This is just the latest shift in a bewildering series of changes to Dutch euthanasia laws. Two years ago, a 17-year-old girl called Milou Verhoof became the first underage person in the Netherlands to be euthanized not for any physical ailment — but because of severe psychological suffering. The number of people euthanized here rose 10% in 2024, with 2025 seeing another jump.

Little wonder Dutch citizens are feeling increasingly uneasy about their country’s ethical frontiers. While there is broad support for euthanasia generally, a study from July 2026 shows that figure falls to about half when discussing very young children. It’s a similar story when it comes to that other progressive nostrum: transgender policy. As a poll from August found, two-thirds of citizens think the Netherlands is too radical in giving hormone treatments to children who doubt their gender.

It all suggests that Dutch hyper-liberalism is increasingly threatened. Yet if that’s an unsurprising reaction to decades of radicalism, the country’s old centrist parties thunder on as usual. Given the rising power of far-Right alternatives in The Hague and elsewhere, that cannot end well.

The Netherlands is often seen as a pioneer when it comes to freedom of thought and action. Postmodernism, which emerged in the late Sixties, found very fertile ground here — as citizens and politicians alike dismantled old truths around religion, science and even the nation state itself. Suddenly, everything seemed possible, and everyone could choose their own fate. Your identity? You decide that for yourself. Your death? Up to you.

Suggested reading

There's no dignity in assisted dying

By Kathleen Stock

These attitudes are typified by “15 Miljoen Mensen” (“15 Million People”), a 1996 song that revels in its liberalism. First sung by a musical duo called Fluitsma & Van Tijn, it’s since become a kind of alternative national anthem. “15 million people / On that tiny piece of earth,” proclaim the song’s lyrics. “They shouldn’t be forced into a straitjacket / Leave them alone.”

How these ideas became so popular is partly a matter of geography. Flanked by swamps and river deltas, and without many resources of its own, the Netherlands has traditionally been a trading nation. Along the way, the Dutch developed a tolerant national character: you can believe what you want, be who you want, as long as we can trade without problems. The fact the Netherlands pioneered freedom of religion in its 17th-century Golden Age is a good example of this attitude, as was the country’s studied neutrality during the First World War. At the same time, the Dutch talent for pragmatism can be attributed to our eternal struggle against the sea. We still talk about our “polder model”: originally referring to the collaboration needed to maintain the country’s dykes, but which now implies a culture of consensus-making across politics, business and the trade unions.

These deep historical trends are shadowed by more recent developments, not least the decline of so-called “pillarization” (“verzuiling”). For all their self-proclaimed tolerance, the Dutch largely self-segregated until the Second World War. Catholics only associated with Catholics, Protestants with Protestants, socialists with socialists. An individual’s whole social life — which church they attended, which newspaper they read — was organized around a single “pillar”.

After 1945, however, this pillarized society fell apart much faster than elsewhere — largely a function of lightning-fast secularization. In the early Sixties, the Dutch were still churchgoers, but a few decades later the nation was largely secularized. The transformation was hardly unique to the Netherlands, of course, but it was unusually rapid and far-reaching. In 1971, only 23% of Dutchmen were non-religious; by 2023, 48% were.

Suggested reading

The euthanasia of the West

By Michel Houellebecq

This cultural revolution might be explained by material factors. From 1945, the Netherlands experienced an enormous jump in prosperity. The new model of social welfare duly made personal development and quality of life more important. Combined with that old liberal tradition, issues like women’s emancipation and sexual emancipation became hugely important, as the Dutch wallowed in their individualistic reputation.

Postmodernism brought us abundance, choice, freedom and tolerance. These were the values that made us, as Fluitsma and van Tijn had it, “the country of a thousand opinions”. But because of that rampant secularization, the Netherlands had relatively few conservative counterforces, certainly compared with more religious countries such as Poland or Italy. This is clear enough in Dutch politics: even Christian Democratic Appeal — nominally conservative, and which dominated parliament for decades — has now embraced postmodern progressivism.

The results of all this are increasingly stark, not least in politics itself. The Dutch establishment now chases individualism in every sphere of life — in appearance, in gender, in how people choose to die. Shared values have fallen away. In their quest to promote this liberal utopia, government systems have become over-regulated and top-heavy, with new laws rushing ahead of public feeling.

A case in point is Mark Rutte, prime minister from 2010 to 2024. He was then replaced by a conservative coalition — including the New Social Contract, a party I co-led in 2025 — but across his long tenure, Rutte and his colleagues increasingly viewed ordinary people with distrust, and dismissed their concerns. If this finally explains the state-sanctioned killing of a toddler, the views of voters be damned, it’s an attitude that’s infected other policy areas too. When, for instance, 44,000 parents receiving childcare benefits were wrongly labeled as fraudsters, the establishment ignored their plight for years, with devastating consequences for families.

If the establishment is still happy with the progressive consensus, voters themselves have started hunting for new values. Or rather, they’re returning to old ones: around community, responsibility, discipline. That, in turn, is pushing increasing numbers of people away from mainstream politics. It’s telling that in recent times a number of Dutch anti-establishment parties have risen in the polls, with New Social Contract just one example.

In the end, the Right-wing cabinet we formed following Rutte’s departure did not last long. Our differences on the rule of law with the PVV, Geert Wilders’ far-Right party, ultimately proved too great. Not that the centrists, now back in power once more, seem to have learned much from their defeat. On they go with the same progressive ideas, even as we’re on the eve of a new values-driven era.

This establishment blindness is clear across politics. Despite plenty of resistance, hospitals can now terminate pregnancies up to 24 weeks. If the baby is nevertheless born alive — babies are viable at that stage — care is taken that their life ends “without suffering”. A generous transgender policy, which two-thirds of Dutch citizens are against, is nonetheless continuing unchanged, while the Senate is also considering a bill that would allow the artificial cultivation of human embryos.

If “sensible” centrist politicians keep on this path, taking no account of the values that ordinary voters are asking for, they will only add fuel to the anti-establishment fire. In our dealings with Wilders and the PVV, I saw how dangerous that could be in the long term. Nor is my country alone. Next year, elections are being held in Germany, France, Italy and Poland, among others. People across the political spectrum will rightfully worry about the rise of the far-Right. But defeating that threat will not come from simply ignoring what voters are saying — on euthanasia or anything else.

Then came this week’s visit by Pope Leo XIV to France, which has been marked by the Bishop of Rome’s constant, special solicitude for those whom medicine once branded “retarded.” Will it spur Christians, and perhaps others, to return the R-word to the realm of taboo? And would such a social shift have any wider positive effect, besides marginally curbing the coarseness of daily language? 

Let us pray. And not just for the sake of being decent. But because in the age of AI and “agentic” machines, a culture that mocks and denigrates human frailty — that reduces worth to intelligence and agency — may soon target many people, including those who today consider themselves gifted and use the R-word with abandon.

Much has been made of the surprising resurgence of French Catholicism, amply on display in the 800,000 souls who attended the Roman pontiff’s Mass at the Place de la Concorde and the long lines of penitents waiting to pour out their troubled consciences to priests in open-air confessionals. Yet if there is a unifying theme to Leo’s French trip, which continues through Monday, it is the inviolable dignity of the vulnerable, including the elderly, the infirm, and people suffering from mental and intellectual disabilities.

More from this author

Pope Leo’s unfashionable universalism

By Sohrab Ahmari

On his way through the streets of Paris, Leo stopped the pope-mobile to bless a severely disabled girl, creating what is likely to be one of the defining images of his reign. At his Paris Mass, the altar servers included six young men with Down syndrome. And speaking at Lourdes, where an apparition of the Virgin Mary has long drawn those seeking healing beyond what medical science can achieve, Leo launched a jeremiad (in the true sense of the word) against abortion and assisted suicide. The former, selective abortion, has all but eliminated people with Down syndrome from some jurisdictions. The latter, assisted suicide and euthanasia, increasingly ensnares people with intellectual disabilities like autism.

“No human law should ever make you lose the certainty of your dignity,” the pope told the patients and their carers at Lourdes. “You are not a burden. You are the beating heart of our humanity and a precious treasure for the Church.” He added: “It is precisely in the name of this inalienable dignity of the human person that we must reject the temptation to cause death under the guise of false compassion. It is impossible to regard causing death as something normal.  What is legal is not necessarily moral.”

Defending vulnerable life is, of course, nothing new for Catholicism. The Didache — one of the earliest compilations of Church teaching, generally dated to the late first century — includes the injunction: “do not abort a fetus or kill a child that is born.” In modern times, that consistent, maddeningly unbending ethic of life has occasioned some of the Church’s most morally heroic moments, even and especially amid its failures. 

In the Nazi period, for example, when too many of the German bishops kept mum about the Holocaust and otherwise failed to resist Hitler, one prelate stood tall for the cause of life. I’m speaking of the bishop of Münster, Clemens August Graf von Galen, who, on Aug. 3, 1941,  delivered a homily condemning Aktion T4, the Third Reich’s program of involuntary euthanasia targeting the physically and neurologically disabled and mentally ill. 

A massacre of the innocents was afoot, von Galen charged, “because in the judgment of some official body, on the decision of some committee, they have become ‘unworthy to live,’ because they are classed as ‘unproductive members of the national community.’ Poor human beings, ill human beings, they are unproductive, if you will. But does that mean that they have lost the right to live? Have you, have I, the right to live only so long as we are productive?”

That productivity aspect is the heart of the problem today. In the postwar period, overt eugenics and overtly coercive euthanasia were out of the question, having been tainted by association with the Nazis. But the Church now detects the same impulses lurking under the guise of “choice” and “compassion” and the obscene phrase “death with dignity,” used to describe doctors dealing death. Scratch through such cant, the recent pontiffs have argued, and you find the same ideas: that worth lies in productive intelligence, the capacity for autonomous choice or “agentic” activity (to use today’s parlance). The distance isn’t far from that premise to the conclusion that some lives just aren’t worth keeping around. 

In his 2015 encyclical, Laudato Si’, Pope Francis warned against a “dominant technocratic paradigm” that only finds value in “a subject who, using logical and rational procedures, progressively approaches and gains control over an external object.” People with intellectual disabilities frequently fall short of this paradigm, but so do many others. So do babies in gestation and young children. So do the elderly. And so do people undergoing chemotherapy. All of us spend great stretches of our lives in various states of vulnerability and incapacity and unproductivity.

Suggested reading

Why artists choose Catholicism

By Valerie Stivers

Which brings us to Leo XIV. The new pontiff has so far devoted the lion’s share of his teaching to the moral challenges posed by AI. He and the Church aren’t opposed to automation. On the contrary, emancipating man from “arduous, repetitive, or dangerous” labor, as his encyclical on AI put it, has long been an aspiration of classical and Christian civilization. Insofar as AI achieves this emancipation, it is to be welcomed — but not when it intrudes upon distinctly human activities or if it recasts our conception of human worth.

That last danger is already present in practices like selective abortion, euthanasia, and assisted suicide, and is likely to be greatly magnified in the age of AI. Indeed, during his visit to France, Leo explicitly linked the two. Speaking on Friday at a gathering of UNESCO, he commented, “The paradox has become increasingly evident: while ‘intelligence’ is attributed to computational systems, we struggle to recognize the inalienable dignity of human persons, whose lives are judged according to the criterion of efficiency and, when deemed no longer productive, are rejected and discarded.”

A large language model can never replicate human intelligence, which, as Leo has noted, includes wisdom and other depths that are impenetrable to the machine. Yet in terms of raw computation and recall, my Claude app is already far more capable than I. Compared to it, I am a “retard.” Is it that hard to imagine a not-too-distant future in which an LLM in the employ of my insurer decides I should no longer receive medical care in light of my mental shortcomings?

Renouncing the R-word won’t forestall such a future, of course. That will take collective political action. And there are plenty of people who are perfectly polite in ordinary discourse, even as they pursue monstrous ends in politics or business. But each time we do use that word, we not only trample the dignity of some of the most defenseless people among us, but strengthen the technocratic paradigm that, left unchecked, could soon discard many or even most of us.

Nos remplaçants s’il y en a, et s’il leur arrive de penser à nous dans quelques siècles, n’éprouveront ni indignation ni colère ; ils ne seront plus concernés. Ils ressentiront probablement un vague dégoût, et surtout une immense perplexité. Les plus lettrés tenteront de la réduire par l’écriture d’énormes ouvrages, dont « Histoire de la décadence et de la chute de l’empire romain » reste un exemple classique. Un résumé simplifié des thèses de Gibbon expliquant la chute de l’Empire romain par le développement du christianisme, outre qu’il est convaincant et clair, présente l’avantage de pouvoir être prolongé sans difficulté par les thèses d’Auguste Comte sur le passage de l’état théologique à l’état métaphysique, dont l’unique fonction aura été de détruire. Le déclin de l’Occident trouve ainsi son explication naturelle dans la chute du christianisme initiée par le protestantisme, accomplie par le siècle des lumières. Nietzsche dit à peu près la même chose, en y rajoutant d’amusants effets spéciaux mettant en scène des saltimbanques et des aigles. Ce qui ne colle par contre plus très bien, c’est que les choses ne vont pas mieux en Asie ; le déclin démographique, dans les pays technologiquement les plus avancés — Japon, Corée, plus récemment la Chine — y est même encore plus rapide, au point que leurs populations risquent, à un terme pas si éloigné, de disparaître. C’est bel et bien la modernité toute entière qui s’autodétruit sous nos yeux incompréhensifs.

« Les choses tombent en morceaux ; le centre ne peut plus tenir / La pure anarchie est lâchée sur le monde » écrit Yeats en 1919, pressentant que, pour l’Europe, la guerre qui vient de s’achever n’aura été que l’annonciation d’autres désastres plus considérables. La guerre a donné naissance à la guerre, le nazisme a ouvert une porte sombre qui ne s’est jamais totalement refermée, les deux guerres mondiales n’ont fait qu’accélérer la décomposition des pays qui ont commis la folie de s’y engager. Un siècle après le poème de Yeats, le centre n’a pas tenu — et cela apparaît avec une évidence particulière dans le cas du centre politique européen, Bruxelles. En Belgique l’euthanasie, ouverte aux « personnes en souffrance psychique » depuis 2002, l’est aux mineurs depuis 2014. Quelques marges tiennent encore, mais l’une après l’autre les digues cèdent, et nous sommes submergés par cette « mer noircie de sang » dont parle Yeats dans le vers suivant.

English Translation

Test article

By Michel Houellebecq

France should be the next barrier swept away by this sea; it remains possible to avoid it, but hope is dwindling. For some time now, several years already, that I have been striving to fight against euthanasia, while the conviction grows in me that I am fighting a losing battle, I feel like I have played all my cards, and even started to cheat. One last time, I do not think it useless to recommend to those whose vote will have the force of law to reflect on the few philosophers who, over the centuries, have approved of suicide — it is even quite astonishing: “progressivism” sweeps away with contempt, with a wave of the hand, not only all existing religious traditions, but almost everything previous philosophers have thought; such arrogance, I think, has never before manifested in human history. But philosophies, unlike religions, speak mainly to the intelligence of the human being, and hardly reach what is essential in him. The Catholic religion, despite apparently some recent stirrings, has long been lagging behind in Europe, and I am not at the point of preferring an Islamic society, on the grounds that secular society deviates from moral law. But I am not sure I want to belong to a society that legalizes euthanasia; defending the West is fine, provided it deserves to be defended. It is enough to examine the arguments of the supporters of euthanasia to be overwhelmed by disgust, and that by force of disgust a moral insurrection is triggered; these arguments are actually summed up in a single one, which is dignity, but this word has been used so often, and in such a perverse way, that it has become difficult to grasp its meaning. Seen by supporters of euthanasia, the desire for dignity expressed by the dying person, as testified by loved ones, is generally expressed by phrases like: “He would not have endured becoming a vegetable.” The assertion would be more convincing if they could complete it like this: “He would not have endured becoming a vegetable, he would have preferred to become a corpse.” Let us add that the vegetable metaphor reflects a painfully pragmatic view of the human being. Ideally, a human being should move, perform acts, in short, lead an active life. And if that is definitely impossible, at least he should communicate, show himself capable of interacting, at least by speech, with the rest of society. The human is reduced to his use value, that is to say his initial value diminished by a coefficient of wear. It is hard to imagine a more direct opposition to human dignity in the sense of Emmanuel Kant, with the Kantian idea that humanity, in its own person as in that of others, must always be considered as an end, and never simply as a means. A first alteration had already occurred, and unfortunately it was on the occasion of the so justified fight against animal suffering, when the “antispeciesists” undertook to lead it in the name of the dubious notion of “animal rights,” when it would have sufficed to continue to heed the modest but incandescent, eternal, voice of compassion. With euthanasia it is no longer a matter of alteration, but of a plunge into the abyss. For Kant, for the thinkers of more naive centuries, human dignity was simply linked to the fact of being a man. We no longer see things the same way. Human dignity is altered in us, our life is in itself a process of alteration, and we must at every moment be ready to justify it in our own eyes, even in those of others (insofar as that makes a difference). For nearly two centuries, the specter of nihilism has haunted Western Europe. Now that’s it, here we are; we were not expecting nihilism in this form, it is neither dark nor twilight; it is rather colorful and cheerful. To picture it, one should not think of Dostoevsky, nor of Nietzsche, but rather remember a Simons store commercial (it is a Canadian clothing store chain) that was supposed to depict a happy euthanasia. It was a dignity to scream about.
Filmé au bord de la mer, il y avait des vagues et du violoncelle, un grand repas convivial avec du cheesecake et des éclats de rire, la chose était titrée « Tout est beauté », la future morte était jeune, émouvante et sympathique, il s’agissait d’une artiste, on la voyait dessiner des formes dans le sable avec un bâton. Simons a retiré son clip, il y avait eu sur Internet trop de commentaires sarcastiques se moquant de l’utilisation des codes de l’industrie du luxe pour promouvoir l’euthanasie. En effet, on se serait cru dans une pub Chanel ou Saint-Laurent.

Let’s dig a little into this matter of dignity. Back when I was researching the Vincent Lambert case, I remember a “white paper” on the operation of EVC-EPR centers, those created by the Kouchner law, and in which Vincent Lambert should have found his place if the medical system had worked properly. One anecdote struck me, that of a woman who had been silent for years, who suddenly started talking again during an unexpected visit. While a doctor expressed his astonishment, because for years he had tried in vain to establish contact, she replied: “What you were saying wasn’t all that interesting”. A very compromised state of health can excuse certain lapses in politeness, but still, it’s a lesson worth remembering: if people don’t talk to you, sometimes it’s because they have nothing to say to you.

Anyone who has written, or even simply tried to write, knows that it is sometimes possible — it’s hard to explain, but it’s true — to express in writing realities inaccessible to speech. And anyone who has actually written knows something else, something sadder: what you’ve written will only be a faint trace of what you dreamed of writing. Even someone as monstrously productive in literature as Balzac admitted it: the books you’ve written are less beautiful than those you only dreamed of. Speech is only a fraction of writing, which itself is only a fraction of inner life. Reducing a man’s mind to his oral communication skills is simply stupid.

If you look at things from the angle of morals, to behave with dignity would be to adopt, in the face of life’s sufferings and sorrows, an attitude of calm, restraint, stoicism. Dignity would, in short, be little different from emotional modesty; which already gives reason for suspicion. If modesty is in all cases a rather shady feeling, a bit too associated with shame, emotional modesty is, of all the forms it can take, by far the most toxic. I’ve heard the “dignity” of victims of this or that tragic news story praised so much in the media that I’ve come to take a dislike to the word dignity. In the face of great suffering, the healthiest attitude is obviously to cry, to scream, to moan, to beg for pity from the deity or from other people. The stoic is basically just a theoretical puppet, devoid of all plausibility, and stoicism a philosophy best left unmentioned.

It’s not only, I realize with surprise, on the sexual level that we are the opposite of the baba cool years that marked my youth. When I was a teenager, it was fashionable to criticize the saying “boys don’t cry”, and instead to encourage boys to freely express their emotions. The significance of this saying had, moreover, been greatly overestimated: literary accounts clearly show that knights of the Middle Ages shed tears without restraint at the death of their comrades-in-arms; it was only from the beginning of the 20th century, and especially in Anglo-Saxon countries, that the injunction to modesty took hold, at the same time as the choice to hide death, and for the same reasons.

