(In memory of David, Jeremy Stanley and Walter)
In part one of a two-part essay Sister Elizabeth John of the Dolgellau Carmelite monastery examines some of the moral issues at stake around Kim Leadbeater's proposed Terminally Ill Adults (End of Life) Bill
A Historical Study: The Moral Problem of ‘Assisted Dying’
This article is an exploration of some of the issues around suicide, euthanasia, and assisted suicide, based on an essay submitted in 2023 for the philosophy element of the Teresianum’s Online Certificate in Spiritual Theology.[1] It is not intended as a comprehensive summary of arguments for or against assisted suicide.
Terminology
Assisted Suicide: An individual is provided
with a fatal drug and has to be capable of administering it themselves.
PAD: Physician or clinician-assisted death-
involves a trained professional administering the drug for the patient.
Euthanasia: Encompasses both of the above
but sometimes has subliminal echoes and references, including what we usually
do with our dying pets.[2]
Medical Assistance in Dying
(MAID): The
term, adopted in Canadian legislation, can include self or
physician-administered situations and simply describes what it is.
Those in favour tend to use the term ‘Assisted Dying’, whereas those against refer to ‘Assisted Suicide’.
The Views of Some Philosophers on Suicide[3]
Most of the ancient city-states
criminalised self-killing but there does not appear to have been a single word
in ancient Greek or Latin that translates our word ‘suicide’.
Plato claimed, in the Laws,
that suicide is “disgraceful … and its perpetrators should be buried in
unmarked graves.” Apart from four exceptions,[4]
Plato saw suicide as “an act of
cowardice or laziness undertaken by individuals too delicate to manage life’s
vicissitudes.”[5]
However, the Stoics, (including
Seneca), held that “whenever the means to living a naturally flourishing life
are not available to us, suicide may be justified, regardless of the character
or virtue of the individual in question.”
St Augustine, particularly in City
of God, is generally credited with offering the first justification of the
Christian prohibition on suicide, seeing it as “monstrous”.[6]
St.
Thomas Aquinas defended this position on three grounds: (1) Suicide is contrary
to natural self-love, whose aim is to preserve us. (2) Suicide injures the
community of which an individual is a part. (3) Suicide violates our duty to
God because God has given us life as a gift and in taking our lives, we violate
His right to determine the duration of our earthly existence.[7]
This conclusion was codified in the medieval doctrine that suicide nullified human beings’ relationship to God, for our control over our body was limited to us (possession, employment), where God retained dominion, authority. Renaissance intellectuals generally affirmed the Church’s opposition to suicide.
David Hume launched a direct
assault on the Thomistic position in his essay Suicide (1783).
In The
Metaphysics of Morals, Immanuel Kant saw suicide as an attack on our
rational wills, which are the source of our moral authority.
Suicide in the Bible
Seven people committed suicide
in the Bible: Abimelech (Judges 9:54), Samson (Judges 16:26–31), Saul
and his armour-bearer (1 Samuel 31:3–6), Ahithophel (2 Samuel 17:23), Zimri (1 Kings 16:18) and
Judas Iscariot. (Matthew 27:5).
Except for Samson, who prayed to God for strength before leaning against the pillars of the temple and whose actions also caused the death of thousands of enemy Philistines, suicide is presented as a cowardly act undertaken by ungodly, disgraced men.[8]
(Dis)Honour, Glory, and Sacrifice
Ritual suicide (‘hara-kiri’ or ‘seppuku’)
was committed in Japan, primarily by Samurai, who desired either to die with
honour rather than falling into the hands of their enemies, or as a form of
capital punishment, or because they had brought shame to themselves. Sometimes
their wives also killed themselves. Socrates drank a cup of hemlock after
having been found guilty of corrupting the minds of the youth of Athens and of
impiety. Duels were fought to restore honour.
Hindu women practised ‘sati’
(or ‘suttee’) – the immolation of a wife on
the funeral pyre of her husband. The
Buddhist monk, Thich Quang Duc, died in1963 by self-immolation in Saigon, protesting
against the persecution of Buddhists in South Vietnam.
