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
Freedom of Belief
Gaza
Middle East
Migration
7 min read

What the Gaza conflict and the asylum seeker row have in common

Iran’s persecution drives its Christians here. This is their story.

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

Rows of soldiers march away from the camera, two in the back row turn their heads back.
Officers at Iran’s Sacred Defence Week parade, 2023.
Tasnim News Agency, CC BY 4.0, via Wikimedia Commons.

The Israel-Gaza war and the recent row between the church and the UK government over asylum seekers don’t seem on the surface to have much to do with each other. But they do have a common denominator: Iran.  

Iran may not have directly sponsored Hamas’ infamous attacks on Israel on October 7th but without Iranian support for Hamas, it is unthinkable that they would have happened. Iran remains on the list of those countries who sponsor terrorist organisations across the Middle East, such as the Houthis in Yemen, and are widely regarded as a force for instability and undermining democracy across the region.  

It is also one of the most repressive nations on earth. It counts in the top ten of countries where freedom of religion or belief are restricted. According to the Open Doors’ World Watch List, list, Iran is the ninth most dangerous country to be a Christian in 2024, just behind Sudan and ahead of Afghanistan. With 1.2 million Christians in the country, they make up just 1.4 per cent of Iran’s population, and yet, they are considered to be a risk to national security and a means by which the West is seeking to undermine the Iranian government. This inevitably makes life incredibly hard for the Christians who call Iran home; to be a recognised Christian means to live your life as a second-class citizen, under constant surveillance, and enduring endless discrimination. 

Given that Iran is hardly a friend of the UK, the USA and its allies, you might have thought western governments would do all they could to support people seeking to escape the country, or a movement that draws people away from the influence of the mullahs. Which makes the attack on asylum seekers seeking baptism in UK churches all the more perplexing. 

Over the past week, Seen & Unseen has spoken to several Iranian Christians in the UK. These are definitely not bogus Christians. Some came to Christianity in Iran after a Muslim upbringing. Others were born into the small Christian community in Iran. Some are training to be ordained in the Church of England, and many of them have been imprisoned for their faith in Iran before coming to the UK. 

“The persecution that Christians are facing in Iran is absolutely real. Does that mean that some of them are leaving the country? Yes. I had to. I’m here. I had to leave my home.” 

One man, Mehdi (his name has been changed to protect his identity) became a Christian in Iran at the age of 18. His older brother converted to the new faith first and Mehdi, having seen his big brother struggling with violence, anger, depression and drugs, was curious about the complete and immediate change in his brother’s life. That curiosity led him to believe in Jesus. It became immediately obvious to these two brothers that their new faith was going to make their life complicated; and at the age of 20 and 26, they found themselves being arrested for the first time.  

He explains what drew him, and many others to Christianity. “It’s the same for many Iranians. There were people around us who are who were, and still are, dealing with lots of difficulties because of the economic situation, because of the oppression and corruption of the government. It feels like there’s no hope, no solution. The only solution can be found in the hidden places. It’s Jesus. He is the hope of a new life.” 

He tells us how Iran sees Christians: “They believe that Christianity is a weapon of Western countries, with a long-term plan to convert Islamic countries like Iran so that they can alter the culture and take the power.” 

After years in prison, much of it in solitary confinement in degrading conditions and yet more threats from the authorities, he was forced to leave Iran. He is now living in the UK with his wife, and at the midway point in his training to be a priest.  

We wanted to know what he thought of the comments concerning the church and ‘bogus asylum claims’: 

“The violation of human rights, the right to both free speech and freedom of belief, in Iran is real, it’s true, it’s happening. The persecution that Christians are facing in Iran is absolutely real. Does that mean that some of them are leaving the country? Yes. I had to. I’m here. I had to leave my home. And there aren’t enough legal routes, there aren’t enough ways to seek asylum in countries like the UK.  

So, it’s true that Christians are leaving Iran. I’m one of them. And I was incredibly lucky, I got here safely and securely.”  

Another convert, Hassan (also a false name to protect identity) while at home in Iran, went though the usual teenage angst, wondering about his place in the world, and whether God really exists. He delved into Islamic theology but says it left him ‘feeling empty’.  

After a few months of praying that God would somehow reveal himself, Hassan had a dream of a figure on a cross. This was the beginning of a journey that led him to faith in Jesus Christ. Hassan talks about his experience with the immigration system: “It’s hard for the Home Office, but the church has an important role to play – to support the people who have been persecuted, who have never before had a place to learn about or worship God. Those who have never had the freedom to express their faith, or live in their faith.”  

They are habitually religious people, so are not naturally drawn to atheism or agnosticism. On arriving in the UK, which they assume to be a Christian country, they naturally want to explore the faith of the country that they have arrived in. 

An Iranian refugee Darbina, unlike the others, was born as a Christian into a Christian family. Yet she speaks of how Christians are persecuted in Iran. She says they are treated like second class citizens, unable to sell food because they are regarded as unclean, unable to enter many professions because they are Christian. She describes the open surveillance of Christians. Her father, a pastor, was imprisoned for ‘acting against national security’ by organising small groups and illegal gatherings. Eventually Daria herself was imprisoned for a year. She experienced degrading treatment as a woman in a predominantly male prison, and frequently had to listen to the torture of others.  

There is another common story. Many Iranians leave Iran not yet as Christians, but seeking a better life from an economically depressed nation and disillusioned with the form of Shia Islam found in the country. They are habitually religious people, so are not naturally drawn to atheism or agnosticism. On arriving in the UK, which they assume to be a Christian country, they naturally want to explore the faith of the country that they have arrived in, even when they find the UK church more lukewarm than they expected. Of course, there are a number of Iranian Christians already in the UK such as Mehdi, Nasir and Daria, ready to help them discover a faith which has become vital to them. This would seem a much more common explanation of Iranian Christians wanting baptism, then simply a cynical attempt to manipulate the asylum system.  

Of course, there are Iranian and migrants from other countries claiming false conversion as a means of advancing their case for asylum. No-one doubts that. Yet the problem has been exaggerated. A recent Times report found that since January 2023 only 28 cases were heard at the Upper Tribunal Court in which a claimant cited conversion to Christianity as a reason to be granted asylum – in other words, just one per cent of cases heard. And of those 28, seven appeals were approved, 13 were dismissed and new hearings were ordered in eight cases. Hardly an ‘industrial scale’ operation. Yet there is a great deal of evidence of numerous people like those we spoke to, who have genuinely converted to Christianity, either in Iran itself, or in the west.   

More significant than the comparatively small number of fake claims, is evidence of a genuine religious revival amongst Iranian Muslims, drawn to Christianity as a more attractive option than the oppressive form of Islam they find in their homeland. Attacks on Iranian and other migrants, with the implication that all Iranians seeking conversion are bogus, or at least feeding suspicion of such claims to conversion is undermining exactly the kind of movement that you would have thought that the British government would be wanting to encourage. 

If there is something of a spiritual revival taking place amongst Iranian Muslims then this should be something to be celebrated rather than penalised or tarred with the brush of deception. We owe it to these people who have risked their lives to find a better way of living and believing.