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.

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Justice

Redemption

15 May 2025

4 min read

The case of Peter Sullivan proves once and for all why we shouldn’t bring back the death penalty

It’s not the wrongly convicted who are redeemed when justice is done - it’s all of us.

George Pitcher

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

A court sits, with judges raised above the others.

The Court of Appeal.

Judiciary.uk.

The quashing of the conviction this week of Peter Sullivan, who served 38 years in jail for a murder he did not commit – along with the release in 2023 of Andrew Malkinson, cleared of rape after 17 years inside – are deeply shameful. They are revolting stains not only on our judiciary, but on all those who politically invigilate it and on the rest of us who elect them. We should all be deeply ashamed.

As we peep through our fingers at these terrible travesties of justice and the lives that have needlessly been wrecked, it’s natural to ask what we do next. In the absence of time travel, we can hardly make it up to Messrs Sullivan and Malkinson.

But we can grapple with what they mean to us for the immediate future. Probably the first and easist thing to say is – if I may not so much mix a metaphor as summarily execute it – that they should hammer legislatively the final nail in the coffin of the death penalty.

Sullivan would doubtless have swung for the murder of florist Diane Sindall in 1986 that he did not commit, if execution by hanging (or by other means) had not been abolished in 1965. True, rape hasn’t been a capital offence since 1841, when the penalty became transportation (which was almost as irreversible as death).

But Malkinson’s case rather makes the point: The very fact that he was still incarcerated meant that he could be released. Let’s take a case in which no such remedy was available – Derek Bentley, say, who was hanged in 1953 for allegedly abetting the murder of a police officer and exonerated, a trifle late, in 1998.

The arguments of thornproof and white-knuckled proponents of the death penalty may be as swiftly dispatched as they would wish such innocent victims to be. They were probably “wrong ‘uns” anyway. Their sacrifice would have discouraged others from committing heinous crimes. The taxpayer shouldn’t have to pay for their decades in the slammer. Well, pah. Try telling any of that to the Sullivan family.

But these are not, to my mind, the biggest issues and, enormous as they are, that must make the biggest pretty gargantuan. I wish to address the business of redemption.

But we can ransom the present to redeem our future.

Now, when I mention this word to those holding the pitchforks, prodding people they despise towards the scaffold, they usually assume I’ve come over all pious and priestly. And I suppose I have. But they invariably misunderstand what we mean by redemption.

The assumption is that the victim of the miscarriage of justice can be redeemed if they are still alive. Their life is in some way redeemed from suffering. That’s true, so far as it goes, but it’s not really what we should mean by redemption in these circumstances.

The Latin root of the word refers to the buying back, or the paying of the ransom, of a slave to enable his or her freedom. The ancient scriptural usage of the word relates often to the saving actions of the Hebrews’ God, in redeeming his people from slavery in Egypt, and to the Christian culmination of that redeeming work at the cross (totally uncoincidentally, both events are commemorated at the Jewish Passover, that first divine covenant being, in Christianity, fulfilled in the second).

The debate down the ages has substantially concentrated on to whom the ransom of that latter redemption was paid. For some, it was paid to a vengeful and wrathful God, for others to a somewhat gullible Satan, who took the bait of pay-off. Either way, a debt was paid which released humanity from bondage and slavery.

The theology of this can only be satisfactory to a proportion of people who read it, whether believers or not. The important matter is to whom the act of redemption is of value. A slave who died building a pyramid for a pharaoh doesn’t seem to have been redeemed in any more meaningful sense than the young Bentley being pardoned 45 years after he was hanged. Exoneration isn’t redemption.

In the Christian tradition, it’s significant that the compilers of the gospels and the books thereafter develop less the idea of ransom to explain the cross, than the idea of deliverance from bondage that was its result.

And there the answer, rather than the victims, hangs before us. We can’t redeem the injustice of the past, anymore than we can give Sullivan and Malkinson back their lost years. But we can ransom the present to redeem our future.

To those who claim that murderers and rapists “get off” because of “loopholes” in the law, we say there are no loopholes, only the law. And we’re all enriched when we get the law right. So, ultimately, it’s not the wrongly convicted who are redeemed when justice is done and they’re finally released. It’s all of us.