In September 2015 a prestigious group of religious leaders intervened in the public discussion of the Assisted Dying Bill [No 2]. The Archbishop of Canterbury, the Cardinal-Archbishop of Westminster, the Chief Rabbi, the Secretary General of the Muslim Council of Britain, and 14 other Christian and Muslim leaders, with Jain, Sikh and Zoroastrian representatives wrote an open letter to Members of Parliament to oppose the Bill. ‘Our focus in writing is pastoral…Our concern is rooted in a profoundly human and profoundly sacred calling to care for the most vulnerable in our society, a concern shared by people of all faiths and of none.’ The Bill, they wrote, would affect both the terminally ill and their families. It could increase pressure on those who believe that they have become a burden to their family to seek a medically assisted death. It would increase the danger to those 500,000 elderly people who are abused each year, most by family members, often for financial reasons. As palliative and end-of-life care continue to improve, the emphasis should be on the natural processes of dying, with the opportunities they offer for precious moments of love, care, reconciliation and even hope. ‘A law based on this Assisted Dying Bill would put at risk many more vulnerable people than it seeks to help.’
Dr Welby himself issued as well an explanatory statement. ‘We have written, not in an attempt to push “the religious” viewpoint on others but because we are concerned that a change in the current law on assisted suicide would have detrimental effects both on individuals and on our society…The faith leaders’ letter…springs from philosophical and theological reflections as well as from a vast range of pastoral experience and a profound sense of compassion.’
A stronger previous position
The leaders’ letter and Archbishop’s plea were eloquent and clearly heartfelt. They could also have been issued by any doctor or lawyer or lay peer. The religious viewpoint remained unrepresented; and the letter itself had not, to be honest, called for much theological or philosophical reflection. We might wonder if such leaders have lost their nerve; if they no longer quite feel able, in public debate before the whole country, to speak openly from and to their fundamental beliefs?
In the more formal setting of earlier debates, Church leaders had been less coy. In 1994 the Anglican and Roman Catholic bishops submitted a paper on Foundations to the Select Committee on Medical Ethics in 1994, of which Lord Habgood, Archbishop of York, was a member. The paper began:
1. The arguments presented in this submission grow out of our belief that God himself has given to humankind the gift of life. As such, it is to be revered and cherished.
2. Christian beliefs about the special nature and value of human life lie at the root of the Western Christian humanist tradition, which remains greatly influential in shaping the values held by many in our society. These beliefs are shared in whole or part by many people of all faiths and none.
We will return to this ‘Western Christian humanist tradition’. It may now need closer definition and more robust vindication; for Christians may seem in our day to be justifying with this vague slogan their intervention in a debate that more naturally belongs to the humanists. It would be helpful to hear in more detail what are ‘the special nature and value of human life’. Life’s sanctity is invoked in such discussion over and again. It is deployed, I think, to confirm that there is something imponderably numinous in human life (most intensely felt when we watch the beginning or the end of a loved one’s life); that we share this life, which we did not create in ourselves, with all other humans and may therefore be answerable to others for its disposal; and that such life has a value independent of any utilitarian calculus and of any Kantian conditions for sovereignty in the kingdom of ends. But theologians, of all people, should ask if these emotive abstractions, sanctity and life, are helpful. We might do well to explore instead, with an equivocal and more secular rhetoric, the dignity of living individuals both in themselves and under conditions of extreme and irreversible physical and/or mental decline.
Life is always a good
In Evangelium Vitae, 1995, Pope John Paul II was forthrightly Christological. The encyclical’s premise, based on scripture, was that life is always a good.
Life in time is the fundamental condition, the initial stage and an integral part of the entire unified process of human existence. It is a process which is enlightened by the promise and renewed by the gift of divine life, which will reach its full realisation in eternity (cf. 1 John 3.1-2)…Life on earth is not an “ultimate” but a “penultimate” reality; even so, it remains a sacred reality entrusted to us, to be preserved with a sense of responsibility and brought to perfection in love and in the gift of ourselves to God and to our brothers and sisters.…..
None of us lives to himself, and none of us dies to himself. If we live, we live to the Lord, and if we die, we die to the Lord; so then, whether we live or whether we die, we are the Lord’s (Rom. 14.7-8). “Dying to the Lord” means experiencing one’s death as the supreme act of obedience to the Father (cf Phil 2.8), being ready to meet death at the “hour” willed and chosen by him (cf John 13.1), which can only mean when one’s earthly pilgrimage is completed. “Living to the Lord” also means realising that suffering, while still an evil and a trial in itself, can always become a source of good. It becomes such if it is experienced for love and with love through sharing, by God’s gracious gift and one’s own personal and free choice, in the suffering of Christ Crucified. In this way, the person who lives his suffering in the Lord grows more fully conformed to him (cf Phil. 3.10, 1 Peter 2.21) and more closely associated with his redemptive work on behalf of the Church and humanity. This was the experience of St Paul, which every person who suffers is called to relive (Col. 1.24).
