“Assisted dying is the equivalent of a zero-hours contract with life”. This was the bold heading for a recent article by Dr Giles Fraser in his “Loose Canon” column for the Saturday Guardian.

Giles Fraser is a former Canon Chancellor of St Paul’s Cathedral and is now the priest-in-charge of St Mary’s Newington, south London. He strongly opposes the practice of assisted dying. Apart from other considerations, he says that assisted dying is “a method of controlling NHS costs”. Overall, his approach is surprisingly utilitarian – especially from someone who often writes from the point of view of Aristotelean virtues in the practice of ethics.

A substantial portion of Dr Fraser’s argument focuses on the economics of assisted dying. He mentions the fact of an aging population and the need to raise taxes to meet the demands of pensions and NHS costs. He points out that intergenerational conflict over fairness will intensify, as he supports his argument with the statistic that “there are four people of working age supporting each pensioner in Britain”.

What Dr Fraser, and others who argue this way, seem to forget is that the pensioners to whom he refers are former workers who have paid their taxes and given their time, energy and gifts to provide the security for their more advanced years of life. They have also played their part in providing the framework for the workers of today and the opportunities available to them.

Whilst he is careful to bring the factor of “personal choice” into the matter of assisted dying, Dr Fraser qualifies this by adding that “let us not pretend that ‘personal choice’ is unaffected by economic realities”. At this stage of his article, Giles Fraser changes his reference from “assisted dying” to the more emotive “suicide option”, as well as posing difficulties with the “personal choice” aspect of assisted dying. He states: “And here the wider pressure – cultural, social and economic – will inevitably press towards a greater take-up of the suicide option”.

This direction of Dr Fraser’s argument is void of statistical evidence. He goes beyond enquiry and submits his readers to personal opinions and statements. Instead, he offers us an anecdote about an elderly lady in his parish. She is 90, on her own, is critical of today’s young people for not caring about the elderly and is obviously someone whom Dr Fraser, in his role of parish priest, visits and knows well. He uses the story of Maud to underscore the conclusion that “assisted suicide is the ideology of the young and healthy and suited for the well-off”.

Furthermore, “assisted suicide amounts to the renunciation of our obligations to each other and to the vulnerable”, with “everyone encouraged to make their own individual choices”, whilst “strong and stable communities are dissolved…even ethics gets done in the first person singular not the first person plural”. He continues his critical comments by saying that “Assisted suicide is a freedom to do what you bloody well like and sod the rest. Caring for each other is just another choice, just another option”.

For Dr Fraser assisted dying becomes a symbol for, even the ultimate expression of, “the freedom to realise one’s own individual goals. It became all about self-realisation, all about me and what I want”. For, with assisted dying “we have arrived at the existential equivalent of a zero-hours contract with life, a contract that can be terminated at will”.

In view of the fact that Dr Fraser is an Anglican priest, it is to his credit that he does not explicitly bring the belief in God into his argument. It is, however, not difficult to understand and appreciate that such a belief is never very far from the surface of his argument.

Notwithstanding, if, as many believe, there is no God, then human beings have no excuse but to be in control of their own lives and destiny. This is a basic tenet of the existentialist approach to philosophy and ethics. If peoples’ belief in God determines their moral outlook, then that is acceptable – but arguable. Nonetheless, religious beliefs are a personal choice and should not circumscribe the ethics of unbelievers. It can be said with some certainty and supported by statistics that the United Kingdom is no longer, even if it once was, a Christian country.

Despite the evidence that the vast majority of British people support a change in the law (a fact seemingly ignored by constituency MP’s), Parliament recently rejected The Assisted Dying Bill. This Bill had received cross-party support in its attempt to legalise safeguarded assisted dying. It was specific and focused on the recognition – repeatedly expressed by the courts – that “only Parliament can change the law to allow terminally people the choice to end their own suffering within a safeguarded framework”.

As a member of The Campaign for Dignity in Dying I would not share Giles Fraser’s expected satisfaction at the failure of this Bill. Curiously, his attitude to a similarly contentious social and ethical issue, abortion, is that it should be “legal, safe and rare” (see the “Loose Canon” article called “For the red pope, being pro-life is more about social justice than abortion”, 24.09.15). The issue of assisted dying is on the same ethical and social justice canvas as that of abortion. Both should be matters of pro-choice and be seen from a humanitarian perspective. This is a rational and mature ethical approach that can apply to all religious persuasions, but beholden to none.

In a House of Commons debate in 2012, without opposition, MPs endorsed the principle that someone helping a loved one to die for compassionate reasons should not be prosecuted. Though a welcome step forward, this left dying people with the unenviable dilemma of either suffering against their wishes or attempting to take their life without the support of healthcare professionals, or, alternatively, travelling to another country to die. With the defeat of the Assisted Dying Bill in September, this situation remains the same.

Dr Giles Fraser’s desire to protect persons like Maud is commendable. His misgivings that society no longer seems able to withstand the winds of change brought by cultural, social and economic pressures – including situations that cause a loss of personal power, is understandable. But for many people this has always been the case – especially the frail and elderly, the terminally ill, the vulnerable young, the poor, disabled and those in need of social care.

Notwithstanding, preventing the confirmation of those things suggested in The Assisted Dying Bill was retrograde. In support of this view The Campaign for Dignity in Dying campaigns for:

*     Choice over where we die, who is present and the treatment options.

*     Access to expert information about our options, good quality end-of-life care and support for

       loved ones and carers.

*     Control over how we die, our symptoms and pain relief, and planning our own death.

The campaign’s overall purpose is that, together, we can help end the unnecessary suffering that some dying people are forced to endure.

It is against this background that arguments against assisted dying – economic, social and theological – need to be viewed. Human beings do not have a say about the manner or circumstances in which we are born. In this sense, the beginning of life can be seen as something of a lottery. This places our death in a more significant and personal perspective. How we die is one of the most important social and ethical decisions of our, or any, time.

In view of Parliament’s recent decision, it becomes even more imperative that salient and rational voices, including those of critics like Dr Giles Fraser, are heard in order to bring about much needed change. This process starts with the situation of those who are suffering and dying and, in consequence, wish to end their lives. Then the movement is towards a solution. This is the purpose of The Campaign for Dignity in Dying.

RSC