All of which points to a serious disconnect between what is now being proposed and many of the issues put forward in support of it. For example, it is urged that medical science has led to excessive efforts to “keep people going at any price” and is “forcing people to live on for many months in unbearable pain.” Whether or not these claims are in fact true, in neither case would assisted suicide seem the optimal remedy. It is certainly not clear that the law as it stands, and still less Christian moral theology, obliges extraordinary measures that cause suffering to the patient. But references to the cost of treatment do hint at a worrying if otherwise concealed and logically separate concern about saving money. Encouraging suicide as a means to financial savings does not seem an especially attractive policy and is surely hard to present as necessarily in interest of the patient. The goals of relieving suffering and saving money are not issues that fit easily together.
Then it is frequently suggested that “It is quality of life that counts, not the number of days.” But this line of reasoning, when cited in the context of social policy must imply a mechanism for assessment. This in turn introduces an inexorable utilitarian line of analysis that can only erode the long-standing religious emphasis upon the intrinsic worth and sanctity of all human life. How can the “quality challenge” not eventually pose the question for all disabled people, on a continuing basis, of whether their quality of life is such as to warrant its continuation?
In fact, the question will be posed with a degree of force proportionate to the disability. The more disabled the person the more doubt it will create about the propriety of their continued existence, and the more urgency will be implied for their consideration of assisted suicide in the duly “organized open and professional way” we urged to embrace. It is not hard to think of historical instances where the disabled were targeted for elimination in a highly organised and professional way. Are we now to suppose that the only fault was a failure to be open about it and perhaps a certain murkiness about securing their consent, insofar as they had the capacity to provide it?
And that last is of course a further difficulty, at a time of so much emphasis upon equality of opportunity, why should the suicide option only be made available for those able to consent: given that those unable to provide it might be all the more in need of its alleged potential benefit of relieving their suffering? It is now often urged that the dying should “have a choice over how and when they wish their lives to end.” Perhaps this fittingly if tragically captures the final irony of our ever growing consumerist emphasis upon the individual’s right to choice — that it should now extend to maximizing choice in death.
No doubt the slogan “a life without choice is a life not worth living” will not be far behind. It would capture very neatly the sin of presumption which in the past informed the Christian objection to suicide: namely that it was an act of contumacy against God our Creator with whom alone should lie the ultimate time and hour of our death. This in turn points to a fundamental difference of perspective between secular and Christian views. For the Christian, death brings us before God and the life eternal, it is not simply a transition to nothingness.
But while such a difference of perspective is hugely important it is far from obvious that there is as much difference as many suppose in the assisted suicide debate over the propriety of relieving suffering. This surely suggests that in theory (if not in practice once the legitimacy of assisting suicide is conceded) all would agree that if pain and suffering can be relieved then there should be no need for suicide. Even now the proposed legislation would only offer support to those facing an imminent prospect of death (within six months) not to anyone just because they find life a burden. This means that the whole debate really turns upon the alleged impossibility, even if in only a very few cases, of relieving such suffering.
But in fact, it is open to doubt if palliative care is not progressing to the point where such pain relief is possible. In addition, the long standing Christian principle of “double effect” means that there is no reason to withhold pain relief even if it has the incidental (though not intended) further effect of shortening life. Accordingly, there is no real need to create the sinister specter of doctors authorized intentionally to kill their patients or “help them to die” in complete breach of the Hippocratic Oath (if they still affirm it) according to which they can “give no deadly medicine.”
Unfortunately however, it seems that prescribing deadly medicine is something to which lawyers and politicians are ever more inclined.
The Rev. Canon Alistair Macdonald-Radcliff is Director General of the World Dialogue Council.