Half a century after the baba cool era, everything has changed, and it’s no longer just men who must hold back their tears; women, preferably, too. With so much dignity, with so much modesty in showing one’s emotions, others come to suppose that you hardly feel any, and that they can quietly go back to their own business. Dignity, in the end, has only one use: to legitimize the constant practice of the most perfect selfishness. It’s a considerable use.

La pudeur, version plus explicit of dignity, has other even more poisonous consequences when it no longer concerns only emotions, but attacks the physical body — and this is something much more serious, much more deadly and heavier than sexual modesty. Let dignity speak. Is it really modest and really dignified, when one is so close to being a vegetable, when one is physically so diminished, to appear in public? To show oneself, even, to anyone? Is it really modest and really dignified, ultimately, to exist?

Now that’s it, you are in the pipeline, you are ashamed of your own existence, and euthanasia awaits you around the corner. I, who have so often amused myself by mocking Nietzsche — and I couldn’t help myself this time again, he’s so funny with his mustache — I would still like to pay tribute to him by quoting these lines from the Gay Science:

“Who do you call bad? — The one who always wants to make others feel ashamed.

What do you consider most human? — To spare someone shame.”

We are, it’s painful to say, perhaps no longer quite human. After a detour of several millennia, the West seems to have returned to that ancient animal wisdom which drives, in almost all social species, the sick animal to move away from the tribe to die alone — knowing well that it has no compassion to expect from its fellows, that it is more likely to be, like the birds of Thomas Mann in The Magic Mountain, sent off with pecks. We had long believed ourselves to be a tribe of a higher order; we were mistaken, say the animalists, and this return to animal law, here’s the strangest thing, should be considered as a progress. What is established in any case is that progressivism functions absolutely like a ratchet mechanism. When a “societal advance” (abortion, death penalty, same-sex marriage, IVF, surrogacy, anything) has occurred, it is out of the question to go back, no one thinks of it. This assumption is antidemocratic: what one law has done, another law can undo; at least that’s the idea I have of the law; but it allows us to identify progressivism for what it really is: a destiny.

One may be right to think that it is vain to fight against destiny, and that every tragedy must go to its end. I can’t help but think that by asking for its citizens access to euthanasia, it is its own euthanasia that France is asking for. People have been surprised that I am hostile to this bill, even though I have often been labeled with a strange neologism: I would be a deprimist. Let’s admit it. It is true that I have worked to scrutinize the symptoms of Western suicide, the rise of nihilism; but I do not recall ever rejoicing in it. We are entering a world where it will be easier to die; I would have preferred a world where one could live.

New York’s proposed Medical Aid in Dying Act threatens to undo this presumption in favor of lifesaving, especially for people with disabilities such as me. This month, the bill passed in a vote of 81 to 67 in the Assembly, the lower chamber of the state legislature. It is now on its way to a vote in the state Senate.

If the Empire State joins the 10 states (and the nation’s capital) that have made assisted suicide legal, it will be adding killing to the options available in doctors’ toolkits. Given my own brushes with death over my 34 years — and those moments of staring into the suicidal abyss as a result of depression associated with my condition — I pray Empire State lawmakers take a step back, and rethink.

This isn’t, and shouldn’t be, a partisan issue. Just last year, John Carney, then the Democratic governor of Delaware, vetoed a similar bill that had passed the state’s General Assembly. In 2012, when Massachusetts voters re-elected President Barack Obama by a whopping 23 points, they also rejected a ballot measure to legalize physician-assisted suicide.

In Britain, former Labour leader Jeremy Corbyn bucked his party to vote against legalization, while former Prime Ministers David Cameron and Rishi Sunak broke with their fellow Tories to support it. Republicans may be more against legalization than Democrats, but Democrats’ long tradition of protecting the vulnerable should militate against Empire State lawmakers passing this bill.

The bill, a mere 12 pages long, is deceptively enticing. At face value, it requires two doctors to sign off on a request for lethal drugs by a patient of sound mind with six months or fewer to live, with a diagnosed terminal illness. The bill proposes, without using such language, to offer those wracked by painful, terminal illness “death with dignity” on their own terms.

Suggested reading

Test article

By Alexander Raikin

Death with dignity is a real thing — many ancient cultures speak of it. In the Jewish religion in which I was raised, a good death is considered a kiss from God. Dying well is likewise an art in the Catholic faith I adopted as an adult. But a good, dignified death cannot come at the hands of doctors helping patients dispatch themselves. It cannot serve the cause of health insurers trying to save a buck. Still, any opponent of the legalization of physician-assisted suicide has to grapple with the fact that the demand for it is there for a reason.

I was born with a recessive genetic neuromuscular condition called nemaline myopathy. Over the years, it’s developed to the relatively stable point where I use a portable ventilator to breathe — hence, my blacking out last September — and a motorized wheelchair to get around. I often require assistance with basic tasks. I’m not terminal — at least, not without taking into account that life itself is terminal, for all of us. But many times, my own body can feel like a straitjacket, and that’s without the physical pain that surges from time to time.

I don’t want to die, and God willing, I’ve got another couple of decades left, at the very least. Under the law as proposed, I wouldn’t be eligible, all things being equal. But all things aren’t always equal. Eighteen years ago, bedridden for a month after major back surgery, I wished more morphine than was necessary for pain relief had been available to me. Watching my late grandfather wasting away in his last six years in a hospital bed at around the same time, I could and still can empathize with those who favor medical aid in dying.

For others, such existential moments can tip into a yearning not to exist — to escape it all.

Which is, of course, the point. If no one wanted physician-assisted suicide, there’d be no reason to make or keep it illegal. But there is such demand. Yet New York would go down a very dark moral path by enabling doctors to accede to such requests, even — as of now — in the extremely limited circumstances of terminally ill patients with six months or fewer to live.

The way the bill is drafted is itself prone to abuse, lacking the necessary safeguards to prevent nonconsensual physician-assisted suicide. A lot has been made of abuses in other countries, such as Canada and the Benelux region, where the category of people approved for suicide-by-doctor has steadily expanded to include the mentally ill, those with autism and ADHD, even teenagers.

The problem is that no safeguards could possibly be adequate. Even with the most tightly drafted laws, patients and people with disabilities are likely to face subtle forms of coercion (“The treatment would be difficult and costly for your family; there is, of course, another option…”). Equally troubling is the way in which legalized euthanasia and assisted suicide twist and distort the medical profession’s oldest commitment, turning physicians into angels of death.

True, the principle of primum non nocere (“first, do no harm”), to which doctors are bound, has on occasion been reinterpreted such that “harm” is taken to include permitting a patient to suffer. At times, we allow medical care or nutrition to be withdrawn, despite the certainty of death. But the trouble is that allowing doctors to help their patients kill themselves means that killing now becomes a legitimate medical option.

My situation as someone with serious physical disabilities may be unusual. But most everyone has dealt with the byzantine bureaucracy of insurance companies and medical billing. Do we really want to make physician-assisted suicide a legitimate form of “treatment” in end-of-life cases? We bemoan the fact that people nowadays have fewer friends, or even close family members. Do we really want to make it so that there’s an “out” to the natural burdens of familial love? Or to mere loneliness?

I’m lucky to have a family and friends who love me. But others aren’t so fortunate, and even my family, by the natural way things go with time, won’t always be around. In medical dramas like Grey’s Anatomy or The Pitt, the medical profession is portrayed as valiant teams of heroes coordinating to save lives — and, don’t get me wrong, plenty of doctors, nurses, phlebotomists, and radiologists are heroic. But reality is far more chaotic and disorganized.

If not for my constant vigilance at my recent stint in the emergency room last year — the price of which was not sleeping for nearly the entire two days I was under observation — I’d have been administered several painful antibiotics I didn’t need, received precious little nutrition, and ended up with a tracheostomy in my windpipe. And that’s with doctors having no right to kill any patient. Let them do that — legally? You can bet death will become an easy option.

Suggested reading

Assisted dying killed my family

By Andrea Dixon

Advocates of physician-assisted, when not resorting to subterfuge, insist that the terminally ill who want to live out their remaining days should be able to do so. So what differentiates them from those who advocates say should be allowed to die? Pain, physical or spiritual. And don’t we all suffer pain? Aren’t we all terminal? Six minutes, six days, six weeks, six months, six years, six decades — one day, the curse of Adam will catch up with us all. I’ve lost friends to tragedies who I thought would live 100 years.

Simply put, we don’t know when our time is. If that’s the case, then the logic of assisted suicide leads inevitably to the conclusion that those with doctor-approved expiration dates are living lives not worth living. Lives unworthy of life, as the Nazis referred to people with disabilities when they set out to exterminate us with their Aktion T4 program.

A life not worthy of living. Well, I’ve heard that before. From peers, from rivals, sometimes from myself. I haven’t been suicidal in a good number of years, but I can’t say that about my teens and early 20s. I’ve had my fair share of heartbreak and physical pain that might have crushed many. Yes, no one wants to end up like Tithonus, locked away to wilt and fade while still breathing. But neither should the state of New York give reason for loved ones to abandon the frail. I’m one of the lucky ones. I fear for a world in which life is cheap.

It’s notable that some New York lawmakers are trying to push the bill in the wake of the death of Pope Francis. The late pontiff was especially vociferous in decrying what he labeled “throwaway culture,” a culture of waste that most afflicts “children, the elderly, the needy, and the disadvantaged.” Euthanasia epitomized that throwaway culture for Francis, and should New York enact the Medical Aid in Dying Act, the trend would only intensify.

The New York Senate must vote down this charter of death. Failing that, it would be an act of supreme political courage for Gov. Kathy Hochul to veto it. As a young man with disabilities — albeit ones that, with assistance, would still allow me to live a full and familial life — I fear what this state should become if the suicide-by-doctor becomes law. All New Yorkers are imperiled when the lives of the most vulnerable are rendered cheap.

He had to do something. So he went to the courts. The legal claim he filed on that frigid winter day would put Wade on a quest no father should have to face: saving his daughter’s life from a Canadian health system that at times appears more committed to delivering death than protecting health. By taking legal action, he managed to delay Marge’s death for a while. But he is set to lose the battle.

Wade and Marge aren’t the real names of this story’s subjects. The case is under a Canadian publication ban issued by a provincial court in Alberta, leaving Marge’s family reluctant to speak on the record. Yet with the pro-euthanasia Liberals re-elected to power in Canada and assisted-suicide legislation swiftly clearing obstacles in Britain and New York state, among other jurisdictions, their story must be told: for it highlights the slippery-slope expansion of the categories of patients deemed eligible for suicide-by-doctor, once the practice is legalized.

After the January notice came the details. The last physician to assess her for assisted suicide, a family doctor practicing with the Alberta Health Services (AHS), took fewer than 24 hours to review and approve her application. And although the neurologist treating her for fatigue and pain assessed her as “normal”, another family doctor, unknown to her parents, declared her to be terminally ill. The clinic at which this family doctor practices referred UnHerd’s request for comment to AHS, which told UnHerd that “as this is before the courts, we are unable to provide comment”.

“She tells us that she’s getting [Medically Assistance in Dying], and of course we freak out”, Wade tells me. “I was new to MAiD. I didn’t know anything about it.” He describes his daughter, Marge, as an intelligent young woman. He loves her, and he was saving money for her to be independent, to move her from the family home to her own apartment. She was healthy, but convinced she was sick.

Her only diagnosed conditions were autism and ADHD, which made it difficult for her to keep in touch with her friends during Covid lockdowns or to hold down a job. Her life was nocturnal and online, and that worried him, as did the sort of online peer pressure that bears down especially on younger women. Wade says: “For the last eight years, she has spent a lot of time online researching medicine and adverse medical conditions”. She slept through the day and stayed up most nights until 4 a.m. or later as she accessed “online support groups and chat rooms with other people who share her sickness”.

Suggested reading

The cruelty of Canada's euthanasia policy

By Lionel Shriver

Canada has become a warning light for the limits of enforcing safeguards for euthanasia. Even though hundreds of reported violations of Canada’s criminal law on euthanasia were never fully investigated by authorities, Marge’s story is different. She has thus far refused to make public the diagnosis on which she based her application for suicide. Her father, however, insists that it’s her autism that has caused to her become fixated with being sick — terminally so.

In Canada, intellectual disabilities or mental illness alone are no reason for people to receive MAiD. That’s unlike the Netherlands, where at least five people with intellectual disorders younger than 30 cited autism as their primary motivation for euthanasia. Canada is supposed to be different — at least, until 2027, when the country will expand the law to approve assisted-suicide requests for cases of mental illness alone.

As it is, to qualify for euthanasia in Canada, you need any two physicians or nurse practitioners to say you meet the eligibility requirements. You must be over 18 years of age, mentally competent, eligible for health care, and have a “grievous and irremediable” physical illness or disability. Marge’s autism, her parents have argued in court, means that his daughter “is vulnerable and is not competent to make the decision to take her own life”.

Suggested reading

The assisted-dying lobby has already won

By Kathleen Stock

It was 2021 when Marge first filled out the form — without telling her parents — asking to die. AHS, the public health-care system, connected her with two physicians. Although one physician deemed her eligible without any diagnosed physical symptoms, according to Wade, the second denied her application, presumably because she had no terminal illness. She seems to have only met some of the requirements, although it is impossible to know for sure without access to her MAiD assessment. Alberta’s policy was that in the case of a tie, the suicide would not proceed.

But Marge was determined.

In 2022, she went doctor-shopping. She found another physician, an Alberta family practitioner, who intervened and supported her (their clinic didn’t reply to UnHerd’s request for comment). Unknown to the family, this doctor signed a change in her “Goals of Care Designation”, which is the medical standard used in Alberta to indicate how severely ill someone is. The doctor switched it to the most extreme category, which in some Canadian provinces indicates the likelihood of imminent death; that was almost three years ago.

Suggested reading

Assisted dying killed my family

By Andrea Dixon

The following year, in 2023, she applied for assisted dying a second time. Once again, the two physicians consulted disagreed. (The clinics at which these two practice didn’t reply to UnHerd’s request for comment; AHS declined to comment, citing the court case.) This time, however, the so-called MAiD navigator, who sherpas patients through the process, connected Marge with a third doctor as a “tiebreaker”. The chosen physician was the same one who had approved Marge’s MAiD application the first time, and did so again, within 24 hours.

It was only then that her parents found out from Marge that she had been approved for assisted suicide. Her parents pushed back. Tempers flared. And the MAiD navigator claimed that Wade was a “safety risk given his threats” fewer than two weeks before she was set to die.

Her father couldn’t understand how any doctor could think Marge was qualified to die. “I thought MAiD was for, like, you’re dying anyway. So, we’ll just speed it up because you’re suffering. That’s what I thought it was for”, he tells me. “And I’m thinking, well, how could this be for Marge?” So, the day before her “MAiD provider” was meant to pay a final house visit, when a physician and a nurse would bring the lethal but now routine injection of a sedative, a coma-inducting agent, and a neuromuscular tranquilizer, Wade filed a last-minute court challenge. He claimed that Marge did not have a “grievous and irremediable medical condition”, that her only diagnosed illnesses were mental, not physical, and that her second tie-breaking assessor was not independent.

Suggested reading

'Why did Canada help my brother die?'

By Flo Read

That day, an initial judge granted the temporary injunction to block physicians from ending the life of Wade’s daughter. But then the case went to trial.

This was the first time anywhere in North America that a legal assisted suicide for a non-terminally ill patient, approved by any two physicians, was stopped by a court, at least in its preliminary stage. The judge, Justice Colin Feasby, of the Court of King’s Bench, Alberta, ruled that Marge’s father had a reasonable cause of action that the correct protocols around assisted dying weren’t followed. Marge had no terminal illness. Neither of the MAiD assessors appeared to be experts on Marge’s autism. And the independent assessor appointed as tiebreaker wasn’t, either.

Once it came to ruling on the substance of the dispute, however, the judge wouldn’t consider whether Marge qualified for assisted suicide; no evidence was accepted on even naming the condition for which she was approved. Any criminal prosecution, the judge ruled, could only happen after Marge is dead: “Parliament has put its trust in doctors and nurse practitioners, and it is not for this Court to second guess that choice.”

In Britain, Kim Leadbeater — a member of Parliament whose proposal to legalize the practice is set for a critical vote in the House of Commons this May — recently claimed that “there would be an injunction” by the parents of a person with a learning disorder if their child was choosing to die for the wrong reasons. In response to this, Wade says, “I know it won’t work”. When his injunction was thrown out, the judge ruled that his doubt didn’t matter. “As a court”, Judge Feasby held, “I can’t go second-guessing these MAiD assessors … but I’m stuck with this: the only comprehensive assessment of this person done says she’s normal”.

The ruling was no surprise. Since the Supreme Court of Canada decriminalized euthanasia, scarcely any judges in Canada have found problems with euthanasia safeguards. Rather, past rulings reinforced that MAiD wasn’t expansive enough. The 2019 Truchon v. Canada case expanded the practice to include nonterminal illnesses. Failing those who weren’t dying, the ruling said, would be tantamount to discrimination against people without a terminal illness.

One of the two plaintiffs, Jean Truchon, a 51-year-old euthanasia advocate with spastic cerebral palsy, requested to die because he was suffering from a severe disability that prevented the use of his arms. Yet Truchon also told a friend that he would have chosen to live if he received adequate support at home.

Suggested reading

How France lost her dignity

By Michel Houellebecq

The Trudeau government chose not to appeal the decision, despite opposition from virtually every prominent disability-rights organization in Canada.

In Marge’s case, too, Canadian disability groups mobilized against the ruling; they agreed with Wade that disabilities shouldn’t be compared to a terminal illness. At stake is a future where disability supports are neglected for immediate and cheaper death-on-demand, only for those whose disabilities are too profound or serious for the state to support.

In September, some of the largest Canadian disability groups launched a constitutional challenge against euthanasia based on nonterminal disabilities. The suit claimed it is an “appalling injustice” to offer suicide just on the grounds of disability. “It is not just wrong”, says Krista Carr, the executive vice president of Inclusion Canada, in an email to me. “It is discriminatory and violates our most fundamental rights.”

Suggested reading

What I've learned about suicide

By Julie Burchill

Yet even if that constitutional challenge triumphs, it will be too late for Wade. He says he has spent more than $150,000 in legal fees, half of it through credit-card debt; a further legal appeal would have to come from money he doesn’t have. But the expense did not bother him: “This is just money. We can make it. We can’t go to the store and buy another Marge. I don’t regret it at all.”

His legal challenge failed, but it restarted Marge’s assisted-dying process from the beginning. He tells me she had applied again. Meanwhile, in April 2024, Wade appealed the court’s decision, which delayed any further assisted-suicide approval until October that year, when his appeal case was to be heard. But Marge began starving herself that June, so he dropped the appeal a week later.

More recently, I received another message from Wade. Marge’s third application to die had been approved. Wade waits, angry and terrified, to receive the scheduled appointment of his daughter’s death. It could happen anytime.

Labour MP Kim Leadbeater — author of the private member’s bill to be introduced next week — called the current law “cruel and unjust”, as though talking about the deliberate withholding of pain relief, rather than a failure to legalise state-sponsored killing. Andrew Mitchell echoed the charge, decrying “the cruelty and suffering inflicted by the blanket ban”. Before long, claims about cruel laws had escalated to insinuations about cruel people, with Kit Malthouse describing himself as standing with the “millions of people who are on the side of compassion and humanity” — thereby making plain what he thought of anyone who disagreed with him.

At first, Baroness Ruth Davidson’s reaction seemed to win the prize for the most queasily syrup-laden, describing Leadbeater’s success at procuring a vote as “amazing news” and thanking her parliamentary colleague with online kisses. But then came Keir Starmer, with the air of someone who was confident listeners would understand the personal difficulty of saying no to a national treasure, revealing that he had “made a promise to Esther Rantzen… that we would provide time for a debate and a vote on assisted dying” and that he was “very pleased… to be able to make good on the promise”. To those previously unaware of a particularly close relationship between Starmer and Rantzen, the revelation that the former host of That’s Life! held such power at the heart of government came as a bit of a shock.

