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
Digital
Work
4 min read

Back to the office! The suspect motives behind the bosses calling for it

Working From Home isn’t the end of the world.

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

An office wall displays a huge motto reading 'punch today in the face'
Really?
Johnson Wang on Unsplash.

If we’d been working from home in 1980, I wouldn’t have met my wife (as she, of course, then wasn’t). The slow demise of the office romance may not exclusively be driven by WFH, when a clumsy or unwanted speculative pass will likely precipitate a visit from the HR police. But it’s sure harder (I’m told) to chat someone up over Zoom than a water-cooler. 

There are some things you just, well, have to be there for. And it’s not just a matter of curating the gene pool for the future of the human race, which is hardly the top priority for most employers. Much more immediate commercial demands are served by employees being bodily present at work. They can check colleagues’ body language, be mentored more spontaneously, gossip about work, read the room and go outside for a fag with a friend. None of that works on a laptop at the kitchen table. 

And yet these aren’t aspects of working life that are much, if ever, cited by opponents of WFH. Yup, for these bosses, it’s always about productivity, which allegedly slumps like the shoulders of a college-leaver told to re-write their CV, when staff work from home. So companies as diverse as Amazon, Boots and JP Morgan are demanding that their workers work five-day weeks at the office again.  

Except, two things: One, that productivity point isn’t true. Professor Nicholas Bloom, an economist at Stanford University, has demonstrated empirically that a hybrid working model of three days at the office, plus two at home, is every bit as productive as fully office-based work overall. And, two, bosses may be shocked to learn that it’s their job to manage productivity, which is just as measurable at home as in the office. But then you don’t get to shout as much. 

And there I think is the real point. Bosses might not be shouty, but their motives for office work are more than suspect. They may be obsessed with control. They need to see their staff working for them for proof of productivity. They want to sit in a big glass-walled office watching them. And, perhaps most of all, if staff aren’t in the office then what’s the point of being a boss? It might bring their own productivity management and role into sharper focus. 

People who are privileged to manage their own time, or lack of it, in an office really shouldn’t be in the business of lecturing people who are not.

Furthermore, it’s been a long time, if ever, since some of those with the loudest voices calling for a return to the office have ever worked an ordinary job themselves. Lord Rose, formerly CEO of Marks & Spencer and chairman of Asda, told BBC’s Panorama that home working was part of the UK economy’s “general decline” (not true – see above). 

And Sir Jacob Rees-Mogg, formerly business secretary (remind me, how did that go?), continues in opposition to fight the bad fight to get civil servants as well as the private sector permanently back at the office. Hilariously, he most recently did so in a video from the drawing room of his mansion in Somerset. Though, to be fair, having lost his seat at the last general election and seeing his investment company sliding down the pan, he’s not so much working from home as just... at home.   

The serious point is that people who are privileged to manage their own time, or lack of it, in an office really shouldn’t be in the business of lecturing people who are not. They really don’t know – or have forgotten - what it is to have your life demanded of you from 9am-6pm from Monday to Friday in a location that is less than comfortable to work in. Is that so complicated to take aboard? 

And there’s another very big thing here. To demand office slaves is to commoditise people, to make them chattels (and, if some of these bosses were honest with themselves, that’s what they want). Staff become just another asset, not unlike the freehold of the office building in which you put them and watch as they make you money every day. 

To put it bluntly, that is a sin. To treat human beings as tradeable commodities is to debase their dignity. And for those of faith, that dignity is vested in each unique one of them bearing the image of God. As a good Catholic, Rees-Mogg should be familiar with the doctrine of Imago Dei.     

So there’s a holy, as well as secular, work-ethic at play here. The worker is worthy of his/her wage. That scriptural phrase usually focuses on the material value of the wage. But it’s also worth registering that the worker is “worthy”. 

To treat staff like they have an inherent worth, rather than simply a productive asset, has a value way beyond the money they are paid. And the dividends on that investment will be immense. Respect them. Let them work from home. 

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