a quote of Therèse of Lisieux. It was from a childhood incident, but it did not mean she reserved the right for total autonomy, but rather the opposite. As she later wrote, “I fear only one thing: to keep my own will; so take it, for ‘I choose all!’ that you (God) will!”

Absolute choice is not a virtue. Choosing where to drive your car is not a virtue as it can endanger other road users. There are many limitations on freedom or taboos that protect others in a society. Taking someone’s life directly or indirectly is a universal one. Individuals submitting to a higher authority holds a community and a nation together.  

Independence

Another related modern heresy is the ideal of independence. How utterly fatuous this is! None of us is born independent. We’re born relational. All of our lives we are interdependent. Being cared for is not to be lacking in dignity. Being 100% dependent does not deprive someone of their human dignity. Even the most disabled person is a human being made in the image of God. It is a dreadful thing when a society regards the disabled, the dependent, the different, the mentally deficient and the declining as inferior and potentially disposable. Of course the advocates of the Bill would vehemently deny that they or it implied any such thing. Yet the history of the twentieth century bears witness to how subtly a society can be seduced by the pernicious philosophy of eugenics.

Compassion

It is a modern paradox that medical advances have contributed to the illusion that death is to be feared. Yes, death has always been the last enemy and, yes, we hope it will be peaceful. But we shall all die. Contrary to received wisdom, the compassionate response to that fact of life is not to “put someone out of their misery”; compassion (literally suffering with) means to be with them in their suffering. This is what good palliative care provides, making the end of life dignified, worth living and even pain free.

As former Prime Minister Gordon Brown pertinently asked, “When only a small fraction of the population are expected to choose assisted dying, would it not be better to focus all our energies on improving all-round hospice care to reach everyone in need of end-of-life support?”

Finance

Of course palliative care costs more than facilitating patients to take their own lives. According to the Daily Mail “Legalising assisted dying would save the taxpayer £10million in NHS costs in its first year, rising to £60million after a decade, according to grim new estimates published by the government.” The estimates are indeed grim, but also attractive to politicians straining to balance the national budget. Yet they raise the fundamental question: do we want to live in a society which values money over life?

Which is the most fundamental of all the issues: the sanctity of life has been a core principle central to all the Abrahamic faiths, which undergird our culture and way of life. In the words of Job on hearing of the death of all his children, “The Lord gave and the Lord has taken away.” The start and end of life are not ours to determine. We lack the wisdom of God.

Apparently the majority of our parliamentarians have decided to place that prerogative into the hands of suggestible and distinctly fallible humans beings. We or our children shall, I fear, reap the whirlwind.

As an afterthought I have a number of friends who disagree with me, often after personal experience of watching a loved one die. I sympathise and I suppose that I must be glad for them that the MPs have represented their wishes. And I would never condemn them if they decided to choose the route of assisted dying for themselves. I hope they won’t have to.

Meanwhile I trust that, when the Bill comes to the upper house, their Lordships will fulfil their function of revising it wisely and effectively. They certainly have relevant expertise, for example in the field of palliative care - which is in danger of being squeezed following this bill.

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Explainer
Change
Community
Migration
Politics
9 min read

The facts and our feelings both puncture the small boats-fuelled immigration argument

From stats to sociology, how to be better informed on the issue

Roger is a Baptist minister, author and Senior Research Fellow at Spurgeon’s College in London. 

A people sumggler steers an overcrowded small boat.
A people smuggler steers a small boat, 2021.
x.com/ukhomeoffice.

Late in the evening of May 20, over 80 refugees clambered aboard the small boat that was to bring them to England. They had not gone far when French rescue services were summoned with the boat still located off the Pas de Calais. An eight-year-old boy and a 40-year-old woman were pronounced dead by the medical team and taken to Calais. Both were believed to be Turkish nationals, with their deaths presumed to have been caused by a combination of crushing and suffocation. The small boat continued its journey without them, though 10 others were also evacuated. 

This story is deeply shocking.  

What is also profoundly disturbing is that, while we may not be aware of the details of this particular case, the story is still familiar to us. According to the University of Oxford’s Migration Observatory there were 73 deaths crossing the Channel in 2024. 

It was almost 30 years ago, in the wake of the UK’s 1996 Immigration & Nationality act that I first became aware of the issues surrounding refugees and asylum seekers. Our church in Croydon was only a short walk from the Home Office’s Immigration and Nationality Directorate based at Lunar House, and it seemed to make sense to begin a drop-in centre. The Croydon Refugee Day Centre has continued its work ever since. 

