When to stand up in an increasingly insecure world

When war is ‘othering’ by other means, the brutal realities of our world can be overwhelming. Ziya Meral contemplates what it means to take a stand.

Ziya Meral

Dr Ziya Meral is a researcher, advisor and programmes director specialising on global trends shaping defence and security, politics and foreign policies. He is a Senior Associate Fellow of the Royal United Services Institute.

Recently, I found myself sitting quietly at a cathedral buzzing with tourists, reflecting on demanding global developments and uttering a few words of prayers, not for world peace, but for guidance on how I should live my own life amidst all these.

Today’s world is a brutal reminder of timeless truths about the human condition, about continuum of violence and aggression in human affairs, about exclusion and marginalisation of the ‘other’ amidst economic downturns, about how fragile peace and prosperity are, and how the future might not always be better than the past.

There is a bitter realisation that there is no clear end ahead of us in the near future to this war of choice by Russia.

As I write these lines, Russian forces continue their brutal invasion of Ukraine, killing tens of thousands, forcing millions out of their homes, destroying town after town, and intentionally pursuing a scourge earth policy to destroy the habitability of towns and cities and sustainability of life. Ukrainians continue to bravely advance their counter offensive to push Russian forces as much as possible, while NATO leaders gear up for a summit in Lithuania in July, which will assess and discuss future support to Ukraine. There is a bitter realisation that there is no clear end ahead of us in the near future to this war of choice by Russia. Some sort of ‘frozen’ peace might be achieved by stopping or reducing violence, but no matter what Ukraine needs our prolonged support to ensure it does not face yet another wave of invasion a few years down the line. This is why even President Macron, who has been cynical about NATO, is now talking about Ukraine’s membership to the alliance as lesser of all of the risks ahead of us.

We have entered a new era, that is not simply just about Ukraine. For the last decade we have seen a major shift in global affairs as not only world’s two major powers, US and China, increasingly saw each other as a competitor and threat against national interests, a long list of medium-sized powers actively used force in invading other countries, or pursuing proxy wars and meddling into politics of other countries. From cyberwarfare to a new era of espionage to attempts at influencing other nations and altering trajectories of their politics, investments into a new generation of nuclear weapons and increasing of nuclear stocks to major investments into defence, most states in the world are gearing towards a decade of instability ahead of us.

Thus, it is not surprising that Sweden and Finland gave up historic policies of neutrality and decided to join NATO, or that Japan is pursuing a historic investment into its defence in a break away from its historic stand, or that China is going to double (or more) its nuclear stocks by 2030, or that even France is about to undertake a historic level of investment in its defence. The list goes on. All of these happen within a context of genuine existential risks to our existence. Like climate change, there are the domino effects of conflicts into our lives from faraway places. From energy prices, to food shortages, to disruption of trade and electronic parts, to new technologies like AI raising all sorts of ethical and practical questions and risks. There are hundreds of millions of human beings living in geographies and countries that are not able to care, provide and protect and give them a sustainable and meaningful life. Irregular migration, named ‘illegal’ in today’s tabloid language, is only increasing across the world, with only a small percentage ever making it to UK or Europe. Human beings do not simply leave their lives behind and take clear risks if they do not feel they have to.

We are far from being the first-generation processing news of wars and conflicts.

All of these are overwhelming realities, ones that we cannot simply ignore. It is normal for us to feel guilty as our daily lives continue in relative peace and property compared to millions of others out there, and it is normal for us to feel helpless and at times despair about all these developments that are clearly out of anyone’s control.

But as I sat there in the cathedral, I could not help but think that this is not the first time the world has gone through such a convergence of insecurities, and unlikely to be the last time, and that we are far from being the first-generation processing news of wars and conflicts and seeing nations take aggressive postures against one another. I thought about so many heroic figures across history that stood up for truth, for peace, for reconciliation, for justice in such moments and so many heroes that gave their lives to defend us against those seeking to harm us. Their legacies remind us that we all have a decision to make, a stand to take and a role to play in such historic moments. On my part, I am all aware of my limitations, and at times feeble attempts to be part of conversations that point towards solutions. I am also all aware of the deep darkness out there, but also as a Christian, a gentle hope that lies within it. The light shines into the darkness, and the darkness has not overcome it. The promise I find in the figure of Christ on the Cross is not an escape to another world, but embracing of the only one we have here and now, in prayer that all of our efforts could together amount to something much bigger than we realise. As TS Eliot put it, for us there is only trying, the rest is not our business!

Article

Assisted dying

Care

Comment

Politics

6 February 2025

6 min read

Assisted dying’s problems are unsolvable

There’s hollow rhetoric on keeping people safe from coercion.

Jamie Gillies

Jamie Gillies is a commentator on politics and culture.

Members of a parliamentary committee sit at a curving table, in front of which a video screen shows other participants.

A parliamentary committee scrutinises the bill.

Parliament TV.

One in five people given six months to live by an NHS doctor are still alive three years later, data from the Department of Work and Pensions shows. This is good news for these individuals, and bad news for ‘assisted dying’ campaigners. Two ‘assisted dying’ Bills are being considered by UK Parliamentarians at present, one at Westminster and the other at the Scottish Parliament. And both rely on accurate prognosis as a ‘safeguard’ - they seek to cover people with terminal illnesses who are not expected to recover.

