Column
Assisted dying
Care
Comment
4 min read

Proposed euthanasia safeguards insult our NHS

We must defend a collective sense of care and generosity.

George is a visiting fellow at the London School of Economics and an Anglican priest.

A gable end mural depicts a nurse in scrubs and a mask turning and looking towards the viewer.
A mural of an NHS nurse during COVID, Manchester.
Mural Republic

It was, I believe, the late political satirist Simon Hoggart who coined the Law of the Ridiculous Reverse, which held that, if the opposite of a statement is plainly absurd, then it was not worth making in the first place.  

This law comes to mind when Labour MP Kim Leadbeater promises that her Assisted Dying Bill will have the “strictest safeguards in the world”, one of which is that those patients who have ordered their fatal dose “would be allowed to change their mind at any time.”   

Where, exactly, has it ever been suggested that an individual, having asked for an assisted death, would not be allowed to change their mind? I’m just wondering which legislator or medical professional has proposed that once a lethal draught has been prescribed then there is no turning back.  

I’m struggling to picture the circumstance in which a terminally ill patient is pinned down and killed, the last words that they hear being: “I’m sorry Mrs Simpkins, but everyone’s gone to a lot of trouble. You asked for it and you’re jolly well going to get it.” 

This is important because, apparently, being able to change your mind about asking for help to kill yourself is one of the strictest safeguards in the world. I hope Ms Leadbeater will forgive me for pointing out that this doesn’t really stack up. 

 And what’s serious about it is that it’s also a massive straw man argument. The clear and rather devious implication is that one of the arguments being made against the introduction of an assisted suicide law is that patients won’t be able to change their minds about it, which I think we can all accept simply isn’t a fact at all. It’s absurd – a Ridiculous Reverse. 

So I’ll defend the NHS with a religious fervour. To my mind, healthcare is a holy mission. We meddle in law with the Hippocratic Oath at our very deep peril. 

It’s also hugely contemptuous of the medical profession in general and rude to the NHS in particular. That’s because there’s a snide impression behind Leadbeater’s comment there may be hundreds of budding Harold Shipman out there, but her powerful safeguards are going to protect us from them. 

We’re in danger of becoming inured to this kind of insult from politicians directed at the NHS. And it’s worth exploring why they might think we need to be protected from unscrupulous doctors and nurses. In this case, one possible reason is that the NHS isn’t being particularly helpful in giving the euthanasia enthusiasts what they want. 

Doctors and their staff have plenty of ethical objections to assisted suicide. But leave those aside for a moment. At the practical level, the NHS has made it clear that it doesn’t have the infrastructure to operate a policy of assisted deaths safely. And it can’t afford to set one up. So a government that introduces assisted suicide is going to have to organise and regulate its own assisted death agency. 

“Oh,” the assisted dying lobbyists seem to exclaim, “we’d presumed you’d do as you’re told.” Just hand out the hemlock. Take your instructions from the legislature. 

But the NHS is better than that. And it’s that kind of high principle that so infuriates feckless politicians. It was the late Nigel Lawson who said, somewhat ruefully, that the NHS “is the closest thing the English have to a religion”. The right wing of politics regularly tells us it’s time to renounce that religion. 

To worship the NHS as a religion would, literally, be idolatrous. But it’s not so to acknowledge its religious qualities. Just look at the word – the Latin religio means something like “good faith”, the essence of who we are, what makes us good. 

The NHS, in its post-war incarnation, has been central to who we are as a people and what defines us. It’s something to do with our collective sense of care and generosity to one another. Its members, like our national Church, make up a single body. 

This is not to co-opt the NHS as the medical wing of the Church. It’s no part of the NHS’s brief to proselytize – rather the reverse; Christian medical staff have been in deep disciplinary trouble for evangelising. It is a profoundly secular organisation. 

So the NHS emphatically isn’t in the business of propagating the gospel. But that’s not to say that we can’t be in the same business. Many priests have stories of their most affirming work being in the company of people of other faiths or of none. 

The NHS’s proud heritage is to offer treatment free to anyone at the point of access. Put another way, it will seek to heal anyone who comes to it. I make no apology for saying that sounds familiar. 

So I’ll defend the NHS with a religious fervour. To my mind, healthcare is a holy mission. We meddle in law with the Hippocratic Oath at our very deep peril. 

And when NHS professionals tell us where we can stick our assisted suicides, I respectfully suggest we give it our solemn attention, rather than patronisingly offering a Law of the Ridiculous Reverse.