Groups of people have committed
mass suicide: for example, members of religious cults (such as Heaven’s Gate
in 1997), the women of Souli in Greece (to avoid capture by the Ottomans in
1803), and German civilians as well as Nazis towards the end of the Second
World War. During the reign of Antiochus Epiphanes, ‘many in Israel … chose to
die rather than to be defiled by food or to profane the holy covenant.’ (1 Mac 1:62-
63)
St Ignatius of Antioch said
that he was “voicing the mind of God” when he begged the Romans not to put any
obstacles in the way of his martyrdom, so that “I may be made a sacrifice to
God.”[9]
A concluding prayer option for the
Common of One Martyr is, “…You gave Saint N. the grace to fight to the
death for the true faith.” St Teresa and her brother “agreed to go off to the
land of the Moors and beg them, out of love of God, to cut off our heads there.”[10]
St Maximilian Kolbe volunteered to die in the place of a fellow prisoner
at Auschwitz.
St Paul was ‘hard pressed’
between living and dying: he desired “to depart and be with Christ, for that is
far better”, but realised it was more necessary for him to “remain in the flesh”.
(Philippians
1:23–24) I knew
several people who died of natural causes shortly after their loved ones had
passed away. The Liebestod (‘love/death’) concept as seen in Tristan
and Isolde, for example, is a dangerous distortion of the desire to be
united with the beloved in death.
Burial of Suicides
Traditionally, in the UK
suicides were buried at cross-roads, sometimes with a stake through their body.
The Foreign Secretary, Viscount Castlereagh, committed suicide in 1822 but was
buried in Westminster Abbey, which may have prompted an 1823 Act which gave
suicides the right to a private burial in a churchyard, but only at night and
without a Christian service. Burial was allowed in daylight hours in 1882.[11]
The Catholic Church dropped its
prohibition in Canon Law on funeral ceremonies for suicides in 1983 and the
Church of England allowed full funerals for suicides in 2015.
Suicide as a Crime
Statistics from 2021 show that attempted
suicide is still a crime in twenty countries (including Nigeria, Bahamas,
Bangladesh, Guyana, Kenya, Pakistan and Cyprus), and is punishable by fines and
up to three years in prison.[12]
Concerning Cyprus, an
unfortunate situation occurred there recently: David Hunter, a British citizen
who had lived in Cyprus for twenty years, killed his wife. He claimed that she
had begged him to do so, though there was no proof, as she was in a lot of pain
with blood cancer (she may not have been terminally ill); he then tried to kill
himself. He maintained that she had lost her dignity. He was charged with
murder, which was changed to manslaughter and then changed back to murder.
Eventually, he was cleared of murder but convicted of manslaughter and jailed
for two years. He was released, as he had spent nineteen months in custody, but
the prosecutors are appealing against the verdict.[13]
England and Wales: Prosecutions after Attempting Suicide
In October 1923, an out-of-work
labourer Thomas McCarthy ‘drank something bad’ on the steps of St. Paul’s
Cathedral after becoming depressed. He was sent to prison for a week.
Police found, in July 1958,
Lionel Henry Churchill with a bullet wound in his forehead next to the
partly-decomposed body of his wife. Doctors said the fifty-nine-year-old needed
medical treatment at a mental hospital but magistrates disagreed and he was
sent to prison for six months.
The number of failed suicide
attempts known to police in 1956 amounted to 5,387 and of these 613 of them
were prosecuted. Most were discharged, fined, or put on probation, but
thirty-three were sent to prison.[14]
Suicide was de-criminalised in
1961, though it had never been criminalised in Scotland. Has decriminalisation
led to a deceptive idea that assisted suicide is acceptable?
A Suicide Survivor
Nineteen-year-old
Kevin Hines, who was bipolar and heard voices saying, “You have to die”, in
2000 survived jumping off the Golden Gate Bridge in San Francisco. No one
enquired if he needed help – a lady even asked him to take her photo. He
regretted his decision as soon as he jumped, so prayed, “God, please save me”. It is possible that a sea lion kept him afloat
until he was rescued. He now travels the world sharing his message of hope,
healing, and recovery under the hashtag #BeHereTomorrow.[15]
He campaigned for the erection of suicide barriers on the bridge and prevention
nets were put in place in January 2024.