This is not just an allergy to lazy heartstring-plucking. Grizzled veterans of the gender wars have been here before: watching aghast as words like “kindness” and “compassion” are bandied about by various earnest-faced, honey-voiced people to justify what only a few years previously would have looked like obvious medical malpractice. Recent history tells us that institutions are often powerless to stay upright in the face of such a pillowy, feminine-coded assault.

And so it now looks likely we are to become a nation where doctors — quite literally — can kill you with kindness. We are officially so frightened of death and its accompanying messes that we have fallen for the imaginative lure of a nice clean finish, and to hell with whatever changes in the social fabric will result. Polls consistently indicate that a majority of the public is in favour of legalising assisted dying, and the medical profession, previously mostly against, seems to be shifting to a more evenly split position. The Prime Minister himself is for it and so are many of his MPs. We might have collectively agitated for improved palliative care instead, but it wouldn’t have provided quite the same reassuring phantasm of control.

Deep down, everybody knows that the introduction of assisted dying legislation will create a new tier of vulnerable people who decide to jump before nature pushes them, and who would not have done so otherwise. Indeed, there are already helpful philosophers arguing that it would be right for them to do so. Poverty, undue family influence, and anxiety about being a burden to others are bound to become contributory factors in decision-making; and whatever the outcome, a tormenting sense of personal responsibility about whether to go or not will be added to an already heavy mental load.

But it seems that most of us don’t care much about this, perhaps assuming unimaginatively that it will never be us. Protests from disabled people, reasonably worried about the Overton window shifting to frame them as expendable, also seem to be falling on strategically deaf ears. Instead, politicians in favour of a change in the law dramatically beg us to focus on the distressing impacts of potentially lengthy investigations for witnesses of suicide under present circumstances, as if this were the most pressing problem in the grand scheme of things. Wealthy proponents tend to talk as if their inability to die exactly where and when they would like is a terrible injustice to which we can all relate. (See, for instance, Rantzen complaining that “I will probably not be given the chance to die in my favourite place, my New Forest cottage”.)

Suggested reading

Assisted dying killed my family

By Andrea Dixon

Supporters also tend to insist that there is no potential for a slippery slope here: that the procedure will only ever be available to those of sound mind who are indisputably terminally ill. The trajectory of similar legislation elsewhere suggests otherwise. Canada’s law has dispensed with the need for a terminal diagnosis provided you are in an “advanced state of decline that cannot be reversed” and “experience unbearable physical or mental suffering… that cannot be relieved under conditions that you consider acceptable”. Both Belgium and the Netherlands euthanise those with psychiatric disorders as long as their suffering is judged “unbearable”, and Canada has legalised similar measures, though recently delayed implementation until 2027.

But never mind other countries, just look at our own. Here again, those familiar with gender medicine shake their heads ruefully, knowing that what starts life as a limited set of measures intended to help a small number of people can blow up years later, unexpectedly, and be demanded by tens of thousands. All that is required is a few internet missionaries arriving wherever the virtual equivalent of Iona is, and exponentially converting heathens to their strange new religion.

Consider that back in 2004, the Gender Recognition Act was passed to respond to the stated needs of a small number of adults quaintly known as transsexuals. Few would have predicted that 15 years later, activists online would be venerating a soul-like object called a “gender identity”, convincing large swathes of young people that they had a badly fitting body that required hormonal and surgical realignment to fit the inner world. But here we are. Those relying on the common sense of doctors to protect the public from passing destructive fads in future might find a reality check in the British Medical Association’s ideological rejection of the Cass Report.

On the face of it, medico-legal language about “unbearable suffering” has a satisfying air of rigour about it, as if diagnosing such a thing were no more complicated than taking someone’s temperature or running a test in a lab. In practice, what counts as unbearable — or indeed even as suffering at all — can differ from person to person, and is also strongly influenced by surrounding social norms about what adults are expected to be able to tolerate without much complaint. Physical pain and suffering are not the same thing. There can be unbearable suffering without pain, and vice versa.

What suffering is, in a species like ours with its capacity for higher order meaning-making, is intrinsically connected to the narratives we tell ourselves: about which situations are tolerable, and which are not; about what pain is for, exactly, and what lessons it can teach us; about what level of mental attention it is respectable or otherwise desirable for an individual to expend, fretting about his problems as opposed to repressing the feelings or looking away.

Those narratives are to some degree up to the individual, but significantly influenced by society’s standards too. And standards can change. Our ancestors put up with things the modern self would typically find impossible to bear. It is said that soldiers at Waterloo got back in the saddle immediately after limb amputation. In the United States in 2018, people were trying to bring emotional support peacocks onto planes. This is not to make light of contemporary experiences of agony — we are where we are, and can’t get out of there by stern self-talk or wishing — but only to put it in some context.

With this in mind, it is myopic to think that a law legalising euthanasia won’t itself eventually have a narrowing effect on what kinds of distress are considered tolerable. Indeed, a quick look at current internet trends contains useful intelligence for writers of dystopian fictions set in the near future.

More from this author

Keir Starmer's moral vacuum

By Kathleen Stock

People who treat chronic illness as an identity of sorts are a huge social media ecosystem: finding each other with hashtags such as #spoonie, #fibromyalgia, #chronicillness and #PoTS, documenting their daily symptoms, and offering each other public support. Most of them are women, and many feel the medical profession offers them nothing but scepticism and contempt. Whether or not these people are indeed incurably ill, the more important point for current purposes is that a lot of them clearly believe they are, and find their own suffering unbearable. Locked in apparently interminable physical dysfunction and with no agreed cure in sight, one doesn’t have to work too hard to imagine a world where assisted dying seems to them the only exit available, with added opportunities to record the whole thing on TikTok channels.

Do we really know for sure that relevant institutions, weak as they have already been shown to be, would be able to see off impassioned appeals from such a cohort for kindness in helping to relieve them from the burden of living? If we Brits look with horror on Dutch doctors legally euthanising a 29-year-old woman on grounds of “chronic depression, anxiety, trauma and unspecified personality disorder”, it is perhaps only because our own old-fashioned ethical standards have yet to catch up.

Grasping for certainty, we might assume that what counts as a disease or an illness, at least, is purely physically determined — but here, too, things are not so clear-cut. The late philosopher Ian Hacking wrote perspicuously about the way that some illnesses are “interactive kinds” showing “looping effects” — meaning that the public’s grasp on the existence of a particular illness, and what count as medically accepted conditions for its diagnosis, can influence the acknowledged prevalence of the illness in question. This in turn imperceptibly shifts the diagnostic criteria over time. For both reasons, the pool of patients can suddenly markedly expand, and especially where there is no easily ascertained underlying physical cause.

As people begin to apply a set of diagnostic criteria to their own lives, and interpret their physical experiences within that frame, hundreds of thousands of people can come to count as patients of a given syndrome, whereas at one point only a few did. Hacking’s prescient examples included multiple personality disorder (now known as dissociative identity disorder) and autism. There’s every sign that chronic disorders such as fibromyalgia and postural tachycardia syndrome (PoTS) are going the same way, with added internet rocket fuel.

There is a way of reading this argument that implies many or even most such self-diagnoses are bogus. Once again, though, this is too simple-minded an approach. Clichéd as it has become to say it, the mind and the body are connected. The habitual framing of a particular bodily sensation as having pathological origins can have knock-on physical effects, building up a prison of real and distressing symptoms over time. Only hubristic doctors feel able these days to pronounce with certainty about whether a given symptom is “purely psychological” or not. From a distance, most of us can see the shape of the problem at scale — the strong effect of transitory cultural influences upon bodily and mental resilience across a population — but at the micro level, treating individual patients, it is usually therapeutically irrelevant information.

More from this author

The god delusion of secular liberals

By Kathleen Stock

Given these treacherously shifting sands, might we at least collectively fight off the idea that a diseased or suffering life has only whatever subjective worth the individual patient places upon it — and that if the answer is “none”, it is time to put an end to things? It seems we have a big job on our hands. One problem is that, perhaps subconsciously craving some kind of hero’s journey in a boringly meaningless world, many of us have turned the quest for physical optimisation into a public identity, with an accompanying sense of failure once inevitable decrepitude sets in.

Broadsheets now tell you how to reduce your “metabolic age” through exercise and changes to diet; dedicated watches track every vital function, spawning thousands of everyday acts of neurotic checking for signs of imminently waning powers; ageing actresses’ faces are cut up and remoulded to hide signs of cellular decay. There is even a “Don’t Die” movement, whose exponents actually hope to achieve immortality through things such as fasting and temperature-controlled mattresses. Though nobody ever explains what all this frenetic body-hacking is for, exactly, Gen Z have obviously received the memo, drinking less and exercising more than previous generations but without much added happiness to show for it. When they too eventually arrive at old age and disease, it will be hard to convince them that the failure of their bodies is not a personal disaster after a lifetime spent hearing the opposite.

In effect, this is the bastardised version of “dignity” we seem to have inherited: one where you only count as having it if all your bodily functions are currently under control. Dignity in dying is a concept we hear a lot about — indeed it’s the name of one of the most prominent organisations campaigning for a change in legislation — and yet dignity is also a culturally porous entity, changing its shape according to prevailing norms and ideals. The Enlightenment philosopher most famous for representing dignity as a universal human value was Immanuel Kant, but he would be horrified at the idea that its possession — or not — somehow depended on your contingent physical state. Yet when a cross-party group of MPs dramatically complains that, under present legal conditions, “so many are forced to die without dignity”, it seems likely this is exactly what they mean.

Nobody relishes the prospect of the opposite. I once worked in a nursing home and a lot of my time there was spent dealing with incontinence: not much fun, either for the resident or the carer. Still, in the right sort of setting, both become accustomed and can look past it to more important things. The venerable Kantian-inspired ideal is that in periods of frailty, you can retain dignity in spite of what is happening to you physically; and this is recognised when carers look after you in non-instrumental, respectful ways that acknowledge your intrinsic human worth.

From this angle, the legalisation of euthanasia does nothing to increase dignity but provides new ways to undermine it, and especially in the present non-ideal context where social care is already underfunded and overstretched. If by “people should be allowed to die with dignity” politicians really mean “people should be put out of their misery” — and where that misery is a direct function of inadequate and demeaning care standards — they should say as much, explicitly, and not hide behind sentimental language designed to make them sound like moral heroes.

This week it was reported that 38 Labour MPs, including 13 in government roles, are already backing demands for the scope of the forthcoming bill to be extended; to cover not just the terminally ill, but the more vaguely construed “incurably suffering” as well. It seems that despite all the denials, a slope beckons after all; though those concerned still seem to think they are in control of the descent. It is ironic that, for a set of people so apparently keen on the value of personal autonomy, politicians defending the legalisation of euthanasia display a naïve trust that the world will always collude with them to maintain sufficient defences against unethical slippage or abuses of power.

They talk as if medics will always make consistent decisions about whether stated legal conditions have been met, and patient pressure groups or ideological movements will never form to distort their judgements; as if subsequent language users are bound to understand vague concepts like “unbearable” or “incurable” in just the same way as we do now; as if distressing illnesses presently affecting a relative few can’t metastasise in future. They are happy to talk simplistically of kindness and cruelty as if they are in primary school, while outsourcing responsibility for maintaining adequate guardrails to more grown-up sounding people and things: doctors, bioethicists, legal definitions, forms signed in triplicate.

In short, although with their babyish words politicians imply that a personal choice about whether and when to die is disconnected from the decisions and actions of other people, it is not, and it never will be. A big clue is in the term “assisted”. If we had any sense as a society, we would decline the invitation to set foot on their big shiny playground slide, but I won’t be holding my breath.

***

This article was first published on 15 November, 2024.

Labour MP Kim Leadbeater — author of the private member’s bill to be introduced next week — called the current law “cruel and unjust”, as though talking about the deliberate withholding of pain relief, rather than a failure to legalise state-sponsored killing. Andrew Mitchell echoed the charge, decrying “the cruelty and suffering inflicted by the blanket ban”. Before long, claims about cruel laws had escalated to insinuations about cruel people, with Kit Malthouse describing himself as standing with the “millions of people who are on the side of compassion and humanity” — thereby making plain what he thought of anyone who disagreed with him.

At first, Baroness Ruth Davidson’s reaction seemed to win the prize for the most queasily syrup-laden, describing Leadbeater’s success at procuring a vote as “amazing news” and thanking her parliamentary colleague with online kisses. But then came Keir Starmer, with the air of someone who was confident listeners would understand the personal difficulty of saying no to a national treasure, revealing that he had “made a promise to Esther Rantzen… that we would provide time for a debate and a vote on assisted dying” and that he was “very pleased… to be able to make good on the promise”. To those previously unaware of a particularly close relationship between Starmer and Rantzen, the revelation that the former host of That’s Life! held such power at the heart of government came as a bit of a shock.

This is not just an allergy to lazy heartstring-plucking. Grizzled veterans of the gender wars have been here before: watching aghast as words like “kindness” and “compassion” are bandied about by various earnest-faced, honey-voiced people to justify what only a few years previously would have looked like obvious medical malpractice. Recent history tells us that institutions are often powerless to stay upright in the face of such a pillowy, feminine-coded assault.

And so it now looks likely we are to become a nation where doctors — quite literally — can kill you with kindness. We are officially so frightened of death and its accompanying messes that we have fallen for the imaginative lure of a nice clean finish, and to hell with whatever changes in the social fabric will result. Polls consistently indicate that a majority of the public is in favour of legalising assisted dying, and the medical profession, previously mostly against, seems to be shifting to a more evenly split position. The Prime Minister himself is for it and so are many of his MPs. We might have collectively agitated for improved palliative care instead, but it wouldn’t have provided quite the same reassuring phantasm of control.

Deep down, everybody knows that the introduction of assisted dying legislation will create a new tier of vulnerable people who decide to jump before nature pushes them, and who would not have done so otherwise. Indeed, there are already helpful philosophers arguing that it would be right for them to do so. Poverty, undue family influence, and anxiety about being a burden to others are bound to become contributory factors in decision-making; and whatever the outcome, a tormenting sense of personal responsibility about whether to go or not will be added to an already heavy mental load.

But it seems that most of us don’t care much about this, perhaps assuming unimaginatively that it will never be us. Protests from disabled people, reasonably worried about the Overton window shifting to frame them as expendable, also seem to be falling on strategically deaf ears. Instead, politicians in favour of a change in the law dramatically beg us to focus on the distressing impacts of potentially lengthy investigations for witnesses of suicide under present circumstances, as if this were the most pressing problem in the grand scheme of things. Wealthy proponents tend to talk as if their inability to die exactly where and when they would like is a terrible injustice to which we can all relate. (See, for instance, Rantzen complaining that “I will probably not be given the chance to die in my favourite place, my New Forest cottage”.)

Suggested reading

Assisted dying killed my family

By Andrea Dixon

Supporters also tend to insist that there is no potential for a slippery slope here: that the procedure will only ever be available to those of sound mind who are indisputably terminally ill. The trajectory of similar legislation elsewhere suggests otherwise. Canada’s law has dispensed with the need for a terminal diagnosis provided you are in an “advanced state of decline that cannot be reversed” and “experience unbearable physical or mental suffering… that cannot be relieved under conditions that you consider acceptable”. Both Belgium and the Netherlands euthanise those with psychiatric disorders as long as their suffering is judged “unbearable”, and Canada has legalised similar measures, though recently delayed implementation until 2027.

But never mind other countries, just look at our own. Here again, those familiar with gender medicine shake their heads ruefully, knowing that what starts life as a limited set of measures intended to help a small number of people can blow up years later, unexpectedly, and be demanded by tens of thousands. All that is required is a few internet missionaries arriving wherever the virtual equivalent of Iona is, and exponentially converting heathens to their strange new religion.

Consider that back in 2004, the Gender Recognition Act was passed to respond to the stated needs of a small number of adults quaintly known as transsexuals. Few would have predicted that 15 years later, activists online would be venerating a soul-like object called a “gender identity”, convincing large swathes of young people that they had a badly fitting body that required hormonal and surgical realignment to fit the inner world. But here we are. Those relying on the common sense of doctors to protect the public from passing destructive fads in future might find a reality check in the British Medical Association’s ideological rejection of the Cass Report.

On the face of it, medico-legal language about “unbearable suffering” has a satisfying air of rigour about it, as if diagnosing such a thing were no more complicated than taking someone’s temperature or running a test in a lab. In practice, what counts as unbearable — or indeed even as suffering at all — can differ from person to person, and is also strongly influenced by surrounding social norms about what adults are expected to be able to tolerate without much complaint. Physical pain and suffering are not the same thing. There can be unbearable suffering without pain, and vice versa.

What suffering is, in a species like ours with its capacity for higher order meaning-making, is intrinsically connected to the narratives we tell ourselves: about which situations are tolerable, and which are not; about what pain is for, exactly, and what lessons it can teach us; about what level of mental attention it is respectable or otherwise desirable for an individual to expend, fretting about his problems as opposed to repressing the feelings or looking away.

Those narratives are to some degree up to the individual, but significantly influenced by society’s standards too. And standards can change. Our ancestors put up with things the modern self would typically find impossible to bear. It is said that soldiers at Waterloo got back in the saddle immediately after limb amputation. In the United States in 2018, people were trying to bring emotional support peacocks onto planes. This is not to make light of contemporary experiences of agony — we are where we are, and can’t get out of there by stern self-talk or wishing — but only to put it in some context.

With this in mind, it is myopic to think that a law legalising euthanasia won’t itself eventually have a narrowing effect on what kinds of distress are considered tolerable. Indeed, a quick look at current internet trends contains useful intelligence for writers of dystopian fictions set in the near future.

More from this author

Keir Starmer's moral vacuum

By Kathleen Stock

People who treat chronic illness as an identity of sorts are a huge social media ecosystem: finding each other with hashtags such as #spoonie, #fibromyalgia, #chronicillness and #PoTS, documenting their daily symptoms, and offering each other public support. Most of them are women, and many feel the medical profession offers them nothing but scepticism and contempt. Whether or not these people are indeed incurably ill, the more important point for current purposes is that a lot of them clearly believe they are, and find their own suffering unbearable. Locked in apparently interminable physical dysfunction and with no agreed cure in sight, one doesn’t have to work too hard to imagine a world where assisted dying seems to them the only exit available, with added opportunities to record the whole thing on TikTok channels.

Do we really know for sure that relevant institutions, weak as they have already been shown to be, would be able to see off impassioned appeals from such a cohort for kindness in helping to relieve them from the burden of living? If we Brits look with horror on Dutch doctors legally euthanising a 29-year-old woman on grounds of “chronic depression, anxiety, trauma and unspecified personality disorder”, it is perhaps only because our own old-fashioned ethical standards have yet to catch up.

Grasping for certainty, we might assume that what counts as a disease or an illness, at least, is purely physically determined — but here, too, things are not so clear-cut. The late philosopher Ian Hacking wrote perspicuously about the way that some illnesses are “interactive kinds” showing “looping effects” — meaning that the public’s grasp on the existence of a particular illness, and what count as medically accepted conditions for its diagnosis, can influence the acknowledged prevalence of the illness in question. This in turn imperceptibly shifts the diagnostic criteria over time. For both reasons, the pool of patients can suddenly markedly expand, and especially where there is no easily ascertained underlying physical cause.

As people begin to apply a set of diagnostic criteria to their own lives, and interpret their physical experiences within that frame, hundreds of thousands of people can come to count as patients of a given syndrome, whereas at one point only a few did. Hacking’s prescient examples included multiple personality disorder (now known as dissociative identity disorder) and autism. There’s every sign that chronic disorders such as fibromyalgia and postural tachycardia syndrome (PoTS) are going the same way, with added internet rocket fuel.

There is a way of reading this argument that implies many or even most such self-diagnoses are bogus. Once again, though, this is too simple-minded an approach. Clichéd as it has become to say it, the mind and the body are connected. The habitual framing of a particular bodily sensation as having pathological origins can have knock-on physical effects, building up a prison of real and distressing symptoms over time. Only hubristic doctors feel able these days to pronounce with certainty about whether a given symptom is “purely psychological” or not. From a distance, most of us can see the shape of the problem at scale — the strong effect of transitory cultural influences upon bodily and mental resilience across a population — but at the micro level, treating individual patients, it is usually therapeutically irrelevant information.

