Assisted dying isn't contested on religious grounds - it's about power, paternalism and control

A recent YouGov poll has shown that a majority of people - from almost all religious denominations - support doctor-assisted dying. It is our secular and spiritual leaders who are refusing to catch up.

Something striking is going on when the British Humanist Association articulates the instincts of religious believers better than their own spiritual leaders manage to do.

Yesterday the national debate on assisted dying reached the Court of Appeal. Paul Lamb, who was almost completely paralysed in a car accident, another man identified only as Martin and the widow of locked-in syndrome sufferer Tony Nicklinson, whose case hit the headlines last year, are arguing that doctors should be allowed to assist mentally competent patients to end their own lives.  As the law stands, such a doctor (or a relative) risks being charged with murder and the mandatory life sentence that follows conviction.  Some indication of the importance being attached to this case may be gleaned from the fact that the Lord Chief Justice and the Master of the Rolls - the most senior judges in the land - are both hearing it.

The appellants have high-powered support for their arguments: the British Humanist Association, which has intervened in the case, has assembled evidence from leading philosophers including Simon Blackburn and AC Grayling. They also have public opinion on their side.  A recent YouGov poll, commissioned by the organisers of the Westminster Faith Debate series, showed support for a change in the law now runs at 70 per cent.

Lord Judge was a bit sniffy about these figures yesterday.  The law can't be decided on the basis of opinion polls, he said and in any case, "the public may change its mind next week."  He's right about the legal principles, of course.  In a society that claims to be democratic, however, it seems rather paternalistic to ignore the clear views of the public on a matter that touches so deeply on individual rights.  But public opinion seems unlikely to change next week, or next year.  The most recent polling confirms what has been a consistent trend, as shown for example in the British Social Attitudes Survey

This is one case in which elitist moral philosophers, cogitating in their ivory towers, seem to be at tune with public opinion far more religious leaders, the majority of whom (though not all) continue to oppose any change.  It's an opposition not shared, it seems, by most of their congregations.  The YouGov showed unequivocally that the majority of people who associated themselves with a religion supported assisted dying.  This included 71 per cent of Anglicans (almost exactly the same as among the population as a whole), more than 60 per cent of Methodists and Presbyterians, 69 per cent of Jews and even 56 per cent of Roman Catholics.  Among Sikhs, support was as high as 73 per cent.  Only Muslims showed a majority against the proposed changes - 55 per cent.  It's true that support for assisted dying was lower among people who described themselves as "active participants" in their faiths, but even here support for a change in the law to allow assisted dying tended to be greater than opposition.

In other words, the most significant divide in this debate is not between the religious and the secular, but between public opinion as a whole and those in positions of power and authority, who tend to take a strongly paternalistic (indeed patronising) line.  However important it is to protect the vulnerable, it is surely equally important to uphold the right of people who are fully competent to decide their own destiny. 

Death comes to us all, and any one of us might find ourselves in the terrible position faced by Tony Nicklinson or Paul Lamb.  Faced with an inevitable and painful decline, prolonged as much as alleviated by medical science, some will respond with determination to bear the suffering, either out of a wish to hang on for as long as possible, or because of their religious belief in the sanctity of life.  But others will wish to die with dignity with a minimum at a time of their choosing.  Neither choice is right or wrong; or rather the rightness or wrongness of such an individual choice is not what really matters here.  The question is rather, why should a responsible adult not be allowed to make that choice?

Certainly, most people in this country now feel this way, as the YouGov poll revealed. The most popular argument in favour of changing the law was a simple appeal to personal autonomy: "An individual has the right to choose when and how to die" (82 per cent).  The common arguments that death can be preferable to long drawn-out suffering and that those assisting a freely-chosen suicide shouldn't be put at risk of prosecution were slightly less popular.  This is significant, it seems to me, because these (rather than the principle of autonomy) are the arguments most often made when the subject of assisted dying is made in Parliament or when the subject is debated in the media. 

The paternalistic impulse to do what is best for other people is the flip-side of the most commonly-made objection to assisted dying: that if it were allowed, people would feel pressurised not to "be a burden" to their loved ones.  Both arguments are ultimately based on feelings of compassion for others rather than respect for them as autonomous moral agents.

The debate about assisted suicide is made pressing by medical advances that can now keep people alive for much longer, and in much more reduced circumstances, than would previously have been the case.  Whether or not life is a gift from God, its perpetuation is often now a gift, or a curse, from the doctors.  But I don't think that's the only reason that the subject is so contested at the present time.  Rather, it's bound up with an increasing conviction that the "right to life" is much more than a simple right to exist: it's also the "right to a life", the right to make one's own decisions as far as one is able to do, and to have one's choices respected.  And at the same time, not imposing one's moral choices on other people.  I don't think it's a coincidence that public opinion now also favours same sex marriage for those who want it.

I don't think this is evidence of an increasingly secular society so much as of an increasingly horizontal one, in which people are less willing to defer to moral authority figures when it comes to decisions that affect their own lives.  This is as true of many religious people as it is of humanists and atheists.  That's why in matters of life and death, as well as questions of lifestyle, believers may find themselves scratching their heads when listening to priestly pontifications but nodding along with AC Grayling.

