A YouGov poll in 2013 indicated not only that 70% of those responding supported a change in the law to allow assisted dying but that a remarkably high 82% of supporters agreed with the statement that “An individual has the right to choose when and how to die”. This seems pretty convincing. There is a very large body of opinion that seems to favour the ‘right to choose’ dynamic of ethics. ‘Rights based’ decision making comes out of an individualistic foundation of making ethical choices. The freedom to choose is paramount. “It is surely my life that counts. It is really my life at stake.” This is an expression of my own freedom to make the biggest decision in my life (or death).
This is all of course expressed in the background noise of what shapes how we make ethical decisions. The overwhelming noise in our own society is the freedom to choose. This seems to be the overarching dynamic that shapes most of our ‘innate’ responses. It seems to be so ‘right’. It is of course, we are told, my right to decide. Well, not yet, at least in UK law.
Anthony Giddens reflecting on the irony of choice, writes that in contemporary society ‘we have no choice but to choose’ (Modernity and Self-Identity : Self and Society in the Late Modern Age, 1994, p 81). Zygmunt Bauman called choice ‘consumer society’s meta-value, the value with which to evaluate and rank all other values’ (Work, Consumerism and the New Poor, 2001, p 58). So a lack of the freedom to choose is perceived as a lack of freedom to live (or die as in this case). And this is at the heart of this ethical dilemma. My freedom to choose as a right-minded individual to end my own life. It is the pinnacle of this type of ethical decision making: “We may not have had the freedom to decide to be born but we can certainly have the freedom to decide when and how we can die”.
Yet the value of having freedom to choose is not found in simply having the choices available. It is in having the freedom to make the right choices. We often make decisions of choice based on no reference to cost, loss or risk. In buying the goods we want or the services we desire we simply part with the money. Hey presto - it’s mine. But we fail to recognise the limiting effects of our choices on others. How we make the right choice is therefore critical.
It simply cannot be based only on the notion of the freedom and right to choose. It must be based on other values. For instance, one powerful question we can raise about the freedom to choose is about what type of world we wish to be part of and to create. We are not in a world of isolated individuals where the decisions we make impact only us. The decisions we make have an impact. They either release or constrict the freedom and choice of others.
It is part of the human vocation to be choice makers so how do we do this? The Christian faith is about making choices. The freedom that God has given us in making choices is one of the main pillars of the biblical faith. We are free to choose but Scripture gently introduces another possibility: the freedom not to choose for the sake of others, the loss of personal freedom for the freedom of others. Jesus goes further and is even more radical in the overpowering statement that those who ‘lose their life for his sake will find it’. Stating the obvious, this of course is not referring to assisted suicide. It is about forgetting the myth that we, as individuals, are the be all and end all. Once we discover the freedom of giving up who we think we need to be, will will in reality discover who we are in Christ. We are not the focus for ethical decision making. We are not the sole arbiters in making choices - we take into account others and the impact of their freedom and choice-making.
For Christians it is so much more than simply the freedom to choose. We see life as a gift from God, who in Genesis is pictured as moulding humanity from the dust of the earth and breathing his life into them. Becoming human is about living into that reality. The life breathed into us is still being breathed into us daily as we surrender who we are into who God is calling and inviting us to be. Human life bears the image of God. We have a duty to live and ensure all live in the truth that they are bearers of God’s image. Assisted suicide could introduce the ‘duty to die’, the thought that we may have become a burden, not a gift.
The Assisted Dying Bill will introduce a role that the state has never played before - developing the boundaries in which someone else can help a person to die. These boundaries will not only be personal as in the relationship between doctor/nurse and patient. They will inevitably see the invasion of fiscal and practical considerations into the ‘decision’. Extra resources will need to be found to help someone make that decision, resources that could have been placed into palliative care, for instance into the hospice movement. where someone who is dying does so care and dignity. Assisted suicide will in the end be the crudest option to end suffering.
John is the Vicar of St Paul’s, Tupsley and St Andrews, Hampton Bishop in Hereford Diocese. He’s also currently doing Doctoral Studies at Kings College London.
Patients (Assisted Dying) Bill 2013/14
In comparison with Lord Joffe’s Patients (Assisted Dying) Bill of 2003, Lord Falconer’s 2013 bill is limited to the prescription of drugs and assisting ingestion or other administration, or providing a device for self-administration; omits the requirement for a solicitor to confirm the patient’s declaration; and relieves the coroner of his duty to hold and inquest. It also exempts the person assisting from criminal offences. Most significantly, it does not require the patient to be “suffering unbearably”. It does not require them to be suffering at all, only to be terminally ill and have mental capacity.
