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
Culture
Digital
Film & TV
Work
7 min read

What my film about the prodigal son really means

Our relentless focus on productivity devalues the things that make us human

Emily is designer and animator at the Theos think tank.

An animated man runs through a jungle.
In Sync with the Sun.
Theos.

Watch now

In his 2021 book 4,000 weeks: Time Management for Mortals, Oliver Burkeman observes that an obsession with productivity doesn’t give us more control over our lives, ‘instead, life accelerates, and everyone grows more impatient. It’s somehow vastly more aggravating to wait two minutes for the microwave than two hours for the oven - or ten seconds for a slow-loading web page versus three days to receive the same information by post.’ 

With technologies like artificial intelligence rapidly accelerating our lives, this constant demand to squeeze more into our time is not only limited to the mundane tasks that we have to do and wish we didn’t. It seeps into what we want to do and indeed must do in order to flourish: creating art, spending time in community, and caring for others. The problem is that these things cannot be measured in productivity metrics because they inherently do not function in that way. How do you measure how ‘productive’ a conversation is? Or a work of art? Artists such as Vincent Van Gogh or Emily Dickinson didn’t see their influence in their own lifetime. 

The more we measure our lives in productivity metrics, the more we devalue the things that make us human, ultimately making our lives and the world around us increasingly artificial. This is the basis of my recent film, In Sync with the Sun, which is a short animation about the rhythms of activity and rest that are written into our world, and what happens when an obsession with productivity takes over.  

I wrote the initial script for the film after a period of burnout. I was fully in the “make the most of every second” mindset, which left me feeling exhausted and confused about where my value resides. In response, I began researching the sleep-cycles of various animals and I was liberated by surprising details such as the fact that lions, which we see as mighty and majestic animals, sleep for around 21 hours a day. Even creatures like jellyfish, which don’t even have brains as far as we know, still have cycles of rest. Every living thing thrives in these rhythms of activity and rest, even down to plants and minuscule organisms. Our whole world is built on this pattern, in sync with the sun. Yet for us humans, our rhythms have been broken by technology, leaving us confused about our limitations and what we should do with our short lives.  

The film begins in nature, deep in the jungle where some leopards are sleeping. But the tranquility is abruptly interrupted by the voice-over declaring, “the war against sleep began when artificial broke into the night.” Brilliant white light breaks up the deep blues and purples on screen, until the screen is filled with blinding white. I wanted it to feel like that moment you peer at your phone in the middle of the night - the pain of your pupils trying to adjust. If you think about it, for 99.9 per cent of human history, our eyes would have never had to do that - until now.  

Artificial light wasn’t powerful enough to change that. Instead, it’s given us an unquenchable guilt about how we use our time. 

With his invention of the light bulb, Thomas Edison was determined to banish the night, and the limitations it enforced on us. Edison was known for being fiercely obsessed with productivity and, as a result, was an anti-sleep warrior who believed,

“There is really no reason why men should go to bed at all.”

As someone living a century on, I find it baffling to imagine that humans should eradicate sleep entirely. Perhaps because just 100 years later we are seeing the results that sleep-loss and over-working can have on our physical health and wellbeing. Maybe we cannot supersede nature after all, since we are an embedded part of it. It seems that “Sabbath" rest is written into our world and into our humanity. Artificial light wasn’t powerful enough to change that. Instead, it’s given us an unquenchable guilt about how we use our time. Now we decide when the day ends, so whoever can rest the least wins. 

The battle is still raging; incandescent bulbs only set aflame that root desire to be increasingly productive. The hamster wheel is spinning uncontrollably, and we must keep up. So, what do we do? The attempt to remove the limitations outside of us has revealed that they are in fact inside of us too. Therefore, the only way to keep up is to remove the human from the hamster wheel altogether. The failure of artificial light leads to the birth of artificial minds.  

 As a creative, this is what frustrates me most about artificial intelligence; that it is mostly being driven by this quest to bring everything under the reign of productivity. It goes without saying that this is greatly needed in some areas of society. Just like artificial light, it can and will do a lot of good in the world. However, when the obsession with productivity is prioritised over human flourishing, that’s when we know there is a big problem with how we view our lives.  

Thinking back to the examples of Van Gogh and Emily Dickinson; what is lost when we don’t allow space for artists, carers, mothers, or any skilled role that requires an element of patience? For me personally, I can’t force creative inspiration, instead it comes at me, often at times when I’m not looking for it. Similarly, sometimes that inspiration leads directly to an instant idea, but most often it’s a vague idea I jot down to which later life experiences and opportunities then build onto, forming it into something bigger and more in-depth. This could be compared to a role or situation that requires relationship building. Sometimes there are moments of instant bonding and “productive” progress in relationships, but it’s often more complex where external experiences or changes, which are outside of our control, may unexpectedly deepen understanding between people after long periods of frustration. 

In my animation, I used the metaphor of a butterfly to illustrate this sentiment. After the character realises he is not made for a life of relentless productivity, he steps out of the black and white skyscraper into the lush wilderness. A butterfly lands on his productivity badge and the voice over says, “You’re not a machine.” I imagine the Creator saying this to the loved creation. Creatures like butterflies seem completely unproductive to our human standards. They take weeks to form in the chrysalis and exist in the world for less time than that. Yet they are a source of wonder and beauty for anyone who has the privilege of seeing one up close. A reminder that nature is not in a rush. Where AI is concerned, however, speed and profit are the focus of desire. But looking at the world around us - that we are a part of - it’s clear that not everything can or should be valued by these limiting metrics alone. 

The overarching narrative of In Sync with the Sun is loosely inspired by the biblical story of the prodigal son. The main character has travelled far away from his home in pursuit of success, and he eventually realises that this master does not love him. At the end he comes home again, finding connection in community and in the good rhythm of productivity and rest that he came from. I wanted the film to address the issues that an unhealthy obsession with productivity can cause, and instead evoke a desire to accept and live more in sync with the boundaries and rhythms that are embedded in the natural world we are a part of.  

The film ends with the line, “The only thing that can stay awake is not awake at all.” In the midst of the changing world of AI, humans might be tempted to measure our productivity levels in comparison to these machines. However, technologies always raise the productivity bar higher and higher, and one day we need to accept that we simply aren’t going to be able to reach it. We don’t sit apart from nature like technology does, so let’s stop resenting that, and instead celebrate it. To quote Oliver Burkeman again,  

“the more you confront the facts of finitude instead - and work with them, rather than against them - the more productive, meaningful and joyful life becomes.” 

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