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
Comment
Film & TV
Politics
Purpose
4 min read

BBC scandals turn the spotlight on its lost mission

When it's good it's great but when it's bad it’s Babylonian

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

Tim Davie in a blue suite smiles
Tim Davie, BBC boss.

I’m a great fan of the BBC. Generally speaking, I like and admire its journalists and its output and, occasionally, I take its and the licence-payer’s shilling. 

I may be increasingly unusual in choosing to be woken by Radio 4’s Today, but love it because of, rather than despite of, its presenters’ impertinent and interruptive style with politicians. Its radio drama is seductive. I admit to having assiduously followed The Archers, until (literally) I lost the plot at Covid. Short radio drama series can be compulsive listening, such as Al Smith’s first-class Life Lines, featuring Sarah Ridgeway as an ambulance call handler. 

As for TV, I’m showing my age – The Repair Shop, Antiques Roadshow and Professor Alice Roberts’ archaeology in Digging for Britain. Ancient Top of the Pops repeats accompany Friday evening drinks. 

But back to the journalism. Say what you like, the BBC’s news output is the world’s benchmark. It has consistently hired best-of-breed reporters, particularly on the foreign stage. Whatever politicians of both the left or right claim, depending on their circumstance, it is even-handed in its analysis.  

Newsnight under Victoria Derbyshire is immeasurably improved by its slick, half-hour, after-dinner sofa format. It disassembles the pompous and hypocritical, from Trump apparatchiks to Jeremy Clarkson at a farmers’ demo, his stammering and panicky “classic BBC” attempted dismissal now cheekily deployed in its own advertising. 

But – and you’ll know the “but” was coming – there’s the dark side. There has recently been a litany of managerial let-downs, any of which could have put a more commercial enterprise out of business. Conservative governments have customarily been most prone to traducing the BBC, possibly because they think it should know its place, which is not so much below the salt as serving at their table. 

So it’s quite the new thing for a Labour culture secretary, Lisa Nandy, further to undermine the credibility of its Director-General, Tim Davie, by listing its “catastrophic” failures on his watch. The BBC has just had to apologise (an occurrence now as regular as Gary Lineker’s controversial tweets) for failing to discover, let alone disclose, that the 13-year-old narrator of documentary Gaza: How to survive a Warzone was the son of a Hamas high-up. 

A separate external review has also found that BBC bosses failed adequately to protect staff on MasterChef from presenter Gregg Wallace’s invasive behaviours. And the corporation has had to apologise this month for broadcasting antisemitic chants by the vile act Bob Vylan at Glastonbury. 

It’s not all about Davie’s alleged shortcomings. As the BBC itself might put it, other director-generals are available. George Entwhistle resigned over a Newsnight crackpot report on a child-abuse scandal; Greg Dyke over Lord Hutton’s report into how the BBC reported the David Kelly suicide affair under the Blair government. Then there was the Jonathan Ross and Russell Brand “prank”. Let’s not, please, lift the coffin lid on Jimmy Savile again. And so, one is forced to say, it goes on. 

Is the BBC uniquely wicked and/or mismanaged? No. But it’s huge and visible. I have a theory that it’s a British institution which, like others, is a victim of its imperial past. It was nurtured in a post-Reith period, when being of the BBC was like carrying a British passport (“His/Her Britannic Majesty requests and requires…”). It not only believes in, it was a child of, its own propaganda. The derring-do of its great foreign correspondents was founded on the unquestioned might of empire. 

That leads, inevitably in a post-imperial age, to hubris. It’s like Babylon, the metaphor rather than the great Mesopotamian city. Once indestructible under emperors such as Nebuchadnezzar, sacker of Jerusalem, it was destroyed by its own vulnerabilities. The scriptural allegory from Genesis is that Babylon raised the great tower of Babel to reach the sky and oversee a world that spoke its one, true language. In his wrath at their pride, God scattered its people, now unable to understand each other, for they’d come to form their own languages. 

See how that works? The BBC has come to believe in itself, rather than its mission. And consequently, it has lost the ability to communicate, both internally and externally.  

It’s not alone. The Church of England has the same post-imperial problem. So does any elected government after about a decade. It’s the jobs of Archbishop of Canterbury and Prime Minister, as well as Director-General of the BBC, that can only end in tears. 

They should get together, these people. Work out accountable corporate structures that can work in the 21st century. Create top leadership jobs that are possible to do, rather than appoint emperors who turn out to have no wardrobes. 

The point surely is not that they are humiliated, but that they have to be humbled. They need to demolish their towers, stop babbling at each other and learn to speak a common language again.  

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