The moral complexities of assisted dying

While I am a big fan of autonomy and personal choice, I have hesitations when it comes to assisted dying and ‘terminal’ illness

More often than not, when faced with a new potentially complex moral question, I prefer to ostrich my way out of the conversation: Head in the sand, fingers in the ears, “la la la, change the subject.”

I am not proud of this character trait, and it does not align with my tendency to have strong opinions and share them loudly. But it takes me a long time to develop my convictions, and I find I cannot respond off-the-cuff to novel dilemmas, despite having a reasonably strong gut instinct about the issue.

And so it was with true curiosity that I joined one of the ICGP’s online discussions about assisted dying (though a significant part of the conversation centred around what we should even call it). I wanted to hear the opinions of others and try to organise my own scattered thoughts into some semblance of order.

Fundamentally, I am a big fan of autonomy and personal choice. “Pro-choice” and “anti-choice” were very familiar labels during the campaigning surrounding the referendum on the Eighth Amendment, back in 2018. As I listened to the group discussion, it dawned on me that this current debate has multiple parallels with the abortion conversation. Why this hadn’t occurred to me before is a reflection of my lack of clarity on some moral issues – I say lack of clarity, what I mean is lack of religion. Because of my atheism, I have developed my own moral code, rather than following a proscribed set of rules, which are reiterated to me on a weekly basis by a chap on a pulpit. I can totally see the advantage of a “What would Jesus do” approach, but unfortunately I am stuck with endless deliberating and chin-rubbing. Jesus, it seems, is not a fan of the inducement of the demise of human life (and is 100 per cent sure that human life begins at conception). So both abortion and assisted dying are a no-brainer if you are a committed Christian, and I am sure other faiths have handy guidelines on them too. 

I see that some of the same faces that supported or opposed Repeal are grouped together on opposing sides of this debate also. There is a risk for me of affinity bias – simply going along with the old gang that I campaigned with in 2018. 

Emotions were high back then, and I fear that some of the old animosities might be stirring once more. Insistent voices, raised heart rates, pink cheeks, deep conviction. There have been concerns expressed by ICGP members that the College has an agenda on this, that it will press-gang its members into participating in something they find morally indefensible. Others rush in to reassure everyone that no one will be forced to do anything that they don’t want to do. It is a little unsettling, like sitting next to a couple having a politely seething argument in a restaurant. These are old foes, old wounds. The rifts are still there, and are in danger of being widened. The discussion will be led by those with strong views, while those like me who are unsure will stay out of it, or be cajoled into taking sides.

I can totally see the advantage of a ‘What would Jesus do’ approach, but unfortunately I am stuck with endless deliberating and chin-rubbing

If we step back, we know that there shouldn’t be ‘sides’ – we are all advocates for a good death. Many of us have read Dr Kathryn Mannix’s writings on how society’s recent approach to dying has resulted in many people fearing it. I think we fear death as a topic of conversation, and dying as an activity. There is also the fear of bad people – people who enjoy killing others, who will get a kick out of terminating terminals. There have been suggestions that assisted dying regulation will herald a cascade of euthanising those with early dementia, or long-term disabilities, or who are a ‘burden’ to their family. This is the classic slippery slope argument, which seems to be a prerequisite for any self-respecting ethical debate these days.

I am all for choice and I support autonomy. And yet. And yet. Much of this debate centres around people living with terminal illnesses. This is where I hesitate.

Advances in medical knowledge mean that our perceptions of ‘terminal’ are outdated and inaccurate. Stage four cancer is now a chronic disease for some (lucky) folk. My own personal hashtag is #terminalmyarse.

It is challenging to listen to conversations about dying that are so wound up in negativity. It bursts the bubble that I float around in, the one that is emblazoned with the word ‘hope’.