Very Interesting Kathleen Stock article

[TempestTost]

I found this article one of the best I have read about assisted dying. It is the only one I've seen articulate so clearly the concerns around how it might change people's ideas about what counts as unbearable suffering.

She clearly draws a lot from her experience looking at what has happened with gender ideology, both legally and socially and psychologically. And her philosophy background clearly helps her frame this in a way that is clear and exact, which is so hard to find.

Anyway, I thought people might find it an interesting comparison. It's from Unherd, so you might need to register to read it but you can do so for free.

https://unherd.com/2024/10/theres-no-dignity-in-assisted-dying/

Great article. I used to be strongly in favour of assisted dying. I’m now probably still in favour of it, just, but I think the concerns being raised are valid and we need really strong legal protections in place. And even with them, it will bring about the kinds of changes Stock outlines.

I also worry that, on some level even if not consciously, assisted dying will become legal as a response to the fact that we have an aging population and cannot afford (or do not want to afford) top notch palliative care for everyone, and the availability of assisted dying will then be used to justify cutting palliative care even further.

When my MiL was diagnosed with terminal cancer, she wanted to go to dignitas. But of course by the time she was ill enough to want to die, she was far too ill to travel. There was also no way she could have killed herself. The only person I know who managed to do this in advanced illness was a friend’s mum who made a conscious decision to stop eating and drinking in order to speed things up (and this is of course rather like how these processes often shut down in advanced illness without the patient making that decision). I struggle to see much objection to assisted dying in cases like that, except of course the slippery slope argument Stock puts forward.

"If assisted dying is not to be passed, there needs to be serious investment in and provision for end of life care with hospices funded by the government and enough places for everyone who might need one. More funding for the NHS so they're not forcing people to be at home without any pain relief because no one can now be trusted with anything other than mediocre amounts of morphine in case of addiction in the last few days."

REGARDLESS of whether assisted dying is passed or not, end-of-life care needs serious assessment, re-working and funding. We will all die one day; it is in all our interests to get this as right as is possible. Anyone who thinks that the NHS is currently in a fit state to take on MORE complex responsibilities, particularly re something as important and sensitive as this, is delusional.

A young woman, 29, with a history of mental illness -depression and anxiety who was euthanised in The Netherlands.

'If by “people should be allowed to die with dignity” politicians really mean “people should be put out of their misery” — and where that misery is a direct function of inadequate and demeaning care standards — they should say as much, explicitly, and not hide behind sentimental language designed to make them sound like moral heroes.'

Brilliantly put, Prof. Stock.

A few years ago I'd have supported this without a second thought. But now, like many others, I'm very wary of laws where the primary arguments seem to be emotional rather than being about, for example, justice or alleviating poverty. Plus I've seen how activists for other causes can be extra-ordinarily careless about safeguarding.

The 'less than six months' phrase alone makes me suspicious. From what I've seen myself, doctors are generally reluctant to make such predictions until death is only days or even hours away. So how is that going to work?

I will wait and see what it actually says before I decide (not that I'll have a say in it) but I have zero confidence that our lawmakers have the wit to draw up anything sufficiently water tight.

That said, and while I think Kathleen Stock makes some great points, I'm not actually that keen on the article and think the digs at Esther Rantzen, (who I'm sure is arguing in good faith whether I agree with her or not) sound a bit crass. I think Sonia Sodha has written much more thoughtfully about it in the Observer.

Well, they have it. People can kill themselves, generally if someone wants to do it, they can.

But as pp have pointed out, if you’re in hospital or incapacitated then that’s not possible.
Also, suicide has consequences for others. Tube and train drivers get PTSD if someone jumps in front of a train; we know of family where one of the children found her mother when she hung herself, and whoever found someone who shot themselves would be affected for the rest of their lives especially if it was a family member or someone they knew.

Have you cared for people at the ends of their lives?

I thought it was an excellent article.

Yes, non-medical methods tend to be painful, messy, unreliable, and distressing for others.

What happens when we can't get help for our degenerative health problems because the opinion is when we get bad enough we could just be assisted to die?

I have degenerative health problems. Getting worse much faster than it would be with actual care. I can't get any dr to list listen to me. It took 3 years of significant impact on my life for NHS to acknowledge I've got a problem and I'm not just a moaning woman. There is treatment to slow the degeneration but I'm struggling to access it. Prompt treatment likely would have saved me facing incontinence for years yet. I fall over. Struggling to dress and wash and cook/clean for myself. Can't enjoy so many parts of life. I wouldn't be this bad if I could access treatment. I wouldn't be so depressed about it if there was support to help me with the things I can no longer do. Treatment and support needs to improve before we start killing off people like me. I'm depressed and would rather be dead than live like this. Would I feel this way if public services function better? Absolutely not

Leaving aside people who are incapacitated, suicide is simply hard to do. It can easily go ‘wrong’ and leave a survivor in a far worse situation than they were before.

It’s interesting that many posters are against assisted dying because they don’t trust the government to get it right. I’m for it because the thought of me of my loved ones having to rely on pain relief and palliative care is terrifying. Of course it’s best if suffering at the end of life can be managed, but I have no faith in this being prioritised or implemented in reality. I also wonder if we need to accept that this isn’t actually achievable in all situations. It’s great saying that we should focus on improving end of life so there is no demand for assisted dying, but I’m sceptical and therefore support choice.

