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.

Column

Creed

Death & life

Suffering

23 October 2025

4 min read

Dressing up in the dark: what Halloween reveals about our uneasy age

Why Halloween feels darker this year

George Pitcher

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

Skeleton figurines clothed in Victoria outfits.

Wallace Henry on Unsplash.

Something bothers me about the approach of this years’ All Hallows’ Eve on 31 October and its accompanying night-time Halloween parties, like an irksome background unease at an encroaching darkness behind the childlike cosplay of the event itself.

God knows, there have been infinitely darker years, some of them within living memory. Two world wars, one of them containing the Holocaust and it doesn’t get darker than that. Genocides, such as Rwanda’s, and famines, from China to Russia to Ethiopia. Terrorist atrocities: Munich, Lockerbie, Madrid, 9/11.

Mass murders of children: Dunblane, Peshawar, Sandy Hook, Southport, to name a few in such a grim litany. Harder to imagine, because they’re further away culturally in either time or place, are the great plagues, conflagrations and disasters of history: The Black Death, Indian Ocean tsunami, Hiroshima.

So one wonders if it’s impertinent to feel uneasy about Halloween this year. I suspect it’s the discomfort of something bubbling under and as yet unseen, like unexploded magma or the unbearable tension of a faultline threatening to give way.

To name it is to call out a most fragile world peace – the pretence of a peace in the Middle East that cannot hold; a peace process that hasn’t even started between Russia and neighbouring Ukraine. Both presided over by an American president who at best isn’t up to securing either and, at worst, has zip interest in democratic process and is only in it for himself.

Then there’s apparently unstoppable mass migration, driven by climate change, to western economies already going to hell in policy-free handcarts. The creeping re-growth of nationalism and antisemitism, social media fuelled hatred of refugees, the collapse of trust in institutions of state in the UK’s unwritten constitution, such as the royal family, parliament, the police and the Church. Grooming gangs and trafficked sex-slaves; we’re not in the gloaming of dusk – it sometimes feels like night has fallen.

At what price, then, do we dress our children (and ourselves) as ghouls and witches and demons and make jack o’lanterns to celebrate the dark side at Halloween? It’s the question at the heart of a debate that customarily divides between those of us who say it’s just a bit of fun and we shouldn’t be spoil-sports, against others who warn censoriously about conjuring up the devil, who once abroad will play havoc with those who so foolishly summoned him.

That’s a fairly pointless argument, as the positions just get repeated and that doesn’t get us anywhere. More fruitful may be to examine what the dark side is, what it is we’re conjuring, if anything, and whether it plays any role in what we fear we may be facing, which ranges from the breakdown of the world order, to great wars and, not to put too fine a point on it, an apocalypse.

Stumbling about in the dark, we’re bound to trip over what’s called theodicy – the theological study of how a supposedly all-loving God can tolerate human evil. One of the more recent and most accessible contributions to this school comes from the US journalist and academic Brandon Ambrosino, who imagines the pursuit of theodicy not to be climbing stairs of knowledge, but the descent to a dark basement: “If the living room is where we ask how exactly God moved Trump’s head out of the way of the shooter’s bullet, the basement is where we ask if God caused the bullet to end up in a fire-fighter’s body.”

One of Amrosino’s conclusions is that “evil is not properly a thing… Evil is nothing, literally [his italics]. It is a void in the fabric of God’s creation.” This concept of evil – the dark, as any parent would comfort a child – as empty is appealing. In the dark of that basement, there is nothing there but hope.

This idea of evil as a void, or moral vacuum, is told in the story of a student (not young Albert Einstein, as widely claimed) who demurs when taught that the problem of evil proves the non-existence of God. “Does cold exist?” asks the student. Of course, replies the teacher. But cold is only the absence of energy, which creates heat. Likewise, does darkness exist? Yes, but it has no wavelength, so it is only the absence of light.

What brings the energy of light and heat, like why there is something rather than nothing, is too big a question for now. But it may go some way to addressing the darknesses listed in the first half of this column.

And perhaps it’s a thought to carry into this Halloween. Children dressed as undead phantasms, with Mum’s lipstick tracing blood trickles from their mouths, aren’t joining the dark, but filling what is empty with laughter. And, in doing so, they’re mocking it, which must offer some sort of hope for the future.

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