Head to head

Assisted dying

In each edition of Pathways, we ask two Christians with different perspectives to explore a topical issue. A recent poll by the Royal College of Physicians asked doctors whether the law
should permit assisted dying. The results were controversial: 43 per cent voted against, 32 per cent in favour and 25 per cent were neutral. The College has now adopted a neutral position. Should we?

The Revd Andrew Lightbown blogs regularly about ethical issues, including the relationship between faith and economics.

Andrew

I am slowly nudging towards acceptance of assisted dying in some, carefully controlled, circumstances. That said, assisted dying is a complex ethical issue and I recognise that the composition of a supportive Christian ethic is fraught with difficulties.

The Bible cannot be mined to find the odd verse which would support assisted suicide. It frequently speaks about the sanctity of life.

In considering whether Christian ethics might allow for assisted suicide, we are drawn into a reflection on the nature of scripture.  I am happy to affirm that the Bible contains everything necessary for salvation, but I do not believe that it is able to speak directly into every contemporary ethical conundrum. Others will disagree.

I first became interested in assisted suicide in 2006 when Dr Anne Turner, who was suffering from Progressive Supranuclear Palsy, decided to end her life at Dignitas. Anne was the mother of an old school friend.

In 2008 my interest was further piqued when a young rugby player, Daniel James, became paraplegic and ended his life in Switzerland. The former England rugby player Brian Moore wrote about Daniel’s decision and the impact on his parents in The Daily Telegraph.

Brian, who I don’t think would describe himself as a theologian, finished his article with a reflection on the nature of divine judgement. The stimulus for nudging towards acceptance is vested in my reflections on the nature of God as articulated through some of the big theological motifs: mercy, judgement and love; alongside free-will.

“Composition of a supportive Christian ethic is fraught with difficulties”

Perhaps the Christian journalist John Cartwright was on to something when he suggested in an article in The Guardian that God, by his very nature, could not delight in a patient being kept alive with no hope for the alleviation of pain and suffering. Could it possibly be that final gift of an all-loving God at times of unbearable suffering is not life, but choice?

Many Christians will argue that God will judge harshly those who choose to walk alongside a loved one to their self-determined death. But here is the dilemma: would a reluctance or refusal to journey with a loved one who has made their final and absolute choice about what, in their  eyes, constitutes a good death, constitute the sin of abandonment? The Jesus who freely gave up his own life told a parable about the consequences of abandonment and neglect: the Parable of the Sheep and Goats.

Interestingly, Brian Moore, in his Daily Telegraph article, reflected on the nature of divine judgement writing that ‘among the many letters Daniel’s parents will get there will be a handful which will suggest they will be punished on the final day.

To such authors I say; if you reserve judgement for God, why usurp this by presupposing the conclusion? If there is a God, I believe he will understand what was done and why.’

God, at the end of the day, is nothing if not merciful.

Margaret

One of the hardest things in the world is to witness unbearable suffering in someone you love. Surely you wouldn’t let an animal go on like this. Isn’t it the most compassionate decision to end their suffering?

These are the understandable feelings behind demands for assisted dying to be legalised. Many propose that the UK should follow the practice of other countries where, within tightly controlled safeguards, a person who is terminally ill can choose assisted dying.

After years of caring for people with cancer, including members of my own family, I am not convinced that this is a safe or wise option for our society. ‘Of course, as a religious person, you would object,’ I have been told. My concerns, however, are far more practical and professional than theological.

It’s easy to look at alternatives through rose-tinted glasses. We tend to underestimate the difficulties, and the very real suffering, which assisted dying can create. The ideal of a peaceful death can be frustrated by the deep anxieties and conflicts which arise. Even within the closest of families, who can be sure that the time and place are right for such an irrevocable decision? Some people are remarkably clear- headed in their thinking. Many of the advocates for a change in policy are well educated, informed, and articulate people. They are used to being in control. Imagining themselves in some future state of degrading dependence, they would like to guarantee, in advance, a legal and reliable escape route.

“Human ambivalence is a far messier reality”

Human ambivalence is a far messier reality. The way we feel about the worth and quality of life can shift considerably, especially when we are vulnerable.

It is not uncommon for someone who has protested their desire for death to change their mind, once their fears have been addressed. Life feels much sweeter when we are assured of the care of others who will travel the journey with us.

These deep uncertainties make it hard to shape a tight regulatory framework. Despite repeated drafts and attempts, our lawmakers cannot agree the safeguards which would reliably exclude abuse. It is particularly hard to ensure that a frightened person is acting freely, with capacity and consent. In practice, many people facing illness and decline can feel themselves to be a burden or lapse into a state of depression. Who is to judge that their request for death is not smothering a deeper cry for help? One of the serious unintended consequences of legalising assisted dying has been a changing attitude, in some countries, towards people with disabilities.

It is a mistake to imagine that individual values and choices will have no impact on the perceptions, or the self-worth, of more vulnerable members of society whose lives could easily be discounted.

As a priest and physician who has been privileged to walk alongside the dying, I often pause to reflect that it is precisely in our weakness that we feel most deeply connected to one another. Perhaps, as a Christian, that should come as no surprise.

Margaret Whipp is a chaplain for the Churchill Hospital and a former Consultant Oncologist.

Further reading

Two books from either side of the assisted dying debate could be worth a read if you’re interested in exploring the topic further.

Paul Badham is a Patron of Dignity in Dying. Vaughan Roberts is the Rector of St Ebbe’s in Oxford and Director of the Proclamation Trust.

The Christian Medical Fellowship has spoken out against the move to neutrality. 

See also our feature on How to Grieve.