The Perceived Value of Human Life
Presumably the cost of trying
to rescue the passengers on the Titan submersible ran into millions of dollars[16]
but, a few days before, possibly
hundreds died on an overcrowded vessel carrying migrants off Greece..[17]
A British
nurse, Lucy Letby, was convicted in August 2023 of murdering seven babies on a
neonatal unit and attempting to murder six more[18]
– but babies of the viable
gestation period required to survive are still allowed to be aborted.
The Sunak government published
in September 2023 a five-year cross-sector suicide prevention strategy.[19]
The police may spend a long time trying to talk someone out of committing
suicide. A police officer, Sergeant Graham Saville, in August 2023, died after
being hit by a train whilst trying to help a person in difficulties on the
track.[20]
A few weeks later, the person returned to the scene, drunk, and
threatened to take his life. He was arrested, pleaded guilty to causing a
public nuisance, and was handed a three-year community order and to wear an
alcohol monitoring tag for 120 days and ordered to attend thirty rehabilitation
sessions.[21]
English Law on Euthanasia and Assisted Suicide
Both euthanasia and assisted
suicide are illegal under English law. Assisted suicide is illegal under the
terms of the Suicide Act (1961) and those found guilty of encouraging or
assisting a suicide face up to fourteen years’ imprisonment.
Depending on the situation,
euthanasia is regarded as either manslaughter or murder. The
maximum penalty is life imprisonment. Euthanasia can be classified as voluntary
when a person makes a conscious decision to die and asks for help to do so,
OR termed non-voluntary when a person is unable to give their consent
(for example, because they are in a coma), and another person takes the decision on their behalf,
perhaps influenced by a previously-expressed intention for their lives to be
ended in such circumstances.22
There were 187 cases referred
to the Crown Prosecution Service (CPS) by the police from 1st
April 2009 up to 31st March 2024 that were recorded as assisted
suicide. However, of these, 127 were not proceeded with by the CPS and thirty-six
cases were withdrawn by the police.
There are currently six ongoing
cases. Four cases of encouraging or assisting suicide have been successfully
prosecuted. One case of assisted suicide was charged and acquitted after trial
in May 2015 and eight cases were referred onwards for prosecution for homicide
or other serious crime.[22]
ENDNOTES
[1]
Taught by Professor Adrian Attard, OCD.
[2]
Consider also the Nazi campaign of mass murder by involuntary euthanasia.
[3]
Michael Cholbi, “Suicide”, The Stanford Encyclopedia of
Philosophy (Winter 2021), ed. Edward N. Zalta
<https://plato.stanford.edu/archives/win2021/entries/suicide/>.
[4]
[5]
[6]
Augustine, City of God, 1.17–27, here
1.27.
[7]
Thomas Aquinas, Summa Theologica, 1271, part II, Q64, A5.
[9]
Letter of St Ignatius to the Romans, see the Second Reading for the Office of
Readings on his feast day (17 October).
[10]
St Teresa of Avila, Life, 1.4.
[11]
<https://www.parliament.uk/about/living-heritage/transformingsociety/private-lives/death-dying/dying-and-death/burying/>.
[12]
<https://www.theguardian.com/global-development/2021/sep/09/suicide-still-treated-as-a-in-at-least-20-countries-report-finds>.
[13]
See, e.g., <https://www.bbc.co.uk/news/uk-england-tyne-66462909>.
[14]
“When Suicide Was Illegal”, BBC, 3 August 2011 <https://www.bbc.co.uk/news/magazine-14374296>.
[15]
<https://time.com/archive/6919647/a-survivor-talks-about-his-leap/>,
<https://kevinhinesstory.com/>.
[16] Titan imploded in June 2023 on a dive to
see the wreckage of the Titanic.
[17]
See, e.g., <https://news.un.org/en/story/2023/06/1137712>.
[18]
<https://www.judiciary.uk/wp-content/uploads/2023/08/LETBY-Sentencing-Remarks.pdf>.
[19] Suicide Prevention in England: 5-Year
Cross-Sector Strategy
<https://www.gov.uk/government/publications/suicide-prevention-strategy-for-england-2023-to-2028/suicide-prevention-in-england-5-year-cross-sector-strategy>.
[20]
<https://www.bbc.co.uk/news/uk-england-nottinghamshire-66619728>.
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