False steps in the assisted dying debate

I am reposting this guest article from Andrew Goddard written last year, since it gives such a clear and full response to the move today to change the law on assisted dying.

Lord-Falconer-011As we approach the House of Lords’ debate on Lord Falconer’s Assisted Dying Bill, it is clear that there is a concerted attempt to undermine the church’s traditional opposition to laws enabling the killing of the suffering and dying. There have always been some Christians who have supported this, such as Hans Kung and Paul Badham and in recent times Canon Rosie Harper has been a prominent Anglican voice. They have now been joined by two senior retired Archbishops, George Carey and Desmond Tutu. What is astonishing, looking at their articles, is not only their lack of theological content but the number of serious flaws and confusions in their arguments. The debate is clearly entering a new phase and it would be a shame if these misleading claims were perpetuated and so prevented a proper reasoned discussion. What follows offers the briefest of sketches of some of the main false steps in recent Christian arguments.

First, letting go is not the same as assisted killing. Archbishop Tutu makes great play of the fact that “What was done to Madiba (Nelson Mandela) was disgraceful” and George Carey claims that “sophisticated medical science also offers people the chance to be kept alive far beyond anything that would have been possible only a few years ago”. These are valid arguments to consider the amount of intervention to prolong life. They are not arguments for ending life. Assisting people to approach death with dignity through the provision of appropriate medical care and support and the non-provision of useless or burdensome treatments must be distinguished as a separate category from assisting them to bring about their death, for example, by prescribing lethal drugs whose only purpose is to end their life.

Second, easing pain is not the same as assisted killing. George Carey notes that “church leaders already understand that the use of pain medication such as morphine may occasionally have the effect of hastening death” and then asks “Why not extend this understanding further, so that the dying have a choice over how and when they wish their lives to end?”. Leaving aside the fact that properly administered pain medication is very unlikely to hasten death and the seemingly uncritical acceptance of unfettered individual autonomy, this simply ignores the important distinction between intended and unintended outcomes of our actions. Pain relief intends to ease pain, lethal injections intend to kill and prescribing lethal drugs intends to enable killing. To facilitate or enact the last two actions does not “extend the understanding” that allows the first. It represents a totally different, perhaps consequentialist, ethic in which either the intention of the agent is irrelevant or the intention to kill or assist in self-killing is held, in this case, to be good.

Third, an appeal to compassion is not an argument and certainly not an argument for assisted killing. Rosie Harper in her speech to peers recently began with the claim, “I’m speaking from a Christian perspective – and this is about compassion” and stated “There is no condemnation in the bible for someone who is too compassionate”. George Carey asserts that the current law “risks undermining the efforts of families and doctors to care for and ease the pain and misery of people reaching the end of their lives” (a claim which is not substantiated and only holds if one assumes making assisted suicide a crime somehow undermines care and easing pain) and that as “such compassion and concern should be at the very heart of our society” there is a “growing gap between the existing law and the need for compassion”. He explains his rethink in terms of asking whether he had been “putting doctrine before compassion” and states it would be “more compassionate” to replace the current legal framework with Lord Falconer’s bill and that our attitude to difficult cases should be one “not of judgment, but of compassion”.

At no point is there any attempt to explain what is meant by compassion or why the proposed law is more compassionate. Compassion refers to a fellow-suffering with someone which leads one to act to relieve their suffering. It is, as Carey notes in one of his few theological points, a mark of Jesus’ ministry: “Jesus’s mission was underpinned with compassion for those suffering from the most dreadful conditions, such as leprosy. To those people, rejected by society and condemned to live apart, he brought comfort, healing and a new sense of dignity”. These actions are those which embody compassion – to claim that enabling the sufferer to end their life is the true expression of compassion is highly counter-intuitive (how is that a sharing in their suffering?) and finding an example of such an embodiment of “compassion” from Jesus’ pattern of ministry an interesting challenge.

