An argument against legalising assisted dying from a societal culture perspective

I hear and agonise over the valid experiences of people and families who want to be able to take the option of legalised assisted dying.

I sometimes do organisational leadership and culture consultancy, and I think a less well addressed issue in the debate around this Bill, is what I see as the inevitability of creating a ‘negative culture of expectations’ in old and sick people, and wider.

While we can throw up our arms initially and say that no decent State or family would ever consider encouraging suicide in another, I think a cultural effect would occur, and happen by degrees, little by little. Not because most people/family/doctors are readily in favour of changing their attitude to old and sick people, but because of the incentive structure created. Both family (crudely for inheritances, houses, conveniences) and State (crudely to save social care and NHS costs) have an incentive towards, not against, assisted dying.

While 99% of people initially might baulk at this incentive having any effect, we know the vagaries of human nature, and we know ‘thin end of wedge’ effects. The incentive structure will mean that societal views of the value of human life in and of itself will become gradually eroded in the psyche of society. Experiments in other countries bear this out, with the wedge getting thicker despite and alongside all compassionate talk.

While many would defend both assisted dying and their self-assessment of how loving they themselves are, at a cross-population level it’s a slow, chilling, subconscious effect. The expectation would gradually grow, slowly and patchily across society, that an old/sick person ‘might’ or ‘should’ choose to die, and that they might just be a tiny bit selfish for not doing so. The incentive structure certainly won’t go the other way.

It’s an argument that is easy to feel disgust over, but we know not only ‘man’s inhumanity to man’, but ‘man’s indifference to man’ (or woman’s). In fact, we all must default to this human indifference daily, just to survive our knowing the injustice of war or famine in foreign lands etc. Humans are good at rationalising towards incentives, by degrees.

Like so many other laws, once things are legal they become normalised, the legal action accepted as, well, perfectly OK.

The effect is also intrapersonal (within the affected person’s own thinking). With assisted dying (suicide) legal, every old or sick person (way outside the proposed initial 6-month limit) and everyone else will be effectively forced to consider their own self-worth, because this legal suicide option is now in all of our consciousness. The very act of considering a) one’s own worth to others and b) one’a own self-worth, in old and sick people will, for many, reduce this very self-worth as they consider the law. And hence some people will move towards a self-worth less than zero, that would not otherwise have been the case. For some of them, this will be to the point of acquiescing to what they see is a societal expectation, dressed up as personal choice.

Is this the direction we wish to go?

I hear and agonise over the valid experiences of people and families who want to take the option of assisted dying. I would only say that this is not a decision that affects only them. A legal change would, according to this argument, gradually affect the culture, expectations and psyche of millions of others over time. And so, despite my libertarian leanings, I believe we would not only see people ‘semi-volunteering’ to die, who otherwise would not have, but also increased levels of depression and suicide in wider society over time too, as the sanctity or value of life itself is questioned more.

So, while I am extremely sympathetic to individuals who may be suffering for up to six months more at end of life, I consider that avoiding the negative cultural impact on society (ie to millions of individuals over time) outweighs the right of individuals to participate in assisted dying.

Your thoughts are welcome on this aspect of a very difficult and emotive but important issue.