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

Assisted dying and the unintended consequences of compassion.

Graham Tomlin

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

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.

Article

Comment

Leading

Politics

24 November 2025

4 min read

Covid inquiry: Johnson, Cummings, and the cost of refusing to grieve

The report exposes mistakes, but our real challenge is learning how to face loss without denial

Jonah Horne

Jonah Horne is a priest, living and working in Devon.

Boris Johnson sits, giving evidence to an inquiry.

Boris Johnson giving evidence to the inquiry.

UK Covid-19 Inquiry.

I distinctly remember the sheer confusion of January to March 2020. Should we flee our flat in London? Should we cancel the lease on our workspace? Will I be able to continue breakfast with my friend on Thursday mornings? I ignorantly scoffed that a lockdown could conceivably take place and then, stood devastatingly corrected only a few months later. However, the UK Covid-19 Inquiry reveals that this ignorance induced confusion was not restricted to the personal level but instead enacted on a national stage.

What’s glaringly obvious as you read the recommendations is that the government acted too slowly and too indecisively. If the initial restrictions been introduced sooner, say in January or February, the first lockdown “might have been shorter or not necessary at all.” This, the report suggests, could have saved approximately 23,000 lives. Brenda Doherty, of the Covid-19 Bereaved Families for Justice group, believes her mother could have been one of these. Instead, she and her sister stood by her graveside in March 2020 as her family members waited a few metres back sectioned off by red tape. The report and accompanying evidence call for sombre reading.

In response, those in charge at the time have understandably launched an attack in their own defence. Boris Johnson has labelled the inquiry "totally muddled,” which ironically sounds like the informal conclusion of his leadership in the report. Similarly, Dominic Cummings has hurled a 2,000-word response into the social media stratosphere, which feels almost as long as the 800-page paper itself.

What seems glaringly obvious about both men’s responses is the very thing Brenda Doherty displays with such elegance: grief. There is, in these men’s retorts, a stunning omission of any sense of responsibility or indeed any willingness to admit defeat. And what frightens me most, as we look towards the future, is our refusal to grieve over the things of the past. The threat on Europe from Russia is growing. AI’s disruption on our workforce seems to be being enthusiastically brushed aside. And another, potentially much more violent, pandemic is unsettlingly likely.

However, in the face of these disruptive forces grief is a remarkably generative power. Without grief we remain, much like Johnson and Cummings, frozen in time. Immovable in our ineptitude and ignorance. Grief, I’d argue, is the very thing that enables us to recognise our shortcomings and, when mixed with hope, energises us towards a future which lies on the other side of sorrow. Yet, when we exist in a place of fragility, the idea of imagining that life lies beyond my incompetency, if only I grieve it, is frightening. Devastatingly though, for us humans, this may be the only way to learn and move forward.

Our future and redemption is undeniably bound up in our ability to grieve. Grief is inherently futural. By grieving our ineptitude, we inevitably witness to the places that require growth, mercy and grace. When we fail to grieve, we remain frozen in time—precariously hiding behind the illusion of our infallibility. This is a deeply fragile state. From this position, any assault or critique on our mistakes becomes a personal attack rather than invitation to redemption. We find ourselves lashing out in fear, terrified of being exposed. Johnson and Cummings embody this predicament to a tee.

This situation however is not unique to the Covid iquiry and our late-prime minister’s response. Another character who lashes out in fear is St Peter, one of Jesus’s friends and disciples. There is a rather poetic story that illustrated this at the end of John’s gospel in the New Testament. One of Jesus’s friends Peter rejects him as he’s taken to be murdered. Peter attacks a guard, cuts his ear off and Jesus famously disarms him and heals the man. Moments later, Jesus is taken, Peter flees and we find him standing in a courtyard, by a fire and where claims not to know his friend and master Jesus. To make matters worse, he rejects him not once, but three times. However, when Jesus returns from the grave, he meets Peter again, at a fireside on a beach, and asks him “do you love me?” Not once but three times. The thing that I think is particularly remarkable about this meeting is that Jesus recognises Peter’s future in bound up in the redemption of his past mistakes. Jesus takes Peter to the place of failure, a fireside, and gives him an opportunity to declare his allegiance and love for him, the same amount of times he had rejected him. He reminded him of his wound to heal him for his future.

If we are to take seriously our response to the Covid-19 inquiry, we must take responsibility for our errors. Not begrudgingly but with a grace filled grief. Our future, one that is filled with hope, does not come to us without a confession of past errors. Instead, a hopeful future may only come to us when we confess, recognise and grieve our mistakes. Indeed, to freely grieve over my failures is to grieve believing in life beyond my defeat.

Support Seen & Unseen

Since Spring 2023, our readers have enjoyed over 1,500 articles. All for free.
This is made possible through the generosity of our amazing community of supporters.

If you enjoy Seen & Unseen, would you consider making a gift towards our work?

Do so by joining Behind The Seen. Alongside other benefits, you’ll receive an extra fortnightly email from me sharing my reading and reflections on the ideas that are shaping our times.

Graham Tomlin
Editor-in-Chief

Pledge now