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
America
Comment
Conspiracy theory
Politics
6 min read

Charlie Kirk: the problem is not murder but anger

How to confront the rage in politics, in media, and in ourselves

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

An aerial view of a gazebo at the site of the Charlie Kirk shooting
The site of the shooting.
KSL News Utah, CC BY 4.0, via Wikimedia Commons

The killing of Charlie Kirk has shaken most of us – including me. Over the past year or so, his pop-up debates on US university campuses kept appearing on my different social media channels, and they were fascinating. Here was a young, articulate conservative, venturing into college campuses – generally left-leaning, progressive places - opening up conversation, debate and challenge. He was opinionated, provocative, unafraid to voice unpopular opinions, generated hostility, but seldom seemed to show it himself. No question was off limits, he seemed to respect those who attacked him, and he made no secret of his Christian faith.  

I agreed with some of what he said but by no means all of it – that’s the point of public debate. His views on gun control, Israel, and Donald Trump just for starters, would be some way from mine. But inviting debate on controversial issues, seeking to change other people’s minds by discussion and reasonable argument is the very heart of a well-functioning democracy. There are precious few spaces where progressives & conservatives talk – and Charlie Kirk’s campus debates were one of them. It’s tragic that they cost him his life.  

In our times, such heinous acts are not usually committed by some secret, politically-motivated cabal, but often by an unhinged or deluded self-radicalised loner, influenced by fringe groups in politics or culture. In the UK, Axel Rudakubana, who killed three young girls in Southport, turned out not to be a terrorist after all (“he did not kill to further a political, religious or ideological cause” said the judge on sentencing) but a disturbed and lonely young man who killed for no apparent reason other than mental instability. The same was true for Ali Harbi Ali who stabbed the Conservative MP David Amess, Sirhan Sirhan who shot Robert F Kennedy, James L. Ray who murdered Martin Luther King, even (despite all the conspiracy theories) Lee Harvey Oswald who killed John F. Kennedy. All of them fit this category of lonely, unbalanced people who kill because of some grievance, sometimes loosely politically motivated, but usually acting alone. Conspiracy theories are alluring, but usually unfounded.  

It's tempting when something like this happens to draw all kinds of wider political and cultural lessons. And there have been no shortage of them over these past days. “Because they could not prove him wrong, they murdered him” went one trope. The problem with that is that ‘they’ did not kill him. One young man - now in custody - did. To imply that every left-leaning person in the USA or elsewhere is somehow responsible for Kirk’s death ironically colludes with the darker motivations of this act. 

It's Jesus who explains why. “You have heard that it was said to the people long ago, 'Do not murder, and anyone who murders will be subject to judgment.' But I tell you that anyone who is angry with his brother will be subject to judgment. Anyone who says, 'You fool!' will be in danger of the fire of hell.”  

Sounds harsh. We all think murder is wrong, but losing your temper with a work colleague? Calling your neighbour an idiot because of who they vote for?  

The saying points to the root of murder as rage. And boy, is there rage around today.  

There are different kinds of anger. There is the red-hot furious kind where your blood boils and your temperature rises. Yet that kind of anger can settle into different mood - a hardened, determined malice, a fixed hatred of the person who provoked your anger in the first place and a determination to get your revenge, or to silence them once and for all. What both kinds have in common is the red mist that descends and remains, leaving an inability to see past the enmity, a refusal to see the humanity in the other person - the fact that they are, at the end of the day, a ‘brother’ as Jesus put it - a blindness to the essential commonality between you and the person you hate.  

Anger is a dangerous thing for us humans. It deceives us into thinking that because we think we are in the right it gives us license to do despicable things.

Killings like this have always occurred, from Julius Caesar, to Abraham Lincoln, to Archduke Franz Ferdinand, to Yitzhak Rabin. And they always will. No political solution will ever erase the possibility of a mentally disturbed or angry person taking it into their own hands to murder another human being, particularly one with political prominence.  

Yet we can do something. When we build algorithms that encourage the strongest and most extreme views, a media culture that highlights argument and division, refuse to see the common humanity in people we disagree with, when we demonise the opposition and blame them for all the ills of society that we see, we sow the seeds that enable this kind of tragic event to happen.  

Another deceptively simple piece of New Testament wisdom runs: “Do not let the sun go down while you are still angry, and do not give the devil a foothold.”  

It is good advice. Yes, we will get angry from time to time. But don’t let it take root. Sometimes a certain righteous anger can be a good thing – but it’s rare. Anger is a dangerous thing for us humans. It deceives us into thinking that because we think we are in the right (and we may well be) it gives us license to do despicable things. The heart of Christian wisdom on anger is that it is God’s prerogative to exercise wrath. Our anger, however initially righteous, tends to harden into something more sinister. God alone can sustain righteous anger that will truly bring justice. 

The right response to the murder of Charlie Kirk, the response that reflects the Christian faith that was so important to him, is not to blame it on an entire group of people, to tar them with the brush of the deluded young man who committed this terrible deed, but to see again the essential humanity that we share with our enemies. It is to actively cultivate a culture that encourages restraint rather than rage. It is to learn to be ruthless with our own tendency to hold grudges, our own deep-seated hostility to those whose views we find repulsive. It is to learn to hate racism, but to love the racist, to hate crime, but to love the criminal.  

To respond wisely is to recognise that even my enemy - whether progressive or conservative - is a human being created and loved by God, a fellow sinner like me, and to look for the things we have in common, more than our differences. When Jesus taught us to love our enemies, he may have asked us to do something supremely difficult, but it is the only thing that can overcome the kind of malice that led to the tragic death of Charlie Kirk. 

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