Latest / Thinking Class / #121 - Kathleen Stock - The West Is Offering Death As A Solution — Do Not Go Gentle

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#121 - Kathleen Stock - The West Is Offering Death As A Solution — Do Not Go Gentle · Thinking Class

0:00
SPEAKER_03: Hello, classmates, and welcome to Thinking Class.
0:03
SPEAKER_03: I'm John Gillam, and today I'm joined by Kathleen Stock.
0:06
SPEAKER_03: Kathleen is contributing editor at Unheard, philosopher, author of Material Girls, and one of the most forensically precise thinkers in British public life.
0:16
SPEAKER_03: Kathleen's new book, Do Not Go Gentle, makes the case against assisted suicide.
0:22
SPEAKER_03: A bill is moving through the British Parliament right now that would allow doctors to help their patients die.
0:27
SPEAKER_03: In Canada, where a similar system has been in place for under a decade, 5% of all deaths now occur through the state sanctioned program.
0:35
SPEAKER_03: In Belgium, they have extended it to newborn babies.
0:38
SPEAKER_03: Canada will allow it for those with mental illnesses alone from 2027.
0:44
SPEAKER_03: In this conversation, Kathleen and I think out loud about how a civilization that once grounded human dignity in the Christian and Enlightenment traditions has arrived at a place where death is offered as a medical solution to the problem of suffering.
0:57
SPEAKER_03: The three types of advocate for assisted dying, the freedom lover, the merciful helper, and the utilitarian who sees humans as units, and why their arguments collapse under scrutiny.
1:07
SPEAKER_03: Why the state's facilitation of assisted dying as a system is categorically different from an individual moral act.
1:13
SPEAKER_03: The slippery slope, that is not a prediction, but a data point, because we can already see where this ends, and what living well in a culture that has lost its account of human dignity actually requires.
1:24
SPEAKER_03: Classmates, this is a conversation about death and dignity, what not only British society has become, but much of the Anglosphere and other parts of the Western world.
1:35
SPEAKER_03: And it questions whether it's possible to recover a civilization that knows the difference between compassion and administration.
1:44
SPEAKER_03: If you value serious long-form conversations like this, subscribe to Thinking Class on YouTube, follow on Spotify, and support the show on Substack.
1:53
SPEAKER_03: Enjoy the show, classmates, and now Kathleen Stock.
2:12
SPEAKER_03: Kathleen, a bill is moving through the British Parliament right now that would allow doctors to help their patients die.
2:18
SPEAKER_03: Its proponents call it assisted dying, and its opponents call it, at least in my view, what it is, assisted suicide.
2:25
SPEAKER_03: It has already passed in countries like Canada, the Netherlands, Switzerland, Australia, and several American states.
2:31
SPEAKER_03: And in fact, in Canada, 5% of all deaths now occur through the state-sanctioned program.
2:38
SPEAKER_03: But I want to set the stall out and say that this episode isn't primarily about the bill.
2:42
SPEAKER_03: It's about what the bill reveals about who we've become here in Britain and beyond, not just in the Anglosphere, about what we now believe a human life is worth and how a civilization that once built its understanding of human dignity on Christian foundations and indeed enlightenment foundations, has it arrived at a place where death is being offered as a solution to the problem of suffering?
3:05
SPEAKER_03: So, Kathleen Stock, philosopher, author of Material Girls, and now the book Do Not Go Gentle, you have in this book offered one of the most forensically precise accounts of how we got here in Britain.
3:20
SPEAKER_03: This bill is being presented as a question of individual freedom.
3:23
SPEAKER_03: It gives people control over the end of their own lives.
3:27
SPEAKER_03: But perhaps let's start somewhere different, which is the human dignity question as a Christian inheritance and an enlightenment inheritance, that life's a gift held in trust.
3:37
SPEAKER_03: It's not a possession that we can just get rid of.
3:40
SPEAKER_03: It's now legislating to offer death as a medical option.
3:43
SPEAKER_03: How did we get here?
3:44
SPEAKER_03: What is the intellectual and cultural story behind this moment in your eyes?
3:50
SPEAKER_02: Well, that's a big question, and I do try and address that in my book.
3:54
SPEAKER_02: But um I would say that we got here through the emphasis on freedom and choice, um, which has gradually eroded uh other principles that were taken for granted in practice.
4:09
SPEAKER_02: So if you look, it's interesting to look at the um the debate that happened in Parliament in the early 20th century about what I call assisted death, because assisted death covers both suicide and euthanasia, and in Canada, for instance, it's mostly euthanasia, um, voluntary euthanasia.
4:27
SPEAKER_02: Uh so in that early 20th century debate, which you can see in Hansad, they talk about mercy, they talk about compassion, I um, but they don't talk about choice or freedom.
4:38
SPEAKER_02: Fast forward to the most recent piece of um, well, attempt at legislation that we've just that we're in the middle of having still actually.
4:46
SPEAKER_02: Um and there's it's all about freedom and choice about the individual.
4:51
SPEAKER_02: So I think um that is a very powerful ideal to give someone control, autonomy, choice.
4:58
SPEAKER_02: You know, this fits very well into a set of values that we barely even notice, they're so ubiquitous in modern society.
5:05
SPEAKER_02: It's consumer capitalism, partly, you know, choice is always a good thing.
5:10
SPEAKER_02: Um and so it just sort of slides in there.
5:14
SPEAKER_02: But as I say in the book, um it in practice it it erodes attempts to give genuine mercy or to respect human dignity um in ways that we might not even notice if we're not paying attention.
5:28
SPEAKER_03: You you have uh within your book identified three advocates for the uh the bill and and what it represents: that the freedom lover, the merciful helper, and the utilitarian who sees humans as units.
5:44
SPEAKER_03: Uh uh are these genuinely distinct positions uh or uh are they um uh are they something else?
5:54
SPEAKER_03: Are they actually all part of this underlying anthropology that's developed in in our part of the world?
6:00
SPEAKER_02: Well, they're sort of they're not peoples, although occasionally you find a very clear-cut case of one or the other, but more are they're intellect I present them as intellectual archetypes, like let's in order to understand the argumentative strands, we need to pick them out and separate them from one another.
6:16
SPEAKER_02: So let's take this character, the freedom lover, it's not a particular human being, it's just a set of ideas, and let's take another one, the merciful helper, and then let's take the utilitarian.