From the beginning it was hard to miss the fact that asylum was a hot-button issue. The reactions it triggered were intense. I also quickly discovered that nothing was straight-forward. Weaponised politics, the labyrinthine complexity and glacial slowness of our state bureaucracy along with the internecine nature of the charitable sector made collaborating with others frustrating and problematic to say the least. 

Over the years I’ve learned two important lessons with regard to immigration and asylum. First, what grabs the headlines is not necessarily the most important issue. Indeed, it can deflect attention, action and resources from what is of primary significance. Then, second, complex issues are rarely solved by simple, straight-forward, 'silver bullet’ solutions. As the American satirist H. L. Mencken observed: 

“Every complex problem has a solution which is simple, direct, plausible—and wrong.” 

So, with the issue unlikely to go away in the foreseeable future, these are some of the things I believe we need to understand and have an eye to. 

Immigration: don’t get confused 

When the Office for National Statistics reported in May that the total of long-term immigrants to the UK in 2024 was 948,000, that really does seem like a very big number. And it is. But it includes everyone coming to the UK who is changing the normal place where they live. It includes those who’ve come to study here (30 per cent) and those who’ve got a UK-based job (33 per cent).  

The foreign students on full fees raise vital revenue for the universities and subsidise the fees for home students, and those coming to work here make a significant contribution to the economy. Not to mention the legacy of ‘soft’ influence when both return home having had positive experiences of life in the UK. 

Incidentally, and a little out of left field, the immigration figure also includes Brits returning home from living abroad. In 2024 they accounted for 60,000 individuals, or 6.3 per cent of the total. 

Asylum seekers and refugees only make up 15 per cent of the overall number (including the Homes for Ukraine scheme), with those claiming asylum from the small boats only 5 per cent. 

The small boats: don’t get distracted 

Perhaps the main reason for the small boats featuring so prominently in the immigration narrative is the compelling nature of the images the news media can use. Include criminal gangs and the jeopardy of life and death and the result is a heady mix. 

But here’s the thing, the Migration Observatory report that: 

“Between 2018 and 2024, the asylum grant rate for people who arrived by small boat was 68%.” 

Allow that to sink in for a moment: almost seven out of ten of those who arrive by small boat have a legitimate reason to seek asylum in the UK. The real villains here are the criminal gangs, not the passengers they transport. 

Things could look very different if there were safe pathways for these asylum seekers to follow. On these figures the bottom would be blown out of the business model of the criminal gangs that operate the small boats, and they would swiftly move on. Especially if accompanied with the speedy removal of those who have no right to remain in the UK. This would act as a significant disincentive to those who would have previously made an unsuccessful attempt. 

This has to be the way to tackle the presenting problem of the small boats, especially when the ‘push and pull’ influences are given proper consideration.  

‘Push’ and ‘pull’: don’t be misled 

‘Push’ issues are those that cause the migrants to leave their home. Iran, Iraq and Afghanistan have consistently been the most common sources for asylum seekers over the last 30 years. and this tells its own story. Together they underscore that the key ‘push’ factor is people seeking to escape persecution, conflict or danger. 

‘Pull’ influences are why a particular country is the preferred destination. Extensive research has established in the case of the UK the ability to speak English, the presence of family already here and the “general impression that the UK is a good place to live" are far and away the strongest influences. Disproving the popularly advocated myth that it is about the black economy or sponging off the benefits system.  

The right to work: don’t be fooled 

The total cost of the asylum system in the UK was an eye-watering £5.4b in 2023-24, a figure that is largely driven by a backlog in processing applications. On average this took 413 days in 2023-24 with the year-end backlog standing at 91,000. For the 38,000 of those awaiting a response in hotel accommodation, this comes at a cost of £41,000 per person, per year.  

Thankfully the number awaiting a decision is decreasing, but because asylum seekers are not allowed to work until they’ve been waiting for over a year, they cannot contribute to their own support. In France they are allowed to work after six months and in Italy after only 60 days. 

It is, perhaps, a sobering thought that those who have shown the initiative, resilience and tenacity to attempt a passage to a new life, not even deterred by the threat of death, might be the kind of asset to the country and its economy that we need. 

