Lord Sumption, in a glancingly thoughtful article on the Terminally Ill Adults (End of Life) Bill, told readers of <em>The Times</em> that autonomy, “…is the moral instinct that individuals are entitled to be the masters of their own fate, subject to limited and well-defined exceptions necessary for the protection of others. We owe it to our fellows to respect their autonomy. It is the necessary foundation of the kind of tolerant, liberal society in which most of us would wish to live. But it is also more than that. It is essential to their dignity as human beings.”
This description of a “moral instinct’ is quite at odds with religious instincts involving a corporate – not merely individual – outlook on human affairs referring to a higher power with an authoritative and decisive claim on our use of our capacities. A moral instinct that we are entitled to be “masters of our own fate” seems explicitly irreligious. Exercises of autonomy, on this man-centred view of the world, are presumptively legitimate, even if some expressions of autonomy must be suppressed in the face of other needs and desires. But such suppression is conditional and fragile: it is not based on any higher claim than the needs and desires of humans more generally.
Sumption goes on to note how his view of autonomy linked to “dignity” - a dignity he believes can be honoured through respect for decisions to self-terminate – is nevertheless in tension with “our” belief in “the intrinsic value of human life”. He comments that “there is no morally satisfying answer to this dilemma”.
It is certainly true that respect for human persons is, among other things, respect for their autonomy or self-direction (an aspect of human rationality). It is also true that we must often step back and allow people to make decisions we think are mistaken, morally or otherwise. We do that when someone refuses a medical treatment we think is still justified in the circumstances i.e. not too burdensome relative to its benefits (I refer here to non-suicidally-motivated refusals). People have the first responsibility for safeguarding their own health, and subsidiarity demands that we let them do this. Exercises of autonomy can be morally mistaken without being appropriately prevented by society. But we honour autonomy chiefly because certain of our actions are worthy expressions of our rationality and orient us to the good, and because subsidiarity is a way of ensuring such good actions have free rein.
However, legalising assisted suicide is not just a matter of “stepping back”, as when someone refuses unwanted treatment, but a matter of “stepping forward” and “helping” a suicidal person to end his or her life. The doctor doing this is sharing the patient’s intention that the patient’s life be ended. He or she thereby violates a paradigmatic prohibition of the Oath that gave birth to the doctor’s profession. And the MP who votes for this is intending that those who wish to kill themselves be assisted by a doctor – in all likelihood acting under the mantle of the revered NHS. This is very close complicity in what is objectively an extremely wrongful action: killing oneself or, in the doctor’s case, giving someone the tools to do so.
How did we get to the point where suicide may now be state-sponsored? It is mordantly amusing to note that even this factual description of what Leadbeater’s Bill proposes has been met with outrage by its euphemism-deploying supporters. Such performances in fact give tacit recognition to the taboo, once so natural, against suicide.
Clarity over the moral evil that suicide constitutes is obscured in an age of liberal “humanitarian” values. Moral cognition can be damaged by a culture which persistently effaces the divine. It is not that the believer and non-believer won’t agree upon many moral truths – both in thinking about human needs and by paying attention to what people’s natural moral sense suggests. But in the latter case, faced with the evil “need” that is self-termination, it may be very difficult to see that “need” as something that must be resisted. Denial of the ultimate Safeguard against our tendency to evaluate a human life as not having a value and meaning which absolutely excludes self-killing ultimately hollows out other “safeguards”. Even a heightened moral sense may fail in the face of unpleasant circumstances where newly-packaged “needs” trump what had once seemed a bedrock assumption of our civilisation. As the philosopher Aurel Kolnai once observed, “Humility and reverence in the human relationships which properly require them may be possible without religious piety, but they cannot help losing depth, savour and firmness, if the sphere of their primary and standard objects is removed.”
And with the removal of that sphere we lose two fundamental data of our existence – a sense of sin, tied to our ideal of perfection, and the idea that this fallen world is one involving suffering, which calls for empathy rather than obliteration of the subject. Loss of a sense of sin results in the false idea that our autonomous choices are somehow worthy of “respect”, even as they violate the rights of the One we are called to serve. As St James reminded us, “This is not the wisdom that descends from above. It is earthly, sensual, devilish” (James 3.15). That “wisdom” was in evidence last Friday as our Parliament, unctuously praised by our media, voted for the Leadbeater Bill as every reasonable objection, every presentation of evidence of the dire humanitarian outcomes such legislation has caused and will cause, was ignored. It is, of course, crucial that people keep fighting this Bill at the next stage. But that fight, in the long run, will involve combatting the much deeper idea that our “dignity” is somehow tied to an autonomy separate from its Creator – an idea that once consumed the angel we now know under another name.
<em>(Dr Anthony McCarthy is founder and director of the Bios Centre for the Study of Bioscience, Biomedicine, Biotechnology and Society)</em>
(Getty)
