Snippet
Assisted dying
Care
Comment
Ethics
2 min read

Who holds the keys of death? The logic of assisted dying

The ethical principle of double effect.

Tom has a PhD in Theology and works as a hospital physician.

white pills form an angle on a blue background
Hal Gatewood on Unsplash.

Healthcare hinges on the principle of double effect. This ethical principle makes the vital distinction between intent and effect. That is, one’s intent does not always result in a single intended effect, whether foreseen or not. In taking a patient’s blood, for example, my intent is to acquire information to aid treatment. An additional effect of this process is that—almost inevitably—this patient will experience pain, albeit minor. This principle of single intent and multiple effects applies throughout the practice of caring for human bodies, in all those instances where caring for those bodies involves physical interference, from prescribing medications to surgical procedures. And, in some instances, identifying and treating symptoms (such as terminal breathlessness) involves the use of medications that, as an unintended effect, result in death. 

In the case of assisted dying, the distinction is important. The intent of assisted dying is to end pain and suffering by ending life. The ending of life is the treatment used to relieve pain and suffering. The intent is not to isolate and treat particular symptoms associated with a condition. The intent is to bring the condition itself to an end—which requires bringing the patient’s life to an end. This is not to make any judgment whatsoever about whether such a course is “right” or “wrong”, but rather to draw out the simple observation that this course involves an unprecedented change in medical practice. Assisted dying involves the categorical adoption of ending life as a possible treatment for a condition. 

This is not quite the same as the slippery slope argument; it is about the logic of assisted dying. The point I am making is this: once ending life is introduced as a treatment, the key ethical step has already been taken. Applying that treatment in other instances of “suffering” (be they mental illness or ageing, for example) does not involve any new ethical steps. It simply involves the further application of a principle that has already been adopted. Despite the considered safeguards of the bill, therefore, the moral-ethical arguments against applying this treatment more widely will, at best, stand on shaky ground. For who could be so bold as to insist on what constitutes “suffering” for an individual?  

Should the bill hold out the keys of death in this way? I can only think of One who is strong enough to wield those… 

Article
Belief
Comment
Leading
4 min read

Here’s what Pope Leo really needs, and it’s not our speculation

What the media analysis misses when projecting on to the new pope.
Pope Leo waves to the crowd.
Vatican Media.

If memory serves, there was a very positive feeling about Pope Francis when he was elected in 2013. Mind you, I had just started my first year at university and was passionately atheistic - I had flunked my ‘General Studies’ A-Level essay purely because I had nothing to say in favour of the proposal that heaven exists. It was plain enough to me that it was all unscientific wish-fulfilment - so a requirement to give balance had to be jettisoned. 

But the late Pope was so adept at doing things that sent a message, that even in my sphere it became commonly agreed that he was a breath of fresh air. Anyone would tell you that he was very down-to-earth. PR types can only dream of that kind of cache among those who have zero interest in what the company is selling.  

The less ostentatious popemobile!  

The refusal to live in the official papal apartments!  

Here was a man clearly wanting to step back from pomp, and the wealth (all that Vatican gold!). 

It is only now that, as a Catholic, I have an inside track perspective on how more complicated this all actually was. Some in the Church found some of the public piety unsettling. All churches have a trade-off to make between the gospel directive to not value treasure on earth, as well as a gospel directive to give honour to God using all of our humanity, which might involve using our sense of beauty.  

But I am not saying I agree or disagree with any of this. Francis was making a point, and it was well made. I am rather saying that there is a tendency sometimes to think of a pontiff in ill-fitting terms - often political ones. As an atheist, I crammed things into a binary of ‘good, stripped-down rationalisation’ versus ‘bad, mythological and weird’. Especially in secular media, there is a tendency to make popes answers to questions that the media have asked, and not the ones of the Church. The story is always more intricate than ‘liberal’ versus ‘conservative’. Francis was not, in the end, the moderniser some commentariat hoped for, but only because he demonstrated what should have already been obvious: that that the Pope is not ‘in charge of’ the Catholic Faith like that. 

At any rate, speculation of a similar kind is already booming around the new Pope, Leo XIV. Everyone is trying to read into every micro-detail we have. What is the significance of his being an American? Is this the conclave’s attempt to create a counter-Trump? Why did Leo come out in traditional garb (which Francis made a point of eschewing)? Why ‘Leo’?  

Rumours have already abounded that this new Pope likes to do his private masses in the old Latin; others have pointed out that he ran with Francis’ crowd - and even his opening speech touched on the late Pope’s theme of ‘synodality.’ Synodality, depending on who you ask, is either a noble attempt at decentralisation and listening to the full range of voices in the Church - or an attempt to sneak doctrinal change under the guise of being pastoral. 

My advice is to stay well away from it all. Perhaps I’m bringing my own personal journey in too much here - but people change their minds all the time. I wouldn’t want someone to judge me on that General Studies essay now, let me tell you. People especially change when given such a task as Robert Prevost has been given. Even on a purely natural view, being handed responsibility for over a billion Catholics is likely to have a sobering effect, and make one hyper-aware of every move one is about to make. 

But, more importantly, on a supernatural lens, Catholics will want to say that this Pope has been, at the very least, permitted by the Holy Spirit. Benedict XVI put it as dismally as this, in 1997:  

"Probably the only assurance [the Holy Spirit] offers is that the thing cannot be totally ruined.”  

Pope Leo’s ability to shepherd the Church is not a power he enjoys on his own - it comes, as the official teaching has it, “by virtue of his office.” He gets it purely from God, and by existing in relationship to a bigger thing, the Church. It is a difficult thing to make sense of, but the Catholic view of the Pope is not really a statement about human power. It is the belief that, at some very foundational level of analysis, Jesus has agreed not to abandon those who follow him; agreed not to “leave us as orphans." The Pope has come to be seen, in time, as that foundation; as that ‘rock’. But he should always be seen within the bigger picture of God’s promises to us. 

For the meantime, the Pope needs not analysis, second-guessing, or projections. He needs prayers.  

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