6:25
SPEAKER_02: Now, in practice, of course, advocates for assisted death move between the language of freedom and mercy, and even sometimes utility, all the time.
6:34
SPEAKER_02: You know, they think, well, you can kill unfortunate metaphor, kill um several birds with one stone.
6:40
SPEAKER_02: But um I think it's worth pulling them out because once you do, particularly with the freedom and mercy archetypes, you see that actually they work in different directions.
6:52
SPEAKER_02: The the freedom, as perhaps we'll get into the freedom lover archetype really doesn't justify um the kind of assisted death we're presented with in practice by states and jurisdictions at all.
7:05
SPEAKER_02: Um it just it's just a totally superficial rationale.
7:09
SPEAKER_02: Really, what those states seem to be gesturing towards in their setups is something like mercy, but the argument of the book is that a system, especially a massive system, a poorly funded system, one delivered within the under the umbrella of healthcare, cannot provide mercy either.
7:28
SPEAKER_02: I mean, if you don't like the word mercy, if if secular people don't like the word mercy, then they might choose compassion or something like that.
7:34
SPEAKER_03: And well, maybe that's the time to outline the rationale of each of these arguments.
7:40
SPEAKER_03: So what do the freedom lovers advocate for and and the what do the merciful helpers typically rely upon in their argumentation?
7:47
SPEAKER_02: Well, the language of the freedom lover is is about autonomy, rights, choice, it is my death, it is my right, it's my body, I should do what I want with it, um, and all that stuff.
7:58
SPEAKER_02: You know, you can imagine it sort of piggybacks on uh tradition that we get through um feminism, actually, my body, my choice, that would be in one articulation of it, but also the liberal tradition more generally.
8:11
SPEAKER_02: But as I point out, um that liberal tradition is about non-interference.
8:17
SPEAKER_02: It's about leaving me alone to do what I want with my body when I want to do it.
8:22
SPEAKER_02: Now, you might have problems, you know, moral problems with that as a stance, but let's just take that at face value.
8:29
SPEAKER_02: Leaving someone alone to end their own life if they that's what they wish for, um, is completely different from demanding as a moral requisite assistance in ending your life from the state, you know, not even from just another human being, a pass uh a friend or a passerby, but a doctor, and a doctor who is emboldened to do this or empowered to do this rather, because policies at state level legislate for that.
8:56
SPEAKER_02: That's completely different.
8:57
SPEAKER_02: So there's that disjunct already that the freedom lover is saying, look, I it is my right to do this, but then they immediately move into the language of assistance, and that that you can't really square that circle.
9:13
SPEAKER_02: The second problem uh very that emerges quite early on for the freedom lover is that if their argument is really I should be allowed to end my life with the assistance of doctors when and wherever I want to, which is kind of how someone like Esther Ransom talks.
9:30
SPEAKER_02: You know, she talks about how she will not be allowed to die in her favourite cottage in the New Forest, um, as if somebody's stopping her, as if the the failure to implement a massive system of assisted death is the thing that is stopping her from being um able to end her own life.
9:49
SPEAKER_02: Um if if we took that rhetoric seriously, then surely we should be arguing for assisted death for everyone, no matter on what grounds, for what reason, at what stage of their lives, because people are suicidal all through their life, you know, potentially.
10:05
SPEAKER_02: So why are we only giving this to the ill, the seriously ill, the terminally ill?
10:09
SPEAKER_02: Well, it looks b the real reason is we're trying to be compassionate, and that's a different, we're trying to end suffering.
10:15
SPEAKER_02: And that's a really different justification from we should be empowering people to do what they want with their bodies.
10:22
SPEAKER_02: That's completely different.
10:24
SPEAKER_03: Well, before we get on to a core question of of what exactly you're objecting to, because I know that you actually have a more complex view of this, it's not just I'm against assisted death, full stop.
10:36
SPEAKER_03: But thinking about how we got here a little bit more broadly, do you do you think that these um uh freedom lovers, merciful helpers, the utilitarians, that these are distortions, I suppose, of the English character and its inheritance, this um kind of hyper-liberalism that's now been severed from the theological and moral framework that had ever uh given those virtues the shape and limits in the first place?
11:01
SPEAKER_02: Well, that's a leading question.
11:03
SPEAKER_02: Um sorry, guilty as charged.
11:07
SPEAKER_02: What I think is that um the the all of these concepts have their roots in the Christian tradition.
11:15
SPEAKER_02: So that's what makes it slightly enraging about the um the terms that we're presented with by assisted death lobby.
11:22
SPEAKER_02: You know, they're saying, Oh, you must all be secretly religious.
11:25
SPEAKER_02: Well, in a sense, we're all secretly religious, in the sense that we use concepts that we inherited and moral concepts that we inherited from Christianity, including dignity.
11:35
SPEAKER_02: So when they talk about dignity, dignity comes from a Christian tradition originally, it's been distorted.
11:42
SPEAKER_02: Um mercy clearly comes from a Christian tradition of relieving a heavy burden from someone of suffering or or otherwise, and um and so in a sense do these vague ideas of utility probably can be related back in some way to moral Christian impulses.
12:01
SPEAKER_02: So um I guess what's happened is that as secularism has um come into the ascendant, and as we've been de-Christianized as a culture, we've lost the um bearings of these concepts, perhaps, or at least we're free to take them in the culture is free to take them in various directions, and we can focus on some at the expense of others.
12:27
SPEAKER_02: There's less requirement for balance, perhaps.
12:29
SPEAKER_02: I mean, I don't know, because I it seems to me that even under a theology that there's the potential for for some values to get very imbalanced um as culture gets hold of them.
12:40
SPEAKER_02: So I'm not saying I'm not I wouldn't say that a Christian culture necessarily has is has immunity to the sort of thing that's happened, but nonetheless, it's I would say capitalism has really speeded this up because of the emphasis on choice and cult technology has speeded this up because we are so much more separate from each other than we used to be.
13:03
SPEAKER_02: Communities really don't exist as they used to, um, and we're not physically located in the world as we used to through because of um our dependence on being online.
13:13
SPEAKER_02: All of that has an imp has a um impact on how we conceive of ourselves metaphysically, whether we are radically individual, whether there's any meaning in our lives apart from the things we want right now, and we are less likely to look at the effects on the the the society as a whole by our the choices we demand by right.
