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
Education
Language
6 min read

Cutting language learning is a moral failure

Learning someone’s tongue is a deeply humble and empathetic act
A check list shows 'thank you' in different languages.

When you go abroad, how do you navigate language differences? Do you just stick everything through Google translate? Or put a few weeks into Duolingo before you go? Or maybe you just speak a bit louder in the hope that that will somehow smooth over any misunderstandings? 

Recently, my wife and I went to Italy for a week. Neither of can speak a word of Italian and we were taking our toddler Zachary with us (who can speak even less Italian), so we booked into a big resort where we knew staff would be able to speak some English if we needed anything for Zach. Even so, we tried learning a few words and phrases:  

‘please’,  

‘thank you’,  

‘could I have …?’,  

‘where is the …?,  

‘please forgive my toddler, he hasn’t learned to regulate his emotions yet’. 

That sort of thing. Just some basics to get by.  

Of course, what happened was exactly what happens every time I speak another language. I try my best to make an effort, people immediately realise I’m a struggling and they put me out of my misery by replying in English anyway.  

All this reinforces the importance of deep and rigorous language learning in society. All this makes the continued diminishment of university modern language programmes rather odd, and more than a little unsettling.  

The University of Nottingham has announced it is terminating the employment of casual staff at its Language Centre. This will see the end of numerous classes for students and others in many languages, both ancient and modern, including British Sign Language.  

Nottingham is not alone in this. The news comes in the immediate aftermath of a review into the University of Aberdeen’s decision to scrap modern language degrees in 2023, which found the decision “hurried, unstructured, and dominated by immediate financial considerations.” (Not that we needed a review to tell us this). The University of Aberdeen has partially reversed the decision, continuing its provision of joint honour degrees, if not single honour language degrees.  

Elsewhere, in January, Cardiff University announced plans to cut 400 academic staff, cutting their entire modern language provision in the process. In May, the University revealed that it would reverse these plans, with modern languages continuing to be offered (for now), albeit it a revised and scaled-down manner. 

The situation is bleak. As a theology lecturer who works for a Church of England college, I’m all too aware of the precarity my friends and colleagues in University Arts and Humanities departments face across the sector. But I was also naïve enough to think that languages might be one of the subjects that would be able to survive the worst of education’s deepening malaise given their clear  importance. How wrong I was. 

There are the obvious causes for despair at the news of language department cuts. One the one hand is the human element of all this. People are losing their jobs. Moreover, as casual workers, the University had no obligation to consult them about the changes or provide any notice period, and so they didn’t, because why would a university demonstrate courtesy towards its staff unless it absolutely had to? As well as losing jobs and whole careers, people will lose sleep, and perhaps even homes and relationships as a direct result of the financial and emotional toll this decision will take on staff. My heart breaks for those effected.  

And yet, the move is also evidence – as if more were needed – of the increasing commercialization of Higher Education. A statement from the University said the decision to cut languages in this way was the result of the Language Centre not running at a “financial surplus.” The cuts will instead allow the University to focus on “providing a high-quality experience for our undergraduate and postgraduate students.” 

And there we have it. Not even a veneer of pretence that universities operate for the pursuit of truth or knowledge. No, nothing so idealistic. A university is business, thank you very much, here to offer an “experience”. And when parts of businesses become financially unsustainable, they’re tossed aside. 

Languages aren’t just ways of describing the world we see, they’re also ways of seeing the world in the first place. 

But cutting language offerings isn’t just a personal and a societal loss, it’s also a huge spiritual and moral failure. And that’s because of what language fundamentally is. Let me explain.  

It can be tempting to think of words as simply ‘labels’ we assign to objects in the world, with different languages using a different set of ‘labels’ to describe the same objects. As a native English speaker, I might see something with four legs and a flat surface on top and call it a ‘desk’. Someone else with a different native language might call it a Schreibtisch, or a bureau‚ or a scrivania, or a tepu, or a bàn làm việc. You get the point: we might be using different labels, but we’re all ‘seeing’ the same thing when we use those ‘labels’, right? 

Well, it’s a bit more complicated than that. Languages aren’t just ways of describing the world we see, they’re also ways of seeing the world in the first place. As such, languages have the capacity to shape how we behave in response to the world, a world itself suggested to us in part by our language(s). As twentieth-century philosopher Ludwig Wittgenstein once wrote, “the limits of my language mean the limits of my world.” 

Let me give you just one example. English distinguishes tenses: past, present, future. I did, I do, I will do. Chinese does not. It expresses past, present, and future in the same way, meaning past and future feel as immediate and as pressing as the present. The result of ‘seeing’ the world through a ‘futureless’ language like this? According to economist Keith Chen, ‘futureless’ language speakers are 30 per cent more likely to save income compared to ‘futured’ language speakers (like English speakers). They also retire with more wealth, smoke less, practice safer sex, eat better, and exercise more. The future is experienced in a much more immediate and pressing way, leading to people investing more into behaviours that positively impact their future selves, because their view of the world – and their future selves’ place within the world – is radically different because of their language. 

Different languages lead to seeing the world differently which leads to differences in behaviour. In other words, there are certain experiences and emotions – even certain types of knowledge and behaviours - that are only encounterable for those fluent in certain languages. And this means that to learn another language is to increase our capacity for empathy. Forget walking a mile in someone’s shoes, if you want truly to know someone, learn their language.  

In my day job as a lecturer, when I’m trying to encourage my students – most of whom are vicars-to-be – to learn biblical Greek and/or Hebrew, I tell them it will make them more empathetic people. It may make them better readers of the Bible, it may even make them better writers too but, more than anything else, students who learn languages will be better equipped to love their neighbour for having done so. They will get a better sense of the limits of their world, and a greater appreciation for the ways in which others see it too. Show me a society that is linguistically myopic, and I’ll show you one that’s deeply unempathetic. I can guarantee you of that.   

We ought to be deeply, deeply concerned about the diminishing language offerings in the UK’s Higher Education sector. To open oneself to other languages is to open oneself to other ways of seeing the world. It is to be shown the limits of one’s own ways of seeing. Learning a language is a deeply humble and empathetic act. And isn’t humility and empathy in desperately short supply at the moment? 

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