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. 

Column
Comment
Football
Identity
Sport
5 min read

Football’s rainbow row shows up symbolism’s flaws

The vagueness that gives symbols power reduces the chance for nuanced conversation.
A football boot with rainbow laces
Premier League.

In 2013, the LGBTQ+ charity Stonewall partnered with the Premier League to launch the Rainbow Laces campaign. For certain matches, Premier League footballers are encouraged to wear rainbow colour laces and armbands when captain. 

The stated aim of the campaign is to ensure “everyone feels welcome” at football matches. All the league’s clubs have committed to the campaign, although the wearing of laces and armbands is optional for players.  

Recently, Ipswich Town’s captain Sam Morsy decided to wear a standard captain’s armband, rather than the rainbow-coloured version. The club later released a statement saying he made this decision due to his religious beliefs, which the club respected. Morsy again declined to wear the rainbow-coloured armband for Ipswich’s match against Crystal Palace a few days later. 

Speaking of Crystal Palace, their captain – Marc Guehi – did wear the armband, but wrote “I [heart] Jesus” on it. While the FA did not punish Guehi or Palace, they did write to them to remind them that religious messaging of any kind was not permitted on kits. Subsequently, during Tuesday’s match against Ipswich, Guehi changed the message to “Jesus [heart] you.” 

It says something about society’s view of Christianity that people saw Guehi’s “I [heart] Jesus” message and took it as an anti-LGBTQ+ message. The Church is doing something wrong if people can so easily equate loving Jesus with hating LGBTQ+ people.  

Of course, it is undeniable that many people have been – and continue to be – discriminated against and persecuted because of their sexual orientation or gender identity in acts of violence and abuse underwritten by religious beliefs. 

However, being ‘religious’ is not a straightforward predictor of someone’s views of sexual orientation. Many people who self-identity as Christian, Muslim, Jewish, or as members of any number of other faiths, would describe themselves as inclusive and affirming of people of all sexual orientations and gender identities. 

So, why are we talking about what colour armband grown men are wearing – or not wearing – when playing football?  

The issue emerges because of the use of these armbands as symbols. Symbols are inherently empty of content; they only mean something when individuals or groups assign meanings to those symbols.  

This is how the meaning ascribed to symbols changes over time, as they are used in different ways and received by different social groups. For centuries, the swastika was a wholly positive religious symbol in a variety of traditions across Hinduism, Buddhism, and Jainism, often carrying connotations of prosperity and good fortune. 

You would be hard pressed to find someone who ascribes this meaning to the swastika from the 1930s onwards.  

Symbols are powerful, but they are so precisely because they are devoid of intrinsic meaning. Humans are unsurpassed in their ability to fall out with one another. By centring campaigns and movements around symbols, people who would ordinarily be at each other’s throats are more easily able to stand alongside one another, ‘filling’ the symbol with whatever meaning sits most comfortably with them.  They are meaningless banners under which odd bedfellows might bury the hatchet in service of greater aims.  

But symbols can be a double-edged sword. Their lack of concrete meaning also allows different people to find competing meanings in the same symbol. Part of the reason for the dispute over the wearing of rainbow armbands, then, is due to different groups ascribing different meanings to the same symbol.  

For some footballers, being encouraged to wear rainbow armbands might be received as being encouraged to wear a symbol encoded with meanings that undermine their entire system of religious belief.  

And, for these people, religious belief is not an optional extra; it is their most fundamental identity and it is the framework within their entire existence and experience is rationalised and given meaning. To undermine a framework like this is no trivial matter.  

But for people who identity as LGBTQ+, seeing their team’s captain wearing a rainbow armband might ‘mean’ something as simple as: “If you identify as LGBTQ+, you are welcome here at this football match, and we want you to feel safe here.”  

It’s not hard to see how a refusal to wear an armband might be received as a slap in the face for people who ascribe that meaning to the armband; it’s tantamount to a refusal to acknowledge their existence. While it unfortunately does need repeating, the mere existence of LGBTQ+ people is not a threat to religious belief.  

The malleability of the symbol means that both individuals – and by extension, the groups to which they belong – are left feeling as though there is no space for them in football. Or, at the very least, that they have to compromise on being who they are if they are to be afforded a place within the football community.  

The desire for beige corporate gestures designed to be cheap, easy and unoffensive wins often reduces the scope for conversation and dialogue. 

And this is the problem with trying to navigate complex issues such as societal inequality through tokenistic gestures and symbols: the same power that enables symbols to unite people can also divide people. The same vagueness that makes symbols so powerful also minimises the possibility for genuine and nuanced conversation. 

This is not to say we should do away with such gestures altogether. The comedian Matt Lucas took to X to recount something of his experiences as an Arsenal fan. Twice this season – just this season – Lucas has been abused at football matches because of his sexuality. 

I’ve never been abused at a football match because of my sexuality, gender, race, ethnicity, or, for that matter, my religious beliefs. I don’t think it’s up to me to decide what does and does not make LGBTQ+ supporters feel welcome and safe at the match. If symbols such as rainbow armbands make these supporters feel safer at football matches – and again, it’s not up to me to decide if they do or they don’t – then I can only imagine that is an unqualified positive.  

That being said, if football is going to have meaningful and fruitful conversations about questions of faith, religion, and sexuality, then I think it’s clear that tokenistic use of symbols is simply not equipped for that. Like so much contemporary public discourse, the desire for beige corporate gestures designed to be cheap, easy and unoffensive wins often reduces the scope for conversation and dialogue.  

Symbols lie at the heart of human experience. The fallout from the actions of Sam Morsy and Marc Guehi demonstrates the significance of symbols to human life, but also of the importance of understanding the meaning of our cultural symbols, both as we understand them, and as they are understood by others.  

Too often we focus on what symbols mean to us, at the expense of what they might mean to others. When we assume that symbols carry a shared, fixed meaning for all, we deny ourselves the opportunity to listen and learn from the ways in which we experience our shared cultural symbols.  

And if there is one thing we really could do with more of, it is listening. 

Support Seen & Unseen

"If you were able to support us on Seen & Unseen with a regular gift of £5 or £10 a week, that would be a great encouragement for us and enable us to continue to produce the content we offer."

Graham Tomlin, Editor-in-Chief