The humanist case against euthanasia

spiked editor Brendan O’Neill was invited to the South Place Ethical Society at Conway Hall in London to debate assisted dying with Dignity in Dying, Care Not Killing and others. His speech is published below.

For me, one of the great mysteries of modern times is how the ‘right to die’ came to be seen as an important progressive cause.

It has now reached a level where if you tell someone that you have liberal instincts, humanist tendencies, and you don’t follow any religious faith, they will automatically assume that you are in favour of legalising assisted suicide. There is almost an unspoken, nudge-nudge agreement amongst a certain section of society that this is a just and righteous campaign: you read the Guardian, you shop at Waitrose, you go to the National Theatre, you support assisted dying.

As a result, when I tell people that I am deeply uncomfortable with the campaign for the ‘right to die’, and I am not convinced that assisted dying should be legalised, they give me funny looks. They instantly assume that I must be one of ‘Them’ – one of those religious people, one of those strange individuals who thinks human life is so sacred that no one should ever be allowed to die until God wants them to.

But I’m not. I’m an atheist. And I consider myself a radical humanist. However, I am also very worried about the drive to legalise assisted dying. I think we need to start making the humanist case against this fashion for voluntary euthanasia.

There are two reasons why, as someone driven by a human-centred morality, I am uncomfortable with legalising assisted dying. Firstly, because it will be bad for the people it is supposed to help: terminally ill people who want to die. And secondly, because it will also be bad for those people who want to live, people who might be sick or disabled or old but who want to continue living.

Opposing the legalisation of assisted dying doesn’t mean callously saying that everyone must be forced to endure all manner of pain and suffering. All of us recognise, and can accept, that very ill people, with the assistance of friends, families and doctors, sometimes elect to die. But legalising assisted dying will be bad for those very people, because it will formalise what ought to be an intensely private decision. It could actually make a terminally ill person’s final choices more difficult and agonising by making them subject to external arbitration and judgement.

Much of the pro-assisted dying campaign seems to be driven by a view of doctors and families as untrustworthy – doctors because they might kill people off just to lessen their workload, and families because they might bump off granny just to get the inheritance. So we have to take end-of-life choices away from doctors and families, claim some pro-euthanasia campaigners, and create new rules and regulations to help people who might want to die.

This gets things entirely the wrong way around. It would be far better if end-of-life-choices for terminally ill people were left entirely in the private realm, between the individual himself, his doctor who is treating him, and his family who loves and understands him. Bringing these decisions into the open and making them subject to new regulations will make the end of life even more traumatic.

For example, Keir Starmer, the UK director of public prosecutions, has drawn up a list of situations in which it would be acceptable to assist someone’s death and a list of situations in which it would not. There are various criteria that an individual must meet – and presumably must prove that he has met – before he can be helped to die. Others have floated the idea of ‘assisted suicide tribunals’ at which terminally ill people could make their case for dying.

Imagine a very elderly person who wants a final push into ‘the next world’ having firstly to check that her circumstances measure up to Keir Starmer’s arbitrary checklist. Or a middle-aged man in the final days of cancer having to make his case to a tribunal before he gets that extra dose of morphine. Surely if there is one thing worse than feeling that you want to die, it is having to convince faceless bureaucrats that you should be allowed to die.

Indeed, the drive to formalise what for centuries has been an informal, humane practice is already making the end of life more difficult for terminally ill people. The idea that we must myopically regulate this area of life to ensure there is no exploitation of sick people by doctors and families is making doctors more cautious about what they might have done naturally in the past: help people die, under the radar.

The legalisation of assisted dying would replace love with law. It would put an end to ‘mercy killings’ carried out by caring families and compassionate doctors and replace them with state-sanctioned killings. This would be a blow to terminally ill people who want to die, because it would deny them the opportunity, at the very end of their lives, to make an independent choice with the help of their loved ones in private. It would zap the very last occasions for love and compassion from their lives, replacing the morally-driven, family-oriented decision to die with the watchful eye of the state and its army of box-ticking, death-sanctioning lawyers.

Secondly, legalising assisted dying would be bad for people who want to live, too. It seems pretty irrefutable to me that the campaign to legalise assisted suicide has become bound up with society’s broader inability to value and celebrate human life today. It is clear that society finds it increasingly difficult to say that human existence is a good thing – you can see this in everything from the environmentalist discussion of newborn babies as ‘future polluters’ to the widespread scaremongering about the ‘ageing timebomb’. And you can see it in the fact that some in the pro-assisted dying campaign want to go beyond having ‘mercy killings’ for people close to death to having ‘assisted dying’ for the very disabled, the ill and even, in the case of Dignitas in Switzerland, the depressed. This effectively sanctions suicide as a response to personal hardship, and gives a green light to hopelessness.

The campaign for the right to die has both been heavily influenced by and also influences today’s broader anti-life culture. It expresses a broader social pessimism, a shift away from improving human life towards focusing a great deal of our moral and political energies on bringing to an end damaged or impaired human lives.

Quite often today the campaign for the right to die goes hand-in-hand with the idea that there are too many people – especially old people – and that society can’t cope with them. When Terry Pratchett, who suffers from early-onset Alzheimer’s, suggested creating assisted suicide tribunals he was championed by commentators who basically said: ‘Yes, we need to do something about all these old, mentally-ill people.’ One sympathetic commentator said the rising number of old people is a ‘social catastrophe’ and pointed out that a patient with dementia costs the economy eight times as much as a patient with heart disease. This is increasingly how we judge human life today: not by its internal worth or moral meaning, but by its financial implications or environmental implications. It is not a coincidence that at a time when society is so down on the worth of human life, there is also a very vocal campaign for the ‘right to die’: these two phenomena are linked in subtle but important ways.

The fact remains, however, that only a minority of people in pain choose to end their lives; the majority think life is worth living. But the views of the very active minority of pro-euthanasia campaigners are likely impacting on the way the majority of people experience their lives, possibly making them feel like a burden – a social, financial and environmental burden – if they choose to continue living. And as a humanist, I am also opposed to any undermining of the majority’s quality of life by a tiny minority of campaigners.

Brendan O’Neill is editor of spiked. Visit his personal website here. The above is an edited version of a speech he gave at Conway Hall on 22 April 2010.