13:37
SPEAKER_03: Yeah, uh that's that's what makes this point in time so difficult, because uh I I suppose, as one of your fellow Times columnists, uh James Marriott has said, we we're in a post-literate society, including those in the uh in the upper echelons of society as well.
13:54
SPEAKER_03: And I suppose what I'm trying to get at here is um because we live in this um this uh this bubble of consumer capitalism, uh, we uh have all been formed by it.
14:06
SPEAKER_03: And uh because we barely read and we're barely inducted into any traditions, uh moral, theological, or otherwise, anymore, is that it's a bit like the Alistair McIntyre argument that they're just these fragments of this moral landscape and we can only pull at them.
14:22
SPEAKER_03: But the thing is, is we we barely even do that anymore.
14:24
SPEAKER_03: So actually, we just use lots of language that finds itself out in the culture.
14:28
SPEAKER_03: And as you've pointed out in the book, so many of the arguments end up blending into one another, or they'll recede from one position into another, and there are lots of contradictions.
14:37
SPEAKER_03: And in the end, it feels like, as you've alighted on, it it feels like it is really just about the idea of well, why can't I just do what I want?
14:46
SPEAKER_03: Yeah, why shouldn't I do it?
14:47
SPEAKER_03: Exactly.
14:48
SPEAKER_03: Go on.
14:49
SPEAKER_02: I mean, I agree with you, and I like I like McIntyre a lot, and I recognise this sort of idea that we're sort of floating about in these orphan with these orphan remnants of uh previous moral systems and all that stuff.
15:02
SPEAKER_02: But um I would also just like to say because you there you were making connection with post-literate society and people not reading enough.
15:12
SPEAKER_02: I don't know that you really need to read a lot to feel that there's something's really wrong with assisted death, and it's not my experience that um the grassroots think this is great.
15:23
SPEAKER_02: I mean it depends on which poll you listen to, and of course my opponents will produce polls to say that society is really behind this, but I think it depends what you ask them.
15:32
SPEAKER_02: Society's behind compassionate um release of suffering, but there's many ways to do that through medicine, and they don't necessarily know all about palliative care, for instance, as an alternative, and they haven't necessarily thought through all the consequences.
15:48
SPEAKER_02: But if you actually specifically say, um, you know, should we put assisted death into the NHS in the following form, and then basically paraphrase Kim Kim Leadbeater's plan, they will see the problems because they know the NHS is falling apart.
16:06
SPEAKER_02: So, in other words, um, and we can get into what the problems are, but in other words, I think this is often a top-down um initiative from well-funded lobbyists, and it's a hobby horse of rich people, actually.
16:20
SPEAKER_02: It's uh it's it's a hobby horse of people who have everything else they want in life and have a total fear of death and want to, as as someone put it to me the other day, seriously, and he's he was an advocate, they want to control their own deaths.
16:35
SPEAKER_02: And it you know, they they they think they can.
16:38
SPEAKER_03: Well, that's a perfect segue into what exactly it is that you're objecting to because you you you've uh you're not necessarily objecting well, you're not objecting to assisted death as as only an individual act.
16:50
SPEAKER_03: It's it's rather the the state's facilitation of it as a system.
16:53
SPEAKER_03: So what why why is that distinction so important?
16:57
SPEAKER_02: Uh it's very important because um it's it's a it's there's a difference between the moral status of an individual act, b an interpersonal act between two people, you know, I help you um end your life, and the moral consequences of the state uh legislating a system which will then say, okay, under these conditions a doctor may help you end your life, because the the second thing, the system will have all sorts of secondary effects, hugely devastating second secondary effects, I think, to the fabric of society, that the first thing will not have, that the individual act will not have.
17:39
SPEAKER_02: The individual act is not legislated for, there are not policies governing it, there are not um eligibility conditions, it's a it's a it's an interpersonal um uh relationship.
17:53
SPEAKER_02: So I I am I wouldn't help someone die myself, um, but I can, and I think most people can think of situations where you know someone is in extreme suffering in front of you, there's absolutely there's clearly absolutely no hope of them surviving.
18:10
SPEAKER_02: You know, literature's got lots of these examples.
18:13
SPEAKER_02: You know, what would you do in this situation?
18:15
SPEAKER_02: I think that's a serious moral question.
18:17
SPEAKER_02: And I and because I inject for most moral questions at the individual level, I'm a I'm uh Aristotelian, basically, I think it always depends on the context, and you can't make up you know very convincing moral rules, you can have rules of thumb, but there's always going to be context which test you.
18:34
SPEAKER_02: So I wouldn't want to write a book about the rights and wrongs at the individual level, but I'm very happy to write a book at the rights and wrongs of the system, because the system, as we can see when it's been implemented in other jurisdictions like Canada, Belgium, the Netherlands, um, has terrifying effects.
18:52
SPEAKER_02: Uh and so that's the difference.
18:54
SPEAKER_02: And can I just add that philosophers have often got really hung up on the individual act?
18:58
SPEAKER_02: Like they just all they care about is is it wrong or is it right at the individual act?
19:03
SPEAKER_02: And I just think they're missing the point.
19:05
SPEAKER_02: And they tend to dismiss investigations like mine as like merely practical.
19:10
SPEAKER_02: But as far as I'm concerned, practicality is the defining question here.
19:16
SPEAKER_03: Hmm.
19:17
SPEAKER_03: Well, with regards to practicality, I suppose thinking about some of the ways that it the system can be abused is I suppose that the bill um seems to uh well, the proponents seem to consider these individuals acting individually with moral clarity, whereas if we know anything about human nature and human relationships, and actually I've been rereading some of Theodore Dolrymple's essays ahead of uh uh an interview with him for the re-release of his uh 25th anniversary of The Life at the Bottom, is that his work in hospitals showed just how much people, whether it was because they were part of the uh British uh underclasses he called them, who were in these coercive relationships or they're part of um some cultures of ethnic minorities that were um coerced by uh parents into various things and not doing things and doing things, uh and um groups uh of of all stripes with with honour codes that would uh see people pushed into things is that um there's a risk here that it's not even just about people um not wanting to be a burden on an individual level, is that actually they could be pushed into it um because they're a burden?
20:39
SPEAKER_03: Whereas the whole argument seems to hang around uh assistant dying being compassionate, but uh where does the compassion end and the coercion begin?
20:48
SPEAKER_02: Yeah.
20:49
SPEAKER_02: Yeah.
