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. 

Article
Comment
Ethics
Politics
War & peace
5 min read

We must invest in defence, fast - it’s the only moral thing to do

The responsible use of force today precludes pacifism

Emerson Csorba works in deep tech, following experience in geopolitics and energy.

Amid a bombed alley, a victim is helped to walk by a rescue worker
Aftermath of a Russian drone attack, Odesa, Ukraine.
Dsns.gov.ua, CC BY 4.0, via Wikimedia Commons.

In May 2016, I was hiking the Southwest Coast Path in a group, trudging through dense forest between Lyme Regis and Weymouth, when a distinctly unsettling event occurred. As we moved along a narrow trail, a buzzing sound began—we assumed we had disturbed a bee’s nest. We quickened my pace, but the buzzing continued. Eventually, we emerged from the woods and looked up. The sound had not come from bees, but from a drone that had been following us.

I will never forget that sound; the eerie sense of something pursuing you, but unseen. In a recent BBC special on the war in Ukraine, a journalist documents the now-pervasive use of drones, the journalist and Ukrainian soldiers hiding under the cover of forest as a Russian drone scans the area, before escaping to their car in which an AI voice says ‘Detection: multiple drones, multiple pilots, high signal strength’ as they journey overground. This is the new era of covert warfare, where the enemy strikes without being easily identified. You hear the hum, but the source is elusive.

In the coming years, this kind of psychological warfare will make its way into Western cities. Terrorist attacks will shift from in-person confrontations—like the Novichok poisonings in Salisbury—towards remote, anonymous assaults: drones drifting from overseas into coastal cities to target civilians, or swarms carrying out mass attacks in dense downtown cores. The aim will be psychological trauma at scale. Civilians will grow hesitant to leave home, hyper-sensitive to the buzz of anonymous drones in their own areas. Iran recently declared that no US, British, or French base is safe from retaliation in the emerging Israel–Iran war. It is not difficult to imagine Western cities soon being viewed as legitimate targets.

We are entering a time of intensified conflict, with national security becoming the dominant framework for policymaking. The watchword of UK government policy is ‘security,’ and—writing now from Montréal—the recent Canadian election was framed around which party and leader could best protect Canadians from external threat. In this context, even domains once governed by cooperation are transformed into zero-sum contests, because national security framing by its nature shifts focus from reciprocity to limitation of the other. 

Free trade, for example - fundamentally the mutually beneficial exchange of goods and services as part of the creation of value - becomes, in a security-focused world, a question of containment. Trade, in a security-focused world, is turned on its head, free trade becoming trade wars. Fairness (in which the pie is grown and shared across multiple people) is replaced by interest, whether the interest of countries or communities and individuals within them seeking to protect themselves. As US–China competition escalates, we can expect human relations—among both states and citizens—to become even more zero-sum. 

In such an environment, do morals still matter? When the enemy grows more ruthless and more innovative in an era of national security, must we match them in kind? Or is it still possible to uphold principles while defending ourselves?

Restraint and humility are still critical virtues—but must not be mistaken for weakness.

In a recent Times column, Juliet Samuel suggested that gestures of non-aggression—such as Finland’s 2015 destruction of its one million landmine stockpile—now appear dangerously naïve. Ukraine, for its part, has rightly disregarded the Ottawa and Oslo (banning cluster munitions) conventions. Its survival depends on ingenuity, rapid technological development (for instance through the work of funds such as D3), and collaboration with its allies to prototype and deploy advanced systems.

Reinhold Niebuhr, in Moral Man and Immoral Society, contends that to be moral, one must possess the capacity for force—‘power must be challenged by power.’ That power, however, must be exercised with responsibility, humility, and moral purpose. Nigel Biggar, my former doctoral supervisor and a key figure in the Niebuhr tradition of Christian realism, argues in In Defence of War that war can be justified on balance when it meets the criteria of jus ad bellum: just cause, legitimate authority, right intention, proportionality, and reasonable prospect of success. 

War, in this reading, can express a ‘kind harshness’—a form of judgment exercised in defence of victims. Like Niebuhr, Biggar grounds his argument in Augustinian realism: the world is fundamentally good, yet broken. Because evil persists, the moral use of force becomes necessary to uphold what is right. I believe this to be true, and directly applicable to the national security-focused world in which we find ourselves. 

What does this mean then for Western countries as national security reasserts itself as the central organising principle of governance?

It means significant and urgent investment in defence and deep technology, including for instance emerging capabilities like cognitive warfare and neuroadaptive systems (wearables that enhance soldiers’ performance in live combat), counter-drone systems for urban, rural, and maritime environments, and next-generation electronic warfare and geospatial intelligence.

If drone attacks intensify at sea—such as those carried out by the Houthis to disrupt global shipping routes—counter-drone systems will be vital to ensure safe passage. In a world of manipulated narratives and disinformation, geospatial intelligence will serve as a source of truth, helping establish what is actually happening on the ground. And as agentic AI grows increasingly capable of manipulating users—through sycophancy, persuasion, and other techniques—oversight technologies like Yoshua Bengio’s new LawZero project will be essential for maintaining objectivity and integrity.

The responsible use of force today precludes pacifism, averting violence altogether. It means maintaining—and advancing—the capability for overwhelming force, so it is ready if needed. Morality in an era of national security demands investment in defence technologies at speed, to stay several steps ahead of adversaries. A ‘whole-of-society’ approach, as recommended in the recent UK Strategic Defence Review, means preparing citizens with such a mindset. Restraint and humility are still critical virtues—but must not be mistaken for weakness. Western nations must be prepared to act swiftly, decisively, and with the deterrent power that peace requires.

This is the world we are entering: one in which governments and civilians alike must be ready for unexpected threats. The hum of a drone overhead is more than a sound—it is instead a warning, reminding not only Ukrainians but those currently in peaceful situations, to prepare ourselves for potential conflicts to come. The appropriate response is not retreat, but the responsible and moral exercise of power: a necessary duty if we are to preserve peace, freedom, and justice in a world increasingly intent on contesting them.

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