More from this author

The god delusion of secular liberals

By Kathleen Stock

Given these treacherously shifting sands, might we at least collectively fight off the idea that a diseased or suffering life has only whatever subjective worth the individual patient places upon it — and that if the answer is “none”, it is time to put an end to things? It seems we have a big job on our hands. One problem is that, perhaps subconsciously craving some kind of hero’s journey in a boringly meaningless world, many of us have turned the quest for physical optimisation into a public identity, with an accompanying sense of failure once inevitable decrepitude sets in.

Broadsheets now tell you how to reduce your “metabolic age” through exercise and changes to diet; dedicated watches track every vital function, spawning thousands of everyday acts of neurotic checking for signs of imminently waning powers; ageing actresses’ faces are cut up and remoulded to hide signs of cellular decay. There is even a “Don’t Die” movement, whose exponents actually hope to achieve immortality through things such as fasting and temperature-controlled mattresses. Though nobody ever explains what all this frenetic body-hacking is for, exactly, Gen Z have obviously received the memo, drinking less and exercising more than previous generations but without much added happiness to show for it. When they too eventually arrive at old age and disease, it will be hard to convince them that the failure of their bodies is not a personal disaster after a lifetime spent hearing the opposite.

In effect, this is the bastardised version of “dignity” we seem to have inherited: one where you only count as having it if all your bodily functions are currently under control. Dignity in dying is a concept we hear a lot about — indeed it’s the name of one of the most prominent organisations campaigning for a change in legislation — and yet dignity is also a culturally porous entity, changing its shape according to prevailing norms and ideals. The Enlightenment philosopher most famous for representing dignity as a universal human value was Immanuel Kant, but he would be horrified at the idea that its possession — or not — somehow depended on your contingent physical state. Yet when a cross-party group of MPs dramatically complains that, under present legal conditions, “so many are forced to die without dignity”, it seems likely this is exactly what they mean.

Nobody relishes the prospect of the opposite. I once worked in a nursing home and a lot of my time there was spent dealing with incontinence: not much fun, either for the resident or the carer. Still, in the right sort of setting, both become accustomed and can look past it to more important things. The venerable Kantian-inspired ideal is that in periods of frailty, you can retain dignity in spite of what is happening to you physically; and this is recognised when carers look after you in non-instrumental, respectful ways that acknowledge your intrinsic human worth.

From this angle, the legalisation of euthanasia does nothing to increase dignity but provides new ways to undermine it, and especially in the present non-ideal context where social care is already underfunded and overstretched. If by “people should be allowed to die with dignity” politicians really mean “people should be put out of their misery” — and where that misery is a direct function of inadequate and demeaning care standards — they should say as much, explicitly, and not hide behind sentimental language designed to make them sound like moral heroes.

This week it was reported that 38 Labour MPs, including 13 in government roles, are already backing demands for the scope of the forthcoming bill to be extended; to cover not just the terminally ill, but the more vaguely construed “incurably suffering” as well. It seems that despite all the denials, a slope beckons after all; though those concerned still seem to think they are in control of the descent. It is ironic that, for a set of people so apparently keen on the value of personal autonomy, politicians defending the legalisation of euthanasia display a naïve trust that the world will always collude with them to maintain sufficient defences against unethical slippage or abuses of power.

They talk as if medics will always make consistent decisions about whether stated legal conditions have been met, and patient pressure groups or ideological movements will never form to distort their judgements; as if subsequent language users are bound to understand vague concepts like “unbearable” or “incurable” in just the same way as we do now; as if distressing illnesses presently affecting a relative few can’t metastasise in future. They are happy to talk simplistically of kindness and cruelty as if they are in primary school, while outsourcing responsibility for maintaining adequate guardrails to more grown-up sounding people and things: doctors, bioethicists, legal definitions, forms signed in triplicate.

In short, although with their babyish words politicians imply that a personal choice about whether and when to die is disconnected from the decisions and actions of other people, it is not, and it never will be. A big clue is in the term “assisted”. If we had any sense as a society, we would decline the invitation to set foot on their big shiny playground slide, but I won’t be holding my breath.

Yet even though she was prepared, her death would still be messy: both for her and the family she left behind. Tensions between my siblings had escalated over the months, as we negotiated a difficult and stressful process. Let down by the officials who were meant to help us, it would be fair to say that assisted suicide killed my family along with my mother. 

Mine isn’t just a personal tragedy. As euthanasia inches towards legality in Britain, with a private member’s bill on assisted dying potentially being debated in the Commons this month, we must think seriously about the logistics of death. Ignore it and we risk wreathing a nation in trauma — long after bereaved families leave their loved ones behind. For whether a longed-for release or slow and painful menace, death is a painful business. 

The protocols, though, are simple enough. Following the Oregon Dignity in Death Act, passed in 1998, the Volunteer Assisted Dying Act in New South Wales encompasses 11 distinct steps and a host of safeguards. It is only available to over-18s who have an illness that will cause death within 12 months, or is causing suffering that cannot be relieved. Patients must undergo three assessments and write a declaration of their intentions.

Suggested reading

'I was offered assisted dying over cancer treatment'

By Ian Birrell

Beyond these tight theoretical rules, however, the practicalities of VAD are less proscribed. For one thing, unlike in the US, assisted dying is free. And therefore more accessible. But far more important is the way in which amateur family members are roped into the protocols. My mother, as part of the process, nominated one of my sisters as her Key Person who would help her navigate the path to euthanasia.

This, though, was a difficult emotional burden for my sensitive sister, who struggled with poor health. To make matters worse, she was estranged from my other siblings. My mother selected this sister simply for her own ease. Another, more pragmatic sister had long been Evelyn’s Power of Attorney, but when new papers were drawn up, her name was misspelled and Mum wouldn’t sign incorrect legal documents. Instead of having the papers corrected, and waiting until her daughter could make the six hour-return drive to sign them, Mum was impatient.

Instead, she defaulted to the most convenient solution: her most available child. KP worked part-time, due to her health issues, while my other siblings work full-time. For my part, I live in the UK. At any rate, the newly bestowed Power of Attorney laid the groundwork for my KP sister being named as the primary support person. It was treated as a coup against my other sister who mum had always sought advice from on important matters or during a family crisis. In fact, that sister was the family vault on all serious matters. The animosity from one sister to the other was established years before my birth.

So I was commissioned as an intermediary, offering updates from my mother and KP to the other side of the family. I had also been passing along the various visiting times and dates of my siblings, so they could avoid each other at the care home. It was exhausting.

In theory, this muddle shouldn’t have mattered. After all, the rules also provide each family with a so-called VAD “coordinator”. These professionals are there to guide and support families through the challenging process. Empathy, it goes without saying, is key. 

Alas, these theoretical safeguards were inadequate. After attending a couple of assessments, my sister was struggling to cope. Even the most resilient adult will find it challenging to accompany a parent who is arranging their own death. My mother, for her part, made the process trickier. Evelyn’s dark humour — once funny — was now hurtful as she took to saying that she was “being put down.” 

That ominous sign would soon be echoed elsewhere. In January, Evelyn passed her third and final medical assessment, and was formally granted permission to undergo euthanasia. She was elated. “I feel like a huge weight has been taken off my shoulders,” I remember her telling me, “I haven’t felt this free in years.” She sounded so relieved and happy that of course I wondered whether she would go ahead with it. But the date was set. February 22, 2024, the wheels were set in motion — and the trouble really started. 

In January, I took a flight from Heathrow to Chicago for a research assignment, in the belief that she would not go ahead with it. Between long flights and epic time differences, my role as intermediary collapsed, as my sister refused to share information with the other side of the family. Soon enough, I received frantic phone calls from other siblings desperate for crucial information. It seems that information is power and that information was being tightly held.

Now, my KP sister and one of her adult children had started to tell me when I could and couldn’t call my mother. They had established themselves as Mum’s guardians. Of course, I ignored their instructions, and Evelyn was annoyed by their interference — but ultimately did nothing to intervene.

I know, of course, that many families are dysfunctional — and VAD can’t be blamed for our internal squabbles. Yet the shallow, inflexible support offered families makes a miserable process far worse, triggering sleepless nights and agony for all of us. 

Then, on February 15, just a week before she was due to die, staff shortages meant the date had to be postponed. A tough woman, not given to weeping, she crumbled. She could not stop crying. She was terrified of dying and had psychologically prepared herself for it, only to be undone by a bureaucratic bungle. Again, I asked her on the telephone why she was going ahead with it when she was clearly afraid. “I’m more terrified of living,” she told me. 

The delay, though, did offer me the opportunity to say goodbye. So I flew out with my daughter, Ava, to Sydney. And my mother was fascinated by the granddaughter she hadn’t seen in so many years. I sat on the bed watching, mesmerised as they laughed and exchanged ideas. The deep interest Mum showed in Ava’s life made it even harder for me to reconcile her decision to be injected with a lethal dose of barbiturates the following day. The notion that she would be dead in 24 hours had not landed. It would not land.

But my mother was determined. And on February 23, we arrived at the hospital early in the morning. A social worker was assigned who, after a whispered conversation with my KP sister, promptly left the room and didn’t reappear. Unable to sit still, I roamed the sterile corridors until I noticed one of my nieces sitting alone in the public waiting area. Such was her distress I hardly recognised her. The social worker, though, was nowhere to be seen. 

Evelyn arrived at midday, dosed up with painkillers, awake and chatting. Only now did it seem real. When we all entered her room, the VAD coordinator was there, having suddenly reappeared after weeks of silence. There she was at Evelyn’s bedside, acting like nothing had happened. Speaking only to my KP sister and Mum, she merely offered a nod of acknowledgement to the rest of us. As so often, our apparent invisibility felt crippling.  

Suggested reading

The assisted-dying lobby has already won

By Kathleen Stock

My mother was oblivious. And after she had whispered a private message of farewell to each person in the room, an anaesthetist ended her life. Just after 1pm on February 23, 2024. Nothing in Evelyn’s life became her like the leaving of it, such was her grace and courage. 

In 2018, my father-in-law died a merciless death in England. The former country GP had Parkinson’s disease and had been in residential care for several years. When he could still make decisions, he made clear that he did not want to live if he could not eat or drink. Specifically, he refused a feeding tube.

When he was no longer able to swallow his death began. It took five days for him to die of thirst. I remain haunted by the harrowing nature of his departure.

So beyond the beauty of her passing, what have I taken from Evelyn’s death? Would I recommend it? Yes, in a sense I still would. I firmly believe NSW Health has opened a much-needed service for the terminally ill. But the system has a long way to go if it isn’t to destroy an ocean of other families. Even the most cohesive units can fracture under such immense strain. The trauma for our family will never be healed. My KP sister didn’t come to the scattering of my mother’s ashes. And none of my other siblings is in touch with her. Going through the VAD process has turned a once close sisterly bond into something uncomfortable and unwanted.

So as Britain begins its serious discussions over assisted dying, it must obviously consider ethics and morality. But equally important is to create an intelligent, reactive system of euthanasia, which cares for both individuals and their families. Failing to create that risks causing even more suffering — which would be an irony indeed. 

Freddie Sayers: Is it your view that liberal civilisation has passed into history? 

John Gray: Yes, and it’s not coming back. Something else might emerge — something which is new, which may revive or reinvent some elements of liberalism. I hope that’s the case; I hope that there can be something like the practice of tolerance again. But what I think has not been noticed by many commentators is that two things have undermined the post-Cold War model of convergence on a liberal civilisation.

One is that other models of society — not ones I would like very much, but the Chinese model is an example — have emerged, which clearly challenge the claims of liberal societies to be potentially universal. But perhaps the biggest change has been in liberal societies themselves, which is that both as economic models and as embodiments of tolerance, they’ve morphed out of existence. 

When people said back in the Nineties that liberalism would become universal, they assumed that the liberal societies that then existed would continue to exist and would extend their reach. But we all know now that practices of cancellation, practices of de-platforming, practices more recently of debanking, have developed whereby people with views that are regarded as beyond the progressive pale, which don’t conform to some progressive ideology — which doesn’t see itself as an ideology, just as diversity and inclusion. They can’t actually see that what they’re promoting is an ideology. Politics is something that goes on in a small way in Westminster. 

And there’s a rather crucial feature of this, which I think has to be taken fully on board. The restraints on freedom of speech and expression that exist in formally liberal societies are not imposed by a dictatorial or authoritarian government. On the whole, they’re imposed by civil institutions themselves. They’re imposed by universities, by arts associations, by museums. All the kinds of things that happen in China, because people are terrified to deviate from the government, happen by themselves spontaneously here. And that’s a profound metamorphosis. I can’t see how we can get back to a situation in which tolerance and freedom of speech and expression for some very wide range is taken for granted. Which it was — I’m old enough to remember the Seventies and Eighties, and even almost up to the Nineties, it was simply taken for granted that you could think and say what you like. 

I remember for example, one of my intellectual mentors was Isaiah Berlin, and he said, “Read this really good book, bit of a Nazi, but read it.” And it was a book by Wyndham Lewis called The Demon of Progress in the Arts. “Brilliant, brilliant, pity he was a Nazi.” Now, you couldn’t say that, couldn’t recommend a book by someone suspect. You could joke, you could talk, you could make references, you could say that people who were in general poisonous or toxic had important insights, you could discuss them and swap them. And that was all taken for granted. If it ever comes back, which I doubt, it will be as a result of a tremendous struggle. 

FS: Should we be trying to rescue that liberal settlement? Or should we just accept that it’s passed?

JG: One feature of earlier generations of liberals is that they understood that a liberal society needed to be maintained politically, that there had to be political action, political discussion and political compromise. Keynes understood that very well. He says somewhere that we can only keep this going by guileful compromises, devices, political stratagems, coalitions, that kind of thing. And one of the features of the liberalism that’s come to prominence in recent years, is that it’s wanted to take more and more issues out of politics, so that they can’t be contested at all. To establish them as rights, legal rights, or in some way whereby they’re just beyond contestation. And of course, the end of the road for that is visible to some extent in the United States.

I say this immodestly, but back in 1991, I said that I thought America would unravel around abortion, partly because there was no general consensus when the issue was constitutionalised — I’m pro-choice, but put that aside. And about a third of the society rejected that right and thought it should be curbed or even reduced to almost nothing. What then happened was a long process of 30 years of attempted political capture by conservatives of the Supreme Court. When I wrote that 30 years ago, people thought it was a sort of fantasy conspiracy theory. But that’s what happens. If you politicise the judicial institutions, if you extend rights, unconditional rights, further than they can be extended in terms of general welfare, or in terms of general ideas of what’s acceptable, then inevitably over time there’ll be an attempt by those who feel they’ve been excluded from this to capture the institutions. 

The stage after that, though, this is the stage we’re getting into. Politics becomes Schmittian — another Nazi, by the way. He developed this notion of politics, which I think is a terrible conception of politics, that it’s a matter of friends and enemies — not of opponents, but friends and enemies. So then it becomes a battle, politics becomes a war. The next stage in America will come probably after the next presidential election, in which whoever wins will not be accepted as illegitimate by about a quarter to a third of the population. That’s when you’ll have Schmittian politics. I’m not saying there will be a civil war, but there could be civil warfare. 

So these processes taking together have eclipsed liberal civilisation in a fairly conclusive way. I don’t see it coming back; I don’t think any of you in this room will see it come back. But what you might see are enclaves of it, enclaves which are hard to shut down. That’s what we should be thinking about: spaces where you can say what you think. 

Suggested reading

Was New Atheism a mistake?

By Freddie Sayers

FS: Could a major war — such as one between China and America — inspire some sort of revival? 

JG: War is not generally redemptive. We are a bit spoiled by the Second World War, which despite all the myths, I think, was a just war and which we didn’t lose. We didn’t have the experience of occupation, which is a very important point. If we’d had the experience of occupation, we would know that most people collaborate. Most of the authorities, most of the middle classes — which are now touted in liberal theory as the beacons of autonomy — they would collaborate as they did right across Europe. But on the whole, I don’t hold out any hope of redemption through war. 

FS: You’ve previously said though that you think war between America and China could come quite soon. 

JG: I did, and I still think it’s possible in the next 18 months. It’s not a firm prediction. It’s such an impenetrable regime, more impenetrable even than Russia. But one can easily imagine them seeing the next presidential election in America as a time of maximum uncertainty in America or maximum introversion in America and maximum distraction in America. So if they’re going to launch anything military, which I think is their second strategy, not their first, it might be then. Because they would say: “Will they react? Will they respond? Maybe they won’t.” 

There is another strategy which they might pursue after the elections in Taiwan. And they might want a way of setting in motion a process of unification without military action. I’m pretty sure that there have been some public hints to that effect from the leadership, that they would prefer that, but there are obstacles to it. And one obstacle is Hong Kong. If they’d respected “two systems, one country” when they took over Hong Kong, they’d be much more likely to succeed in a political strategy in Taiwan. But if people in Taiwan fear the lid coming down on all their freedoms, then they might not vote for it. 

In the slightly longer term, if I’m wrong about the next 18 months to two years, I see the absorption of Taiwan by China as practically inevitable, partly because a lot of Taiwanese business has interests on the mainland, but also because there are vast amounts of American capital in China. And what you should be aware of is when people talk of a “second Cold War” as some sort of natural continuation of the first, this is completely different. In the actual Cold War, the two main protagonists were not economically codependent. The Soviet Union had some impact on the oil price and various industries here and there, but nothing like this. Whereas, the West — America and Europe — are joined hip and thigh to China. But there’s no way Xi Jinping or any other post-Xi Jinping leader, will give up the claim on Taiwan. It’s the jewel in the crown for them, having been to China, having talked to various people, having heard them say what they do. 

FS: You’ve previously written a lot about the green movement, and in recent weeks there’s been a rolling back of the net zero plans. When we spoke before, you were saying you think that’s one of the big issues that is turning across Europe, and that in some years’ time, we might look back at the net zero era and almost laugh. Do you think that’s possible?

JG: I do. I think it’s more than possible. I should say, I’m not a climate sceptic. I’m a disciple in that regard of a great friend who died recently, James Lovelock. He used to say, climate science is inexact but if it has a bias it’s probably towards underestimating the speed of climate change. He thought that climate change would consist of sudden jumps and it could transform things quite quickly, in a couple of decades. We might be in the middle of it. That’s my view — I’m not a climate sceptic. What I am very sceptical about is net zero, and the kind of conventional green policies that are being launched, for a number of reasons. First of all, they were launched before the infrastructure was there. They were launched before the technology was developed that could make them work. No consideration was given to the fact that many of the raw materials that were needed for the inputs, the batteries and so on, were now substantially or even largely controlled by China in Africa and elsewhere. It’s in Africa that the Great Game of the 19th century is being refought.

Now, they might be found in other countries — in Sweden and America, various deposits have been found. But they’re not quickly developed. And in the meantime, these programmes can’t go ahead. Nor were the economic costs of these green programmes properly assessed. There was a constant insistence that they would be job-creative. Well, even in America, they haven’t been that job-creative, actually. And remember, America is very big, and they can throw very large amounts of money at these things — the Green New Deal is largely a protectionist scheme. So they can do it. We can’t do that because we’re too small, we’re too exposed to flows of international companies. So the idea that in Britain or in Europe these programmes could ever possibly work — it’s a bit like suffering from cancer and using candle therapy. That’s how it will be remembered — candle therapy. 

And then people might say, “But we’ve got to, we’ve got to show that we’re on the right side, we’ve got to accomplish it, even if other people don’t do it.” I think that’s the politics of narcissism: “I want to feel good.” But in the meantime, you’re wasting resources and you’re wasting time. There is a serious possibility that we’re now in the early stages of runaway climate change. We should be focusing everything we’ve got — not on having an infinitesimal impact on global carbon levels, which would be the case even if the whole programme was implemented — but on policies of adaptation. And adaptation is not going to be easy. Remember, most climate scientists agree that once human-induced climate change is in the works, it goes on for decades or even centuries. You can’t just stop it. There’s a general idea among environmentalists that we started this so we can stop it. No. We started it, probably, but we can’t stop it. 