The world we live in: don’t close your eyes 

We cannot uninvent the fact that we live in a globalised world. The preponderance of international supply chains and the fact that 54 per cent of Brits travel abroad on holiday only underlines how ingrained it is in our everyday lives. We are all interconnected to a degree that we cannot possibly comprehend.According to the World Health Organisation, the origin of COVID-19 in Wuhan, China in December 2019 led to between 8-9 million deaths worldwide; the container ship Ever Given, stuck in the Suez Canal in March 2021 cost the global economy $9.6 billion per day; and the Russian invasion of Ukraine in 2022 had a catastrophic effect on grain and fertilizer prices in sub-Saharan Africa. 

All that to one side, migration to these shores has been part and parcel of our history since before we had a history. From the Romans, Anglo-Saxons, Vikings and Normans, to more recent arrivals from the Caribbean, South Asia, Poland and Hong Kong this is an integral and ongoing part of the story of the British Isles. It is what has made us British. 

The politics of migration: don’t be seduced 

In these febrile political times, many will be quick to jump on the bandwagon of blaming the immigrants for everything that is wrong. The narrative is a seductive one that makes a visceral connection with listeners. Where the substance of argument is missing emotive language will do the heavy lifting on its own, so look out for speech like this: 

  • Crisis or emergency language: out-of-control, unprecedented, overwhelmed 
  • Metaphors of flooding or invasion: tidal, swamped, relentless 
  • Threatening or dangerous terms: illegal, criminal, extremist 
  • Dehumanising or reductive language: waves, swarms, hordes 
  • Economic or social burden framing: unsustainable, overstretched (services), job-stealing 
  • Warnings of loss: losing our culture and traditions, no-go areas 

It’s the sociologist Zygmunt Bauman, commenting on life in the city, who coined the terms ‘mixophobia’ and ‘mixophilia’ to describe some of the dynamics he observed. But I think they can extend to the whole of society, not just our cities. Indeed, with Bauman I think we can even experience both feelings within ourselves at the same. We experience the fear of ‘mixophobia’ – of being involved with strangers – in our  

“… reaction to the mind-boggling, spine-chilling and nerve-breaking variety of human types and lifestyles that [we] meet and rub elbows and shoulders [with] in the streets” 

“Mixophilia”, by contrast, is the joy of being in a different and stimulating environment. 

“The same kaleidoscope-like twinkle and glimmer of the urban scenery, … never short of novelty and surprise, [that] constitutes its difficult-to-resist charm and seductive power.” 

Born a Polish Jew in 1925, Bauman’s family fled to Russia in 1939. As Professor of Sociology at the University of Leeds t He maintained that the holocaust was not the breakdown of modern civilisation, but rather the product of it. 

Twenty years ago, he predicted that Europe would be faced with a battle between “two contending facts of the matter”. On one side would be the life-saving role played by immigrants in a fast-aging Europe. On the other, “the power-abetted and power-assisted rise in xenophobic sentiments eagerly recycled into electoral votes”. 

For Bauman “mixophobic paranoia” feeds upon itself and acts as a self-fulfilling prophecy. It may temporarily reduce the pain that those afflicted by it feel, but ultimately only makes the condition worse. Rather, “mixophobia” is the symptom of their anxiety, not the cause – acting on it is like “removing the rash while mistaking it for the cure of the illness”. 

If there is to be any hope for him, it is in the cohabitation and interaction with strangers that the future lies. 

So, there it is. As shocking and disturbing as the stories and images of the small boats are, it is not really about the small boats. Sitting beneath the phenomena is the age-old issue of migration, with the sharp and divisive edges of its present-day expression. 

In the late 1990s I was proud of the churches in Croydon rallying together to establish the Refugee Day Centre. In the years that followed it was often groups of churches who took the lead in their own towns and cities as asylum seekers were dispersed around the country. 

It was a practical way to “love our neighbour as ourselves”. In the rallying cry of the Victorian Christian social reformers, “The Fatherhood of God means the brotherhood of man.” 

As the historian Tom Holland has observed it is because Western values are deeply rooted in the Christian tradition that human dignity and the sanctity of life are deeply prized virtues that animate our best intentions and our understanding of what is good. 

In his mid-80s, Bauman wrote: 

“For more than forty years of my life in Leeds I have watched from my window as children returned home from the nearby secondary school. Children seldom walk alone; they prefer walking in groups of friends. That habit has not changed. And yet what I see from my window has changed over the years. Forty years ago, almost every group was ‘single colour’; nowadays, almost none of them are …”