Article
Assisted dying
Care
Comment
Death & life
Suffering
5 min read

Why end of life agony is not a good reason to allow death on demand

Assisted dying and the unintended consequences of compassion.

Graham is the Director of the Centre for Cultural Witness and a former Bishop of Kensington.

A open hand hold a pill.
Towfiqu Barbhuiya on Unsplash.

Those advocating Assisted Dying really have only one strong argument on their side – the argument from compassion. People who have seen relatives dying in extreme pain and discomfort understandably want to avoid that scenario. Surely the best way is to allow assisted dying as an early way out for such people to avoid the agony that such a death involves?  

Now it’s a powerful argument. To be honest I can’t say what I would feel if I faced such a death, or if I had to watch a loved one go through such an ordeal. All the same, there are good reasons to hold back from legalising assisted dying even in the face of distress at the prospect of enduring or having to watch a painful and agonising death.  

In any legislation, you have to bear in mind unintended consequences. A law may benefit one particular group, but have knock-on effects for another group, or wider social implications that are profoundly harmful. Few laws benefit everyone, so lawmakers have to make difficult decisions balancing the rights and benefits of different groups of people. 

It feels odd to be citing percentages and numbers faced with something so elemental and personal and death and suffering, but it is estimated that around two per cent of us will die in extreme pain and discomfort. Add in the 'safeguards' this bill proposes (a person must be suffering from a terminal disease with fewer than six months to live, capable of making such a decision, with two doctors and a judge to approve it) and the number of people this directly affects becomes really quite small. Much as we all sympathise and feel the force of stories of agonising suffering - and of course, every individual matters - to put it bluntly, is it right to entertain the knock-on effects on other groups in society and to make such a fundamental shift in our moral landscape, for the sake of the small number of us who will face this dreadful prospect? Reading the personal stories of those who have endured extreme pain as they approached death, or those who have to watch over ones do so is heart-rending - yet are they enough on their own to sanction a change to the law? 

Much has been made of the subtle pressure put upon elderly or disabled people to end it all, to stop being a burden on others. I have argued elsewhere on Seen and Unseen that that numerous elderly people will feel a moral obligation to safeguard the family inheritance by choosing an early death rather than spend the family fortune on end of life care, or turning their kids into carers for their elderly parents. Individual choice for those who face end of life pain unintentionally  lands an unenviable and unfair choice on many more vulnerable people in our society. Giles Fraser describes the indirect pressure well: 

“You can say “think of the children” with the tiniest inflection of the voice, make the subtlest of reference to money worries. We communicate with each other, often most powerfully, through almost imperceptible gestures of body language and facial expression. No legal safeguard on earth can detect such subliminal messaging.” 

There is also plenty of testimony that suggests that even with constant pain, life is still worth living. Michelle Anna-Moffatt writes movingly  of her brush with assisted suicide and why she pulled back from it, despite living life in constant pain.  

Once we have blurred the line between a carer offering a drink to relieve thirst and effectively killing them, a moral line has been crossed that should make us shudder. 

Despite the safeguards mentioned above, the move towards death on the NHS is bound to lead to a slippery slope – extending the right to die to wider groups with lesser obvious needs. As I wrote in The Times recently, given the grounds on which the case for change is being made – the priority of individual choice – there are no logical grounds for denying the right to die of anyone who chooses that option, regardless of their reasons. If a teenager going through a bout of depression, or a homeless person who cannot see a way out of their situation chooses to end it all, and their choice is absolute, on what grounds could we stop them? Once we have based our ethics on this territory, the slippery slope is not just likely, it is inevitable.  

Then there is the radical shift to our moral landscape. A disabled campaigner argues that asking for someone to help her to die “is no different for me than asking my caregiver to help me on the toilet, or to give me a shower, or a drink, or to help me to eat.” Sorry - but it is different, and we know it. Once we have blurred the line between a carer offering a drink to relieve thirst and effectively killing them, a moral line has been crossed that should make us shudder.  

In Canada, many doctors refuse, or don’t have time to administer the fatal dose so companies have sprung up, offering ‘medical professionals’ to come round with the syringe to finish you off. In other words, companies make money out of killing people. It is the commodification of death. When we have got to that point, you know we have wandered from the path somewhere.  

