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.

Snippet

Comment

Politics

Work

4 September 2025

3 min read

Who’d be an MP today?

A vulnerable vocation that we should all consider

Jamie Mulvaney

Jamie is Vicar of St Michael's Chester Square, London.

MPs sit and stand in a crowded parliament.

The House of Commons sits, and stands.

Houses of Parliament.

Last year, 132 Members of Parliament headed for the exit. Of course, the reasons for this vary, but the unsustainable nature of the role must be factored in. As the Westminster Parliament returns for another session, who on earth would want to be an MP in today's day and age?

Most starkly, we saw the murders of Jo Cox and Sir David Amess, with the latter writing in 2020 that the fear of attacks "rather spoilt the great British tradition of the people openly meeting their elected politicians". Herein lies much of the issue of being an MP today: accessibility. They might be highly insulated within the Palace of Westminster, but within their phones and outside of those gates they are always available, and always on, with slings and arrows that are verbal and violent.

The combination of abuse and accessibility is a potent force. It's not limited to the MPs themselves. Dr Ashley Weinberg, an occupational psychologist from the University of Salford, said that 49.5 per cent of MPs' staff suffering from distress was double the level experienced by the general population. Those in vocation-based work need some boundaries as capes don't come with the parliamentary pass.

And if the exit sign is so alluring, how do we remove barriers to entry? In Why We Get the Wrong Politicians, Isabel Hardman writes that seeking a seat is 'the most expensive and time-consuming job interview on earth'. Only to be met by remuneration that doesn't quite make up for the package deal. Of course, there's the uber-keen. Morgan Jones, writing in The New Statesman, notes 'People who want to be MPs really want to be MPs. They are willing to try and try again: in the footnotes of the careers of many now-prominent politicians, one finds unsuccessful first tilts at parliament.'

Being adopted, working class, a mum, a carer, and a cancer survivor didn't stop Conservative MP Katherine Fletcher from standing as an MP. In fact, it all contributed to it: 'You stand on a podium and say, "Vote for me please!" To do it properly you have to bring your whole self.' The sense of calling to a vocation comes from a frustration, where she found herself yelling at the TV, intersecting with our core experiences and values.

Even with five-year terms, there's an inherent reactivity in the daily nature of being an MP. Where is the space to think? To really reflect. In a plaintive but not totally despairing summer article, Andrew Marr, the veteran observer of politics, wrote more broadly about British society: 'What is new and disorientating is that we have so few storytellers to shake us or point a way ahead… This means that we push our anxieties, our frustrated hopes and our confusion even more on to the shoulders of political leaders who are entirely unsuited to bearing the weight.' As we lack imaginative drive, 'The fault is not in our stars but in ourselves.'

We need everyone from poets to plumbers to make this society work. And there's the question of vocation: where does my gifting and passion meet the needs of our society that solves problems or inspires others to?

We rightly have high expectations of our leaders, and project our hopes and fears onto their blank canvases. But their canvasses aren't blank. They are crammed with the urgent and important. We can't expect our politicians to do and be everything - and we all need to play our part. Our blame-and-shame culture finds hysterical, theatrical representation at Prime Minister's Questions. Sir Tony Blair said that 'A private secretary would come in and say: "Well, Prime Minister, a grateful nation awaits." I would follow him out feeling as if I was going to my execution.' The agonistic, antagonistic design of the House of Commons, where one side is pitted against the other, has ripples in our society with an increasingly antagonistic public discourse.

In pointing the finger we have three pointing back at ourselves. As Jesus famously said, 'Why do you look at the speck of sawdust in your brother’s eye and pay no attention to the plank in your own eye?'

Our vote at the ballot box may be our exercise of judgement. But before scathing our members of parliament, it's worth us first asking 'what have I done as a member of the public?'

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

Pledge now