Parliamentary attempts, in Westminster and Holyrood, to legalise assisted suicide so far have been unsuccessful: most elected politicians seem wary of the issue, unsure perhaps whether it is a vote-winner or a vote-loser. Surveys of British public opinion, by contrast, record large majorities in favour of legalisation, and in Europe and North America assisted suicide or voluntary euthanasia have become legal in a slowly, but steadily growing, number of states. It is possible therefore that something like Lord Falconer’s Assisted Dying Bill, currently being debated in the House of Lords, or like the late Margo MacDonald’s Holyrood Bills, will eventually succeed, enabling terminally ill adults to be provided with life-ending medication to take when they believe the time has come.
One of the main ethical arguments in favour of assisted suicide is that, unlike voluntary euthanasia (where, as in the Netherlands, the doctor injects the life-ending medication), the final responsibility is left in the hands of the person themselves. Distancing doctors from the act itself may also be seen as a way of reducing medical opposition which is currently greater than opposition among the general public. An additional argument for such legislation is that British citizens who are determined to seek assisted suicide would no longer have to do so far from home in a foreign country like Switzerland. That families or friends (but not professional carers) who may accompany them there have now been officially advised that in these circumstances they will not be prosecuted for assisting suicide, only increases the pressure for legalisation in the UK.
The main ethical arguments against legalisation derive in principle ultimately from ‘thou shalt not kill’, and in practice from the fear that no legislative provisions, however carefully drafted, will be able to prevent consequences at least as bad as those of not legalising. What might Christian traditions of moral thinking have to say about these?
The commandment ‘thou shalt not kill’ is fundamental to all traditions of Christian moral thinking: but it also requires interpretation in certain circumstances, such as when killing an aggressor may be the only way of preventing another person from being killed. Who or what may or may not be killed, non-human animals for example, also requires interpretation. Again, medical treatment intended to relieve terminal suffering which at the same time incidentally hastens death has traditionally been interpreted as morally justified under the Catholic doctrine of ‘double effect’. Today, when suffering is difficult or impossible to alleviate by other means, keeping some dying patients unconscious for a short time until they die can be seen as ethically as well as medically justified. The moral distinction between this and advancing the hour of death by more directly life-ending medication however may seem a very fine one, especially if that is what the dying patient has asked for. Insofar as this overlaps with assisted suicide, moreover, there are also different Christian moral interpretations of whether or not suicide is wrong in all circumstances: the distinction between suicide and self-sacrifice to save others sometimes again may be a fine one. The more significant issue here for Christian moral thinking therefore may not be so much what is done but why it is done.
Why it is done, motivation, may also be the key contribution of Christian moral thinking to practical concerns about the consequences of legalising assisted suicide. It may well be that no legislative provisions, however carefully drafted, will be able to prevent consequences at least as bad as those of not legalising – vulnerable elderly people requesting assisted dying because they feel they do not wish to be a ‘burden’ to others, for example, or weary health professionals assisting the suicide of a patient whose active life could be extended, or more meaningful death enabled, by more difficult means.
Central to Christian tradition is the insight that in order to work well, good laws have to be acted out by good people. Without love, in short, legalising assisted suicide gains nothing. ☩
Kenneth Boyd
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