None of this is to say I don’t appreciate there are risks and I agree all angles need to be explored.

However, I didn’t like the article’s framing of campaigning around this as coming from privileged luvvies. Firstly, I don’t think it’s overindulgent to care about how and where we die as in the Esther Rantzen example. Secondly, people who wish to access assisted dying for themselves have always been central to campaigning for it.

Of course it’s best if suffering at the end of life can be managed, but I have no faith in this being prioritised or implemented in reality.

Yet you have faith that assisted dying will be implemented correctly and that the rules won't stretch once it's introduced.

I'm sure @GeraniumLeaves is quite capable of speaking for herself but I'm not sure how you can accuse her of that when she's specifically said this:

'None of this is to say I don’t appreciate there are risks and I agree all angles need to be explored.'

I'm currently leaning towards opposing this bill because I have so little trust in our lawmakers. But it really doesn't help when I see arguments misrepresented.

I'm not misrepresenting the poster, I'm wondering how someone could entertain this bill when there's such a lack of care in this country and much of the suffering could be alleviated with better management and investment.

Yes I've had a 180 on this issue in the last couple of years. In the past I agreed with an individual's right to euthanasia but social change has made me more cautious. Quite simply I don't trust what Britain has become and is becoming. We were more compassionate but pragmatic in the past. Now it feels like the Hunger Games with everyone in a knife fight for very scarce resources.

I think heading in this direction is inevitable by the way, I just won't be celebrating it.

Yes, this is the point.

They don't have autonomy, they are involving other people, and the law.

It's not, therefore, a private issue about autonomy. It has much more significant social consequences.

Yes.

There are some really interesting things on the side of "tacking things on".

One is that even while laws like this are still in the drafting state, there is lobbying going on by these dignity, and they appear to be on the lookout for court cases.

I have a huge number of questions about these organizations, and who is really leading them. They claim to be grass roots, but there seems to be a lot of atroturfing going on. Dying WIth Dignity in Canada for example is largely funded with grants from the federal government.

This article though - it doesn't seem any of the arguments really describe what happens with a slippery slope, where the underlying issue is that having introduced a new principle, people begin to apply that principle to other issues, and to it's logical conclusions. This may be less obvious in the first or even second generations, where people have qualms left over from the old way of thinking. But soon enough you have people who have never had such qualms and they will not shy away from applying the principle in full.

Brilliant article. Thanks for sharing

It's a terrible article written by someone who clearly has no real idea of the problems.

MySaxIsOnFire gave some examples of how people can suffer and the response was totally dismissive, with no sympathy whatsoever for the suffering. The only method available for someone in extreme pain to kill themselves can be to refuse food and drink and yes some people do that. It is not a good death and there should be another choice.

It is not just politicians who give little thought to this, many of the opponents of assisted dying are as blinkered as any TRA.

There are valid arguments on both sides . I think this is an eloquent and well reasoned argument ( as you would expect from Kathleen Stock)

This. And this issue is a lot closer to home for me than it used to be.

My overriding sense is that this is such a deeply, ethically complex issue, that it absolutely needs to be discussed from all angles, and discussions like here, on this thead, are so important. Perhaps the key value of Kathleen Stock's article is what it brings to the debate.

What comes up for my own part, is having had two pets euthanased, which felt like a compassionate act; an act of love, I have often wondered why we view it so differently and prolong suffering for humans (I think about having also had the experience of living with a parent at home suffering long through terminal illness).

I also know, having been through one prolonged and painful health condition- and how small and focussed on suffering my sense of self became at those times, that if I had thought there would be no end to this, that I would not want have wanted to live that way for ever.
I also would not want to live feeling I was a burden to others. These are my personal feelings. In that instance, I am imagining I would welcome the option of being able to choose a way out.

And then, I read the point made by TempestTost here, and it makes me think again, from another perspective:

..the underlying issue is that having introduced a new principle, people begin to apply that principle to other issues, and to it's logical conclusions. This may be less obvious in the first or even second generations, where people have qualms left over from the old way of thinking. But soon enough you have people who have never had such qualms and they will not shy away from applying the principle in full.

To me, this uncomfortable to and fro-ongoing between confronting aspects is vital.

The tension between the personal and the universal; the immediate and the far reaching.

I think we so struggle with the discomfort of complexity, perhaps now more than ever, and my biggest concern would be that there is a rush to resolve the issue, because we as a society don't currently seem to have the maturity to sit a bit with the contradictions and discomfort of the dilemma in order to come to the wisest decision.

Me too

A friend of mine (who campaigned against ‘assisted dying’) refused food and drink. With adequate pain relief provided it’s not an unpleasant death, and importantly the person remains in control of the decision, the state doesn’t give someone else the power to end that person’s life. Many of the examples of bad deaths and protracted suffering that people give are the result of over-intervention, where someone is not given the choice of whether they want to continue being admitted to hospital with pneumonia, to be fed through a tube, etc. It would be much safer to change practices around palliative care and medical decision making than to solve those problems by giving the state the right to kill its citizens in certain circumstances.