Is the Fight against Assisted Dying a Lost Cause?
By Mehmet Ciftci, originally published May 21, 2024, Public Discourse
Canada’s infamy has led many to rethink their support for assisted dying, no matter how strong the purported safeguards may be.
The legalization of assisted dying in the UK is inevitable, according to UnHerd columnist Kathleen Stock. She argues that the death of God has created a secular outlook that “paralyzes many of us intellectually” and “means that a selfish mental focus upon alleviating future personal suffering is the only cause we can really get behind.” Without “some deeply felt theological or philosophical principle about the intrinsic value of human life” there remains nothing but “vague intuitions and orphaned remnants of moral reasoning inherited from a formerly Christian outlook.” These will be “no match against the powerful lure of a vision of preventing personal physical suffering in [the] future, or the suffering of loved ones, via the offering of a serene and painless death.”
She does seem convinced that legalization would “wreak more quantifiable havoc than it prevents, in exactly the ways anticipated by critics: guilt-tripping those who feel like burdens into premature endings; tempting the already depressed towards easy oblivion.” And yet, she also thinks that arguing against this would require “positive belief in something.” She notes: “Those who want to see the back of assisted-dying laws had probably better start praying harder, though I wouldn’t hold out any hope.”
But the fight against assisted dying is not as hopeless as she thinks. In fact, there are reasons for hope in recent news that should encourage those in the United States who are looking nervously at what is going on in Canada.
Legalization Is Not Inevitable
First, we need to reject the view that treats the entire matter as a lost battle. Stock is not the only one to say that more and more countries will inevitably legalize assisted suicide. The British journalist Matthew Parris, in an article tastelessly published on Good Friday in the Times, wrote approvingly that societies burdened with too many old people will have to drop an absolute taboo against ending the life of the sick or aged if they want to survive and remain competitive. In 2015, he wrote with an even greater sense of fatalism: “I do not therefore need to campaign for assisted dying. . . . My opinions and my voice are incidental. This is a social impulse that will grow, nourished by forces larger than all of us. I don’t exhort. I predict.”
This is rhetoric intended to weaken any opposition through sheer demoralization. There is something particularly paradoxical about reading Parris, a former Conservative member of Parliament when Margaret Thatcher was prime minister, using Marxist rhetoric. I remember when I read the Communist Manifesto as a teenager, being intrigued by its intoxicating language: “What the bourgeoisie therefore produces, above all, are its own grave-diggers. Its fall and the victory of the proletariat are equally inevitable.” But what I did not realize (until I became a lapsed Marxist years later) is that this would make politics, or even any human action, pointless and superfluous before the unstoppable march of history. In Orwell’s 1984, the protagonist’s torturer tells him: “If you want a picture of the future, imagine a boot stamping on a human face—forever.”
That would be a good image of our situation if the course of history were predetermined, and politics set to go in just one direction. But we do not live in an iron cage of determinism, and that is partly what makes 1984 preposterous as a novel about totalitarianism. The rhetoric that treats what is wished for as a foregone conclusion is a standard trope of prophetic literature, and there is no shortage of false prophets with us today. It is vital then that we dispel the language of inevitability that misleads and demoralizes us into treating the battle as a lost cause before it has even begun.
Reasons for Hope
It is also important not to be distracted from the genuine signs of resistance to assisted dying, even in many unexpected places.
Readers may be aware of the several attempts to introduce it in various state legislatures in the past ten years, such as in New York, Massachusetts, Maryland, and Connecticut, all of which, one way or another, faltered and failed.
As for the UK, there is no denying that there is a concerted campaign underway to push for physician-assisted suicide in its various jurisdictions: Scotland, Jersey, and the Isle of Man have all had bills presented in their legislatures. When a bill to legalize assisted suicide was first proposed by a member of the Scottish Parliament, Liam McArthur, it was greeted by a supportive media establishment. The Herald reported that “ethical experts” and anesthetists were in favor of it. When McArthur introduced the bill in March of this year, he was confident that he had the majority of members of the Scottish Parliament on his side.
