Article

Assisted dying

Care

Comment

Death & life

Suffering

27 November 2024

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 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

General Election 24

Politics

13 June 2024

10 min read

‘Let your yeah be yeah’: when style supplants substance

The frustrating language of politics.

Roger Standing

Roger is a Baptist minister, author and Senior Research Fellow at Spurgeon’s College in London.

Campaign slogans.

Newzeepk, X.

You know what it’s like. A catchy piece of music is going round and round in your head. You can’t stop it. You don’t know where it came from. And, if you did originally like it, you find yourself quickly going off it.

Some call it ‘sticky music’, while others have labelled the phenomenon as ‘stuck song syndrome’. I prefer the more evocative ‘earworm’ as it ably expresses the experience of something both invasive and undesirable.

On this occasion the tune was accompanied by its refrain, ‘Let your yeah be yeah, and your no be no, now’. Round and round and round it went. It’s not a song I know well, and I couldn’t even remember who sang it.

Thankfully a quick google identified it as a top 10 single from 1971 by the Jamaican reggae trio, The Pioneers. Unfortunately, discovering that did not make it go away.

It was not rocket science to understand what was going on inside my head. It was the first week after Prime Minister Rishi Sunak had called the election and the campaigning had begun in earnest.

Now it’s not that my instant reaction was to do a ‘Brenda from Bristol’. Brenda, you will remember, became an internet sensation in 2017 for her memorable outburst when Teresa May called a snap election. She exclaimed, ‘You must be joking, not another one!’ No, I’m to be found more at the aficionado end of the political spectrum.

Still, I have been finding myself increasingly exasperated over recent years. I don’t think my irritation is just about getting older and becoming more grumpy. But I do find myself frustrated by what politicians do with language and the words they choose to use. I’m annoyed by the strategies they adopt as they justify themselves and the rhetorical devices they surreptitiously employ to bolster an argument.

Inside I find a deep longing for people to say what they mean and mean what they say. Is it too much to ask? Of course, there’s the root in my psyche, ‘let your yeah be yeah, and your no be no, now’.

It’s not that this is some kind of naïve desire for politics to become what it never can be - some kind of genteel, educated, middle-class debating society.

The very nature of democracy has passionate argument at its very heart. We don’t wrangle over what we agree on and hold in common. Democracy obliges our leaders to be in a mindset of perpetual persuasion towards us.

No, for me, the nub of the problem is when emotive words are chosen to make a point that the substance of an argument can’t. Or, when rhetorical sleight of hand is deployed on an unsuspecting audience, much like the misdirection of a magician in creating the illusion of magic.

Style supplants content and soundbites replace substance that has depth and an evidential basis.

This is nothing new. It has been a part of our public life in the West since the classical era of Aristotle, Plato and Cicero. It was the English rhetorician Ralph Lever who, in the sixteenth century, attempted to translate the key concepts of Aristotelian logic into English in his The Arte of Reason, rightly termed, Witcraft. That is, ‘witcraft’ – the art, skill or craft of the mind, NOT ‘witchcraft’: though some might see that as an apt descriptor of the dark arts that classical rhetoric can enable.

Aristotle, however, was clear in his understanding that the function of rhetorical skills was not to persuade in and of themselves, but rather to make available the means of persuasion. The substance of an argument was always to be more important than the manner in which it was communicated.

It is hardly a revelation that the world of contemporary comms has been birthed in a brave new world of technology. As the American media theorist and cultural critic Neil Postman pointed out, the advent of TV introduced entertainment as the defining principle of communication and what it takes to hold our attention.

Amusing Ourselves to Death: Public Discourse in the Age of Show Business was Postman’s 1985 era-defining commentary of how things have changed. Gone are the 2-hour long political ‘stump’ speeches and hour-long church sermons. Style supplants content and soundbites replace substance that has depth and an evidential basis.

The speed of the internet, the ubiquity of social media and the omniscience of the algorithms have only served to distil and intensify the phenomena that Postman was concerned about. That recent history has witnessed the success that has accompanied the media experience and understanding of Boris Johnson and Donald Trump, only serves to underline the prescience of Postman’s observations.

The ability to cut through the surrounding cacophony, engage an audience and then hold their attention long enough to communicate something of value is challenging to the nth degree. This has merely served to ramp up the intensity, exaggeration and immediacy of political speech. To impact us it must evoke an emotional response. In this anxiety and fear are the most effective drivers.

Former Labour Prime Minister Harold Wilson was quite clear in his assessment that ‘a week is a long time in politics’. We might now consider a day, or even an hour, to be the operative chronological measure. The news cycle can turn very quickly indeed.

Yet the underlying dynamics of communication remain. Rhetoric remains supreme. Political machines have become the masters of ‘spin’ and of the art of gaming the opportunities, language and positioning presented by contemporary media.

As voters we should always be highly sensitive to what’s being communicated when a speaker talks about ‘us and them’, ‘ours and theirs’, ‘we and they’.

All this is in a context in which it is estimated that those in middle age have consumed an average of 30-40,000 hours of TV and some 250,000 advertisements. Britain is a media savvy society. Yet for all of this sophistication in media consumption, I remain fearful of how aware my fellow citizens are of the techniques that inform contemporary political messaging.

The former Speaker of the House of Representatives in the United States, Newt Gingrich, provides a helpful case study. Back in 1994 he produced a notorious memo to Republican candidates for Congress entitled ‘Language: A Key Mechanism of Control’.