It adds an offence of providing a misleading medical or other professional opinion (s.10(2)). A legal minefield.
For a long time now, suicide has not been regarded as a crime. Anyone can go and eat a bowl of deadly nightshade or hemlock, which grow ubiquitously. Similarly, it’s not hard to amass a lethal dose of prescription or non-prescription drugs. And there are many other ways to kill oneself. In hospitals and hospices, many very ill patients give “do not resuscitate” notices, and as far as I know, there is no limit to the power of morphine to relieve physical pain.
It seems, then, that the bill is aimed at the provision of lethal medicines to people who lack the ability to acquire or administer them, and are otherwise physically unable to kill themselves.
However, since the availability of many such medicines is strictly controlled by the state, and so people are not able to get them for the sole reason that the state prevents it, then could this bill be seen as a limited deregulation of that control over medicines? and as such as a lessening of the extent to which the state dictates what is or is not good for us?
The serious potential problem of any such legislation providing a licence to murder is, in this case, exacerbated by the removal of the coroner’s duty to enquire. That’s not the point of this thread, though.
The bill does little to actually give us the power to choose to die, it extends it to a very few people who, mainly for reasons of incapacity, are denied a choice that most people do have, and at exactly the time they want to choose otherwise than they chose every other day of their life. Does it not sound a little unfair, put that way?
It says in Scripture, “I have set before you death and life… Now you choose life!” (Deut.30:19)
Does impotence to choose death undermine the meaning of choosing life?
I have always felt the most tender sympathy for those poor souls who depart this life by their own hand, invariably through great mental, and often physical, suffering. I am certain they are not damned, but immediately forgiven and received by the Lord with open arms, as the beloved treasure they are.
I believe I would find it impossible to help administer a lethal drug to someone, but would administer analgesic drugs, and sit by that person’s side. The bill provides for “conscientious objection” (s.5). But I cannot find it in myself to say to somebody else, “thou shalt not”, which the law presently does.
There are many, many things if life which people do but which my own conscience would not permit me to do.
I think our true battle is against the forces which measure the value of humans by worldly estimation, economic or social or in terms of “happiness”. I’ve spent enough time in care homes and hospices to have seen, I think, the most abject humiliation and degradation possible by nature. I have held on to, kissed, prayed for, and with, people without an ounce of dignity in any sense other than the most purely spiritual.
But I have seen that dignity, perhaps better to say I have appreciated or understood it. Our job is, I suggest, to bear witness to that dignity which comes from God, and to do what we can to convince others of it, especially the people who themselves are the ones who have little or no worldly dignity. I think we must let people choose to die, and let people help them to kill themselves, but must faithfully teach them to be guided by their conscience, to listen to God. Maybe we must help them ourselves if our conscience dictate it, though as I said, I think mine would not, though the situation has never arisen.
It may even be that, should such a law be passed (though this bill is not expected to go through, at least in it’s current form), it will create many opportunities for the advancement of the gospel. God has proven most able in bringing good from what seems to be bad.
In fact I think the debate now is already such an opportunity.
The text of the bill can be seen at
http://www.publications.parliament.uk/pa/bills/lbill/2013-2014/0024/2014024.pdf
Another way of looking at this is Do we want to exercise the human right we have over and above the “to be a living sacrifice”? It is a difficult dilemma, everyday surgeons save human being who in the natural order of things would die of natural causes. There are many terminal illnesses where if there had not been medical intervention a persons life would be shortened anyway. Chronic care however is different that is about living a life of isolation and rejection a never belonging anywhere being tolerated at least and resented at worst, it is a life of fear and anxiety. Terminal care is a life of certainty of outcome but not certainty of time .” How long oh lord must I suffer”? comes to mind. Alongside the Psalms where we see for centuries believers in God have fought the same battle. But biblical times did not have medical intervention to prolong life.. Medicine is a great tool to heal and create life God given I believe, but when the bible tells us we will suffer for sins it confuses issues for the best of us. When the bible tells us we pay the price for the sins of the fathers it confuses us. Some people in Christianity believe and promote that ill health and pain are a punishment from God it has been promoted on here many many times in relation to homosexuality and women in ministry. This is the problem the edges get blurred , everything comes down to are you willing “to be a living sacrifice” It is a tough call especially when in the instance of a Christian they may say yes only to be faced with that sacrifice not being about what can be done, but what finances and personal situations dictate will be done. Sometimes for some everyday is preceded by the thought can I cope with being a living sacrifice today? Prayers to God do not always go unanswered and many people survive the day against their own natural will and desire, where as if God was not in the equation they might not. But we were never meant to face the question about the right to live, intervention has created that question. It is scary . The question really should be do others have the right to choose that we should suffer or die.