CAN the debate on assisted dying ever be satisfactorily resolved? At the beginning of After Virtue, the philosopher Alasdair MacIntyre considers several debates in which there seems to be no rational way of securing agreement in our culture. Is assisted dying another?
Macintyre offers three examples. Can a modern conflict can ever be a “just” war? Can abortion be ethical? Can private health care and education be defended in a fair society? He concludes that, in each case, the arguments on the opposing sides proceed from premisses that we have no way of reconciling. Is justice more important than survival? Do rights eclipse responsibilities? Does liberty trump equality? How can we measure one against the other?
What adds confusion to the assisted-dying debate is that the opposing sides use the same word — dignity — to mean different things. Google “dying with dignity” and you will find endless websites under headings such as “Right to Die” and “Physician-assisted suicide”. But a 2017 Theos report, Dignity at the End of Life, offers another perspective.
Most arguments in favour of changing the law focus on personal autonomy, insisting that individuals should have the freedom to decide when to end their lives. But, the Theos report suggests, dignity is also rooted in our relationships. Dignity in dying is, in part, conferred by the love and compassion of those who care for us.
MacIntyre would undoubtedly have agreed. If the principle of autonomy is our sole guiding force, moral questions become fragmented and individualised. Yet Christian tradition suggests that they should be social and relational. Dignity cannot be reduced to a person’s ability to live without pain. It is also conferred by the solidarity of loved ones who offer us physical, emotional, and spiritual support when we are most in need. That is why relationships can be deepened in times of greatest adversity.
Once society begins to see death as a solution to suffering, our ethical boundaries will become increasingly blurred. If dignity is located in choice and independence, what about those whose choices and independence are limited — by disability, chronic illness, mental-health problems, dementia, or other inability to exercise rational or physical autonomy?
This new impoverished definition of dignity will subconsciously undermine such individuals’ sense of worth. It will be undignified to be old, ill, or dependent on others. Voluntary euthanasia will be extended inexorably to them. Soon they may perceive an obligation to cease “being a burden” to their family, especially as health and care systems struggle to find the money for palliative care. Killing will always be cheaper than caring.
Something precious in the deep moral fabric of society will perish. Intergenerational solidarity will be undermined. So, too, will the relationship between patients and doctors, whose ethics have traditionally bound them, following Hippocrates, to “do no harm” and commit themselves to the “utmost respect for human life from its beginning”. Society’s commitment to caring for the sick and defenceless will be doubly eroded.
A law that places individual autonomy above communal responsibilities and virtues might confer on the dying the “dignity of choice”. But it will leave them bereft of the deeper dignity that arises from the moral obligations that we have to one another when we are at our most vulnerable.
The Church Times and Modern Church will be hosting a webinar on assisted dying on Thursday 28 November. Find out more here