20:49
SPEAKER_02: So the um assisted death lobby uh present this light of hand that um as soon as you have a terminal diagnosis, which was the eligibility condition that we would have had if lead beater's bill had worked, I mean it's now being timed out, so it looks like it won't go through this session.
21:04
SPEAKER_02: Um the eligibility condition is you're terminal you've got a terminal diagnosis, a prognosis of six months or less.
21:11
SPEAKER_02: Um right, you're in the door.
21:13
SPEAKER_02: Now, from now on, you cannot be suicidal.
21:17
SPEAKER_02: You're not even going to commit suicide.
21:19
SPEAKER_02: It's something else.
21:20
SPEAKER_02: Even though you will be ending your own life deliberately ingesting poison, it has now moved into a completely different frame of reference.
21:28
SPEAKER_02: It's no longer killing, it's no longer suicide, and there could be no other reasons for you to want to do this except that you have rationally thought about it, autonomously come to the decision that you want to end your own life.
21:40
SPEAKER_02: That's a fantasy, right?
21:41
SPEAKER_02: So the the reality is that people who get terminal prognoses and therefore get become eligible can have a range of circumstances, just as human nature varies generally, and they could be in situations which um domestically, where there's lots and lots of pressure on them to take.
22:00
SPEAKER_02: Take this route for financial reasons, because carers are fed up of caring for them, because they're being coercively controlled.
22:08
SPEAKER_02: So there's two, with the coercive control, there's two different scenarios.
22:11
SPEAKER_02: One is where, you know, sort of the most Machiavellian in a way, where you imagine someone, a partner, like a just a manipulative partner, pushing them into suicide with the help of the state.
22:21
SPEAKER_02: But the other is where they're just being, their life is just such hell.
22:24
SPEAKER_02: You know, they're be on a daily basis, they are being beaten black and blue or whatever, that then they they see this as an easy way out.
22:32
SPEAKER_02: So um both of those I think are unacceptable.
22:36
SPEAKER_02: The state should not be helping people to die under those circumstances, even if they're terminally ill.
22:41
SPEAKER_02: And the other, the other sort of thing that we really need to bring out is people who are ill, and often this will be elderly people, most often it will be elderly people, people who are terminally ill will be most often be elderly, but either way, they're vulnerable.
22:56
SPEAKER_02: They're they're weakened, they're perhaps um mentally confused somewhat, in a way that wouldn't show up necessarily in a capacity test, which is a very low bar, um, but nonetheless don't, you know, would be making decisions they might not make in other contexts.
23:12
SPEAKER_02: They might be in pain, of course, and pain itself might be pushing themselves, pushing them to make decisions they wouldn't make if they weren't in pain.
23:21
SPEAKER_02: Um, so so for those reasons, it's really, really important to look at the big range of cases of people that might be in this situation, and not just this fantasy of the perfectly rational um you know person with a wonderful family setup and everything's perfect.
23:42
SPEAKER_02: Not you know, that's not how safeguarding works.
23:46
SPEAKER_03: Yeah, and it it seems to uh uh uh come up very roughly against the notion of of dignity.
23:53
SPEAKER_03: All of those um scenarios you've just outlined suggest that actually in the name of dignity, dignity, you might actually just be stripping someone of it.
24:01
SPEAKER_03: And uh you you discuss in the book Kant, who was actually one of the uh I suppose first people to start getting a coherent conception of what dignity is, um, and one of them is persons ends in themselves, not not treated merely as means and and more than that.
24:18
SPEAKER_03: But and you you you not necessarily make the case but highlight that if he were to be um uh reanimated and brought back today, he wouldn't necessarily recognise the assisted death uh stuff as being dignified.
24:34
SPEAKER_03: So how how do you think the word dignity has been captured and then used by the sort of diamond?
24:39
SPEAKER_02: Absolutely, he would not recognise it.
24:40
SPEAKER_02: I mean it's a it's a broad brush story, but let's just stick with it.
24:45
SPEAKER_02: That that the Kantian conception of dignity and other enlightenment conceptions of dignity were really replacements for the Christian sanctity of life.
24:56
SPEAKER_02: Um, but in a secular context of also even though Kant was religious, but you know, they were there was this move to replace explicitly Christian concepts like every everyone's life is sacred because it belongs to God, with something that could survive the death of God but still give us pretty much the same outcome.
25:16
SPEAKER_02: So there is a question for Kant, always a question about what we say about people who aren't rational, because he um he he connects rationality to dignity in a very intrinsic way.
25:27
SPEAKER_02: And I do talk about that, you know, what's the what would be the effects on um learning disabled people or people with dementia and so on.
25:36
SPEAKER_02: But leave that aside for a moment.
25:38
SPEAKER_02: Within the sphere of rationality, everyone's got dignity, whether they're die, according to Kant, whether they're dying, whether they're ill, whether they're incapacitated or not.
25:47
SPEAKER_02: It's so what we've got in the modern world is a completely shallow idea of dignity that's something like um connected to embarrassment or connected to being humiliated.
26:01
SPEAKER_02: So it's connected to feelings, and it's um it's the idea that like there's something essentially undignified about having lost control of your bodily cap your bodily functions, for instance, or being unable to get about on a in a and pursue do your daily tasks and stuff like that.
26:22
SPEAKER_02: So that's not what dignity is in the in the Enlightenment tradition.
26:26
SPEAKER_02: Now the problem you might say, well, okay, what's the problem?
26:29
SPEAKER_02: If somebody really doesn't want to like get their arse wiped by a carer, let's put it in plain terms, why shouldn't they check out before that happens?
26:42
SPEAKER_02: Um but the point is that you on the individual level, I'm not gonna say someone shouldn't feel like that, but at the state level, once we've made it official policy that when someone doesn't want to face these un supposedly undignified outcomes, we dispatch them or we help dispatch them, that sends a terrible message to disabled people or terminally ill people in the very same situation who do want to live, who don't mind the supposed indignity, who would rather still be alive, and who want a good quality of life.
27:17
SPEAKER_02: So once it, in other words, once we start implementing these kind of value judgments at the state level about the so-called dignity of an incapacitated life, and we say effectively, it's a good thing for people that want this that we end their lives because those lives have become so undignified, then we automatically make a value judgment about people in the very same situation, disabled people who's have lost you know, capacity, bodily um, have lost control over bodily functions and so on.
27:50
SPEAKER_02: And then so what do we do about them now?
27:53
SPEAKER_02: Is there an incentive to improve their lives?