Last time Freddie and I spoke, I said we were in an age of tragedy. I’m not too sure about that anymore. I think we’ve advanced further than tragedy. We’re entering an age of absurdity. An example of that would be German climate policy. Germany, as we know, is incomparably more adult, more advanced, more modern, and in every way superior to bungling Britain. But in Germany, the result of their closing down of nuclear and going for renewables has been an increased reliance on the dirtiest kind of coal. Well, that is tragic, but it’s even more than tragic. It’s completely absurd. The world is advancing rapidly, I think Western society particularly, into utter absurdity. That’s one of the things we’ve got to cope with. And if you put these arguments forward, it’s difficult to do because people start shouting at you or they start crying or they say they can’t get up in the morning. I rather brutally suggest: “Well don’t. Stay in bed till you get a better reason for getting up. And if you don’t, well, there we are. Progress always has casualties.” 

One of the great books of the last century in English was a book by the American scholar, Philip Rieff, called Freud: The Mind of the Moralist, in which he said Freud was a stoic moralist. He quoted a wonderful letter of Freud’s, where Freud said his aim in therapy was not to enable people to realise themselves or to achieve happiness, his aim was to change hysterical misery into the everyday suffering of normal human life. Now, that was somehow forgotten. And he wrote a later book called The Triumph of the Therapeutic, in which he said that a therapeutic model of behaviour was spreading in every part of society. Rather than using moral terms or even political terms, people started using psychoanalytical terms. “What do you want out of this? I want closure.” Well, the thing about Freud is there’s never any closure. Closure is impossible for Freud. We bear the scars as well as the good things from infancy, whatever we do. We can’t change ourselves in these fundamental respects, according to Freud. And so I think, climate policy, conventional climate policy, is for therapeutic people to feel good. They don’t want to feel powerless, so they deceive themselves. 

Suggested reading

The motorists are fighting back

By Matthew Crawford

FS: If you’re right, at least, on the politics of that issue, what kind of collapse follows the descent into absurdity? 

JG: If there’s an optimistic scenario, which there may be, then it’s one that involves the rebirth of politics. Because the trouble with technocratic pragmatism is it doesn’t work. Because what technocratic pragmatism means is approaching what are carefully defined problems defined by conventional thinking, by groupthink, and applying some conventional medicine. That’s it. 

But there’s also the question of political legitimacy. And what’s being discovered now, is that there are limits to political legitimacy for policies that severely disrupt the practical lives and incomes of large numbers of people in society. So if you impose a Ulez scheme in an area where there’s practically no public transport, so most of Britain or large parts of Britain, or it’s unreliable or scarce, that has a severe impact on people trying to get to work. And there’s also the subjective feeling, which is very important, a feeling of being imprisoned in one of these 15-minute cities, of somebody doing something to you which you resist. 

In the taxi that brought me here, the taxi driver was saying that he knows that lots of people who are going round and smashing or disabling the Ulez cameras. And what will happen is the numbers build and the policy will eventually be overturned, or you’ll have a period of anarchy. I remember, when Thatcher having trialled and failed to impose the poll tax in Scotland, she did it in England. And this happens to all leaders, whether they be liberals or not. They tend to become anti-empirical. They double up instead of learning from their mistakes. And that resulted in riots and her being toppled. Something like that, I think, could happen in the case of these green policies. Because it’s a huge blow, not only to the faith, the worldview of the technocratic elites that support it, but also to the perception of them, as their competence hasn’t delivered any of the results it’s supposed to deliver. 

And people are supposedly converting to electric vehicles when there are hardly any charging points. By the way, someone who is an expert on this made a point to me, which I hadn’t thought of, he said one thing which is commonly neglected is that if these charging points were installed, they’d be very, very large, much larger than ordinary petrol stations, because it takes a long time to charge up. If each car in line charges up for half an hour, it’s going to be huge. So basically none of this is going to happen and enormous amounts of money will be wasted. People’s lives will be disrupted, and then it will be forgotten. It’s more like prohibition in America than it is like a rational solution. It’s the most nakedly irrational solution you can have to the growing danger of climate change. 

So what’s the solution? In Britain, I have a tiny sliver of hope. I’m hoping for a hung parliament, which might not happen because Labour has been rejuvenated in Scotland. But if it doesn’t get a working majority, there’s a realistic chance of electoral reform. The only way you can really have any new ideas filtering into politics is by creating new incentives, which involves the destruction of the existing party framework. The parties would split, they’ll split immediately. Perhaps two or three parts of Labour will split: you could have a real socialist party (hopefully non-Corbynite); you could have a green party but not a not a conventional green party; you could have a Liberal Party; you could have a Libertarian Party. You can have a variety of parties, and I think that would be a much healthier situation. There’s the sliver of hope.

*      *      *

FS: I think now is a great moment to open it up to our audience.

Question One: I understand you’re familiar with the work of Fritz Stern, particularly his essays and his books on the failure of liberalism in Germany pre-1933. He’s quite clear that for all the attraction of liberalism, there is in his words a terrifyingly large part of the population that is attracted to coercion, and ultimately it always fails. Ultimately, liberalism is the least worst of all outcomes. Do you agree with that? 

JG: I’ll answer your question with an historical example. If you thought that liberalism was the only thing — in my own view, this is slightly pessimistic — and everything else doesn’t work, the question is, at what cost does it not work? And how can you get the next best mix? Let me give you an example. Back in the early Nineties, I actually took part in a debate with Jeffrey Sachs, some of you will know who that is, who was tremendous advocate of radical market policies in post-communist Russia. I was a critic of radical market policies in post-communist Russia, because it had been communist for 70 years, and large parts of the Soviet economy were military-industrial Rust Belt, there was cataclysmic pollution practically everywhere, and the only entrepreneurship even before the communist collapse was often criminal. 

I thought an attempt to push a strong liberal line in Russia would — and you can read what I wrote in the early Nineties — lead to disaster. I thought the best thing in Russia was a hybrid, some elements of authoritarianism — after all, in its long history, it’s had practically no extended period of removal on freedom. A tiny little bit of anarchy under Yeltsin; a certain amount of feeble constitutionalism coming to nothing and then being withdrawn under the last tsars. But almost nothing. So the difference — by the way, any argument about Russia and fascism is too optimistic because actually during fascism in most of the European countries, even in Germany, there were institutions and civil society relics was still there that could be revived. There’s almost nothing in Russia. So I think the danger of saying only liberalism works is you focus everywhere on trying to get a liberal model, rather than getting something more mixed, and more realistic. So I disagree with him.

Question Two: I just wanted to go back to your point now about economics, and to understand what we’re experiencing now is that the development of capitalism is also having an impact on the decline of liberalism from a political point of view. Would one way to solve that be to act more on the economic structure?

Question Three: You talked about cancel culture in universities. And I understand that one university is running a programme called disagreeing well, with an attempt to develop what is known as epistemic humility. In other words, you don’t diss the other person because you think their data is rubbish immediately. And I wondered what you thought about it? Is this something that will work in restoring liberal and civil debate within universities?

JG: Well, any such initiative can be valuable. I’m glad there are such initiatives, but it tells you something that what used to be good manners and fair play and decency is now called “epistemic humility”. You haven’t got epistemic humility if you think I’m going to cancel you! I’m joking — I think they’re important. But it shows the difficulty that we have to somehow have a theory of what “disagree well” means in order to try and get back to what used to be an accepted practice of tolerance. But if you ask what the main problem is, I think the fundamental idea that reasonable people can have divergent beliefs and values has been lost. I noticed this in the Brexit debate (it wasn’t a debate; it was a hate-fest). Basically, my view — I was pro-Brexit — my view was that it was an issue that reasonable people could differ profoundly on. And by the way, the best argument against Brexit that was put by one of my friends turned out to be true. I said, “Why are you voting Remain?” He said, “Because I think the British political class simply isn’t up to making Brexit work. They’re hopeless.” I think that was a very powerful argument and a very perceptive argument.

FS: You’re still pro Brexit?

JG: It’s been botched and bungled, and aborted to the extent to which it’s hard to see how it can be saved. I don’t think we’ll go back into any complete EU. I don’t think we will rejoin. I don’t think that could be democratically legitimated. What we’ll end up with is in some halfway house, which is worse than being in or out. But every progressive opinion will be tremendously pleased by this, because the one thing that progressive opinion is not interested in is Europe. Europe is becoming a hard-Right bloc for various reasons, and you’ll never see this mentioned. People say, “We’ve got to get back into Europe; total disaster; leaving Europe was catastrophic…” It’s more illiberal than it was when we left. They’ll probably blame that on Brexit — they were very convoluted arguments. 

Where does economics fit in? I’m a bit of a dissident on this. I think that those of you who are market liberals or libertarians will find this really shocking. But I think there’s a good argument for renationalising, or taking back into some other kinds of public ownership, various public utilities. Because I think just looking empirically: it hasn’t worked in water; It hasn’t worked with the railways; it hasn’t worked on the whole with the banks. They’re very good at stripping people of their civil liberties, but they’re not so good at keeping their branches open, or giving people a decent return on their savings. They’re dreadful entities.

Question Four: In terms of the practices that we see in Canada around assisted suicide, or in the Benelux countries, would you see that as hyper-liberalism or post-liberalism? Particularly in relation to the idea that there’s something about faith, about Christianity, that’s welded into the human ethic and the ethic against killing in forms of enlightened liberalism. Do you think there’s a moment where society reverts to a sort of post-liberal paganism or is that not how you see it?

JG: No, I don’t see it quite like that. But I do agree with you on the earlier part of your question which is: what stopped? There are a lot of people who say, “This is a problem with the decadent liberalism or the hyperbolic liberalism we’ve got now, but if we get back to classical liberalism, everything will be alright.” But classical liberalism was an offshoot of Christianity. The roots of the early modern — the root of the practice of tolerance, of conscientious objection in the wars of religion, of the idea of an inner life in which people perceive the truth not obstructed by external authorities — wasn’t in the Enlightenment. Most of the Enlightenment thinkers — Voltaire might be an exception — were not that keen on freedom of thought and expression. Auguste Comte, a very influential later-19th century enlightenment thinker, said there’s no more reason for tolerance in ethics and politics than there is in physics or chemistry. You just have experts. If you want to know what to do, ask an expert. It’s ridiculous, because that’s the age of absurdity.

I was told this by a friend of mine who advised American governments — I think it might have been Libya — he raised an issue with some high-level American officials and said, “What shall we actually do about this?” They said, “Don’t worry, we’ll send out some experts, they’ll solve it.” So they destroy a dictatorship or tyranny, they destroy the Gaddafi tyranny, and it leads to a situation of anarchy in which there are two governments at least, i.e no government, under which it’s practically impossible to control the people smugglers because there’s no government to control them. The damage has been done. 

Suggested reading

Lionel Shriver: 'I benefited from wokeness'

By Lionel Shriver and Katie Law

FS: And on euthanasia?

Well, is it hyper-liberalism, or repaganisation, a kind of post-liberal repaganisation? I don’t think it’s paganism because, as I say in my book, the extraordinary thing about paganism is its moral modesty. One of the advantages Christianity had over paganism in the ancient world, is that when there were plagues, the Christians didn’t all run away. That’s what the pagans did. The Christians bound themselves together. They thought it was something sent by God as a trial. They had to show their virtues to each other. The pagans just say, “It’s something meaningless; do what you can; run away.” So actually, Christianity had a kind of Darwinian advantage, you might almost say, over paganism at that time. I think one of the fundamentally mistaken views is that this is repaganisation. Actually what it is, is a corrupt and hyperbolic and hollowed out form of Christianity. The woke movement, the hyper-liberal movement is liberal, it comes from liberalism. But what restrained the matrix of theology and metaphysics and values beyond the human will, that restrained liberalism in an earlier period, has gone. So this kind of development is inevitable.

I’ll give you a different example. Once you get rid of this theological background — I’m not a Christian myself, I’m an atheist — but once you get rid of it, it’s very difficult to stop things emerging like the technological pursuit of immortality. Most, not all, but most of the billionaires, the American oligarchs, are deep into this. Because, after all, what could be more of a curb on human autonomy than mortality? Now, the euthanasia case is in a sense the obverse of that, where you turn death into a chosen choice. And I think that one of the key things that happens in a post-Christian society or a society which contains many people for whom Christianity means nothing, or even theism means nothing, is that suicide becomes an option. You can’t get away from that. And then you’ve got to consider how that can be contained within a legal and a moral and a social framework without really having a Canada-like result. Or you can take the view which Christians might take, which is it should be prohibited altogether. 

But I don’t actually think that’s sustainable in a modern society, or even in an ancient society, because the key thing that tolerance was a solution for was the fact that human experiences and human values have always been, are now, and will always be, dissonant. So we will always be living among others, some of whose values and beliefs we despise, and hate. That will always be the case. That’s why we need tolerance. But of course, we say, “The solution is that we get rid of people who don’t have the right opinions, or we gradually educate them out of their opinions, or any difference from the progressive incentive is a sign of stupidity, or wickedness.” That simply takes you down the road to the kind of soft totalitarianism that some people have complained about — although, once again, never underestimate the fumbling stupidity of the people who try and impose this.

Question Five: I just wanted to come back to your comments about universities, because when I joined the University of Sussex in 1991, as a teacher, the ideology at the time was poststructuralism, and the deconstruction of everything. And there was no such thing as truth, there was no such thing as a self, there was no such thing as an author, and it was quite a struggle to take an alternative view at the time. Now, it seems almost like a volte face, that maybe what post structuralism did is to create a philosophical vacuum where everything’s been deconstructed. And now we have the reaction to that, which is that we must have an ideology to replace all the ones we’ve deconstructed, and this one is not deconstructible. What’s your view?

JG: I remember myself when that was a strong influence in universities, but I don’t take the view that postmodernism and poststructuralism are at the back of what’s now called the woke movement. I think that suggests that if there hadn’t been postmodernism or poststructuralism — if there’d been no Derrida or Foucault — we’d be in a much better situation. I interpret hyper-liberalism, as the term suggests, as a metamorphosis within liberalism. Ask yourself a question: why is the woke movement strongest in the Anglosphere? They’re probably most strong of all in Canada now, then maybe America, thirdly, Britain. People interpret it as a universal movement, but it definitely isn’t when you talk about it to people in China. They regard it partly with contempt and partly with incredulous glee, because it means their chief rival is deconstructing itself before their very eyes. It’s not a universal, it’s something that has spread throughout the Anglosphere. 

But I’d say, having read Derrida and Foucault, that the playfulness of Derrida never comes through among any of these woke writers and the mordant wit, the almost cruel wit of Foucault, doesn’t come through. And equally it’s not Marxism — in fact it’s almost the opposite of Marxism because one of the things about hyper-liberalism is it doesn’t locate inequalities where they partly are, which is in what used to be called class, which affects different ethnicities. It locates them in microaggressions, in cultural things, in historical interpretations of what happened during colonialism. 

I interpret it in the book as partly a revolt of the professional bourgeoisie against their own superfluidity. They’re increasingly redundant. The cognitive elite doesn’t know anything, most of it. It knows a patois, a vernacular, that it learns at university, then it moves out into the world and finds that the opportunities for that are not infinite and they’re shrinking, shrinking for various reasons, one of which is now AI. So they’re all on the hiding to nowhere actually, those people. And therefore they get an idea: how can I possibly be safe; how can I get on a career ladder when most of the career ladders have been destroyed, or the rungs have been pulled out? Well, you can get a career if you’d like as a guardian of society, as an enlightened guardian of society. 

So there is an economic explanation for it, as well as a deep, spiritual, civilisational explanation of these movements, in terms of a narrative of meaning in life, a narrative of advance in history, like that in Christianity, in which, rather than a succession of events, history is an intelligible narrative of redemption. Although it’s not quite clear what redemption is in woke. Because one of the features of it is it doesn’t allow those who sinned very easily to stop sinning. But that was true in American puritanism. It was hard to get redemption from having been a witch. You were much more likely to be killed or subjected to various terrible trials. So I guess the answer is, I don’t believe it’s something extraneous like Marxism or postmodernism or poststructuralism. I think it’s internal to liberalism. 

And that’s why, to go back to our very start tonight, I do think that particular civilisation is over. The liberal-conservative strategy of saying: “Let’s find a form of liberalism which is pure and authentic; let’s find one which isn’t doesn’t have all these horrible intolerant, censorious elements.” I think it’s hopeless. You’ve got to do something new, something fresh, something which tries to recreate spaces of free thought and inquiry that are not late, faded copies of ones that might once have existed. And maybe some people — UnHerd and the New Statesman where I write — they’re practising this. So, my optimistic message is: don’t calculate whether you’re going to win or lose. Just live like this as long as you can.

I’ve likewise argued for legalised assisted dying. After all, nobody asked us if we wanted to be here (a favourite headline: “Woman Sues for Being Born”); the least we might expect is help leaving the building. Why should living be an obligation? While the strongest candidates for a gentle, legal assisted death are patients with agonising terminal illnesses, any respectable libertarian would maintain that outfits such as Dignitas in Switzerland simply provide a service, of which consumers in any medical condition should be free to avail themselves. And for lack of a better word, I’m a libertarian.

I gained an appreciation for how being alive could simply fail a clinical cost-benefit analysis in the summer of 2020. For five days, I was in such blinding pain from a nerve in my spine that I awoke each morning screaming at my poor husband: “I would rather be dead!” I wasn’t being histrionic. Well, okay, I was — but I was also brutally sincere. Had remaining alive been conditioned on such intense and unrelenting suffering forever more, for the first time I could see a persuasive case for calling it quits. During the blackest periods of those days, on which I took half an hour to descend a single flight of stairs, I was incapable of pleasure, humour, or love. The sole thought in my head was that I would do anything to get the pain to stop.

Canada has an unusually liberal programme called Medical Assistance in Dying, or Maid — although this acronym doesn’t tidy your flat but sponges your existence from the known universe. The Great White North should, therefore, represent my perverse version of Valhalla. Instead, Maid’s lax protocols make me queasy. In theory, maybe everyone has a right to die if they want to. In practice, maybe the state needs to keep a tight regulatory reign on whom it graciously provides a one-way ticket to nowhere.

Introduced in 2016, Canada’s government-sanctioned euthanasia by medically administered lethal injection and legalisation of assisted suicide (there’s a difference; the latter usually entails patients themselves swallowing fatal tablets prescribed by a doctor) were initially intended to put the terminally ill who’d had enough out of their misery. Yet sister programmes in the seven other countries that permit euthanasia generally restrict the pool of applicants to people destined to die naturally within six months. Maid initially codified no such limitation, merely citing vaguely that death should be “reasonably foreseeable”, as it is for all us mortals. Hypothetically, then, even the programme as originally conceived could have been open to people whose ailments would only kill them many years hence. Yet, bolstering its critics’ “slippery slope” argument, the programme soon radically loosened its restrictions. Assisted dying is now available in Canada to all adults with a serious illness or disability, regardless of whether the source of their torment would be fatal over time.

More from this author

Western society is built on stigma

By Lionel Shriver

Most controversially, the government is considering the offer of lethal injection to “mature minors” — whatever that means. The programme is also set to extend to Canadians who are mentally ill. That said, the start date of state-sponsored death for the psychologically unwell (which on one day or another would probably include us all) has been pushed back to March 2024, indicating a degree of bureaucratic anxiety.

Given the stories in the press, that anxiety may be warranted.

At the age of 61, Alan Nichols had a history of depression and was hospitalised as a suicide risk in 2019 — something of an irony, as in due course the hospital staff, according to his family, was altogether too helpful in facilitating the patient’s application for euthanasia. That application was accepted, even though the only health condition it cited as so intolerable that Nichols wanted to die was “hearing loss”. After Nichols was put to death, his family objected that the man was not suffering unbearably, had been refusing to take his medication, and wouldn’t use the cochlear implant that helped him hear. But no medical personnel had ever contacted his relatives, out of respect for patient confidentiality.

Suggested reading

'Why did Canada help my brother die?'

