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

The ethical principle of double effect.

Tom Dove

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

Comment

Football

Justice

29 July 2025

5 min read

The 50-year injustice at the heart of women’s football

Now we need to do these two things to put right decades of disparity

Jonathan Rowlands

Jonathan is a theology lecturer and Liverpool FC fan.

A victorious women's football team celeberate.

It came home.

The Football Association.

I don’t normally like men’s international football. I spend all season wishing Bukayo Saka and Jordan Pickford nothing but misfortune and now, suddenly, I’m expected to cheer them on? Not for me, thanks. I’ll stick to revelling in scouse Schadenfreude when football, inevitably, does not come home.

By contrast, I find the Lionesses much easier to support. That’s probably because, to my shame, I don’t really follow the Women’s Super League as much as I should. I don’t watch them with any petty grudges lingering in my mind. It does mean, however, that I can happily join the 12.2 million other people tuning in to watch Chloe Kelly hop, skip, and volley England to another European Championship.

It also helps that they seem to keep winning in the most implausible ways possible. There’s a stat going round social media at the moment that, across all the knock-out games of this Euros, England were only ahead for 4 minutes and 52 seconds. Incredible.

The Lionesses have – yet again – managed to show their nation the joy and drama of football and look set to inspire yet more women and girls to get involved in grass roots football. Women’s football, it would seem, is in rude health. But, look beneath the surface a little, and there are still significant disparities between the women’s game and the men’s game.

In May, Chelsea effectively sold their women’s team to themselves: they sold the team to BlueCo (Chelsea’s parent company) for a reported £198.7m. This is not the first time Chelsea have engaged creative accounting. In April. 2024, the club revealed it had sold two hotels it owned to one of BlueCo’s sister companies (a move later upheld by the Premier League itself). A whole women’s football team – a good one, at that! – being leveraged for accounting purposes.

Elsewhere, Liverpool Women’s Team sold their star player – Canadian forward Olivia Smith – to Arsenal for a world record fee of … £1m. To put that into context, Liverpool’s men’s team have already bought Florian Wirtz for roughly £116m this summer. They may add to that by buying Alexander Isak for anywhere up to £150m. And that’s to ignore the purchases Hugo Ekitike (£69m), Milos Kerkez (£40.8m), or Jeremie Frimpong (£35m). Moreover, the first male player to be sold by an English club was Trevor Francis, sold by Birmingham City to Nottingham Forrest. The year? 1979. 46 years ago.

In purely financial terms, then, the women’s game seems to be about 50 years behind the men’s. And yet, there are the Lionesses. They have just retained the European Championship. They have made three finals in a row, winning the Euros twice and narrowly losing the World Cup final in 2023. By contrast, the men’s team famously haven’t won a major trophy since 1966.

And so why does women’s football exist in an alternative financial universe about 50 years behind the men’s game? Well, I think a big part of it is making up for lost time.

The FA banned women from playing at FA-affiliated grounds between 1921 and 1971. Did you know that? It’s one of the UK’s greatest sporting shames and yet it’s hardly common knowledge. How like this country to front up to its institutional mistakes with silence.

For 50 years women were effectively unable to participate in the sport in any meaningful and professional way. 50 years. Where have we heard that number before?

Prior to this, women’s football had been rather popular. Dick, Kerr Ladies FC regularly attracted matchday audiences of thousands. In 1920, the year before the FA ban, 53,000 fans went to Goodison Park to watch they play against St. Helens. For context, this is a crowd so big the vast majority of Premier League stadiums would not be able to accommodate it. It would fill Brentford’s stadium three times over, and there would still be people queuing up outside.

For 50 years, men’s football was able to accelerate and grow while women’s football matches simply weren’t possible. Who knows where women’s football would be now, if it had been allowed to continue with the successes it had won for itself.

The success of the men’s game is built, in part, upon the enforced stagnation of the women’s game. People watched men’s football because it was the only football it was possible to watch. Men’s football owes its success in part to this. I don’t see how we can say otherwise. In response to this, I wonder if there are two things the sport might do to attempt to rectify this somewhat: one big, one small.

First, the big change. I wonder if there does need to be some form of reparations instituted to restore parity and to right the wrongs of the past? I know this won’t be popular. I love football, and I love it when my football club spends loads of money on players. I love that Liverpool (men’s team) might spend over £100m on two separate players this summer. I probably shouldn't be rubbing my hands at this, but if I’m honest, I am.

But at least some of this money ought to be diverted away from the men’s game and funnelled towards the women’s game. If men’s football is built in no small part on the enforced cessation of women’s football, then this seems only to be right. It’s not about punishing men’s football or paying a penalty for wrongdoing. It’s simply about restoring back to women’s football that which rightfully belongs to it.

Second, the small change. We should start calling men’s football teams ‘Men’s Football Teams’. When I talk about Liverpool Men’s Team, I just say ‘Liverpool’. I know, and anyone listening to me knows, that I mean the men’s team. I then add ‘Women’s’ when I’m talking about the Women’s Team.

The effect of this is that the ‘Men’s Team’ becomes the ‘default’ way of thinking about football. It is the ‘normal’ way of engaging with the sport, and this is then qualified or relativised by my talking about ‘Women’s football’ elsewhere. ‘Women’s Football’ becomes a smaller sub-category of the bigger category of ‘football’ as a whole, which is implicitly linked to ‘Men’s football’ specifically.

By taking the time to specify ‘Men’s Football’, we remind one another that football needn’t be played by men at all. That it, too, is just one way in which the sport might be engaged with or played. Not the ‘default’ or ‘correct’ way the sport exists. It’s a small change that, with time, may have a big effect on the way the sport as a whole of perceived.

50 years of injustice cannot be repaired overnight. There is a lot of work to be done to undo the wrongs of football’s historic treatment of women. But the sooner men’s football starts, the sooner justice will be restored.

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