27:55
SPEAKER_02: I susp I suggest not.
27:57
SPEAKER_02: I suggest we've actually undermined the incentive to improve their lives because we've effectively conceded those lives aren't worth living.
28:06
SPEAKER_03: Well, uh uh hopefully you'll permit me to bring it up.
28:10
SPEAKER_03: I suppose you wrote in your book, so hopefully okay to bring it up.
28:13
SPEAKER_03: But you're you you have an example of a good friend who was um subject to a terminal diagnosis, only only three months to live.
28:21
SPEAKER_03: And I suppose based on what you just said there, is um there's every chance that um under a state sanctions assisted dying bill, that she probably would have had it put in front of her a few times that it's it's time for you to go.
28:37
SPEAKER_03: But the thing is, is she she she was at she had stage four cancer, but she she recovered, and um and actually you and your friends um uh conducted uh a serially uh what what she came to term afterwards a living funeral.
28:51
SPEAKER_03: And it was it was uh an incredibly touching moment in the book, but to to know that ultimately she was she was facing death with dignity, um, and to know that actually if the bill had been passed, she could well have had it put in front of her uh to off off you go, and none of those things could have happened.
29:08
SPEAKER_03: So um this is this is the the the kind of hundred million dollar question, really, is that there are just so many people that actually uh want to face death in their own way anyway, um, but also that there are plenty who overcome whatever it was that either uh would have led to a terminal diagnosis or at least mentally might have driven them to suicide in the first place.
29:32
SPEAKER_02: Yeah, so my this is my friend Amanda, I actually saw her at the weekend, um, and she doesn't mind me talking about it because I checked.
29:38
SPEAKER_02: Um I think her her kind of case raises a number of issues.
29:42
SPEAKER_02: So she had breast cancer, then she had two brain tumours, both removed, um, and she's still with us.
29:48
SPEAKER_02: But she I mean at one point she was in a hospital she was receiving outpatient hospice care.
29:52
SPEAKER_02: Um now, in a way, so I I raise her case.
29:56
SPEAKER_02: There's the obvious um implication here, which I think is well taken, which is that doctors get prognoses wrong all the time, because it's a totally imperfect art.
30:05
SPEAKER_02: And actually, six months is a particularly difficult prognosis to give.
30:09
SPEAKER_02: It's much easier as you get closer to death, you know, like you can say two months with much more security than you can say six months.
30:16
SPEAKER_02: So it's a bit of an awkward one, and I I just I explain why.
30:20
SPEAKER_02: So, yes, of course, there are miracles, even for very late, for very sort of short prognoses, there are miracles.
30:29
SPEAKER_02: And that means that for every person that gets an assisted death in that context, there will be a question, like, might they have survived, might they still be with us?
30:39
SPEAKER_02: We just don't know.
30:40
SPEAKER_02: In fact, I know someone who had I know s of someone, a friend of a friend who had an assisted death, and I was talking to um the French mutual friend about it, and he said, I'd have liked to have had her around for a few months more.
30:53
SPEAKER_02: She was, you know, she was ambulatory, she wasn't in pain.
30:58
SPEAKER_02: He felt she'd gone early.
31:00
SPEAKER_02: So there's that basic message, but I think the I also don't want to put too much weight on that because actually I think even if the prognosis is right, there's still a problem here, and the problem is for everyone else who wants to live or who just wants to spend their final months without a doctor coming in saying, you know, uh actually we've got this thing we could do for you.
31:27
SPEAKER_02: Because there's nothing to stop a doctor bringing up, even several times or several different doctors bringing it up in this legislation.
31:34
SPEAKER_02: Um, because the the the the point is, once the system has recognized it as a good thing to help people die when they want it, then there's it becomes almost a straightforward implication.
31:46
SPEAKER_02: Well, you better offer it.
31:48
SPEAKER_02: You know, you can't keep quiet about it.
31:49
SPEAKER_02: This is a good thing.
31:51
SPEAKER_02: And then you have to start thinking, well, this ethnic group has access to it, but what about this ethnic group?
31:57
SPEAKER_02: Or what about the learning disabled?
31:59
SPEAKER_02: Should they, you know, they don't know about it, so now we need an easy read version of the policy.
32:04
SPEAKER_02: Now that was something that came up in the Labour government's impact assessment about assisted death last year.
32:10
SPEAKER_02: They had suggestion that learning disabled people should have an easy read version of the information.
32:16
SPEAKER_02: Um, so you do you see the logic that basically, I'm sure everyone can, that once it's a good thing, you think, well, more people, more and more people should have access to this good thing, which means we need to tell them about it, we need to have posters and waiting rooms about it, we need everyone to be educated about it, um, care homes need to know about it, relatives need to know about it, and gradually it becomes a socially acceptable choice on the horizon that was not there before, and every person with the right prognosis has to ask themselves, why am I not taking it?
32:49
SPEAKER_02: And that's a huge burden.
32:52
SPEAKER_03: Well, you uh outlined other examples in in your book as well about um how um some of the uh access based on equality grounds, um besides the the disability point for ethnic minorities, for example, less likely to have uh identification and various forms of documentation.
33:14
SPEAKER_03: So there was this um a proposal to reduce the requirements so as um not to hold people back, um, which uh uh as we've discussed um leaves things a little bit exposed to further coercion.
33:28
SPEAKER_03: But you you also humorously, though, grimly humorously, uh cited uh an occupational therapist in Liverpool um who had taken part in this Liverpool care pathway.
33:41
SPEAKER_03: Um and effectively, uh within that, that was for palliative care being a cost-effective solution.
33:48
SPEAKER_03: And NHS suddenly were putting this in front of everyone.
33:51
SPEAKER_03: Uh, and he said, Do you honestly think that if it's just a death came out?
33:55
SPEAKER_03: Oh she, sorry.
33:56
SPEAKER_03: Um, she he she said, Do you honestly think that the NHS won't put this forward as a cost-effective solution?
34:02
SPEAKER_03: You know, get kill your sign here, kill yourself, save the NHS.
34:06
SPEAKER_03: Um, and uh I suppose that that leads me on to the question of what the slippery slope is here, because if 5% of Canadian deaths are now occurring through a state sanctions medically assisted death programme, um, then the slope's been well and truly slid there.
34:22
SPEAKER_03: So um, you know, what's the trajectory?
34:24
SPEAKER_03: Where does it where does it end?
34:27
SPEAKER_02: Well, there's there's actually multiple slippery slopes.