But despite the well-financed efforts of lobbying groups like Dignity in Dying Scotland, the campaign has found itself in trouble. Humza Yousaf, who was until recently the head of the Scottish government and leader of the Scottish National Party, has said that his opposition to the bill was strengthened after meeting with disability activists. The new leader and deputy leader of the SNP both have a history of voting against the legalization of assisted dying in earlier debates in 2010 and 2015. The health secretary and the leaders of the Scottish Labour Party and the Scottish Conservative Party have all revealed that they will vote against the bill. Nicola Sturgeon, former First Minister, has said in recent articles that she may vote against it too, saying that “so far, despite my expectations, the more deeply I think about the different issues involved, the more I find myself veering away from a vote in favour, not towards it.” Sturgeon is among the more widely known Scottish politicians and a household name due to her constant presence on TV screens during the pandemic. Her loss would be a significant setback for McArthur’s campaign.
Sturgeon’s surprise at her unexpected desire to vote against it is a common story. She recently reposted an article on X by Dr. Ashley Frawley that she called a “worthwhile read.” Frawley writes about what made her change her mind:
In the past, I was supportive of this kind of legislation. I understand the case being made by advocates, who highlight very difficult cases. As a liberal type, I thought: “Who am I to stand in the way of another person’s choice?” But after looking at evidence . . . and seeing the effects of “assisted dying” in my home country of Canada, I changed my mind.
The tragedies created by Canada’s Medical Assistance in Dying (or MAiD) seem to have had an important role in changing the minds of many. In an article for the left-leaning Observer, a journalist pointed to Canada as her first example when she wrote that her mind was changed by “the international evidence that, once you cautiously nudge the door on assisted suicide, it is very difficult to stop it swinging wide open.”
Canada has had its own backlash against MAiD, which has fortunately led to the proposed expansion of MAiD to those suffering from mental illnesses alone being postponed by one year, and now by three years. Conservative Party leader Pierre Poilievre (who is likely to win the upcoming election) has promised that he would prevent MAiD from being expanded in this way.
The backlash is partly due to the brilliant investigative work carried out by several Canadian writers. Rupa Subramanya in The Free Press wrote about a mother’s battle to prevent her son of twenty-three years from choosing MAiD. He was deemed eligible to be euthanized on the grounds of being blind in one eye, diabetic, and feeling depressed and hopeless. Similarly, David Brooks in The Atlantic, Alexander Raikin in The New Atlantis and elsewhere, and Amanda Achtman and Yuan Yi Zhu in various places, have all drawn attention to MAiD’s disastrous consequences.
There is no denying, of course, that the legalization of MAiD has also had the effect of normalizing what ought never to be normal. Seventy-three percent of Canadians support MAiD, according to one poll. Fifty percent are in favor of its being available for those with a disability, 28 percent for homelessness, and 27 percent for poverty. Matthew Parris, whom I mentioned earlier, offers a good explanation of this:
We who may argue for “permissive” legislation must have the intellectual honesty to admit that the ending of a legal prohibition does act as a social signal. . . . [H]umans are social animals, and one of the ways a society signals its attitudes is by criminalizing behavior it thinks very harmful, and decriminalizing behavior towards which its attitude has softened.
I am not, therefore, arguing that we can be complacent. The debate is still alive and ongoing in Scotland and elsewhere in the UK. Once assisted dying is legalized, as Canada has demonstrated, one can hurtle down the slippery slope with terrifying speed, plowing through the established moral intuitions of society against killing the old and infirm.
Stock and others are also right to point out that secularization is hollowing out the moral intuitions of many, leaving them with a sense that some things are right and wrong without a clear idea why. That leaves us in a dangerous situation. If the rule against taking innocent life is up for debate, then we must always remain vigilant.
But there remain reasons to be encouraged. Canada’s infamy has led many to rethink their support for assisted dying, no matter how strong the purported safeguards may be. It has already led the campaign to legalize assisted suicide in Scotland to falter and meet real opposition. This may turn out to be the fourth failed attempt to introduce it in Scotland, taking its place alongside the numerous failed attempts to pass it into law in Westminster.
We all fall prey to doom-scrolling. But being captivated by the seemingly unstopped spread of assisted suicide and euthanasia from country to country can make us forget something important about these campaigns: their successes are outnumbered by their failures.
Dr. Mehmet Y. Ciftci is the Public Bioethics Fellow at the Anscombe Bioethics Centre and a research assistant at the McDonald Centre in the University of Oxford’s Faculty of Theology & Religion.