Able-bodied people are theoretically capable of taking their own life without assistance and every year some do. Suicide is no longer a criminal offence in England and Wales (and never was in Scotland) so there is no question of prosecution. Some disabled people are practically unable to take their own life without help, yet anyone who assists them to do so could be prosecuted, potentially for murder, since ‘assisting a suicide’ remains a criminal offence. On the face of it this appears to be a clear case of disability discrimination. Tony Nicklinson, who was severely paralysed by a stroke in 2005, thought the logic of his ‘right-to-die’ argument was so powerful it would lead to a change in the law when he brought a case before the High Court in 2012. But three judges disagreed, arguing that any decision to change the law on assisted dying should be left for MPs in Parliament. Mr Nicklinson was devastated, refused all food and died six days later after contracting pneumonia at the age of 58.
Cases such as this have added weight to a vigorous campaign for the law to be changed to allow people to be assisted to die without those who assist being in fear of prosecution. On 19th July, Former Solicitor General, Lord Falconer, introduced a bill in the House of Lords to legalize assisted dying and the bill passed its second reading, which means it will be given further consideration. However, there are not yet plans for the issue to be debated in the House of Commons. Public debate appears polarized with supporters – including Stephen Hawking and former Archbishop of Canterbury, Lord Carey – arguing that the current law creates much misery and/or that individuals have a basic human right to ‘die well’ when faced with a terminal condition. Opponents – including former Paralympic athlete, now Baroness, Tanni-Grey Thompson and former Conservative Minister Norman Tebbit – say the bill would create financial incentives to assist people to die and does not contain enough safeguards against potential abuses. The debate in Britain also tends to be characterized as divided into those who focus on the sanctity of life and those who instead prioritize individual autonomy (Warnock and Macdonald 2009).
One campaign group, Dignity in Dying, actually distinguishes four types of ‘assisted’ dying. Euthanasia refers to the administering of medication aimed at ending the life of another person. Voluntary euthanasia means the patient has consented to the ending of their life. Assisted suicide is where a person who is not at or near the end of life wants to die and calls on another to help them. Assisted dying is a term reserved for those who have been diagnosed as terminally ill and want to die who nonetheless need some help to be able to self-administer life-ending medication. Dignity in Dying only supports the last of these and it is this which is at the centre of current debates and proposals for legislative change. However, critics of the present assisted dying bill argue that there may be a ‘slippery slope’ here. Legalizing assisted dying could be the first step towards legalizing assisted suicide and possibly voluntary euthanasia in the future.
It might reasonably be thought that opponents of assisted dying probably have a strong religious faith and are committed to the sanctity of life, whilst supporters may not be (as) religious and privilege individual autonomy and the freedom to choose. However, there is a broader historical context to the present situation which helps to explain why the concept of assisting others to die, even at the end of life, remains emotionally difficult to handle. The period known as modernity has been characterized, amongst other things, by science and its practical application. In the field of health and medicine, a scientific approach is the dominant one and we have all got used to a relentless stream of scientific diagnosis and technical innovation.
However, Zygmunt Bauman (1992) argues that this process shapes attitudes towards death and the process of dying. Although everyone knows that one day they will die, this knowledge can be very effectively side-lined as medicine deconstructs the dying process into identifiable diseases and causes that can be tackled individually. Hence, we can focus on resolving those individual health problems and forget that, ultimately, all we are doing is delaying the inevitable end. Preventative medicine also provides us with lifestyle guidance on what to eat, how to exercise and what to avoid that, again, gives us a focus for living – a ‘life strategy’. As Bauman notes (1992: 142), ‘The price for exchanging immortality for health is life lived in the shadow of death; to postpone death, one needs to surrender life to fighting it’. This concentration on how to live produces a deep-seated reluctance to allow death into everyday life, to talk about death and dying, and leads to a failure to relate to those who are undergoing the process. In this way and despite all of its clear benefits, modernity has led to many people having to face an emotionally and often physically lonely death in hospital (Elias 1982). And this remains the case for many in spite of the hundreds of academic and self-help books on the broad subject of death, dying and bereavement (Walter 1994).
Small wonder then that campaigners for the ‘right to die’ have struggled to have their arguments aired when the opposition is more than just those with religious beliefs or others with rational arguments but is rooted in the culture of modern societies. Assisting others to take their life runs against the grain of all of our individualized health practices and lifestyle choices. Lord Carey’s conversion to the assisted dying campaign is on the basis that forcing people to continue living with a terminal illness may be to condemn them to intense and unnecessary suffering, which ‘is the opposite of the Christian message of hope’. On the other hand the present Archbishop, Justin Welby, sees the present bill as ‘dangerous’. As the apparent divide between secular and religious thinking on this issue is shown to be inaccurate, polarized positions may give way to a discussion based on the merits and consequences of the issue itself.
[NB: I have left Bauman’s (1992) argument on possible postmodern life strategies for readers to explore themselves.]
Bauman, Z. (1992)Mortality,Immortality and Other Life Strategies (Cambridge: Polity).
Elias, N. (1985)The Loneliness of the Dying(London: Continuum).
Walter, T. (1994)The Revival of Death(London: Routledge).
Warnock, M. and Macdonald, E. (2009)Easeful Death: Is There a Case forAssisted Dying?(Oxford:Oxford University Press).
Chapter 9 on the Life Course specifically covers sociological work on death and dying (including assisted dying) on pages 370-4, though the previous section on ageing will also be useful, as will Chapter 11’s discussion (pp. 441-9) of the rise to dominance of the biomedical model of health and illness as well as critics of this model.
In Sociology: Introductory Readings,the contrast between modernity and postmodernity is explored in Readings 7 (Bauman) and 8 (Giddens), whilst a taster of Elias’s main argument in The Loneliness of the Dying constitutes Reading 33.