The language of “compassion” is here being used emotively rather than rationally. This is a highly dangerous move as it portrays defenders of the current law and traditional Christian teaching as lacking in this central Christian virtue. Indeed, Rosie Harper concludes by stating that the “bottom line” is that to vote against the bill is “neither moral or Christian” while Carey is only slightly more temperate in implying the traditional teaching favours doctrine and dogma over compassion and human dignity and sanctions “anguish and pain, the very opposite of the Christian message”. This points to the real danger that, aided and abetted by such rhetoric and lack of reasoning by Christian leaders, secular society will soon dismiss traditional Christian teaching in relation to dying as immoral and cruel. Better to acknowledge that no perspective has a monopoly on compassion and to engage in serious discussion about the nature and limits of compassion and what actions best embody it.

Fourth, hard and difficult cases make bad law. Harper, Carey and Tutu all follow the standard pattern of recounting powerful examples of human suffering in the approach to death to support the view that the law must change. The reality is that every law, by its nature, creates hard and difficult cases where the strict application of the law may be open to question. That is not in itself an argument against the law. As Nigel Biggar, for example, has argued, there is a strong case for the current law in this area, and this is so even if one grants there may be extreme cases where the taking of human life in the approach to death could be morally justifiable. The legal process has various means for handling difficult cases in relation to whether to prosecute and sentencing following conviction. To change the law would represent a much more fundamental shift and the warning of Baroness Butler-Sloss needs to be heard:

Laws, like nation states, are more secure when their boundaries rest on natural frontiers. The law that we have rests on just such a frontier. It rests on the principle that we do not involve ourselves in deliberately bringing about the deaths of others. Once we start making exceptions based on arbitrary criteria like terminal illness, that frontier becomes just a line in the sand, easily crossed and hard to defend. The law is there to protect us all. We tinker with it at our peril.

Fifth, whose lives should the law allow us to assist in ending? One of the strangest features of the arguments of the two Archbishops is the hard and difficult cases they cite in support of changing the law. Lord Carey admits that “it was the case of Tony Nicklinson [a sufferer of locked-in syndrome] that exerted the deepest influence on me” and also appeals to the situation of Paul Lamb, paralysed in a car crash. Desmond Tutu appeals to the South African Craig Schonegevel who killed himself in tragic circumstances “after 28 years of struggling with neurofibromatosis” as he “decided his quality of life was too poor” and the law meant he could not “end his life legally assisted, listening to his favourite music and in the embrace of his beloved parents, Patsy and Neville”. It would appear that the proposed Bill would have done nothing for them or anyone else in similar circumstances as they were not terminally ill and expected to live for less than six months.

This highlights the lack of logic in the arguments but also the fundamental challenge to any change in the law. Unless the law allows an unrestricted “right to die”, it needs to define certain groups of people who would be eligible for assistance in ending their lives; in so doing it excludes other people whose situation of suffering would appear to require similar treatment. Despite Lord Carey’s protestations that “it would be outrageous” if the bill’s scope “were extended beyond the terminally ill to an ever-widening group of people, including the disabled and the depressed” his own argument shows that this is not a possible slippery-slope arising from human weakness. It is rather the inherent logic of the position he has adopted. Compassion as he defines it and the cases he cites must lead to a widening of the scope of those able to be legally assisted to kill themselves and, lest we discriminate against those physically incapable of ending their own lives even with assistance, will press hard on extending this to allowing others to kill them.

Sixth, what about the weak and vulnerable? By focussing on hard cases the bigger picture is easily lost. Once a category of people are legally classed as eligible for support to end their lives all those who find themselves in that class will face either spoken or unspoken cultural and perhaps familial pressure to exercise their legal right. The category currently proposed are in many ways the most vulnerable – “given I/you have only a few months left, why not take control, do what needs to be done, save lots of money being wasted, and end things sooner rather than later in a way I/you want?”. Much better if society, through the law, tells every living person, however old or near death or depressed or incapacitated, that their life is valued and anyone who takes it or assists them in taking it has done something for which wider society, through the law, will hold them to account.