You would have to be stony-hearted indeed not to feel the force of the argument to avoid pain-filled deaths. Yet is a change to benefit such people worth the radical shift of moral value, the knock-on effects on vulnerable people who will come under pressure to die before their time, the move towards death on demand?  

Surely there are better ways to approach this? Doctors can decide to cease treatment to enable a natural death to take its course, or increase painkillers that will may hasten death - that is humane and falls on the right side of the line of treatment as it is done primarily to relieve pain, not to kill. Christian faith does not argue that life is to be preserved at any cost – our belief in martyrdom gives the lie to that. More importantly, a renewed effort to invest in palliative care and improved anaesthetics will surely reduce such deaths in the longer term. These approaches are surely much wiser and less impactful on the large numbers of vulnerable people in our society than the drastic step of legalising killing on the NHS. 

Snippet
Comment
Digital
Fun & play
Sport
3 min read

Line judges replaced by robots? You cannot be serious!

Wimbledon is about more than efficiency, it’s about humanity.

Matt is a songwriter and musician, currently completing an MA in theology at Trinity College, Bristol.

Tennis line judges stand and lean forward with hands on knees
Line judges, Wimbledon, 2012.
Carine06, CC BY-SA 2.0, via Wikimedia Commons

It’s the most wonderful time of the year! No, I’m not talking about Christmas, but Wimbledon, of course. Two weeks of absolute delight. Tennis matches on the TV non-stop. Incredible displays of athleticism and skill. Wimbledon never fails to be an emotional rollercoaster for Brits as we watch our favourites reaching for glory (to various degrees of success). 

But it’s not just the tennis: it’s the entire aura around the Championships. The Pimm’s & Lemonade; the strawberries and cream. The big serves but bigger personalities. The familiar cadence of retired legends in the commentator box. The ball kids, impeccably disciplined as always, run like the clockwork we come to expect at the tournament. The outrageous Englishness of it all, from the refined fashion to ridiculous costumes, to the umpire’s chiding of the raucous crowd, popping champagne bottles at inappropriate moments. Wimbledon is like a faithful friend, who even after a year of being apart, makes a deep connection instantly. 

However, this year something - or rather someone - seems to be missing. I am of course speaking of our old friends, the line judges. 

Those stoic sentinels, guarding watch over the chalky borders of the court, have gone. In their place, a machine: efficient, faultless (apparently), and it doesn’t require a pension. But we still hear the ghost of the line judges haunting the court: their disembodied voices, recorded for posterity, call out from somewhere in the AI aether. 

Gone are the days of the drama of McEnroe’s ‘you cannot be serious’, and even the Hawkeye challenge - an apparently rude interruption to the gameplay - is no longer necessary. Perhaps this was inevitable: the next step on the path of progress, the realisation of a techno-optimist utopia. Fewer human errors, more tennis for us, even fewer shirts for the All England Club to iron. 

Technological advancement has made our old friends, the line judges, obsolete. 

But I’ve got to be honest, I miss them. It’s not that the technology seems to be glitchy at times, nor that I’m an old-fashioned technophobe. 

I recognise we don’t really need those line judges anymore, but I think, deep down, we do want them. 

Wimbledon is about more than efficiency, it’s about humanity. 

It’s about the on-court drama when a player disagrees with a line call. It’s about the risky moments where a line judge narrowly (and somehow quite elegantly) misses a 120mph serve. Computers eliminate risks, but they also diminish these human moments. 

I miss the line judges like I miss the conversations with people at the bus stop. Both made redundant by the people upstairs who benevolently(?) oversee our technological advancement. 

Our world teaches us to value efficiency, but at what cost? Just picture it, in years to come: the ball kids replaced by a super smart lawn mower with a sucker pipe to retrieve wayward balls, or God-forbid, Tim Henman recreated as an AI commentator avatar. 

Perhaps they may decide that’s a step too far. Perhaps our technocratic overlords may seek to consult a moral authority before destroying all human connection. 

Speaking of moral authorities, I believe in a God who created us, not because he needs us, but because he wants us. He could have made perfect robots with far less risk, far less drama, far less pain. But he chose to create human beings that fail, and frustrate our desire for efficiency. While the potential that AI offers is exciting, I am wary that we lose the potential latent in every human being: to connect. Let’s learn to see others not for their efficiency, but their humanity. 

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