By Florence Read

While some Canadian disability advocates are upset that disability alone is now a qualification for euthanasia, arguably sending a social signal that the disabled are a burden and better off dead, Nichols did not nominate himself as a political representative of any group. He was just one person who didn’t want to be here anymore, and if we’re not impressed by his motives, that’s our problem. Whether or not to head for the back door was his decision, his business.

Still — I’m reaching here. Hearing loss? Really?

Suffering from Lou Gehrig’s disease at 41, Sean Tagert required 24-hour care, but British Columbia only provided 16-hour assistance. Paying caretakers for the remaining eight hours cost Tagert CA$264 per day. Health authorities did offer to move Tagert to an institution, but its location was far from the young son who was clearly his father’s prime reason for living, as Tagert described such a separation as a “death sentence”. The man managed to raise CA$16,000 to invest in medical equipment that would allow him to remain at home, but the funds were insufficient. So instead he applied for euthanasia. The end.

More from this author

Why wait to die?

By Lionel Shriver

All health systems have finite resources, so let’s assume that 16-hour care was all British Columbia could afford. If Tagert couldn’t manage on that support, we wouldn’t encourage a bureaucracy to give in to blackmail: If you don’t give me 24-hour care, I’ll kill myself. On the other hand, the availability of assisted dying as a solution to his problems must have made it more likely that Tagert would choose death, as opposed to giving institutional care a go and perhaps discovering that seeing his son somewhat less often wasn’t the end of the world. In general, then, legalising assisted dying without fierce limits on who qualifies may increase the likelihood that, rather than find more creative escapes from their predicaments, people give into despair.

In more than one instance in Canada, too, patients seem to have been actively pressed to consider pulling their own plug to save the health system money. Hospitalised for a degenerative brain disorder, Roger Foley was, according to Associated Press, “so alarmed by staffers mentioning euthanasia that he began secretly recording some of their conversations”. In one recording, the hospital’s director of ethics informs Foley that his hospital stay is costing the institution “north of $1,500 a day” — quite the guilt trip. Foley asks about the plan for his long-term care. “Roger, this is not my show,” the “ethicist” said. “My piece of this was to talk to you, to see if you had an interest in assisted dying.” But Foley himself had never expressed the slightest interest in dying.

For while the Australian province of Victoria, for example, forbids doctors from bringing up the option of euthanasia, lest it be mistaken for medical advice, Canada’s physicians can cheerfully recommend being killed as one of patients’ “clinical care options”. Thus, Sheila Elson took her daughter to an emergency room in Newfoundland six years ago. Unprompted, the doctor informed Elson that her daughter of 25, who had cerebral palsy and spinal bifida, was a good candidate for euthanasia. As Elson later told the Canadian Broadcasting Corporation, the doctor chided that not taking up the state’s kindly offer to slay her daughter would be “selfish”.

Given that they both tattled to the media, Foley and Elson clearly resented being enticed to please consider lethal injection as an economy for the state. But more fragile characters might be less apt to stand up for their rights.

More from this author

Children can't be experts on themselves

By Lionel Shriver

At least four cases have been unearthed of veterans with, say, PTSD being encouraged to consider assisted dying in preference, as one staffer put it diplomatically, to “blowing your brains out”. Maid has been active in prisons as well, whose population is also costly and understandably prone to feeling glum. I wouldn’t melodramatically portray this programme as some wicked Final Solution for castoffs and criminals, but there’s more than a hint here of the brutal social utilitarianism that horrified Captain Kirk in more than one episode of Star Trek.

The woman who has most alarmed critics of Maid’s prospective extension to the mentally ill is Lisa Pauli, who is queueing up for assisted dying months in advance. At 47, Pauli has been anorexic for the better part of 40 years and now holds out no hope of defeating the disorder. She weighs 92 pounds and goes days without solid food. Pauli’s psychiatrist assures her that once the law in Canada becomes more encompassing next year, she’ll probably be eligible for assisted dying. Yet it takes one look at Lisa Pauli’s picture to conclude that she doesn’t need a lethal injection. She needs a sandwich.

Maid is popular in Canada. In a recent Research Co. poll, 73% of Canadians approved of the regime in its current form, while only 16% opposed it. Moreover, a goodly measure of Canadians would be happy for the programme to expand further: 27% claimed Maid should be an option even for people whose only affliction was “poverty”; 28% would offer state-sponsored oblivion to the homeless. A fifth of respondents would provide Maid to anybody for any reason. Sean Tagert’s was one of several cases of Canadians finally choosing death after years of struggling to obtain sufficient health care, and a hefty 51% of poll respondents believed that “inability to receive medical treatment” should qualify applicants for the needle.

I wonder if these Canadians are exercising their imaginations. For governments, citizens are an annoyance. Is it really in the broader interest of us peons to make it too easy for the authorities to simply dispose of us, rather than contend with our messy, expensive problems? Keep loosening the restrictions on such programmes, and pretty soon it’s only so fanciful to envision California cleaning up its tented encampments of homeless alcoholics and drug addicts by sending Swat teams marching through the cardboard and corrugated iron with sub-machine guns.

As for qualifying for euthanasia by dint of mental illness, psychic afflictions are still poorly understood and poorly defined. Because the portion of the population claiming to have mental health problems continues to rise, this is surely the gateway to offering the ultimate cure for human suffering to everybody. Although all pain is subjective, the physical kind usually has an objective correlative. In 2020, I could have shown you on an MRI exactly what was wrong with my back. Mental pain, though, is heavily dependent on self-reporting, so that assessing its severity from the outside is almost impossible.

While Maid guidelines stipulate that whatever drives a candidate to seek a last resort should be incurable, it’s also impossible to tell whether mental problems are temporary or intransigent. In fact, one of the major concerns of too-ready access to assisted dying is that people are moody, fickle, and changeable. One day, one month, or even one year, our outlook can be unbearably bleak, and the challenges of the future can appear insurmountable. But fortunes and frames of mind can pick up, clouds lift: we get a new job, fall in love, finally put a bereavement behind us, after which the prospect of asking to die may strike us as preposterous. Many a failed suicide has been grateful in retrospect for having botched the job.

What’s especially puzzling about Canada, of all places, having such loose restrictions on assisted dying is that Justin Trudeau’s government is famously — I would say notoriously — Left-wing. It’s the Left that traditionally prides itself on concern for the “vulnerable” (a ubiquitous catch-all adjective I’ve come to detest). We would expect Canadian worthies to be out on the streets protesting the state’s offer of nonexistence to the incapacitated, the incarcerated, the addled, or the down at the heel, and instead a slim majority of the country seems to see assisted dying as an answer to the shortcomings of their healthcare system. In a way, I’m impressed. I didn’t think those wet Canadians capable of such cool, callous calculation.

To be fair, the average age of Canadians euthanised by Maid in 2021 was 76; 80% had already been in palliative care, and 65% had cancer. In majority, the regime continues to serve the patients it was originally designed to help: people in searing physical pain who are certain to die soon anyway.

Suggested reading

'Why did Canada help my brother die?'

By Flo Read

I come full circle, then. I still believe in legal assisted dying. After that experience of paralysing nerve pain — which has blessedly not returned — I would even endorse extending such a service to people in non-fatal agony if such life-despoiling torture is chronic and physicians can offer no effective relief. But that’s where I’d draw the line, and I’d hold the line: relieving people of physical pain, for which I have developed a sober respect.

Ironically, the very liberality of Canada’s system has turned it into a political weapon for opponents of kindred programmes proposed in countries such as Britain, where the practice of assisted dying is still banned. But there’s no reason a state that allows what used to be called “mercy killing” under strictly defined circumstances necessarily slides down that hackneyed slippery slope and starts slaughtering every citizen whom someone considers inconvenient or costly. A well-designed protocol should require a waiting period and make it easy for clients to change their minds. Knowing they have the option of an ultimate exit gives many people the fortitude to keep going.

If I would not offer legal euthanasia to anorexics, people with hearing loss, or depressives, much less to the poor or homeless, let’s remember what’s at issue: not whether the state forces you to keep living but whether the state actively helps you die. For any folks bound and determined to not be here anymore, a range of old-fashioned if unpleasant remedies remain at hand. If that disagreeableness presents enough of a barrier to get you to reconsider, maybe you’re still up for continuing to kick around the planet after all.

Last year, assisted suicide accounted for 3.3% of all deaths in Canada, a third more than the previous year. At the same time, deaths officially recorded as suicides fell to the lowest rate in two decades. The Medical Assistance in Dying, or MAiD, Act was passed in 2016, requiring that a patient’s condition has to be “grievous and irremediable”, and death “reasonably foreseeable”, for them to qualify for euthanasia. But the law appears to allow loose interpretations of these conditions.

As a child, Alan Nichols had suffered complications from surgery which affected his mobility on one side and left him with hearing loss. Still, he was living independently before his death. Physically, Gary says, his brother had been doing much better: “He was being treated for absolutely nothing, no illness.” But Alan’s mental health was volatile. “He would go through stages where life was good and then he’d hit a stage for a while, for a month or two, where he didn’t feel like living.” He was prone to paranoia and reacted badly to change: if Gary was getting ready to leave, Alan might say: “Are you going to leave me home with all these knives?” And Gary would have to say: “Alan, I trust you. If that’s what you want to do, I can’t guard you 24/7.”

He did guard Alan, as well as he could. After their parents died, Gary and his other brother Wayne took turns in helping Alan to do tasks that overwhelmed him, such as banking. But they both had their own lives, and Alan struggled to accept help from friends. In the months before his death, he had begun to feel increasingly isolated. His local network was coming apart: Wayne had decided to take a trip across Canada; a trusted neighbour was planning to relocate; his favourite shop had closed. His story isn’t unusual: of the 31,664 assisted deaths in Canada, 17% of the patients cited “isolation or loneliness” as a reason for wanting to end their lives.

Suggested reading

How France lost her dignity

By Michel Houellebecq

The week before Wayne was due to leave, Alan was found by paramedics on the floor of his apartment. The neighbour he trusted had raised the alarm after not seeing him for days. He was malnourished and clearly suffering a major depressive episode. He was taken to Chilliwack General Hospital.

Alan did try to resist being sectioned. Gary was told that his brother “was fighting not to go into the ambulance”. Gary rushed to the hospital to see his brother, who said to him: “If you’re not here to bust me out, you might as well leave.” Gary didn’t bust him out, a decision he now says he regrets. He trusted the hospital to look after Alan. When he called to get updates on Alan’s condition, the staff were optimistic: “The hospital would say, ‘Oh, he’s doing fine. He’s okay. Yeah, he’s eating.’” It made Gary think Alan was “getting back on track.” What the hospital didn’t tell Gary was that his brother had actually signed his own death warrant.

For some Canadians, assisted suicide is a peaceful alternative to an unpleasant death. Patients with terminal illnesses often point out that end-of-life care can be highly undignified, and appreciate the power to choose something else. Don Kent was assisted to die in Ottawa after being diagnosed with terminal cancer. In a blog post written before his death, he declared: “We euthanise our pets humanely, but it is only recently that we have started applying humane dying to our own species. I want medical assistance to ease my way out of this life — nay, I demand it!” His family describe the process as cathartic: “As he requested, Deep Purple’s ‘Child in Time’ was cranked up in the background. His death was completely on his own terms, just as he wished.”

But what happens when there is no terminal diagnosis? What if your family don’t support your wish to die? In the days and weeks following his hospitalisation, Alan refused to take visits from his brothers. Gary tells me that patient confidentiality meant that the doctors didn’t have to inform them about Alan’s application for assisted dying. The people who loved him didn’t find out about it until a couple of days before the procedure was scheduled. Gary sees the hospital as partly responsible for keeping Alan from his family. “The last two weeks, they were treating him for nothing. They were giving him room and board.” He could have gone home. When, later, Gary asked the hospital, “Why did you keep him there?”, they said: “Alan didn’t think he should go home because you guys would try to convince him otherwise.”

Suggested reading

What I've learned about suicide

By Julie Burchill

Gary did, indeed, spend the last day of his brother’s life trying to change Alan’s mind. He winces at the memory: “I think we came really, really close to convincing him not to do this.” Aware that his brother felt isolated, Gary told him: “Alan, I’m contemplating retiring this year, and possibly coming back to Chilliwack. To give you a little more support and a little more family close by”: “He just looks at me and says, ‘Geez, I wish I’d known that.’” In Alan’s view, it was already too late to alter his decision.

Now, Gary wonders if his brother would have regretted his attempt to end his life, had it not succeeded. It’s common knowledge in psychiatry that most previously suicidal people do. One Harvard study shows that “nine out of ten people who attempt suicide and survive will not go on to die by suicide at a later date”. Gary says he feels utterly betrayed by the hospital, the Canadian government, the whole system that undid all his family’s hard work to keep Alan alive.

Other countries are taking tentative steps towards a debate on legalised euthanasia. Last year, Spain passed legislation stating that a person can qualify for euthanasia if both incurable illness and “unbearable suffering” are proven. In the UK, both euthanasia and assisted suicide are currently illegal. But in 2021 an Assisted Dying Bill was proposed to the House of Lords and in the same year YouGov polls showed 73% of citizens supported legalising euthanasia for terminal patients. Only 35% of MPs agreed at the time, but since then the violent suicide of a grandfather with debilitating prostate cancer revived the debate, which remains preliminary and cautious.

Suggested reading

Mental illness doesn't make you special

By Freddie de Boer

Justin Trudeau, meanwhile, is barreling at breakneck speed towards near total liberalisation. The Canadian system is set to become similar to Belgium’s or Switzerland’s. In March 2021, adults with “incurable diseases” but no foreseeable death were made eligible. Now, the “Special Joint Committee on MAiD” is considering whether to expand the law to “mature minors” (no further clarification given) and offering assisted dying to those with solely mental health conditions. Both tweaks to the law could come into effect in Canada as early as 2023.

Evidence suggests that there is demand for these services. Rupa Subramanya recently reported, for Bari Weiss’s Common Sense, on an epileptic woman called Victoria, who was only 21 when she considered applying for MAiD to alleviate her family’s dire financial situation. Subramanya also told the story of 23-year-old Kiano Vafaeian, who is seeking MAiD for depression, and his distraught family. Alan’s MAiD form, which I have seen, only listed “Hearing Loss” as his reason for requesting to die.

The conflicts of interest here are troubling. A 2020 preparatory analysis of MAiD predicted that it could save $66 million in healthcare costs. And facilities that carry out assisted suicides are given government support. In Alan Nichols’s case, the nurse who approved his application was also the “practitioner” giving him the fatal injection. “It’s like you’re writing your own paycheck,” Gary says.

Gary suspects Trudeau will allow the laws to go even further. “Why don’t you just set up a walk-in clinic for it? Because that’s what’s going to happen: once the government opens the door, these physicians and medical teams are just going to open it wider.”

As we say our goodbyes, Gary remembers something:

“In 2008, my mum called me and said: ‘Alan didn’t show up for dinner last night.’ So I said: ‘Okay, I’ll go check on him.’

So, I went over to see him, and his door was locked and wasn’t opening. I called a locksmith who came and opened up the door, and we went in there and he was laying in his bed.

And he says: ‘I knew eventually somebody would come to see me.’”

You can call Samaritans for free on 116 123, email them at jo@samaritans.org, or visit www.samaritans.org to find your nearest branch.

What should we make of this three-page tangent, one that neither develops into a real argument nor develops any real consequences for any of the novel’s admittedly smudgy plot-lines? Perhaps Houellebecq sees a parallel of his own oeuvre in that of the Wachowskis’: between the decade-defining original Matrix (1999) and the Molotov cocktail Houellebecq threw with his Nineties debuts, Extension du domaine de la lutte (1994) and Les particules élémentaries (1998).

Those first two novels were literary sensations, mixing fire-tongued dissection of l’après-68 with science fiction, evoking the dead-end of the everyday and imaging the dead-end of the species. On the newest tome, critics have been more divided.

They agree, however, that with this one, there’s a newer, calmer, more optimistic Houellebecq: finally, “Houellebecq makes room for love”. With this clumsy ode to the least philosophical Matrix, is Houellebecq perhaps telling us that though it might not look like it, this novel — this sentimental, mushy-penned final novel — is his true masterpiece?

He seems to believe so. As he told Le Monde, “contrary to what a famous formula claims, I think that it is with good feelings that we make good literature”. The murderous misogynists of his earlier books are gone, replaced with a pretty reasonable technocrat who’s nice to his wife (Paul “Raison” — clever!). Indeed, most of the characters are pretty nice. That’s by design: as Houellebecq continued, “the ultimate achievement would be if there were no bad guys at all!”

How can this be the Houellebecq we know and love, the Houellebecq who complained that female readers found it “difficult to accept pure negativity”?

Suggested reading

The narcissistic fall of France

By Michel Houellebecq

Houellebecq has never been known as the greatest of stylists or the fairest of psychologists. When I studied him for an aborted PhD, there were, of course, the requisite titters: he was sexist, he was racist, and what’s more, he was populaire. It’s clear that Houellebecq is an important writer — the most interesting, the most provocative, the most of our time, for better or worse.

Fan as I am, though, his “badness” occasionally frustrated me: could it escape Houellebecq’s attention, I wondered as I read, say, La Possibilité d’une île (2005), that it’s a little unconvincing for a perfectly harmonious couple to calmly and spontaneously dissolve at the very first appearance of ageing on the wife’s previously perfect body?

I don’t know. But now, annihilated by Houellebecq’s 735-page attempt at a less Manichaeian narrative, I mourn the venom. I mourn the badness. I mourn the bad guys.

In the acknowledgments of Anéantir, Houellebecq announces that this will be his last novel. As the title predicts, of course, this is a novel about annihilation. Radical ecologists are attacking Europe, targeting immigrants and artificial reproduction, the only bulwark against the population collapse of the West. Paul’s father is dying. Paul, ultimately, dies. And Houellebecq writes his last book.

On such an occasion, with this strange and sentimental swan song, should we recall what made Houellebecq so wonderful? In a recent defence of Anéantir published in The Spectator, Houellebecq is compared with Balzac, in both his “comparable ambition” and his “tireless work”. This is, of course, familiar to any reader of Houellebecq; not only has he ceaselessly praised Balzac for two decades, but his novels have been peppered with allusions to him.

But Balzac’s ambition wasn’t primarily the psychological complexity of individual characters: his devouring ambition, the one that kept him writing for 15-hour days, on 50 cups of coffee, was to write the complete Comédie humaine of France, the one that would depict in narrative, like a map in lines, French reality from the Restoration to the July Monarchy. These 91 novels, furiously written by a man who had tried to be a respectable, bourgeois lawyer, and ended up wearing Middle Eastern robes and writing through chronic illness, are a capsule of a time of dizzying social and economic change. They are not about people; they are about people in a society. Many of his novels, indeed, were designated “studies”.

So, too, in Houellebecq: like his hero, he gives his characters, at his best, birthplaces, birthdates, and parents. Like his hero, he has an encyclopaedic bent, a desire to explain, a will to knowledge. Like his hero, he wants to understand what on Earth is going on. The laziest critics of Houellebecq dismiss him as a novelist of the patriarchal white male, who doesn’t “recognise that it is societal structures such as poverty, racism, colonialism and inequality that are the source of men’s suffering”. But this is precisely where Houellebecq succeeds: he does recognise that society is making us miserable.

That’s what is so special about him today. Almost no modern writer seems interested in the society we live in. Here in America, at least, there’s plenty of slumming-it, reheated-Carver poverty porn and box-checking census-opera; but ultimately, these currents are more cynical attempts to avoid criticism than criticism themselves.

Suggested reading

How France lost her dignity

By Michel Houellebecq

As literature has become an increasingly hard way to make a living, aspiring writers would do best to be born wealthy. Otherwise, they might choose to write Young Adult fiction (far more lucrative than grown-up fiction, and therefore dominant). Or they might choose to take a creative writing program; on this workshop-based path, the entire incentive structure is a risk-averse one aimed at pleasing one’s elders and avoiding attention from one’s peers. Under these conditions, whoever is writing literature is a coddled rich kid and/or person who has largely interacted with the sorts of individuals who can tolerate creative writing workshops. The longer they stay in this bell jar, the less and less they know about what society even is.