Paul Lamb and Jane Nicklinson at the Royal Courts for a hearing on legalising doctor-assisted dying. Photograph: Getty Images.
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Erdogan’s purge was too big and too organised to be a mere reaction to the failed coup

There is a specific word for the melancholy of Istanbul. The city is suffering a mighty bout of something like hüzün at the moment. 

Even at the worst of times Istanbul is a beautiful city, and the Bosphorus is a remarkable stretch of sea. Turks get very irritated if you call it a river. They are right. The Bosphorus has a life and energy that a river could never equal. Spend five minutes watching the Bosphorus and you can understand why Orhan Pamuk, Turkey’s Nobel laureate for literature, became fixated by it as he grew up, tracking the movements of the ocean-going vessels, the warships and the freighters as they steamed between Asia and Europe.

I went to an Ottoman palace on the Asian side of the Bosphorus, waiting to interview the former prime minister Ahmet Davu­toglu. He was pushed out of office two months ago by President Recep Tayyip Erdogan when he appeared to be too wedded to the clauses in the Turkish constitution which say that the prime minister is the head of government and the president is a ceremonial head of state. Erdogan was happy with that when he was prime minister. But now he’s president, he wants to change the constitution. If Erdogan can win the vote in parliament he will, in effect, be rubber-stamping the reality he has created since he became president. In the days since the attempted coup, no one has had any doubt about who is the power in the land.

 

City of melancholy

The view from the Ottoman palace was magnificent. Beneath a luscious, pine-shaded garden an oil tanker plied its way towards the Black Sea. Small ferries dodged across the sea lanes. It was not, I hasten to add, Davutoglu’s private residence. It had just been borrowed, for the backdrop. But it reminded a Turkish friend of something she had heard once from the AKP, Erdogan’s ruling party: that they would not rest until they were living in the apartments with balconies and gardens overlooking the Bosphorus that had always been the preserve of the secular elite they wanted to replace.

Pamuk also writes about hüzün, the melancholy that afflicts the citizens of Istanbul. It comes, he says, from the city’s history and its decline, the foghorns on the Bosphorus, from tumbledown walls that have been ruins since the fall of the Byzantine empire, unemployed men in tea houses, covered women waiting for buses that never come, pelting rain and dark evenings: the city’s whole fabric and all the lives within it. “My starting point,” Pamuk wrote, “was the emotion that a child might feel while looking through a steamy window.”

Istanbul is suffering a mighty bout of something like hüzün at the moment. In Pamuk’s work the citizens of Istanbul take a perverse pride in hüzün. No one in Istanbul, or elsewhere in Turkey, can draw comfort from what is happening now. Erdogan’s opponents wonder what kind of future they can have in his Turkey. I think I sensed it, too, in the triumphalist crowds of Erdogan supporters that have been gathering day after day since the coup was defeated.

 

Down with the generals

Erdogan’s opponents are not downcast because the coup failed; a big reason why it did was that it had no public support. Turks know way too much about the authoritarian ways of military rule to want it back. The melancholy is because Erdogan is using the coup to entrench himself even more deeply in power. The purge looks too far-reaching, too organised and too big to have been a quick reaction to the attempt on his power. Instead it seems to be a plan that was waiting to be used.

Turkey is a deeply unhappy country. It is hard to imagine now, but when the Arab uprisings happened in 2011 it seemed to be a model for the Middle East. It had elections and an economy that worked and grew. When I asked Davutoglu around that time whether there would be a new Ottoman sphere of influence for the 21st century, he smiled modestly, denied any such ambition and went on to explain that the 2011 uprisings were the true succession to the Ottoman empire. A century of European, and then American, domination was ending. It had been a false start in Middle Eastern history. Now it was back on track. The people of the region were deciding their futures, and perhaps Turkey would have a role, almost like a big brother.

Turkey’s position – straddling east and west, facing Europe and Asia – is the key to its history and its future. It could be, should be, a rock of stability in a desperately un­stable part of the world. But it isn’t, and that is a problem for all of us.

 

Contagion of war

The coup did not come out of a clear sky. Turkey was in deep crisis before the attempt was made. Part of the problem has come from Erdogan’s divisive policies. He has led the AKP to successive election victories since it first won in 2002. But the policies of his governments have not been inclusive. As long as his supporters are happy, the president seems unconcerned about the resentment and opposition he is generating on the other side of politics.

Perhaps that was inevitable. His mission, as a political Islamist, was to change the country, to end the power of secular elites, including the army, which had been dominant since Mustafa Kemal Atatürk created modern Turkey after the collapse of the Ottoman empire. And there is also the influence of chaos and war in the Middle East. Turkey has borders with Iraq and Syria, and is deeply involved in their wars. The borders do not stop the contagion of violence. Hundreds of people have died in the past year in bomb attacks in Turkish cities, some carried out by the jihadists of so-called Islamic State, and some sent by Kurdish separatists working under the PKK.

It is a horrible mix. Erdogan might be able to deal with it better if he had used the attempted coup to try to unite Turkey. All the parliamentary parties condemned it. But instead, he has turned the power of the state against his opponents. More rough times lie ahead.

Jeremy Bowen is the BBC’s Middle East editor. He tweets @bowenbbc

This article first appeared in the 28 July 2016 issue of the New Statesman, Summer Double Issue