Goddard andrew(3)In conclusion, as we consider the current proposed change to the law and doubtless others in the future, it is vital that the emotions that we rightly feel in the face of suffering and dying and the desire to do something to help do not prevent us engaging in serious, reasoned reflection. The points above highlight that even Christian leaders often fail to do this when they critique the current situation. They also often fail to promote the clear, indisputably Christian alternative. The obligation to show compassion which is at the heart of Lord Carey’s argument is one which – with Christians playing a leading role – has found expression in the medical and nursing professions (which risk becoming compromised if implicated in the deliberate ending of life, hence their widespread caution or antipathy to changing the law) and in particular in the provision of hospices and palliative care for the dying. As the Church of England calls for a Royal Commission in this area it needs not only to continue its reasoned defence of the law but also to consider afresh how, as we face the possibility of changes in the law and the need to be distinctively counter-cultural, it can support this alternative embodiment of faith, hope and love in the face of suffering and death as the true expression of Christ-like compassion.

This article can also be found on the Fulcrum website

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14 thoughts on “False steps in the assisted dying debate”

  1. Well, as expected, the scaremongering worked, and the bill failed. It’ll be back.

    When it returns, hopefully the Christians who oppose euthanasia will be open about their reason: the belief that our lives belong not to us, but to God, and therefore, only God has the right to kill. They could then explain why it’s right to impose that belief on secular society.

    All this stuff about coercion, which applies equally to the right to end treatment, even if a full recovery’s expected, is just a pretext.

    Oh, and Andrew, I’d skip the bizarre parsing of the word “compassion” next time around. Its meaning’s plain, not some mystery to be decoded.

    • We already impose that right on society. It’s called being charged with murder.

      Assisted dying is a misnomer. There is no law about committing suicide, it is the fact that you want someone else to kill you that is the problem. This is an utterly selfish act. You are asking a member of the medical profession to act against their medical oath. Or you are leaving your loved ones with your death on their conscience.

      It’s amazing how they all want to live right up until they decide it’s the right time, there is always the option of suicide when first diagnosed. The right to die by a few will cause those who do not want to die to be disposed of when unnecessary to society.

      Why not bring back hanging. We could save some money on prisons and focus on end of life care.

      • Presumably asking for pain meds is also “selfish,” as is asking not to be resuscitated.

        The law was about assisted suicide, not euthanasia, and plenty doctors are willing to act. Many don’t swear an oath, and those who do, can reasonably interpret it to allow assisted dying, as they currently interpret it to allow withdrawal of treatment and “dual effect” pain relief that has the side-effect of killing the patient.

        A better example of what I described couldn’t be asked for!

        • The selfishness is in involving a third party in your death. But it can also be in the suicide as you leave loved ones in a terrible state of mind.
          There is nothing wrong in asking not to be resuscitated, this is non-intervention, not deliberate killing. There is also nothing wrong with pain medication even though this may hasten death- the reason is to relieve pain, not intentionally kill someone.
          As I said “assisted suicide” is asking someone to kill you- that is euthanasia.
          I have experience of my mother’s long illness and often prayed for the Lord to take her, but I could never have intentionally ended her life. If this is made law it will allow humankind to decide who is worthy of life and who is not. In every country that has allowed this the boundaries are continually changing. In Belgium children are now killed and those not of sound mind.

          • My condolences for your loss Tricia, and be assured, I respect your decision.

            That’s what this is about: respecting people’s wishes. Other families feel differently, and can’t bear to see their loved ones forced to suffer against their will. The ban on euthanasia causes them great anguish, and faces them with choices, such as flying to Switzerland, that may shorten life prematurely.

            Unless there’s a compelling reason to criminalize them, if any position’s selfish, it’s coopting the force of criminal law to impose religious beliefs on them that they do not share. Since the coercion argument applies equally to withdrawing treatment and DNR notices, I see no secular justification for criminalizing euthanasia. Do you have one?

          • ‘That’s what this is about: respecting people’s wishes.’ Only if you assume an individualist situation ethic where each person does what is right in his or her own eyes.

            If you believe that there are some objective values of right and wrong, you are going to end up in a different place.

          • Secular criminal law doesn’t exist to enforce morality.