So the sacraments will help us to live our birth, life, suffering and death as a participation in the Paschal Mystery of the Crucified and Risen Christ. This statement of classic Catholic doctrine – in an encyclical that is fundamentally a document of profound joy in the mystery of life – is likely now to raise at least two questions, when church leaders seek to influence public policy both in the legislature and in wider discussion. Is the suffering of those subjected to painful terminal illness properly brought into such close connection with the suffering either of the innocent Christ (for the redemption of the world) or of Paul (on his active, freely chosen missions to spread the gospel)? And can we – in particular, after the patent moral abyss of the Holocaust – even imagine adducing such an argument with regard to the suffering of those who acknowledge no allegiance to Christ?
Perhaps this is why our bishops have lost their nerve. They just do not quite dare speak like this. Every generation re-interprets its debts to the past into its own terms. It may well treasure principles of its own that are closely analogous or identical to those long-since attained in the language of the past. But it still needs and seeks to reach those principles in its own terms along the particular routes opened by its own vocabulary of thought and belief. And it is not clear that the classic Christian position on suffering summarised by the late Pope has any close analogy in the secular thought of our own age. If we accept Rawls’s condition on those who would earn a place in the public square, such a Christian voice, as Rawls himself would expect, will be excluded; for states must rely on ‘public reason’, comprised of reasons that ‘all citizens can reasonably be expected to endorse in the light of their common human reason’ (Political Liberalism, 1st ed, 1993, 212-54).
The change in priorities
In 2005 the House of Bishops and the Catholic Bishops’ Conference resubmitted to the Committee on the Bill for Assisted Dying for the Terminally Ill [HL] much of the foundational written material that they had submitted to the Select Committee on Medical Ethics in 1994.
By now the case of Dianne Pretty was in everyone’s mind. Four representatives of religious bodies appeared before the Select Committee in 2005. Perhaps the most impressive was the Rev. Prof. Robin Gill, representing the Archbishop of Canterbury. He had made a submission in support of Dianne Pretty; but he spoke against changing the law. It was better, he said, to have an overall brake on all such actions, but occasional compassionate exceptions, than to open a door open to terrible abuse or simple cold indifference. Lord Taverne adduced the ‘policeman’s dilemma’: the American case of a driver inescapably trapped in a burning lorry who begged a policeman to shoot him; the policeman did. Did the policeman do the right thing? Should he be prosecuted? Professor Gill insisted the policeman had done the right thing, should not be prosecuted – and yet without any change to the law on murder.
The House of Lords eventually voted on the measure. It was rejected by 148 votes to 100. Fourteen bishops voted against it. It was a moment at which the bishops’ role in the legislature became a live issue. Lord Habgood was struck by the change in the tone of the discussions in 2005. The 1994 report had begun with the prohibition of intentional killing; the 2005 report began with the concept of personal autonomy. The changed definition of the task inexorably changed its outcome. Priorities had changed quickly and starkly in Parliament, and perhaps in the country at large.
The nature of human freedom
And so we reach our own day. There was a debate in the House of Lords on the Assisted Dying Bill in July 2014. The cases now in everyone’s mind were those of Debbie Purdy and Tony Nicklinson. The present Archbishop of York spoke powerfully:
The present Bill is not about relieving pain or suffering…. The Bill is about asserting a philosophy, which not only Christians but also other thoughtful people of good will who have had experience in care for the dying must find incredible—that is, the ancient Stoic philosophy that ending one’s life in circumstances of distress is an assertion of human freedom. That it cannot be. Human freedom is won only by becoming reconciled with the need to die, and by affirming the human relations we have with other people. Accepting the approach of death is not the attitude of passivity that we may think it to be. Dying well is the positive achievement of a task that belongs with our humanity. It is unlike all other tasks given to us in life, but it expresses the value that we set on life as no other approach to death can do.
The Archbishop’s point was well made; and Rabbi Lord Sacks has also written of his disquiet at the resurgence of Stoicism. But the ancient Stoics are admired in some of the finest modern moral philosophy; Martha Nussbaum has argued persistently for its wisdom. Many of us were ourselves brought up to admire the Stoic Cato (who killed himself to deny to Caesar the privilege of offering him a pardon) and Seneca (who persisted in his slow suicide to pre-empt Nero’s soldiers). From an earlier age, Socrates remains a paradigm: he refused to escape from the sentence of death passed on him, looked forward to his soul’s escape from the body and without hesitation drank the hemlock. Who, then, in our own day speaks for whom about self-inflicted death? What role is justifiably played by the leaders of which faith communities, and in the name of what community or higher law?
