False Steps in the Assisted Dying Debate

As 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.

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.

3 thoughts on “False Steps in the Assisted Dying Debate”

  1. Social pressure is an issue however, it is not an either or situation. We have had this debate several times over the last few years, and the reality is is that this bill seeks to protect those who are left to endure more than Christ endured himself. Social pressure works in more than one way , people are socially pressured into all sorts of things including being made to fear going to the GP or to any part of a system who under the guise of risk assessment punishes a person for seeking help. That is a serious issue. The Social Service that was designed to help people socially cope with chronic and terminal conditions is now a crisis service it is not in any way shape or form a social service. That is why numerous charities were formed to fill in the gaps which the government cannot provide. The figures may show you the success stories The pride of Britain will show you the exceptions, none of them show the complete picture, they show you a picture that says look if you have friends you can achieve this or if you have family you can achieve this. Well many people have neither they die alone in pain over a long period of time with the intervention only of strangers. The church will not be there, because they simply won’t be, it’s not in the job description. You see years ago I may have believed that compassion came before business, there are a few exceptional individuals for which that is true, but mostly in order to have friends you have to.pay for it stop paying or buying a service friends soon disappear and after a while your invisible. That’s the way it is. The church only supports on their terms, there may not be too.much wrong with that, but the church needs to be honest about it. Lord George Carey has been honest and compassionate I don’t suppose when he started his ministry he would have thought of proposing such a thing but experience has taught him that God is not a government paper and that healing is about more than biblical phrases and quotes. Medical intervention keeps many of us alive including George Carey but if that intervention becomes counterproductive and increases suffering that was not God’s intention for the human race. The bill should be supported and the social pressures should be removed . Of course I believe in care not killing but I also believe in the relief of suffering . It is possible to do both.

  2. Thank you, Andrew, for a really clear article. A pharmacist told me that recent research suggests high doses of morphine do not prematurely kill the patient but do provide relief from greater pain of the terminally ill. This contradicts the earlier assumption about its desirable effect but fatal side-effect. So it seems that there is a range of palliative interventions to reduce suffering for those dying. But care of the terminally ill, although a challenge, is irrelevant to the legislation that is being proposed. Rather, it seeks to legitimise social pressures on someone to decide to die in place of a commitment to compassion. If I am ill and feel depressed, how easy would it be to persuade me to be assisted to die?

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