34:30
SPEAKER_02: Some of them are very stark, some of them are sort of more gentle inclines, as I say in the book, but they do all lead down.
34:36
SPEAKER_02: And um one way is just that first point that's what what would strike anyone as safeguards, as reasonable safeguards, were you genuinely interested in offering compassionate um care to somebody?
34:52
SPEAKER_02: So for instance, offering a palliative care assessment, because we haven't mentioned it but much, but palliative care is the um alternative to um assisted death in this arena.
35:04
SPEAKER_02: Uh both of them aim to relieve suffering.
35:08
SPEAKER_02: Both of them can do it quite well.
35:11
SPEAKER_02: But one of them is much more expensive than the other.
35:13
SPEAKER_02: And we have seen through Lead Beater's bill that attempts to get um the legislation to say, look, every person opting for assisted death should also be offered a palliative care consultation with a specialist were voted down because of course they'd be too expensive.
35:29
SPEAKER_02: So um, so that's one way in which you get the slippery slope.
35:33
SPEAKER_02: You basically get things that look like safeguards being batted away in the name of freedom.
35:38
SPEAKER_02: Known, they're not safeguards, they're actually obstacles to freedom.
35:41
SPEAKER_02: They're holding people up from getting to their destination.
35:44
SPEAKER_02: And you see that across every system.
35:46
SPEAKER_02: So even in small ways, they start with sort of a month-long reflection period, and that will get reduced over time to 10 days.
35:54
SPEAKER_02: Or in Canada, you can get same-day uh medically assisted dying.
35:59
SPEAKER_02: So someone can just decide in the morning and be dead by the evening if they've got the if they've got the the right prognosis, which in Canada is very vague to start with.
36:08
SPEAKER_02: So that's one way.
36:10
SPEAKER_02: The other another way is just the concept of suffering expand is expanding.
36:14
SPEAKER_02: So what counts as unbearable suffering is shifting.
36:17
SPEAKER_02: Uh, and uh it's what used to be merely traumatic is now complex PTSD, also, you know, for instance.
36:27
SPEAKER_02: And that makes a difference to um systems which are geared towards the relief of suffering because they tend to end up going down what's called the psychological suffering only route, which you have in well, you actually had it right from the beginning in Belgium and the Netherlands, but Canada will have it from 2027.
36:48
SPEAKER_02: So basically they are killing people with mental illnesses who want to die on the grounds of unbearable psychological suffering.
36:56
SPEAKER_02: And it's quite often people that have got multiple diagnoses of PTSD, BPD, ADHD, you know, all these technical sa sounding terms um piling up on particular individuals and so that they become convinced there's no hope.
37:13
SPEAKER_02: Um so that's another slippery slope.
37:15
SPEAKER_02: A third one is the way um that the idea once again you've conceded that death is a good thing, it slots into existing systems like or or value systems like the idea that there should be equality.
37:32
SPEAKER_02: In Canada, you we got this when it started for that assisted death was being offered for terminally ill people only, and then there was a legal challenge, and it was then um given to disabled people without a terminal prognosis on the grounds of equality and rights, you know.
37:50
SPEAKER_02: So they both had the right to die, and it was important that um what was being given to this group to alleviate suffering should be given to this group to alleviate suffering.
38:01
SPEAKER_02: And then once you so there's always attempts to chip away at that.
38:04
SPEAKER_02: And I talk in the book about an attempt in Canada to roll out assisted death for drug addicts on the grounds that addiction causes unbearable suffering.
38:16
SPEAKER_02: You know, and I just don't know where this is going to end.
38:18
SPEAKER_02: Like, are we we're gonna end up offering it pretty much to anyone who thinks they're suffering enough.
38:25
SPEAKER_02: That's an entirely subjective measure.
38:26
SPEAKER_02: You'll never be able to tell someone that they're not suffering as much as they think they are or they haven't reached the right level of suffering yet.
38:33
SPEAKER_02: The system will just say yes.
38:35
SPEAKER_02: Um, so these are all ways in which what starts as a small thing can get bigger.
38:41
SPEAKER_03: Well, I I certainly don't want to conflate this issue with the discussions on uh abortion in the United Kingdom, but uh I know that uh opponents of the recent decriminalization of um abortion up term in the United Kingdom um will say, well, there's there's there's very little difference between ending the the pregnancy uh a few days before the end of the term and just doing uh and just ending the life of the child once born.
39:08
SPEAKER_03: And uh Lord Nigel Bigger has made this argument that um you know abortion uh terms have extended and and uh with regards to those that are um permissible in the United Kingdom since the abortion act in 1967, it's it's a very permissive um uh legal framework.
39:27
SPEAKER_03: And he says, look, we the assisted dying bill, if it were to come in, even though he would argue and you argue that there are very few safeguards in there already, will just become even more permissive.
39:37
SPEAKER_03: But not just that, is I suppose all the things you've described, Kathleen, um, with regards to how much the there'll be an institutional push for these things to make them become even more uh uh uh morally acceptable, um the the done uh or the way of doing things, is he argues that well perhaps we'll come to just accept infanticides, you know, philosophers like Peter Singer are already normalizing it and moral boundaries tend to creep forward once the principle's been conceded.
40:06
SPEAKER_02: And in Belgium they have uh euthanasia for neonates.
40:11
SPEAKER_02: Uh so and I have written about abortion recently to late abortion too, um, because I find it reprehensible that the the the the obfuscatory language around late abortion being decriminalized as if there's no difference between a 39-week baby being killed uh and um a three-month fetus.
40:39
SPEAKER_02: I mean, I understand that many of the people listening will object to both, but I think it is possible to make a distinction and someone like me has to make a distinction between those two things.
40:49
SPEAKER_02: Um so I guess I guess what I'm what I draw from both of those cases is that people aren't aren't need to think long term.
41:00
SPEAKER_02: They need to think about not just about what things be like next year, but what they'll be like in 20 years after this legislation comes in.
41:07
SPEAKER_02: Once generations have got used to the idea that yes, it's nothing controversial about it, it's perfectly appropriate for doctors, the state to um provide this as a service for people that say they want it.
41:23
SPEAKER_02: What will our society look like under those conditions?
41:26
SPEAKER_02: And what will then seem like the um the pushing of that further, you know, because that will be the norm, and and there are always activists that like to push norms in the name of these shallow, um shallow values like freedom and and even a very shallow conception of mercy.
