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.

Support Seen & Unseen

Since Spring 2023, our readers have enjoyed over 1,500 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

Article
Comment
Migration
Politics
Romance
5 min read

Families like mine are impossible now, thanks to the idol that is the net migration target

Politician priests are making pointless sacrifices on the altar of numbers

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

A Border Force officer wears body armour with Immigration Enforcement written on the back
UK Border Force.

Let me tell you a love story. Eighteen years ago, in a time before politicians had taken to immolating their values on the altar of the semiannual net migration totals, I fell for the pretty Scottish bridesmaid at my sister’s wedding. The romance presented some challenges for an American like me, but none that were insurmountable. She found a year-long internship near me in Seattle and, just before she returned home, I popped the question.  

The process of applying for a UK visa was just another bit of the tedious logistics of an overseas move, the kind of thing a romantic comedy skips over with a ‘One Year Later’ movie subtitle so that it can end with a joyous wedding ceilidh in a picturesque Scottish locale. Our first few years together in Edinburgh were lean ones. Having takeaway coffee more than once a week felt like a scandalously indulgent luxury. Even so, I was able to progress seamlessly from my marriage visa to indefinite leave to remain, to citizenship.   

None of this would be possible if we were young twentysomethings in love today. We would fail every test of what the Home Office now considers to be acceptable romance.  

During our first year of marriage, the stipend my wife received while training for ministry would have been well short of the £18,600 income threshold introduced in 2012 for a sponsoring spouse, let alone the £29,000 required now. While we did have some savings, they were nowhere near the £88,500 now needed to waive the income requirement, and, in any case, would have been substantially drained by the £5,000 in fees and health surcharges that a two-and-half-year spouse visa now costs. It is little wonder Brits who have found love abroad, even ones in a substantially better financial and professional position than we were then, are now finding it impossible to move back to the UK.  

What is the cause of these new barriers? A hint can be found in the title of a recent Guardian article about recommendations for a slight relaxation of the income threshold to between £23,000 to £25,000. ‘Lowering UK’s income requirement for family visas ‘would increase net migration’, the piece was headlined. When even the most left wing major daily in Britain can’t report on the possibility of things being marginally easier for Brits who have the temerity to love a non-citizen, without framing it in terms of net migration, it’s a sign that we have all fallen captive to this singular statistic.  

Net migration is a number created by humans and yet it has come to play the role of an angry god which demands sacrifices every time it is reported. The right of working class people to marry a non-citizen spouse, the economic viability of our universities, and the proper staffing of the NHS are all victims its politician-priests have offered up in hopes that they would satiate its hunger. Net zero maybe next. 

There is no particular reason to think totting up the total number of people who arrived in the UK with the intention of staying here for a year and then subtracting the total number who left with the intention of staying abroad for a similar duration is a particularly meaningful exercise. It conflates people like me, who came here with every intention to settle and start a family, with students coming for a one-year master’s, doctors filling vital roles in NHS with children try to stay with with a migrant parent and Afghan refugees seeking long-term sanctuary with oil workers serving time in Aberdeen before moving on to Calgary or Brunei.  

The dominance of this statistic in our discourse has warped our moral discernments. 

There are perfectly legitimate reasons to think carefully about how much of each form of migration to allow, but when they are all grouped together under this single measure a peculiar logic sets in. Want to do the right thing by welcoming refugees from Ukraine and Hong Kong? Well, then, we’ll have to offset that with restricting visas for overseas students and throwing our higher education sector into chaos. Need more highly skilled programmers working in banks in London? Well, maybe we can balance that by demanding care workers abandon their kids if they want to look after someone in Nottingham. There is no reason to weigh the needs of these different sectors against each other, and yet the logic of this statistic demands that we do. 

The Bible has a word for human-made things which take on their own singular, violent logic. It calls them idols. While that word may conjure images of golden calves, the accusation which biblical writers consistently make against idolaters, that their idols blind them to what is really important and numbs their critical thinking, applies equally well when the idol is a statistic. The dominance of this statistic in our discourse has warped our moral discernments. It has made us unable to say what should be said without glancing nervously at its imposing shadow. It causes us to say things that should never be said and not notice how absurd they are. 

Instead, we should be able to celebrate that hundreds of thousands of people want to come to study at our universities (the vast majority of whom return home after finishing their studies)  and, hopefully, someday also be able to celebrate when hundreds of thousands of refugees are able to return to a peaceful and liberated Ukraine without having to calculate that the former will raise and the latter lower our totals. We should be able to welcome easing of income restrictions on spouse visas without noting that it will lead to a marginal increase in net migration. We should be able to see that sending an eight- and eleven-year-old back to Brazil without their parents is not, in the words of a Home Office official, “a degree of disruption in family life” which is “proportionate to the legitimate aim of maintaining effective immigration control”, but rather a gross violation of human decency. 

Migrants are not just numbers on a balance sheet. The diversity of our lives, what we give to the UK, what we receive in return, cannot be summed up in a single annual figure. And yet every six months, as the figure comes out, politicians express disappointment and announce measures to put that little bit of extra pressure on us, so that maybe a few more of us who can leave will. In the process they are sacrificing to this idol not just the peace of mind and the economic well-being of many migrants, but also much of the vitality of the nation as a whole. The Bible has a solution for idols. They are only fit to be melted down, destroyed, and forgotten. It is time to consider giving this one a similar treatment. 

Support Seen & Unseen

Since Spring 2023, our readers have enjoyed over 1,500 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