            Moreover, in a pluralist society, it can’t. Whose “objective values of right and wrong” are enforced? Yours, as an evangelical Christian? Mine, as a liberal? The teaching of the Catholic Church? Sharia law? Humanism? Wicca?

            How do we decide? Based on the majority view of a legislature? That’s an invitation for one group to impose its will on another, tit-for-tat. It’d trample over freedom of religion and freedom of conscience.

            If nothing else, since objective morality’s being appealed to, I believe I’ve established that a fear of coercion is not the principle ground for opposing this law, making appeals to that risk a pretext.

        • I agree with Ian that there are values in life. There is right and there is wrong and a just and fair society protects the weak. The law in this country is compassionate – how many people have been accused and found guilty of this crime. Justice has always been tempered with mercy in the court system as it is understood to be a very emotive and painful issue.
          One of the proponents in the Dutch euthanasia debate who was vehemently for assisted dying has recently visited The Westminster Parliament to say do NOT go down this route. He now understands how this soon becomes a snowball and also as Ian has mentioned it defunds end of life care. For Governments it is a cheap option for an ageing population.
          As has been said many times “individual emotive cases make bad law”. You only have to listen to the disabled lobby on this issue to see the problems. And the dynamic between doctor and patient is irrevocably changed.
          When Abortion was legalised in this country we were assured it would be only where there was danger to the mother’s health or her mental state. Now 1 in 5 babies are aborted for reasons such as the wrong sex or inconvenience. I was shocked when my daughter was offered an abortion because her child was cleft palette. This is evidently routine procedure. My grandson is a beautiful boy and we are blessed that his cleft was able to be corrected due to the wonderful skill of the team at QMC.

          • My support for euthanasia rests not on hard cases, Tricia, but a hard-headed analysis of the facts.

            As you accept, the law isn’t enforced, which undermines the rule of law. People are driven to die sooner than they otherwise would, so the law fails even on its own terms. And if people are being pressured to die, it’s a separate issue, that affects currently legal practices like withdrawing treatment and DNR notices.

            Disabled people are, obviously, not of one mind on euthanasia. I can sympathize with the fears of some disabiled people without accepting their arguments; and note that others have an ulterior motive of their own, adherence to the social model of disability, which causes them to reject any suggestion that physical impairment can be insufferable.

            Like abortion, even if you disagree with euthanasia, criminalization’s ineffective, and that being so, the suffering it causes unjustified.

        • I don’t accept that the law is undermined by showing understanding and compassion for actions taken. The law is strengthened by showing clemency and mercy.
          I don’t see that the facts justify the change in the law. A small number of people maybe choose to die abroad and shorten their life. This cannot be a reason to put thousands of people at risk from having their lives ended.
          In all cases where euthanasia has been allowed, deaths in this way rise year on year.
          How you can allow these facts to lead you to a conclusion that this is a good idea, I do not comprehend.

  2. ‘It is, as Carey notes in one of his few theological points, a mark of Jesus’ ministry: “Jesus’s mission was underpinned with compassion for those suffering from the most dreadful conditions, such as leprosy. To those people, rejected by society and condemned to live apart, he brought comfort, healing and a new sense of dignity”.’

    Yes, but I do note that Jesus healed the leper and did not help him to die out of compassion for his suffering. In fact, I don’t remember Jesus helping anyone to die out of compassion.

    • Cure is always preferable to euthanasia. The Jesus of the gospels could deliver cures, so had no need of the good death. We’re not so fortunate, although everything should be done to advance medicine to the point where euthanasia’s unnecessary.

      • It is the hospice movement which offers the possibility of a good death—something in which we lead the world, and which has withered and died in countries which have legalised assisted suicide.

        • Hospices can’t eliminate pain or incapacity: euthanasia’s different in kind to palliative care, as shown by the British citizens who travel to Switzerland (in a grim example of unintended consequences, fearful that they might become too ill to make the journey if they wait, some die sooner than they would’ve if assisted dying were legal in their own country).

          What’s the evidence that hospices have “withered and died” in jurisdictions that legalized assisted suicide and euthanasia? What were their hospices like before? Has this decline affected all jurisdictions equally, including Oregon, on whose regime the English law was based.


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