Article
Assisted dying
Death & life
Ethics
Politics
4 min read

What will stop the culture of death that libertarian Britain has embraced?

Now we’re allowed to end life with impunity

Graham is the Director of the Centre for Cultural Witness and a former Bishop of Kensington.

Diane Abbott speaks in the assisted dying debate.
Dianne Abbott MP speaks in the assisted dying debate.

Just a few days apart, two debates recently took place in the House of Commons concerning life and death. In the first, MPs voted to decriminalise late-term abortions. In the second, they voted for assisted dying. Both times, the reach of death grew a little longer.

Imagine a mother about to have a baby who is suddenly having grave doubts about whether she can manage a new child as the moment draws near. It’s not hard to sympathise with many in this situation, but rather than recommend she goes through with the birth, and perhaps putting the baby up for adoption for childless parents desperate to adopt, we now have passed legislation that allows us to terminate the baby’s life instead. Proponents argued this was to relieve a small number of women who had been prosecuted for late-term abortions. The reality is, however, that it will probably become more common. In the debate, Jim Shannon MP pointed out that in New Zealand, in the first year after their parliament voted the same way, late-term abortions increased by 43 per cent.

A baby a week before and a week after birth are virtually identical. Yet as a result of this bill, it will not be a criminal act to end the life of the first, but it will be to do the same to the second. What’s the betting that the logic of this will stretch before long to allowing parents to terminate the lives of newborn babies with a new limit – say up to one month after birth? The arguments will be exactly the same – sympathy for distressed parents who suddenly realise they cannot cope with a new life on their hands, especially if the baby is discovered to be flawed in some way. When emotional sympathy, personal choice and the rights of the mother over the baby become the only moral arguments, the logic is inevitable.

Despite the argument shifting rapidly against the Terminally Ill Adults Bill – the vote passed by 314 votes to 291, with 32 MPs apparently having changed their minds - it now looks likely that this second bill will pass into law in a few years’ time, despite scrutiny in the Lords.

Here on Seen & Unseen, we have scrutinised the arguments put forward for assisted dying over past months. We have argued about the unintended consequences for the many of permitting assisted dying for the few. In The Times a while ago, I argued that if ‘dignity’ means autonomy — my ability to choose the place, the time and the manner in which I die — there is no logical reason why we should refuse that right to someone who, for whatever reason feels their life is no longer worth living, however trivial we may feel their problems to be. With this understanding of dignity as unlimited choice, the slippery slope is not just likely, it is philosophically inevitable.

In both cases the logic of the arguments used means the march of our ability to bring about death will not stop with these measures, despite their proponents’ assurances that safeguards are in place.

These two votes reminded me of something Pope John Paul II once wrote. In an encyclical, Evangelium Vitae – the Gospel of Life - he warned that “we are facing an enormous and dramatic clash between what he called a “culture of death” and a “culture of life”.

He warned that this “culture of death” would be “actively fostered by powerful cultural, economic and political currents which encourage an idea of society excessively concerned with efficiency.” It is, in effect, he argued, “a war of the powerful against the weak: a life which would require greater acceptance, love and care is considered useless, or held to be an intolerable burden, and is therefore rejected in one way or another. A person who, because of illness, handicap or, more simply, just by existing, compromises the well-being or lifestyle of those who are more favoured tends to be looked upon as an enemy to be resisted or eliminated. In this way a kind of ‘conspiracy against life’ is unleashed.”

They were strong words, and in the UK at least, back in 1995, might have seemed alarmist. Yet I couldn't help thinking of them as these two bills passed through the UK’s national parliament. In both cases, the bills were introduced very rapidly with little time for serious moral deliberation. Both depended on emotional appeals to a small number of admittedly distressing cases without serious consideration for the wider cultural and philosophical ramifications of these seismic moves. Both encouraged the steady encroachment of death on demand.

What concerns me is what these bills say about the kind of culture we are becoming. MND sufferer Michael Wenham makes the point powerfully that this is all about autonomy and independence, a spurious kind of compassion, and the fact that palliative care is more expensive than subtly encouraging the dying to take their own life. Looking behind the arguments for compassion, it's not hard to spot the iron law of libertarian ideas of freedom, where individuals have absolute rights over their own lives and bodies that trump everything else. This is the kind of libertarian freedom that prizes personal autonomy above everything else and therefore sees our neighbours not so much as gifts to be valued and cherished, but limitations, or even threats to our precious personal freedoms.

Pope John Paul was right. It does seem that we are opting for a culture of death. And my fear is that it won’t stop here.

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