41:46
SPEAKER_02: So we will it once it's instantiated instantiated as part of the the value system, it will be really very difficult to pull back because almost everyone will be implicated.
41:55
SPEAKER_02: We will all know people that took that route, we will know doctors that did it.
41:59
SPEAKER_02: Um it will be difficult to take back, I think.
42:03
SPEAKER_02: So yeah, we should think about that.
42:05
SPEAKER_03: Well, um this is uh a very dystopian um uh ivory tower-like conversation I'm about to um uh have here.
42:17
SPEAKER_03: But um you you uh cite um uh someone called Al Alvarez who has written that if secularized man were were kept going only by the pleasure principle, then the human race would already be extinct.
42:30
SPEAKER_03: And um I I think he's right, and I think we see um us tending towards uh at least the inability to reproduce our civilization anyway.
42:41
SPEAKER_03: So we we obviously have far fewer babies being born.
42:45
SPEAKER_03: We're now finding very many permissive routes in which to end the lives of people, almost regardless of age and and suffering.
42:52
SPEAKER_03: And so it feels like we're we're headed towards many different political expressions of enabling the extinction of our society in some way.
43:02
SPEAKER_03: And it seems to me it ties all the way back to what we've been talking about, which is the pleasure principle just seems to have b taken primacy.
43:12
SPEAKER_03: Would you would you agree?
43:13
SPEAKER_03: Do you think this is setting us on?
43:16
SPEAKER_02: I would.
43:16
SPEAKER_02: And I I I raise that point, I think, um talking about the effects of accepting assisted death on the attitude to suicide prevention generally, because it puts societies in this um untenable contradiction where on the one hand they're saying no, we don't approve of suicide, um, and no, we you know, and we will make active efforts to stop people from killing themselves because we consider their lives are worth living.
43:46
SPEAKER_02: To oh oh, actually, no, we're not even just gonna let you do it, we're gonna help you do it, and that's that's just raises ridiculous contradictions.
43:54
SPEAKER_02: But um the yes, I mean, yes, you can obviously see that the more.
44:00
SPEAKER_02: that a society moves towards the idea that any kind of the sort of the goal the goal of life is to eliminate difficulty and to um optimize control over the body in particular and those are ends in themselves for some reason like why I'm not sure they don't seem very satisfying to me but you know um then you will get a society in which assisted death looks more and more attractive um and also where more and more sort of middle class things get decriminalized like late-term abortion and helping someone die you know because they too have difficulty built in anxiety you know we're constantly being told we should eliminate the anxiety of people who have done these things why should they face the terror of a judicial investigation?
44:53
SPEAKER_02: Well why not?
44:54
SPEAKER_02: You know I mean lots of people have to face the terror of a judicial investigation but that's become a kind of motive in itself to get rid of whole laws um that might cause distress to people.
45:06
SPEAKER_02: So yeah we need we society needs a better understanding of what the point of life is and if the point is just to kind of smooth out our passageway and control um death where and and decay wherever possible we'll get more of this.
45:24
SPEAKER_03: Well that that's probably a segue to uh a a new uh a new penultimate closing question that I'm going to trial on you um um because I do have a standard thinking class close and that is um oh no it's not unexpected questions I can't do anyone oh I I'm you I'm you you you're a philosopher you can handle this uh so given everything we've discussed the bill the trajectory and what it reveals about where we are now as a society uh what what in your opinion does living well in this moment actually require?
45:59
SPEAKER_03: What would you tell someone who asked how to build a good life, form good character, contribute to the recovery of a culture?
46:05
SPEAKER_02: Look I'm not no one's gonna come up with a sound by answer to that question and you shouldn't trust them if they do but flourishing is more than pleasure it's more than happiness even like construed in the modern way.
46:23
SPEAKER_02: It's it's not just pheromones or serotonin or you know whatever or the absence of cortisol like it's it's pursuing meaningful um goals that aren't just meaningful because they make you happy but because they are um because you're doing something good.
46:45
SPEAKER_02: Now I can't tell you what good is I refer you back to my earlier Aristotelianism which is always very handy in this sort of context but you know there aren't any rules but on the other hand you know it when you see it I think quite often and you can always emulate people who are good and kind and or brave or whatever the virtue is.
47:05
SPEAKER_02: So virtu living virtuously um pursuing projects that are meaningful and not just for what they give the feelings they give you.
47:14
SPEAKER_02: That's the most I could say.
47:17
SPEAKER_03: Well you talking about it's not just about cracking cortisol levels and all the rest of it.
47:22
SPEAKER_03: It does it does strike me when I look around at at so many um who are doing things like sleep trackers and cortisol spikes and um number of steps and and that is actually how people are genuinely starting to measure whether that was a good day.
47:39
SPEAKER_03: Oh well look I kept my stress levels under control and I did the appropriate number of steps and it looks like I had a pretty decent sleep last night.
47:49
SPEAKER_03: Whereas um what you've just outlined there, I suppose is is um more like well life is a a bit more than just making sure that um we're we're within the bounds of what um you know the medical profession says is is healthy.
48:03
SPEAKER_03: There's got to be something that we're we're oriented toward that is striving towards.
48:09
SPEAKER_02: And also I think this actually relates to um something that's coming up in my newsfeed this week which is about having children.
48:18
SPEAKER_02: You know there's some surveys discovered that having children doesn't make people happy or something like that.
48:24
SPEAKER_02: Or it doesn't make them as happy as they thought it did or it there's no difference between the happiness levels of childless people and and like were you really having children to make you happy for a start like what an incredibly narcissistic selfish thing that sounds um but I would like want to go further and say being happy isn't the point of life either I don't I mean I know that's going to sound ridiculous to to the modern ear because people just can't imagine anything else but it's it's possible to have an unhappy life full of meaning and purpose and value.
49:03
SPEAKER_02: Even though it's a struggle you're anxious you're frustrated you're maligned everybody thinks you're a bigot or whatever it is you know I mean it's possible to be unhappy but still know that you're doing something good and and that includes having children because yeah I've had them and of course half the time you're worried about your mind but I can't I don't look back with enormous sense of happiness but if I look at them now my God you know I'm so glad that I had them.
49:34
SPEAKER_03: Well I suppose this is also because we we we live in this highly egocentric world which is all about our own identity.
49:44
SPEAKER_03: When you talk when you when you speak about me men or women of of uh more modern persuasion often the thing that they'll talk about besides the happiness is oh I'll lose my sense of identity if I have children.