In 2015 the Assisted Dying Bill [No 2] was being debated. Former Archbishop of Canterbury Lord Carey was among those who now urged reform of the law. He was in a group of signatories of a letter to The Daily Telegraph: there is, they said, ‘nothing sacred’ about suffering in itself and no one should be ‘obliged to endure it’. Lord Carey wrote as well in The Daily Mail. He had simply changed his mind in the face of needless and unendurable suffering. He wrote: ‘Today we face a central paradox. In strictly observing the sanctity of life, the Church could now actually be promoting anguish and pain, the very opposite of a Christian message of hope’. The churches do have challenges to face here. Relatives of those who have died in immense and prolonged pain have written that their loved ones were treated as nobody would treat a pet dog; is this in practice how the churches honour the sanctity of life? Dworkin argues that value lies in the biography, not the biology of a human life; with the end of that biography in deep dementia or in persistent vegitative state, what value resides in (mere) biology? We may be distressed by the expectation that some people will choose to die so as not to be a further burden on their families; but Baroness Warnock has famously asked why do Christians at this moment decry the altruistic care for the family that in any other circumstance they would praise?
The Christian tradition
Church leaders, then, are caught in a dilemma. Either they speak in purely secular terms, and seem to add nothing to the discussion except the prestige of their voices; or they speak openly of classic Christian doctrine, and forego their place in the public square. It may not be surprising (even if it is not quite clearly honest) that they invoke in vague terms ‘the Western Christian humanist tradition’. Perhaps they should do so with better definition and greater verve. An abhorrence of suicide entered the Western tradition with Augustine; and such Christian influence runs through all subsequent moral philosophy up to and including Kant’s. But this ancient origin does not reduce the current value of that thought. The Christian tradition has, for better and for worse, made us as a country who we are; and the tradition is still defined by its care for the vulnerable. It is striking how hard it still is to provide, without religion – without a God whose children we all are – a compelling ground for universal human worth and human rights. We can stipulate such rights; and the Kantians have for 200 years established the irreducible rights of potentially, possibly or actually rational and mature moral agents. But this does leave, exposed to terrible chill winds, those who can never – or never again – be such rational agents; and it is just those for whom the churches seek to take special care.
This will not yet earn for the bishops a long-term place at the table of public policy. What they have said in recent months could have been said by anyone; what they say in the future from an overtly ‘religious’ viewpoint might be jejune or irremediably alien to their fellow citizens. But they can reasonably adduce the churches’ enduring care of the elderly and infirm as a passion that has in fact helped to define our culture; and they can as reasonably ask whether the resources of government, secular charities or insurance companies will so gladly be given over to such care 20 years after the quick and painless termination of the patients’ suffering is legally and societally endorsed.
A conflicted calling
Everything in the churches’ history, doctrine and culture is opposed to assisted dying and to the changes in society as a whole that would be represented, portended and encouraged by a relevant change in the law. But we might wonder if church leaders have in recent debates sounded almost unappealingly olympian. There are those who may be – quite literally – unable to communicate effectively for themselves and who are profoundly frustrated by their effective exclusion from debate about themselves. Church leaders, speaking against them with the authority of office, are not helping them to be heard. The leaders of the established church in particular may have a conflicted calling here: to adopt, alongside their principled concerns, Robin Gill’s proactive, public compassion for those terminally sick individuals who despite all the medical and palliative care they are offered still look for a final rediscovery, with their family’s help, of their dignity and their peace in the management of what they themselves are likely to see as their own final end.
Contributor The Revd Robin Griffith-Jones Master of the Temple Church
The King’s Dying
Lord Dawson of Penn (1864-1945) was Physician-in-Ordinary to King George V and Queen Mary. He attended the King in his final illness, and drafted the statement issued on 20 January 1936, at 9.25pm:‘The King’s life is moving peacefully towards its close.’ In his notebook, published decades later, Lord Dawson recorded ‘that the last stage might endure for many hours, unknown to the patient but little comporting with the dignity and serenity which he so richly merited and which demanded a brief final scene’ and so Lord Dawson ‘decided to determine the end and injected (myself) morphia gr. 3/4 and shortly afterwards cocaine gr. 1 into the distended jugular vein’. On 1 December 1936 Lord Dawson spoke in the House of Lords against the Voluntary Euthanasia (Legalisation) Bill [H.L.]: ‘There has gradually crept into medical opinion, as there has crept into lay opinion, the feeling that one should make the act of dying more gentle and more peaceful even if it does involve curtailment of the length of life…This is something which belongs to the wisdom and conscience of the medical profession and not to the realm of law’.