An obvious problem with this approach is the fact, evidenced above, that doctors cannot be sure how a patient’s condition is going to develop. Doctors try their best to gauge how much time a person has left, but they often get prognosis wrong. People can go on to live months and even years longer than estimated. They can even make a complete recovery. This happened to a man I knew who was diagnosed with terminal cancer and told he had six months left but went on to live a further twelve years. Prognosis is far from an exact science.

All of this raises the disturbing thought that if the UK ‘assisted dying’ Bills become law, people will inevitably end their lives due to well-meaning but incorrect advice from doctors. Patients who believe their condition is going to deteriorate rapidly — that they may soon face very difficult experiences — will choose suicide with the help of a doctor, when in fact they would have gone on to a very different season of life. Perhaps years of invaluable time with loved ones, new births and marriages in their families, and restored relationships.

Accurate prognosis is far from the only problem inherent to ‘assisted dying’, however, as critics of this practice made clear at the – now concluded – oral evidence sessions held by committees scrutinising UK Bills. Proponents of Kim Leadbeater’s Terminally Ill Adults (End of Life) Bill and Liam McArthur’s Assisted Dying for Terminally Ill Adults (Scotland) Bill have claimed that their proposals will usher in ‘safe’ laws, but statements by experts show this rhetoric to be hollow. These Bills, like others before them, are beset by unsolvable problems.

Coercion

Take, for example, the issue of coercion. People who understand coercive control know that it is an insidious crime that’s hard to detect. Consequently, there are few prosecutions. Doctors are not trained to identify foul play and even if they were, these busy professionals with dozens if not hundreds of patients could hardly be counted on to spot every case. People would fall through the cracks. The CEO of Hourglass, a charity that works to prevent the abuse of older people, told MPs on the committee overseeing Kim Leadbeater’s Bill that "coercion is underplayed significantly" in cases, and stressed that it takes place behind closed doors.

There is also nothing in either UK Bill that would rule out people acting on internal pressure to opt for assisted death. In evidence to the Scottish Parliament’s Health, Social Care and Sport Committee last month, Dr Gordon MacDonald, CEO of Care Not Killing, said: “You also have to consider the autonomy of other people who might feel pressured into assisted dying or feel burdensome. Having the option available would add to that burden and pressure.”

What legal clause could possibly remove this threat? Some people would feel an obligation to ‘make way’ in order to avoid inheritance money being spent on personal care. Some would die due to the emotional strain they feel they are putting on their loved ones. Should our society really legislate for this situation? As campaigners have noted, it is likely that a ‘right to die’ will be seen as a ‘duty to die’ by some. Paving the way for this would surely be a moral failure.

Inequality

Even parliamentarians who support assisted suicide in principle ought to recognise that people will not approach the option of an ‘assisted death’ on an equal footing. This is another unsolvable problem. A middle-class citizen who has a strong family support network and enough savings to pay for care may view assisted death as needless, or a ‘last resort’. A person grappling with poverty, social isolation, and insufficient healthcare or disability support would approach it very differently. This person’s ‘choice’ would be by a dearth of support.

As Disability Studies Scholar Dr Miro Griffiths told the Scottish Parliament committee last month, “many communities facing injustice will be presented with this as a choice, but it will seem like a path they have to go down due to the inequalities they face”. Assisted suicide will compound existing disparities in the worst way: people will remove themselves from society after losing hope that society will remove the inequalities they face.

Politicians should also assess the claim that assisted deaths are “compassionate”. The rhetoric of campaigners vying for a change in the law have led many to believe that it is a “good death” — a “gentle goodnight”, compared to the agony of a prolonged natural death from terminal illness. However, senior palliative medics underline the fact that assisted deaths are accompanied by distressing complications. They can also take wildly different amounts of time: one hour; several hours; even days. Many people would not consider a prolonged death by drug overdose as anguished family members watch on to be compassionate.

Suicide prevention

It is very important to consider the moral danger involved with changing our societal approach to suicide. Assisted suicide violates the fundamental principle behind suicide prevention — that every life is inherently valuable, equal in value, and deserving of protection. It creates a two-tier society where some lives are seen as not worth living, and the value of human life is seen as merely extrinsic and conditional. This approach offers a much lower view of human dignity than the one we have ascribed to historically, which has benefited our society so much.

Professor Allan House, a psychiatrist who appeared before the Westminster Committee that’s considering Kim Leadbeater’s Bill, described the danger of taking this step well: “We’d have to change our national suicide prevention strategy, because at the moment it includes identifying suicidal thoughts in people with severe physical illness as something that merits intervention – and that intervention is not an intervention to help people proceed to suicide.”

Professor House expressed concern that this would “change both the medical and societal approach to suicide prevention in general”, adding: “There is no evidence that introducing this sort of legislation reduces what we might call ‘unassisted suicide’.” He also noted that in the last ten years in the State of Oregon – a jurisdiction often held up as a model by ‘assisted dying’ campaigners – “the number of people going through the assisted dying programme has gone up five hundred percent, and the number of suicides have gone up twenty per cent”.

The evidence of various experts demonstrates that problems associated with assisted suicide are unsolvable. And this practice does not provide a true recognition of human dignity. Instead of changing the law, UK politicians must double down on existing, life-affirming responses to the suffering that accompanies serious illness. The progress we have made in areas like palliative medicine, and the talent and technology available to us in 2025, makes another path forwards available to leaders if they choose to take it. I pray they will.

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