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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The Prevent strategy needs a rethink, not a rebrand

A bad policy by any other name is still a bad policy.

Yesterday the Home Affairs Select Committee published its report on radicalization in the UK. While the focus of the coverage has been on its claim that social media companies like Facebook, Twitter and YouTube are “consciously failing” to combat the promotion of terrorism and extremism, it also reported on Prevent. The report rightly engages with criticism of Prevent, acknowledging how it has affected the Muslim community and calling for it to become more transparent:

“The concerns about Prevent amongst the communities most affected by it must be addressed. Otherwise it will continue to be viewed with suspicion by many, and by some as “toxic”… The government must be more transparent about what it is doing on the Prevent strategy, including by publicising its engagement activities, and providing updates on outcomes, through an easily accessible online portal.”

While this acknowledgement is good news, it is hard to see how real change will occur. As I have written previously, as Prevent has become more entrenched in British society, it has also become more secretive. For example, in August 2013, I lodged FOI requests to designated Prevent priority areas, asking for the most up-to-date Prevent funding information, including what projects received funding and details of any project engaging specifically with far-right extremism. I lodged almost identical requests between 2008 and 2009, all of which were successful. All but one of the 2013 requests were denied.

This denial is significant. Before the 2011 review, the Prevent strategy distributed money to help local authorities fight violent extremism and in doing so identified priority areas based solely on demographics. Any local authority with a Muslim population of at least five per cent was automatically given Prevent funding. The 2011 review pledged to end this. It further promised to expand Prevent to include far-right extremism and stop its use in community cohesion projects. Through these FOI requests I was trying to find out whether or not the 2011 pledges had been met. But with the blanket denial of information, I was left in the dark.

It is telling that the report’s concerns with Prevent are not new and have in fact been highlighted in several reports by the same Home Affairs Select Committee, as well as numerous reports by NGOs. But nothing has changed. In fact, the only change proposed by the report is to give Prevent a new name: Engage. But the problem was never the name. Prevent relies on the premise that terrorism and extremism are inherently connected with Islam, and until this is changed, it will continue to be at best counter-productive, and at worst, deeply discriminatory.

In his evidence to the committee, David Anderson, the independent ombudsman of terrorism legislation, has called for an independent review of the Prevent strategy. This would be a start. However, more is required. What is needed is a radical new approach to counter-terrorism and counter-extremism, one that targets all forms of extremism and that does not stigmatise or stereotype those affected.

Such an approach has been pioneered in the Danish town of Aarhus. Faced with increased numbers of youngsters leaving Aarhus for Syria, police officers made it clear that those who had travelled to Syria were welcome to come home, where they would receive help with going back to school, finding a place to live and whatever else was necessary for them to find their way back to Danish society.  Known as the ‘Aarhus model’, this approach focuses on inclusion, mentorship and non-criminalisation. It is the opposite of Prevent, which has from its very start framed British Muslims as a particularly deviant suspect community.

We need to change the narrative of counter-terrorism in the UK, but a narrative is not changed by a new title. Just as a rose by any other name would smell as sweet, a bad policy by any other name is still a bad policy. While the Home Affairs Select Committee concern about Prevent is welcomed, real action is needed. This will involve actually engaging with the Muslim community, listening to their concerns and not dismissing them as misunderstandings. It will require serious investigation of the damages caused by new Prevent statutory duty, something which the report does acknowledge as a concern.  Finally, real action on Prevent in particular, but extremism in general, will require developing a wide-ranging counter-extremism strategy that directly engages with far-right extremism. This has been notably absent from today’s report, even though far-right extremism is on the rise. After all, far-right extremists make up half of all counter-radicalization referrals in Yorkshire, and 30 per cent of the caseload in the east Midlands.

It will also require changing the way we think about those who are radicalized. The Aarhus model proves that such a change is possible. Radicalization is indeed a real problem, one imagines it will be even more so considering the country’s flagship counter-radicalization strategy remains problematic and ineffective. In the end, Prevent may be renamed a thousand times, but unless real effort is put in actually changing the strategy, it will remain toxic. 

Dr Maria Norris works at London School of Economics and Political Science. She tweets as @MariaWNorris.