Houellebecq, of course, wins here. Balzac was a would-be lawyer, Flaubert was a would-be lawyer, every writer on the “recommended” table at my local bookstore is a graduate of one of 12 college prep schools. But Houellebecq was a computer programmer: a code monkey, a cubicle rat. And so when Extension du domaine de la lutte came out — a novel about a programmer so miserable he drives his hideous virgin colleague to suicide — it was a cri de coeur for an entire, degraded society. It was catharsis.

In La Nausée (1938), Houellebecq’s clear predecessor Sartre evoked a man in existential crisis, in a world without God in which the structures of city, family, and religion no longer have any transcendental meaning. In Houellebecq’s novels, there is nausea enough: the first act of a Houellebecqian hero is to vomit in the middle of an office party, at the end of the first chapter of Extension. But the despair has reached the point of near-numbness, and God is no longer a real possibility (even if a Muslim takeover of the Sorbonne, as in Soumission, is).

In Sartre, the structures have become meaningless; in Houellebecq, they have ceased to exist. The frames that gave comfort, stability, and meaning to life have been destroyed in the name of freedom. To borrow Houellebecq’s description of this novel’s miserable couple, we live in “une sorte de désespoir standardisé”. Miserable white-collar Everyman that he is, he wonders why.

Houellebecq was not, of course, the first person to criticise 1968. Foucault denounced sexual liberation (though this seems to elude many of his most enthusiastic advocates); so did Michel Clouscard; even Marcuse himself admitted that the sexual revolution had been coopted by consumerism. But Houellebecq’s critique of sexual liberation wasn’t theoretical; it wasn’t a Semiotext(e) book, and you didn’t have to know Hegel, and you didn’t have to take notes.

You read those books, and you recognised it: how it felt to shop alone and read the over-enthusiastic copywriting on a pre-made meal for one; how it felt to feel that every conversation you had with a work colleague was an excruciating effort to appear happy and convivial with a terrifying alien; how it felt to feel like the basic elements of life you had been promised — a more or less kind spouse who loved you, a child, a little home you could plant bushes in front of — were merely plot points in silly tales for little kids.

And, importantly, he talked about feeling ugly: a surprisingly rare topic. For Houellebecq, the modern environment is one of sterility and predictability, punctuated by occasional violence; it is one of quiet humiliations wrapped in consumer packaging; it is one of forced enjoyment and unbelievable exhaustion.

Houellebecq’s novels are so tantalising because they actually analyse our dysfunction. As was the subject of Sérotonine (2019), we live in a society in which a schizophrenic mixture of chemical determinism and trauma discourse has turned almost every feeling into an aggressively-treated and individual one. We have developed a world in which antidepressants — and, often, both amphetamines and anti-anxiety medication — are considered a completely normal, almost essential, supplement. This is, obviously, a nightmare. And some people, occasionally, want an alternative.

That’s why we need Houellebecq’s pauvres types. That’s why they need to be miserable. That’s why they need to be completely out of their minds. Houellebecq has never been a great psychologist; he has never been a great stylist. But his mal du siècle is more sickening than anybody else’s, and his analytical drive is, at its best, in a league of its own. Other writers of bureaucratic hell (see Halle Butler) don’t have Houellebecq’s Balzacian side, which is his triumph: he hates everything, and yet he wants to understand why. He persists, even though critical thought itself has come to seem obsolete. As his stand-in in La Possibilité d’une île, a controversial comedian, reflects, “I was, indeed, a cutting observer of contemporary reality; it was just that everything now seemed so elementary to me, it seemed that so few things remained that could be observed in contemporary reality.”

More from his author

Licorice Pizza: a forgettable nostalgia flick

By Esther Manov

Bewilderingly, much of that has disappeared in this last volume. It’s far too long, and shockingly boring; entire transcribed conversations serve virtually no purpose, and every scene starts earlier and ends later than it should, as though he wrote the book on stimulants or perhaps under hypnosis. Maybe Houellebecq’s editor (accurately enough) figured it wasn’t that important to edit. Or maybe Houellebecq is the victim of his own success: his early books are so iconically masterful at capturing the malaise of a pleasure-driven and unpleasant society that even his clever observations seem a little old hat. As Houellebecq himself recognised, “in opening my literature to theoretical conceptions one might develop about the world, I am constantly vulnerable to cliché and, in truth, I’m doomed, my only chance at originality consisting of (to borrow Baudelaire’s intuition) developing new clichés.”

There are highlights; I teared up towards the end, when Paul’s wife gets emotional remembering when the two of them were teenagers, going through the loneliest period of their lives, and hadn’t yet met. As the protagonist of Extension whispers to his coworker, as the protagonist of Particules tells us, we are haunted by the teenage loves we didn’t have. And how sad to have wanted, at death’s door, to have been there.

All told, this much-noted turn to love leaves much to be satisfied: essentially, the protagonist and his wife, two énarque bureaucrats, have not been sleeping together, but she develops a mild interest in paganism and therefore feels a little more feminine and since her ass is still firm, then they do. Once he is dying of cancer she starts wearing thongs.

The same goes for the other plots. The political one is so predictable in its observations — yes, Macron is like a made-for-TV president; yes, the Right is popular in France; yes, cyberterrorism is a threat — that it seems almost AI-generated. The protagonist’s father is in a coma, and while Houellebecq does not support euthanasia, this parental loss somehow carries almost no emotional weight.

The protagonist’s brother is married to a journalist, and she is very annoying and evil. The protagonist’s sister is very Catholic and not evil at all, her husband is poor, she has a black son, and at one point her daughter inadvertently gives the protagonist fellatio. But somehow, every plot simply fizzles out to leave us to contemplate the character’s relatively sudden cancer diagnosis. On the one hand, that diagnosis elicits the very fine observation that modern life revolves around the dissimulation of “l’agonie”; but on the other hand, even this death plot falls into elegies to knickers and blowjobs.

Perhaps Houellebecq, in his novel about two men declining through no fault of their own (unlike, say, the wheelchair-bound swinger of Particules), couldn’t bear to go into full-on nihilism. Perhaps it seemed too dark to have these men die in sadness, without meaning, without redemption, to say their lives had ceased to have meaning long before their strokes or cancers.

In its breathless review, Le Monde said that “one feels, above all, that his writing seeks more than ever to fuel, if not hope, at least values”. But what values? Our hero observes that his Catholic sister seems happy, but he still can’t believe; he observes that politicians should have real values, almost like kings, but no such hero arrives.

Ultimately, the only real lesson is to try to have sex with your wife again before you die, which thankfully seems pretty simple. So, sure, this book’s less dark. But having turned on the lights, there’s not much to see: annihilation, indeed.

Nitschke features heavily in The Inevitable: Despatches on the Right to Die, Katie Engelhart’s recent book on assisted suicide. Here, Engelhart describes how for the majority of people seeking euthanasia, pain isn’t their fear. Rather, “losing autonomy” is “their primary end-of-life concern”. Others, she reports, “worry about ‘loss of dignity,’ loss of the ability to engage in enjoyable activities, and ‘losing control of bodily functions’”.

This is a growing problem for the generation perhaps most closely associated with the push for autonomy and self-determination: the one that came of age around the Sixties. In other words, the boomers, born between 1946 and 1964. Philip Nitschke (b.1947) is, as his partner puts it to Engelhart, a “child of the Sixties”.

How to stay in control of something – death – that can’t be controlled? This is a generation who grew up amid boundless optimism about the seemingly limitless potential of technology to extend human freedom and potential infinitely, and smash every seemingly natural constraint – even that of biological sex.

The invention of the Pill enabled women to defy a previously irreducible difference between the freedom of men and women to pursue risk-free sexual self-expression. And it was arguably that extension of sexual freedom to women that kicked off the “swinging” Sixties, and informed much of the boomerism that has followed.

A generation marinaded in the positive nature of cultural, political and bodily freedom is thus now confronting, in every ageing boomer body, its own Boomerdämmerung. According to Engelhart, Nitschke himself sees his movement as boomer-driven: “Boomers getting into their twilight years,” he says to Engelhart, “just want access to lethal drugs.”

Not every person born during this period rages thus boomerishly against the dying of the light. Some want to evade it altogether. Late-era boomer Jeff Bezos (b.1964), now the richest man in history, is reported to be funding a new venture to research eternal life. Elsewhere, boomers are seeking to greet the Boomerämmerung not with a heroic last stand, but a form of ascension into virtual realms.

The latest news story to dress this response to Boomerdämmerung in feel-good clothing comes from Seventies pop sensations ABBA, who announced last week that they’re releasing a new album for the first time in four decades.

Two new tracks – the ballad I Still Have Faith In You and the upbeat Don’t Shut Me Down – are already available, making the band the hottest trending search in YouTube’s music category at the time of writing. Both tracks are recognisably ABBA-ish. But the most arresting thing about the band’s relaunch is not its surprise appearance after so many years saying “never”. It’s the way the new venture combines classic ABBA energy with a very 21^st-century boomerism.

More from this series

It's time to stop blaming boomers

By Ben Sixsmith

For ABBA aren’t coming back in person, like Led Zep frontman Robert Plant did in all his craggy glory alongside Alison Krauss, for the superb 2007 country album, Raising Sand. No; they’re embracing the tech-enabled boomer fightback against ageing. But though Björn Ulvaeus is an outspoken advocate of assisted suicide, ABBA are not shopping for a ‘Sarco’. Instead, they’re coming back as holograms.

In this, they have extensive boomer precedent. Biotech entrepreneur and boomer transhumanist Martine Rothblatt (b. 1954) talks in From Transgender to Transhuman (2011)about how, in the future, “people of flesh will upload into software the contents and processes of their minds”, resulting in the emergence of a new species, homo creatus. Rothblatt makes heavy use of another futurist (and boomer of the same vintage as ABBA): the inventor and futurist Ray Kurzweil. Kurzweil argued in his 2005 book The Singularity Is Near: When Humans Transcend Biology that the pace of technological innovation is accelerating, propelling us toward an event he calls “the singularity”.

In this event, Kurzweil argues, aggregate machine intelligence will surpass the human kind, triggering a fusion between human and machine. In turn, the fusion of human and machine intelligence will enable people to upload their consciousness to the cloud, escaping the constraints of flesh and mortality entirely, for a new world of infinite possibility.

What such a singularity might mean for those parts of human experience given shape by embodiment, loss, limitation or adversity is rarely made clear in such optimistic accounts of human/machine fusion. Those experiences, though, do form a vital part of what’s lovable about ABBA’s classic oeuvre: their improbable ability to set human complexity, fallibility and pain to a sing-along disco beat.

The theme of Mamma Mia, for example, is a woman who keeps going back to a serial cheater. In some hands this would be dark material for a misery-fest. In ABBA’s hands, it’s a jolly wedding-disco classic. One wonders: would homo creatus be capable of such paradoxes?

More from this writer

Nightclubs won't save you

By Mary Harrington

Regardless, this bittersweet-disco energy has made ABBA irresistible for every decade since they first hit megastardom. And ABBA’s two new releases have the age-old mix of human complexity with sing-along cheese that’s most endearing about their music. They’re as catchy and human as ever, with lyrics about love and friendship that feel like they’re written by people too far past the flush of youth to be dizzied by sex or easy promises of ‘forever’.

Tickets have just gone on sale for a tour in which ABBA updates this Seventies paradox with one that couldn’t be more 2021: the “Voyage” experience, where the band will appear as digital versions of their younger selves, called “ABBAtars”, created by George Lucas’ studio Industrial Light & Magic.

Ray Kurzweil premiered the precursor to the “ABBAtars” two decades ago, at a TED talk in which he appeared in the guise of “Ramona”, his “female” digital alter ego. “Ramona”, a kind of holographic puppet, was operated remotely via sensors on Kurzweil’s body, combined with voice-change technology that reformatted his voice in more feminine tones. The result is, as you can see, unsettling to say the least.

But CGI has got better since then, as the rise of “deepfake” footage (and even deepfake pornography) attests. The ‘ABBAtar’ footage that appears toward the end of the I Still Have Faith In You video looks convincingly on a continuum with the video’s many clips of their 1970s footage. Inasmuch as there’s a difference, it’s no more so than the gap between someone today posting on Instagram with and without filters. In other words, comfortably within the acceptable envelope of digitally-enhanced reality as we’re accustomed to it today.

More from this writer

We are all Britney now

By Mary Harrington

“Virtual reality…you can be someone else” Kurzweil claimed two decades ago, in the guise of Ramona. We’re now waist-deep into our mass experiment in what happens when the boomer generation encourages its offspring to believe that this is (at least online) literally true. But regardless of the effect such claims may have on those who’ve never known a world without internet, the boomer race to create a de-corporealised haven from the Grim Reaper is growing ever more urgent as the boomers themselves become, corporeally, more haggard.

It’s not clear whether the band will perform as themselves at their ‘Voyage’ events. But why should they? They’ve arguably just come closer than Ray Kurzweil has managed yet to achieving boomer apotheosis: eternally perky, fresh, un-dying versions of their youthful selves, able to continue indefinitely doing what those younger selves did, without ever getting tired, ill or divorced.

Thus, once again, ABBA are the kings and queens of paradox. In the Seventies they stretched the tension between upbeat music and tragic lyrics to breaking-point. And their musical relaunch offers songs about the scars left by time’s passage, in digital avatars that spare the band any unflattering contrast between their dewy youthful public image and craggy, ageing contemporary selves.

The ‘trad’ in me wonders whether any of this is even necessary. My mum gave me her ABBA compilation when I was a tween in the early Nineties, and the same compilation is now my primary-age daughter’s favourite. I can’t think of another band that could unite three generations of women in singing at the tops of our voices in the car. Surely having fostered that kind of intergenerational love of cheesy pop is immortality enough?

Regardless, it’s clear that ABBA weren’t just a key sound of the Seventies, and (in revival) the Nineties. They’ve also captured a key 2020s boomer zeitgeist: the wisdom of age, with a glossy coat of high-tech optimism, over a howling abyss of memento mori.

Proposition one: no one wants to die. As a rule, we prefer a diminished life to no life at all; because we think we will always have the little pleasures of life. And are there any pleasures other than little ones? That is a subject worth exploring.

Proposition two: no one wants to suffer. Suffer physically, that is. Moral suffering has its charms, it can even generate aesthetic material (as I have discovered for myself). Physical suffering is pure hell, devoid of interest and meaning, from which no lessons can be drawn. Life has been sketchily (and falsely) described as a quest for pleasure; it is, more accurately, an avoidance of suffering; and more or less everyone, given a choice between unbearable suffering and death, chooses death.

Proposition three, the most important of all: physical suffering can be eliminated. At the beginning of the 19th century, morphine was discovered. Many similar substances have appeared since then. At the end of the 19th century, hypnosis was rediscovered; it remains little used in France.

Ignorance of these facts might explain the alarming opinion polls which support euthanasia (96% in favour, if I remember correctly). Ninety six percent of people think that they are being asked the question: “Would you rather be helped to die or would you like to spend what remains of your days in appalling suffering”. The other 4% know all about morphine and hypnosis. Those proportions seem about right to me.

I’m going to resist launching into an argument for the decriminalisation of drugs here (and not just “soft” drugs); that is a subject on which I yield to the wisdom-filled observations of the excellent Patrick Eudeline.

Partisans of euthanasia like to gargle on words whose meanings they distort to such an extent that they should no longer even have the right to utter them. In the case of “compassion,” the lie is palpable. When it comes to “dignity”, things are more insidious. We have seriously deviated from the Kantian definition of dignity by substituting, little by little, the physical being for the moral one (and maybe even denying the very notion of a moral being), substituting the human capacity for action with a shallower more animal concept of good health — turned into a sort of pre-condition of all possibility of human dignity, even maybe its only true meaning.

Put in this way, I have rarely had the impression that I have manifested extraordinary dignity at any time in my life; and I do not have the impression that this is likely to improve. I am going to end up losing my hair and my teeth. My lungs will be reduced to shreds. I will become steadily more or less impotent, more or less incapable, perhaps incontinent and possibly even blind. Once a certain stage of degradation has been reached, I will inevitably end up telling myself (and I will be lucky if it is not someone else pointing it out to me) that I no longer have any dignity.

Well, so what? If that is dignity, one can very well do without it. On the other hand, everyone more or less needs to feel themselves necessary or loved; and, failing that, esteemed—even in my case admired. It is true that can also be lost; but one cannot do much about that; others play in this respect the determining role. And I can easily imagine myself asking to die in the hope that others reply: “Oh no, no. Please stay with us a little longer.” That would be very much my style. And I admit this without the slightest shame. The conclusion, I am afraid, is inescapable: I am a human-being utterly devoid of all dignity.

Part of the usual sales pitch for euthanasia consists in maintaining that France is “lagging behind” other countries. The preamble for the bill that will shortly be proposed is in this respect comical: looking for countries that France is allegedly “lagging behind,” they can only find Belgium, Holland, and Luxembourg; frankly, I am not impressed.

The rest of the preamble consists of stitching together citations from Anne Bert, presented as “admirably forceful”, but which have the unfortunate effect of raising my suspicions. For example, when she maintains: “No, euthanasia does not fall under the heading of eugenics.” On the contrary, it is obvious that the partisans of both the ideas are exactly the same people, from the “divine” Plato to the Nazis. Likewise, when she adds, “No, the Belgian law on euthanasia has not encouraged inheritance theft.” I admit that I had not thought of this, but now that she mentions it…

Immediately afterwards, she lets the cat right out of the bag by claiming that euthanasia “is not a solution of an economic nature”. There are, however, indeed certain sordid arguments that one only hears from “economists,” insofar as that term has any meaning. None other than Jacques Attali has insisted, in an already dated work, on the cost to the public purse of maintaining the lives of very old people; it is hardly surprising that Alain Minc, more recently, has gone in the same direction, Attali just being a stupider version of Minc (without even speaking of that clown François de Closets, who is something like the performing monkey of the other two, their Hanswurst).

Catholics will do their best to resist, but, sad to say, we have more or less got used to the idea that the Catholics always lose. Muslims and Jews, on this subject as on other subjects deemed “societal” (that ugly word), think exactly the same as Catholics; the media are generally in strong agreement about hiding this fact. I do not have a lot of illusions; these faiths will end up by giving way and submitting to the yoke of “republican law”. Their priests, rabbis, or imams will in future visit euthanasia candidates to tell them that yes, it is an ugly business, but tomorrow will be better, and that even if people have abandoned them, God will take care of them. Let us be honest about that.

From the point of view of the Lamas, the situation is without doubt even worse. Any attentive reader of the Bardo Thodol knows that death throes are a particularly significant moment in a man’s life, for they offer him a final chance, even in the case of unfavourable karma, to free himself from samsara, the cycle of rebirth. Any early interruption of death-agonies is thus a frankly criminal act; unfortunately, Buddhists rarely intervene in public debate.

There remain only the doctors, in whom I had placed little hope, doubtless because I am not very familiar with them; but it is undeniable that some of them resist and refuse to kill their patients and that they will remain perhaps the last barrier to euthanasia. I do not know where they get this courage; maybe it is only respect for the Hippocratic oath: “Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course”. It is possible. The public uttering of this oath must have been a significant moment in their lives. In any case their struggle is an admirable one, even if it is a struggle “for honour”.

The honour of a civilisation is not exactly nothing. But really something else is at stake; from the anthropological point of view. It is a question of life and death. And on this point I am going to have to be very explicit: when a country — a society, a civilisation — gets to the point of legalising euthanasia, it loses in my eyes all right to respect. It becomes henceforth not only legitimate, but desirable, to destroy it; so that something else — another country, another society, another civilisation — might have a chance to arise.

This essay appeared in Le Figaro on 5 April 2021. Translated for UnHerd by Dr Louis Betty. 

