Editor’s Note: This essay is paired with another essay which appeared yesterday. The first was from the context of Canada; this second from the United Kingdom. Both authors are Anglican bishops.
There was a lot of buildup to the debate in the U.K. House of Commons on November 29 about the “Terminally Ill (End of Life) Bill.” BBC headlines described the prospect of a change in the law allowing people to be assisted to die as a social change as great as those changes ushered into society by the 1967 Abortion Act. Given that 25 percent of pregnancies in England and Wales now end in abortion, 99 percent funded by the National Health Service (NHS), the comparison did not fill me with confidence. Alarm bells rang even more when I read that the increasingly permissible changes to Canadian law make “assisted death” the country’s fifth-leading cause of death.
After five hours of debate, MPs voted 330 to 275 in favor of the bill to allow, in its own words, “adults who are terminally ill, subject to safeguards and protections, to request and be provided with assistance to end their own life; and for connected purposes.” In many ways, it was a good example of the British Parliamentary system in operation. As is customary in the U.K. for ethical matters of this sort, MPs were given a free vote. There were no party lines to follow. Indeed, each party apart from the Greens was divided. The MPs were serious and compassionate in their deliberations, conscious of the weight of responsibility on their shoulders. The result reflects that, at least according to polling, a majority of people in the U.K. support some form of assisted dying.
To be sure, there is still a long journey for the bill with various parliamentary staging posts along the way, until it passes into law. Already the bill has strong safeguards built into it, and it is possible that more will be added as it progresses through Parliament. However, it is still true to say that the Rubicon has been crossed in several respects: politically in terms of the State, taking upon itself the right to end the adult life of its citizens through its lawmaking; medically in terms of doctors fascilitating the end of life in ways that go beyond immediate pain management; philosophically in terms of directly causing death and enabling suicide (and suicide it will be, for the death will be self-administered) for those who feel it is in their best interests; and theologically in terms of treating life not as a sacred gift to be preserved by society according to the will of God but rather as a possession to be disposed of according to the choice of the individual.
It was a decade ago when the House of Commons last debated a bill to legalize assisted dying. Then it was defeated by a majority of 3 to 1. Since 2015, there has been a buildup of pressure to reverse that decision. We have had a number of attempts in the House of Lords to change the law; a concerted campaign to permit assisted death by Dignitas and others, often involving some high-profile individuals; a number of court cases causing judges to call on Parliament to debate the current legal framework; and a trail of citizens heading off to soulless clinics in Switzerland to end their lives beyond the reach of U.K. law.
It has been clear for several years that it would be only a matter of time before the U.K. followed some other jurisdictions in permitting a form of assisted death. Nevertheless, there were some very significant interventions, in the weeks and months before the debate, which gave me some encouragement.
Our Secretary of State for Health, Wes Streeting, argued that the debate was coming at the wrong time. In his mind, our inadequate provision of palliative care needs to be put right before we can judge whether proper end-of-life care would, in fact, meet the fears that many people have of an unbearably painful death. Mr. Streeting also doubted whether the NHS could cope with the extra demands of an assisted dying service that the bill would make upon it, services that could, he thought, deflect the Health Service away from life-preserving work.
Our Secretary of State for Justice, Shabana Mahmood, criticized the bill on several grounds, including, along with the Health Secretary, that it would lead to a slippery slope in which the law would be widened — as it has been elsewhere — to other categories of people who wanted the right to choose death. She was concerned that the elderly, the sick, and the disabled would be coerced into choosing death, either by their sense of guilt at the burden they felt they were placing on others, or by the implicit pressure of their families that doctors and judges would find impossible to detect. Moreover, Ms. Mahmood was clear that the State’s contract with society is to defend life, not to cause death.
Religious leaders have not been silent. The Archbishop of Canterbury and the Cardinal Archbishop of Westminster spoke clearly and firmly, though always compassionately, against the legislation. Cardinal Vincent Nichols’s warning that the right to die could easily become a duty to die was been oft-quoted in the media as a neat summary of the profound misgivings that many have about the bill. A combined group of religious leaders from across the religions in the U.K. wrote movingly about their experience in caring for the dying, and the way that dying — when allowed to take its course supported by the right sort of medical, familial and pastoral care — can be a beautiful experience for all concerned.
In the days before the debate, when it looked as if the dissenters might somehow turn the tide of societal pressure, there was a sharp intervention from Lord Falconer, a prominent member of the House of Lords and a former Secretary of State for Justice in a Labour Administration. Charlie Falconer, a long-standing proponent of assisted death, said some politicians objected to the bill simply on the grounds of their religious faith rather than through the responsible use of their reason weighing the evidence. Shabana Mahmood, a Muslim, whom he accused of “imposing her beliefs on everybody else,” was in his sights. Perhaps Wes Streeting, a Christian, was in the firing line as well. Certainly Bishops in the House of Lords will be when the bill comes to be debated there.
Lord Falconer’s comments, and others I heard from different Peers in my several years in the House of Lords on this and similar matters, have led me to three conclusions about the place of Christian faith in forming public policy.
First, yes, we do have a principled commitment to life. Our ethical framework is an ethics of life, and that affects the way we approach anything that threatens, damages, or destroys life. As those who believe that life is a gift from God, we cannot accept Martin Heidegger’s definition of authentic humanity as “being toward death.” We seek to promote a culture of life, life in its fulness as Jesus promised, life empowered by the breath and “Spirit of Life.” In that sense our ethical instinct is to assist life rather than to assist death.
Second, that principled commitment does not generally make us absolutists. Christians recognize that their ethic of life is worked out in the realities of human life with all its complex ambiguities about the beginning of life, end of life, situations of conflict, and so on requiring careful, considered choices to be made in the face of evidence about where the good is to be found and where fulness of life is best served.
Third, our bias to life, just as much as our deliberations on what that looks like in the practical circumstances of human beings in society, is an exercise of rationality. To be sure, the assumptions of God’s gift of life on which we operate are different from the assumptions of human autonomy that undergird many of the arguments of those promoting assisted dying. But we use the best powers of our minds in testing that assumption and applying its implications in particular situations, drawing on a long tradition of reasoned thought over many millennia.
Let me end, though, on a point of agreement between those on each side of the debate. That is the necessity of putting more political energy, supported by proper government oversight and the necessary public funds, into ensuring that palliative care across the country offers the very best treatment to those who are facing death, in order to ensure that death is as a comfortable and pain-free as medical, nursing, and social care can make possible, so that the dying may “depart in peace.” If that were to be in place, we may find that the calls upon the provisions of this bill, whatever its final form, will be very much reduced.
My hope and prayer remains that, with such skilled and compassionate care in place, society will come to see that it needs no such law.
The Rt. Rev. Dr. Christopher Cocksworth is Dean of Windsor, having been previously Bishop of Coventry and Principal of Ridley Hall Cambridge after serving in parochial and chaplaincy ministry. He is also a member of the Foundation and Board of Directors of TLC.