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

Culture

Economics

Ethics

1 May 2025

6 min read

The rights and wrongs of making money with meme coins

When does investing become speculating, or even addictive gambling?

Laurence Fletcher

Laurence is a journalist at the Financial Times.

A montage shows Trump with a raised fist against other images of him and the phrase 'fight fight fight'.

$Trump coin marketing image.

gettrumpmemes.com,

Donald Trump’s “liberation day” tariffs may have driven sharp swings in global financial markets, but his actions in markets a few months earlier were in some ways even more peculiar.

On the Friday before his inauguration as the 47th US President in January, the Republican surprised many with the launch of the $TRUMP memecoin, described by its website as “the only official Trump meme”. The cryptocurrency token, in which Trump’s family business owned a stake, initially soared in value to more than $14bn over that following weekend.

Then, on the Sunday, Trump’s wife Melania launched her own memecoin, $MELANIA, which reached a value of $8.5bn. Even the pastor who spoke at the president’s inauguration subsequently launched his own memecoin.

For those wondering what exactly a memecoin is, you are not alone. In short, they are a form of cryptocurrency - an asset class that itself has attracted plenty of questions about its substance and purpose - representing online viral moments. They have no fundamental value or business model and, according to the US securities regulator, “typically have limited or no use or functionality”.

Donald and Melania Trump’s coins subsequently plunged in price, but still have a value of around $2.5bn and $214mn respectively, according to website CoinMarketCap.

There are plenty of others in existence. PEPE, based on a comic frog, has a value of around $3.6bn; BONK, a cartoon dog, has a market cap of $1.5bn; and PNUT, a reference to a squirrel euthanised by authorities in New York and about which Trump was allegedly “fired up” (although doubt has since been cast on the president’s involvement in the matter), is still valued at around $174mn, despite having fallen sharply in price.

Dogecoin, seen as the world’s first memecoin and originally created as a joke, boasts a market value of around $25bn. (There are other memecoins which may not be suitable for these pages).

Some people’s willingness to buy an “asset” with no use or fundamental value may seem strange to more traditional investors. But it can be viewed as just one manifestation of the speculative investor behaviour evident since the onset of the coronavirus pandemic and, indeed, at times throughout history.

The price of Bitcoin recently rose above $100,000, despite many investors still viewing it as having little or no value (in 2023 the UK’s Treasury select committee described cryptocurrencies as having “no intrinsic value, huge price volatility and no discernible social good”). In early 2021, shares in GameStop - a loss-making US video games retailer that some hedge funds were betting against - rocketed as much as 2,400 per cent, as retail investors piled in, many with the aim of inflicting pain on the hedge fund short sellers (in that respect at least, a highly successful strategy that became the subject of the film Dumb Money). The huge rise in AI and other tech stocks in recent years - until the recent tariff-driven volatility - has also been described as a bubble by some commentators.

Whether or not such episodes can be compared to infamous bouts of speculative mania in history depends on your point of view (and often can only be judged with the benefit of hindsight) - be it the 17th century Dutch tulip bulb mania, shares in the South Sea Company in the 18th century or the dotcom boom and bust of the late 1990s and early 2000s.

But it does give rise to the question of when investment should start to be described as speculation or even as gambling? And what are the rights and wrongs of any of those activities?

There can be negative effects, for instance if the actions of speculators force businesses in the real economy to change their plans or divert time and resources...

Gambling can be thought of as risking a stake on, for instance, the result of a game of chance or sport in the hope of a bigger payout. While often the result is purely down to chance, in some cases a strategy or an element of research (for instance of a horse or football team’s form) can be used. Investment, in contrast, tends to involve purported economic utility and assets believed to have some sort of underlying value, and holds the hope of future profit (although there are also plenty of bad investments or those that have gone to zero). While an investor must be prepared to lose their entire stake, in some cases such an event is relatively unlikely (for instance, if they buy a fund tracking the performance of a major stock exchange). Speculation is harder to define, but is generally seen as shorter term than investment, with more chance of a bigger gain or loss, and dependent on price fluctuations. Rightly or wrongly, the term has a more negative connotation than investment.

One writer who explored the ethics of these activities was Oswald von Nell-Breuning, a Jesuit theologian and economist who served as an adviser to the Pope and who was banned from publishing under the Nazis.

While he found that “one general definition cannot capture all the nuances” of speculation, he identified two different types of speculative activity - one that was purely trying to make a profit from financial market trading, and one based on trying to create a viable business. (See this article in the Catholic Social Science Review for a fuller explanation of Nell-Breuning’s views on speculation).

As the CSSR article shows, Nell-Breuning found that there can be positive effects from speculation - one might think of better liquidity and price discovery in a market, while, in commodity futures markets, speculators allow producers to hedge risk.

But he also argued that there can be negative effects, for instance if the actions of speculators force businesses in the real economy to change their plans or divert time and resources away from production.

And whereas gambling typically takes place within a circle of players who have chosen to take part, speculation, he wrote, can affect a greater portion of society - for instance, if it affects the price of shares or bonds they hold.

The Bible - on which Nell-Breuning’s faith and analysis was based - does not take a prescriptive approach to such activities. But it does provide some interesting guidance.

An entrepreneurial approach to business and investment is applauded, for instance when the writer of the book of Proverbs (traditionally believed to be King Solomon) praises the virtues of “an excellent wife”. These include investing in a field and using her earnings from business to plant a vineyard, and feeding her family from her gains.

Jesus tells a story of a master who, before going on a journey, gives his property to his servants, each according to their ability. To one he gives five “talents” (a large unit of money), to a second two and to a third servant he gives one.

The first servant trades with his talents and makes five more talents - a 100 per cent profit - and is applauded by the master on his return. The second servant also trades and similarly makes two more talents and is again applauded.

But the third servant, being afraid and believing the master to be “a hard man”, hides the money in a hole in the ground. He is condemned as “wicked and slothful”, and told that he should at least have put the money in the bank.

While Jesus’s story may primarily be about how we view God’s nature, how we use our God-given abilities and whether or not we can take risks in faith for Him, it is also hard not to see investment and indeed wise speculation as being virtuous activities here. Putting the money into a bank account is, in this story anyway, more of a fallback option.

But the Bible also warns us against putting money above all else in our lives. The love of money is, famously, a root of all sorts of evil, while we are also told to be content with what we have, and that “wealth gained hastily will dwindle”.

Nell-Breuning similarly warns that a “get-rich-quick” mindset, when this is placed above all else, can be harmful, and advises caution in situations where the lure of big profits can lead the speculator into market manipulation or fraud.

After all, both gambling and crypto trading have the potential to become dangerous and damaging addictions needing treatment.

Ultimately, Nell-Breuning struggled to come to a simple conclusion on the question of whether speculation, in and of itself, is morally wrong. It is, he wrote, a judgment call for those involved.

When making such decisions ourselves, his - and the Bible’s - warnings may be worth bearing in mind.