Following extensive testing in focus groups and scrutiny by PR specialists he highlighted around 200 words for Republicans to memorise and use. There were positive words to associate with their own programme and negative ones to use against their opponents.

The positive words he advocated included:

opportunity… control… truth… moral… courage… reform… prosperity… children… family… we/us/our… liberty… principle(d)… success… empower(ment)… peace… rights… choice/choose… fair…

By contrast, when addressing their opponents:

decay… failure … collapse(ing)… crisis… urgent(cy)… destructive… sick… pathetic… lie… they/them… betray… consequences… hypocrisy… threaten… waste… corruption… incompetent… taxes… disgrace… cynicism… machine…

Careful choice of words can then be layered with other strategies to construct a highly sophisticated political message.

At a most basic level come the ever popular ‘guilt by association’ and its twin sibling ‘virtue by connexion’. Are migrants portrayed as ‘sponging off the benefits system’ or ‘filling recruitment shortfalls in the NHS, social care and industry’? Is British culture under threat of being overwhelmed or enriched by cultural diversity?

Integral to this use of language are the various methods of ‘virtue signalling’ to a particular audience and the infamous ‘dog-whistle’ subjects and phrases to call them to heel. Tropes and labelling also play their part. On labelling, the nineteenth century statesman John Morley powerfully denigrated the practice by suggesting that it saved ‘talkative people the trouble of thinking’.

As voters we should always be highly sensitive to what’s being communicated when a speaker talks about ‘us and them’, ‘ours and theirs’, ‘we and they’. By implication who is ‘in’ and who is ‘out’? We should be aware too when more general arguments are made that leave us, as listeners, to fill in the blanks. This hidden rhetorical manoeuvre gets us ‘onside’ by leading us to intuitively believe that the speaker agrees with us. Along the way they haven’t defined what ‘responsible government’, or ‘critical priorities’ or ‘British values’ actually are. Instead, they have left for us to supply our own definition, ensuring our agreement and support.

To these can be added the ever more common practice of ‘gaslighting’, where information or events are manipulated to get people to doubt their own judgment, perception and sense of reality. And then there’s my favourite that the Urban Dictionary defines as a ‘Schrodinger’s douchebag’. Especially popular among populist politicians, this is where an outrageous statement is made and the speaker waits for the audience to respond. Only retrospectively do they declare whether they meant what they said or were only ‘just joking’.

It's perhaps no surprise that Rhetorical Political Analysis is actually a thing. Academics study it and political journalists use it to sniff out any hint of obfuscation. Depressingly, in the media, this frequently descends into an unholy game of ‘bait and trap’. Politicians, for their part, then become much more guarded as they seek to side-step a ‘gotcha’ move, whether merited or not.

… the truth will set you free’, he said. Free from the ducking and diving around our half-truths and fabrications.

So where does that leave the aspiration of ‘Let your yeah be yeah, and your no be no, now’? It may be surprising to some that The Pioneers’ song about a troubled love affair is directly quoting Jesus’ Sermon on the Mount. But Jesus’ focus is not about romance here.

What he is talking about is truthfulness, authenticity and integrity. Say what you mean and mean what you say. For Jesus, truth and truthfulness was at the very centre of his own identity. Indeed, in Christian theology Jesus is the ‘word made flesh’, the ‘exact representation’ of who God is and what he is like. Jesus then advocates what he embodies: an alignment and integration of who we are, with what we say and what we do.

This has to be the foundation for authenticity and integrity. These are the very principles that are so highly prized in the political arena, and yet so quickly abandoned in the maelstrom of the conflicting demands of public life.

Jesus advocated living a truthful life, not least because of its liberating outcomes, ‘… the truth will set you free’, he said. Free from the ducking and diving around our half-truths and fabrications. Free from the fear of being found out or the implications of the ever-deepening holes to be dug. Free to be ourselves and have all the bits of our lives fit together as one.

This has to be the principle to live by, the standard to benchmark, the way of life to aspire to. It’s no coincidence that integrity and honesty are two of the seven Nolan principles that inform the UK government’s Committee on Standards in Public Life.

But the fact is we know the world to be a complicated place. We are not always the people we long to be. In the church’s liturgy the prayer of confession calls out our challenges. We miss the mark ‘through negligence, through weakness, [and] through our own deliberate fault.’

The reality is that, while we aspire to be the best that we can be, we also need to be alive to alternative realities. Our political processes can throw up flawed actors, bad actors and nefarious actors. They present very differently, yet we must always read through what is being communicated to access what is being said.

Life is complicated. There are many different ways to legitimately tackle the issues that we face as a country. Always there are trade-offs. Frequently the future turns out to be different to what has been predicted. Ultimately there are too many variables.

The 2024 General Election has proven to be refreshingly different. Neither Rishi Sunak nor Keir Starmer are as natural or charismatic in front of a camera as some of their predecessors.

It rained on the Prime Minister when he announced the election without an umbrella and the day after took him to the Belfast shipyard where the Titanic was built. Such gaffes are reassuringly human. Labour’s tragically cack-handed approach to Diane Abbott and whether she could stand for election as MP for Hackney North & Stoke Newington where she faithfully served for 37 years is in a similar vein.

Yet, through it all it is worth noting Laura Kuenssberg’s comments for the BBC.

Both leaders inspire unusual loyalty among their teams. They are often praised by those who work with them as being warmer than they appear on camera: staffers describe them as decent family men, who take their jobs incredibly seriously and work incredibly hard.

I find this remarkably encouraging. In the meantime, that song keeps going round in my head.

‘Let your yeah be yeah, and your no be no, now’.

Please make it stop.