49:57
SPEAKER_03: Yeah it's like well no your identity changes it becomes a family identity it's not yeah as you as you as you outline in your book it's not just all one individual act we we are absolutely connected to one another including us who've arrived here we seem to forget that we're part of this long chain.
50:14
SPEAKER_02: Yeah I actually I mean you lose your your selfish identity and you gain a self a more selfless one and that's not a bad thing.
50:22
SPEAKER_02: I mean so much of this does seem to me um so much of the the modern mores about preserving your identity and getting recognition and um and controlling your body as we've just described and getting pleasure it's all I think starts to fade away once you accept your mortality and actually weirdly writing this book was a really good exercise in that for me because for basically for six months I completely immersed myself in death um and suffering and thinking about it, reading about it um imagining it and remembering it.
51:01
SPEAKER_02: So once you've accepted I honestly it's gonna be hard I people are not going to necessarily be able to do this overnight, but once you've accepted that we are mortal finite beings a lot of these other neuroses just fade away I think.
51:15
SPEAKER_03: Well whilst I haven't I haven't stared in the face of it as you have in in this project is um my my wife and I as part of our estate planning joint wills we we um uh went a little bit further than just this is where our things go but we had we appended our our funeral wishes and thought about what the service would look like and the readings and all of those things and where we'd like to be buried and um and and furthermore we we find ourselves and this is partly me just dragging her around ecclesiastical sites but you go through these really old these old starts along for death exactly like what was I doing with this um it's uh you you find yourself wandering through churchyards with these um Victorian uh headstones and the vernacular local stone and what what you you notice between the difference of the modern headstone to the the historic one is the historic one uh can often talk about the travails of that person or what they how they tried to live a good life.
52:16
SPEAKER_03: I appreciate it was often in biblical terms that's not for everyone but there was something like tried to remain faithful tried to uh live an upright life uh all of these things that tried to say something of the character and and often you don't really get that anymore and I suppose um my wife and I came from that uh experience with writing our funeral wishes and we're both aware of of death but it certainly focuses the mind and it makes you um try to properly sit with each day and not get dragged away by the small things and focus on those bigger, more meaningful projects you you talk about.
52:55
SPEAKER_03: And yeah I think so many of us are just so afraid to to look it in look it in the eye.
53:00
SPEAKER_02: It's not that bad once you've looked it in the eye properly I think although I would say that I'm a lot older than you and I think Jung says something like you know it's it's not appropriate to for 20 year olds to be thinking about death all the time 30 year olds they shouldn't be they should be thinking about life and full of energy but it's you know once you get to middle age that's an appropriate time to start transitioning into a different frame of mind a different identity if you will um and you've got to start f accepting it because you can see people who don't accept it and it never goes well.
53:32
SPEAKER_02: Yeah you can find them all over the uh daily mail columns exactly with all the latest beauty treatments um um final question this is the the the standard thinking class close which I ask all of my guests and and and what what have you changed your mind on during the course of your life maybe it was a moral absolute maybe it was something smaller and and what was it that that made you think differently okay I mean I probably I've changed my mind on lots of things that I can't remember but my characteristic experience of writing a philosophy uh paper used to be that I would start off arguing for one side of things and then halfway through I would realise oh hell I have now taught myself out of this and now I have to redo the entire paper to argue for the opposite so um but that's on that's in sort of abstract matters that nobody's interested in.
54:23
SPEAKER_02: I think in um in recent times given the public battles I fought I've become I used to be quite an unthinking um apolitical person who just assumed that progressives and liberals had basically the right idea and were clever enough to and and morally conscientious enough to kind of steer us all in the right direction.
54:55
SPEAKER_02: Absolutely don't believe any of that anymore uh in fact believe quite the opposite so I've I've definitely changed my mind on um progressivism generally and um the the trust I placed it in institutions is gone.
55:12
SPEAKER_02: That's not a very inspiring answer but I do think we should all keep stay frosty on that.
55:16
SPEAKER_03: Well it ties on very nicely into your mistrust of institutions with regards to your most recent book and it it's it's it is remarkable how many people I've spoken to who've either been through the the the kind of tribulations you have with with their own flavours or people who have um focused their whole um their their life's work on gaining access into an institution and then they find themselves in there and realize they're actually surrounded by quite unimpressive people and that actually it's not quite uh as trustworthy as it appears from the outside and actually I can't just have my blind trust put in this and um and I I think in a world where we do all either look to um the state increasingly to um basically allow for our every need and also private corporations and just hope they might do the right thing um we do seem to outsource a lot of responsibility or at least we all act as if we're all living in a really really high trust society when in fact um we're not really at least it it can be misplaced it's not to say walk around side eyeing everyone but but but that we we have outsourced a lot of uh responsibility and and and value judgments to others uh and and and misplaced our trust I'd say completely I mean that I actually debated um Rabbi Jonathan Romain at the Oxford Literary Festival on Friday and really what became clear because he's a former chair of Dignity and Down very nice man um written a book in favour of assisted death is that he just seems to think the system's going to work perfectly and I think it obviously isn't going to work perfectly I mean it just isn't so I think quite often it's a temperamental difference between people who perhaps um just aren't as I would say realistic about systems as we are well Kathleen it's been an absolute pleasure thanks so much for joining me before I let you go uh perhaps you could uh both hawk your most recent words and tell people where they can find you in the dark corners of the internet.
57:29
SPEAKER_02: Absolutely well my new book is Do Not Go Gentle The Case Against the Sister Death it is out ooh I've got a copy of it even here.
57:36
SPEAKER_03: There you go.
57:38
SPEAKER_02: And um it is out on Thursday about available from all booksellers hopefully and um if they in case unless the the book assistants have hidden it like they did my last one but get online if you can't find it.
57:54
SPEAKER_02: And um I write I'm a contributing editor on heard I write there so you can get me there every week.
58:01
SPEAKER_03: Well I would uh encourage everyone to go and not only buy a book to actually follow your work in Unheard and the Times because I think there are few people who actually do seek to um make their way through this moral maze that we're in and also you you you revise I would say your own your own views as you go and uh that that's pretty rare.
58:23
SPEAKER_03: So Kathleen thank you again and I hope we can speak again in the future.
58:28
SPEAKER_02: Thank you John I've really enjoyed it thanks.
58:30
SPEAKER_03: All the best