And even if Eichmann had pretended, what then? It would have made no difference. Once a Jew, always a Jew. Saul, by becoming Paul, had merely transmuted all that was most baneful about the Jewish conspiracy against the Nordic race into a more infectious, and therefore more lethal, form. Hitler, who traced the glories of ancient Greece and Rome to Völkerwanderung from the northern reaches of Europe, also attributed the downfall of classic civilisation to the virus introduced by Paul into the bloodstream of the Roman Empire. Its devastating effects had been evident ever since. Lethal variants had evolved. In January 1942, even as war was raging in the snows of Russia, Hitler placed Operation Barbarossa in the context of 2,000 years of history:

“The Jew who fraudulently introduced Christianity into the ancient world — in order to ruin it — re-opened the same breach in modern times, this time taking as his pretext the social question. It’s the same sleight-of-hand as before. Just as Saul was changed into St. Paul, Mardochai became Karl Marx.”

Two particularly toxic evils, both of them derived from Christian teachings, threatened the Nordic race with ruin. First, there was the insistence that the weak, the sick, the persecuted merited compassion. So infuriating did Hitler find the objections of church leaders to the Reich’s on-going sterilisation of mental and physical defectives that already, by 1937, he had begun to envisage the elimination of Christianity once and for all. Clearly, there was no prospect of the Germans fulfilling their racial destiny while they were cancerous still with compassion. Hitler’s own preference — one that he was quick to put into practice the moment Germany went to war — was for a mass programme of euthanasia. This, a policy that was sanctioned both by ancient example and by the most cutting-edge scientific thinking, could never satisfactorily be carried out by a people who persisted in seeing it as evil.

Yet it was their own folly, their own blindness, that constituted the authentic evil. The Christian morality they clung to had resulted in any number of grotesque excrescences: alcoholics breeding promiscuously while upstanding national comrades struggled to put food on the table for their families; mentally ill patients enjoying clean sheets while healthy children were obliged to sleep three or four to a bed; cripples having money and attention lavished on them that should properly be devoted to the fit. Idiocies such as these were precisely what National Socialism existed to terminate. For the Germans to continue in their opposition to policies so transparently vital for their own racial health was insanity. The churches had had their day. “Harping on and on that God died on the cross out of pity for the weak, the sick, and the sinners, they then demand that the genetically diseased be kept alive in the name of a doctrine of pity that goes against nature, and of a misconceived notion of humanity.” The strong — as science had conclusively demonstrated — had both a duty and an obligation to eliminate the weak.

More from this series

The calculated evil of Adolf Eichmann

By Alexander Faludy

They also had a duty to trample down the second doctrine with which Christianity had poisoned the world. In 1942, an SS pamphlet quoted a line from Paul’s letter to the Galatians to illustrate just what it was that they had been summoned to fight against. “There is neither Jew nor Greek, there is neither bond nor free, there is neither male nor female; for ye are all one in Christ Jesus.” Here, the pamphlet warned, was a universalism that had dimmed the claims of blood, that had privileged the inferior races over the superior, and that over the course of the centuries had served to geld the Nordic race. A doctrine as pernicious in its effects as this could only have come from one source.

Of course Jews were not Greeks, and of course they could not be permitted to live alongside other, healthier races — of whom the healthiest was the Nordic. “Apes massacre all fringe elements as alien to their community. What is valid for monkeys must be all the more valid for humans.” Hitler knew that there was nothing particular about man. He was as subject to the struggle for life, and to the need to preserve the purity of his race, as any other species. To put this into practice was not evil. The truest evil was to do as Christians did: to oppose the ways of the world.

The Nazis, of course, did not succeed in their attempt to redefine for Europeans the parameters of morality. Their Reich did not last a thousand years. Their programmes of euthanasia and genocide are not commemorated today as models of enlightened statecraft, crafted in accordance with ancient wisdom and modern science. Quite the opposite. Today, across the Western world, the Nazis serve as the very archetypes of evil. The old supernatural cosmography that for centuries structured how people in Christendom understood the dimensions of hell may no longer possess the currency it once did; but the concept of hell itself still endures. It has become difficult, since the liberation of the death camps, to imagine it as anything other than a muddy cesspool, surrounded by barbed wire, crematoria silhouetted against a wintry sky. A belief in the satanic as Christians had long construed it, as a literal demonic force, may have faded in the West; but not the conviction that evil is to be identified with a single, sulphurously charismatic figure. Who needs the Devil when there is Adolf Hitler?

More from this author

Homosexuality's Christian roots

By Tom Holland

Who indeed needs Jesus? It is no coincidence, perhaps, that the more Nazism has come to shadow the imaginings of people in the West, the less they have gone to church. Other regimes in European history have aspired, as Hitler did, to eradicate the hold of Christianity; but only Hitler aimed to eradicate, not just the institutional forms of the religion, but the doctrines of charity for the weak and sick, and the universalism, that lay at the heart of its traditional teachings.

This is why, 80 years on from the Second World War, the Führer retains his starring role in contemporary demonology. Communist dictators may have been no less murderous than fascist ones; but they — because communism was the expression of a concern for the oppressed masses — rarely seem as diabolical. Today, when we ask ourselves “what would Hitler have done?”, and do the opposite, we are as obedient to the weathering effects of Christian morality as our forebears were when they wondered “what would Jesus have done,” and sought to do the same.

Nietzsche, declaring in a famous parable that God was dead, declared as well that in the great cave that had once been Christendom His shadow still fell, an immense and frightful shadow. It is there in our readiness to use “fascist” as the ultimate insult; to sanctify those who suffer oppression; to regard racism as a sin beyond compare: a shadow that continues to define for us, even in this godless age, the meaning of evil.

And what if the number of terminally ill people who sought recourse to assisted dying were to increase over time? Would that be a cause for concern? Or would it vindicate the legislation, simply showing that people were exercising rights previously denied to them?

These are the kind of critical questions MPs failed to ask in last week’s debate on assisted dying – the first in four years. Any serious consideration of the way legalisation could transform our whole culture in relation to ageing, chronic illness and dying was sorely missing.

Suggested reading

The ethical nightmare we won't confront

By Douglas Murray

Instead, MPs lined up to explain why they had dropped their previous opposition to assisted dying. From Nick Boles to Sir Vince Cable, one by one they registered their volte-face on the subject. And by doing so they abdicated their responsibility as leaders: to paint a vivid picture of possible future scenarios. They repeatedly refused to accept the invitation – one offered by Lyn Brown for example – to foresee the difference such a monumental step could make; indeed, even to acknowledge it would be a monumental step.

Assisted dying is a highly emotive and deeply distressing issue. I cannot begin to imagine the acute pain, profound fear and bewildering loss of control that is said to come with motor-neurone disease or the late stages of cancer. That suffering, those stories, must not be left out of deliberation. Nor should we dismiss the strength of such unwell patients’ desire for control over the manner and timing of their deaths.

But nor should we ignore the wider effects that a change to the law might have on society; how it would transform the experience of ageing, the dynamics of the family and the practice of medicine.

In his revealing speech to the House, Crispin Blunt invoked what he clearly viewed as the spectre of an ageing society: “By 2040 nearly one in seven people will be 75 or over,” he said. “More of us will have to grapple with surviving with the pain and indignity of crippling progressive infirmity later in life.” The solution to this? Care will only ever be one part. Providing an “escape from pain and indignity” through assisted dying will be necessary, he said.

Blunt insisted the vast majority would not take this route. But if assisted dying were being sold as a viable alternative to social or hospital care, that would surely normalise it, making it par for the course for an ageing society. Premature death could well become a cultural expectation.

Suggested reading

Can we be trusted with euthanasia?

By Ian Birrell

True, many of the MPs involved in the debate emphasised the restrictive conditions under which euthanasia might be legalised. Only terminally ill patients with six months to live would be eligible.

But, again, the politicians’ unwillingness to consider the consequences was breath-taking in its naivety. The fundamental logic of assisted dying – that I should have control over my death as I have had over my life – fundamentally clashes with this restriction. If we enshrine in law the principle that I should have control over the manner and timing of my death, why should that not be extended to the terminally ill patient with seven months to live? Or the person suffering from devastating mental rather than physical ill-health? Or someone simply tired of life? Do they not have an equal right to autonomy?

Indeed, at one point Steve McCabe voiced this very challenge to the six-month criteria. “Life expectancy in itself,” he said, “does not tell us anything about suffering.” Rather, if someone is given the right to choose, that right should extend to “a stage where he has no quality of life”. The six-month restriction is wholly arbitrary, McCabe was rightly saying. Thus, within the course of the debate itself, a member of the house, unnoticed, was sliding down the slippery slope from tight to lax restrictions.

The second massive transformation the legalisation of assisted dying would enact would be on the dynamics of the family.

Nick Boles assured the House that any assistance would require an independent assessment of the state of mind of the patient. Doctors and a High Court Judge would have to be absolutely persuaded that the person wanting to die did not “show any signs of coming to a decision under pressure or because they felt they were a burden”.

Boles was confident abuse would show up this way, refusing to countenance a picture of the future informed by the real-life contexts in which end-of-life decisions occur today. When we look unflinchingly at what happens when life draws to a close, we see complexity, dilemma and sometimes even abuse. Wills, inheritances, care costs – arguing over these do not always bring the best out of us.

So let’s fast-forward to a world in which assisted dying is now an option. An 85-year-old grandmother, no longer able to look after herself, has received a diagnosis that she is terminally ill and has only a few months to live. Does she go into a fiendishly expensive nursing home which will exhaust her lifetime’s savings? Or does she bow out? No one in the family has said a word to her. Yet she feels a pressure – her decisions have been complicated by the possibility of assisted dying.

Eventually, she settles on assisted dying. She’s not escorted to the clinic with a son holding a gun to her head. No grandchild has attempted to manipulate her. No one has said anything to her, in fact, so no independent assessment panel will pick up on overt coercion.

And yet, who’s to say that what’s really going on is a grandmother choosing to die prematurely because she feels she has become a burden? Are we really okay with that?

Suggested reading

Who wants to live forever?

By Nigel Cameron

Finally, and most unsettling, is how the introduction of the law would transform medical practice. Again, no one in the debate mentioned this.

Answering the question of what had changed to justify reopening the assisted dying question, Nick Boles appealed to the Royal College of Physicians (RCP)’s decision in February to shift its stance from opposition to a neutral position on assisted dying.

Now, crucially, this only happened because a cabal at the top of the RCP changed their rules on how they determined their stance – as Fiona Bruce pointed out in the debate (another ignored intervention). Previously it was straightforward. The institution’s leadership adopted the most favoured option of their members – which is opposition to assisted dying. But this time it was decided that the College would default to neutral unless opposition secured a supermajority of 63%. So, extraordinarily, the leadership of the Institution no longer represents the dominant view of its members.

This move has masked the real attitude of most doctors, which is that getting into the business of assisting people’s deaths fundamentally changes the practice and also perception of the profession. According to the Hippocratic oath, the first duty of the doctor is not to harm (primum non nocere). And the distinction between intentional killing (administering barbiturates) versus letting die (turning off the life-support machine) protects doctors from becoming anything other than the helping profession.

If this distinction were to collapse, what would the country look like in 40 years time? Hospitals could be transformed from places of healing and care, to places of last resort, haunted by mistrust and fear.

The virtue of prudence involves making a good judgment about the present based on a sober assessment of the future. It is the virtue we expect from statesmen. Which is why we were let down last week. Instead of imagining future scenarios – not indulging in speculative fancy, but making predictions informed by a sense of history, by a sense of how things tend to go in the world – most MPs buried their heads in the sand. They should be ashamed of themselves.

Naomi Wolf was on the receiving end of it recently. It emerged, in the course of a live broadcast, that she had made a serious mistake in interpreting some of the evidence which she had marshalled to defend the argument of her new book. And gosh how people enjoyed it.

People on social media, with little real interest in Wolf and her oeuvre, joyfully shared the audio clip of her being informed of her error. As it happens, Wolf dealt with it graciously. She did not rail, storm, deny or prevaricate. Most important of all, she did not continue to defend it after it had become clear it was no longer defensible (a most common habit of the age). Instead, she said that she would like to address where her research had gone wrong.

In general, people do not react like this when their errors are revealed. And some errors have more serious implications. So it was this week with the news, and then correction, about a tragic case from the Netherlands.

Suggested reading

Can we be trusted with euthanasia?

By Ian Birrell

The story broke of a 17-year old Dutch girl called Noa Pothoven who had been euthanased at an ‘end of life clinic’. In a number of countries (including Italy where I was at the time), this was front page news. It was obvious why: this is exactly the sort of story which epitomises the fear felt by those who oppose the introduction of euthanasia. Outrage swept through social media.

But before the day was out, the story had been debunked. Local media reported that, rather than having died at a euthanasia clinic in The Hague, Pothoven had in fact died at home in Arnhem on 2 June after refusing to eat or drink.

Thus was a massive media misinterpretation and over-reaction corrected by cooler minds. But the underlying ethical nightmare lingers, playing on the fears of rational minds. It was all too plausible. And while people point out the media’s mistakes, no one’s addressing the underlying problem.

I have researched and written about the issue of euthanasia in Belgium and the Netherlands a number of times. It is particularly striking how relatively few people are willing to take on the deep challenges that the whole issue throws up.

Suggested reading

Why the herd hates Cleese

By Douglas Murray

Those who do, tend to be those who hold the traditional views of the Catholic church on beginning and end of life issues (as the prominence of the Pothoven story in the Italian media proved). To those who regard life as God-given, sacred, and not to be stopped from the moment that life originates, the whole question of euthanasia is recognised to be a profound challenge to their view of life and its purpose.

Outside of this, the euthanasia debate has become mired in some of the most shallow and prevalent attitudes of the age. These include, though are not limited to, arguments couched in the language of ‘human rights’, as though the ability to die at a time of one’s own choice is not merely a human right but the ultimate, perhaps final, such right. For who is anyone else – let alone the law of any land – to refuse us the right to such a final demonstration of autonomy over our own bodies and lives?

When Lord Falconer attempted to pass an ‘assisted dying’ bill in the British Parliament in 2014, it was presented as a humanitarian necessity: one which partially solved a medical – you might say terminal – problem. Although that bill was eventually unsuccessful, the tone in which it was argued is now familiar in those countries, such as Australia, where the euthanasia issue has been recently debated. The argument focuses on people with terminal illness, suffering unbearably at the very end of their lives, and is generally supported (or at least leaned towards) by those who favour the reduction of suffering unconnected with any wider system of ethics beyond that.

This was not the case with Pothoven. She was clearly a very unhappy and unfortunate young woman. Her friends say that she had made repeated efforts to kill herself, had suffered severe depression and also suffered from anorexia. It also appears that she approached one of the ‘end of life’ clinics in the Netherlands last year, and that they had judged her too young to die. But for how long will this remain the case?

Suggested reading

The reason people peddle lies about Farage

By Douglas Murray

Since euthanasia was legalised in the Netherlands and Belgium, both countries have seen a remorseless push on two fronts. The first is to broaden the recognition of what should be deemed to be a ‘terminal illness’. Just last year a 29-year old Dutch woman called Aurelia Brouwers was euthanised despite suffering no terminal physical condition. Brouwers suffered from mental illness.

The other direction in which the euthanasia argument spills out is in the lowering of the age of those able to be euthanised. In the Netherlands and Belgium, campaign groups have called for a lowering of legal limits for euthanasia from the moment that the practice was first permitted. Belgium has allowed children as young as nine who are suffering from terminal illnesses to be euthanised.

These are two vast ethical traps which require far deeper consideration than a mere ‘media gets something wrong’ story allows.

The lowering of the age at which people can be euthanised is, in many ways, the simpler of the two problems. Most countries have age-limits on a range of activities, and it’s quite possible euthanasia could be kept within the same restrictions as access to tobacco or alcohol. This could allay any fears about desperately miserable teenagers.

But the far more serious problem, which always creeps up on societies which permit euthanasia, is the line between mental and physical illness. This is a primed bomb.

Suggested reading

Is cultural Marxism a myth?

By Douglas Murray

In most Western European countries, there is an increasing drive to view physical and mental illness as having parity. In the UK, the government has repeatedly said that it wishes to take mental illness issues as seriously as physical illness issues. Everywhere the melding of the two is (rightly or wrongly) going on. But in a society which permits euthanasia, things get more complicated; the bomb explodes. For who is to say that a severely depressed person in their 20s is not to be judged to be in as serious a condition as somebody with cancer of the same age?

I have yet to find anyone willing to explore this boundary. Most look away, postpone or try to find false consolation in mocking reporting errors like those in the Pothoven case.

In the long-term, this is a mistake. Such serious ethical matters must be addressed at length as well as in depth. It might be fake news today, but tomorrow it could be a reality. Yes, the factual errors of this case need to be corrected. But to simply dismiss the case, without acknowledging its desperate possibilities, is a reckless move which will have long and severe consequences. There’ll be little schadenfreude if we get this one wrong.

So should we let individuals make the ultimate decision: to control the timing and nature of their own death when they have debilitating and terminal health conditions?

This question cuts to the heart of our humanity and rights. Several places in North America and Europe already permit death-on-demand in different forms. Now, as pressure grows for reform in the UK, often driven by powerful testimonies from terminally-ill people, the influential Royal College of Physicians is polling its 35,000 members on whether the law should be changed. The body has said it will ditch its opposition to any change unless six in 10 doctors are opposed.

For Britain to follow Belgium, Canada and the Netherlands down the path towards euthanasia, would be significant. Our nation is seen as a pioneer in the creation of the hospice movement and development of palliative care thanks to the late and very great Dame Cicely Saunders. But surveys indicate there is strong public support for change. I am, as an atheist and unashamed liberal, philosophically sympathetic to those seeking legalisation of assisted dying.

Suggested reading

The invisibility of disability on screen

By Ian Birrell

Yet, ultimately, I am concerned about any proposed change. Putting aside my admiration for our palliative care system, which I have seen at first hand within my own family, this is for two key reasons. The first was driven home to me two months ago when I spent a few days investigating the impact of this issue in Belgium.

This was the world’s second nation to legalise euthanasia and almost 15,000 people have officially ended their lives this way since 2002. It was impressive to see how assisted dying had become entwined within health and palliative systems. Beyond those with strong religious beliefs, I found few concerns over people with late-stage cancer or the cruellest physical conditions opting to terminate their lives. Some doctors remained uneasy about killing patients themselves with fatal doses of drugs, yet were content to assist people who had made rational choices to end their own lives. Other medics were more sanguine, such as the activist doctor I met who had personally despatched 140 people including two of his own friends.

Yet there is no doubt that in Belgium there is a slippery slope: as euthanasia becomes normalised in medicine and society, the number of cases surges and the scope widens. Look also at the Netherlands, where assisted dying now accounts for one in 25 deaths and right-to-die activists are pushing for ‘tired of life’ legislation that would permit any elderly person over a certain age to obtain drugs to kill themselves on demand.

Suggested reading

How charities are corrupted by Whitehall

By Ian Birrell

“The process of bringing in euthanasia legislation began with a desire to deal with the most heartbreaking cases – really terrible forms of death,” the ethicist Theo Boer, a member of a Dutch regional euthanasia board for nine years, was quoted as saying in The Guardian last month. “But there have been important changes in the way the law is applied. We have put in motion something that we have now discovered has more consequences than we ever imagined.”

Belgium, for example, now permits euthanasia for children. It has allowed at least three minors – two of whom were children under 12 – to receive lethal injections since the law was changed five years ago. It also allowed a pair of deaf adult twins who feared turning blind to kill themselves. And it is available for those with ‘unbearable’ psychiatric pain. If we accept people have the right to death as relief from intense suffering, then this makes ethical sense, since there should not then be distinction between physical and mental agony. Yet such distress is harder to detect and more open to subjective interpretation.

It can also be highly complex. One woman scientist told me she felt more comfortable and in control of her life once she had been permitted to choose her own time of death, and experts pointed out that euthanasia is kinder on a patient and their family than the grisly alternative of suicide. Yet it is hard not to be unsettled when you hear, as I did, the tale of a depressed woman aged only 21 going through a legal process that will end in death. I also heard concerns from psychiatrists over elderly people facing pressure to kill themselves; in at least one case, simply to enrich their family.

Suggested reading

Animals. Are they so different from us?

By Ian Birrell

It is, therefore, no coincidence that both Belgium and the Netherlands face landmark court cases over controversial deaths following this surge in numbers. One involves the diagnosis with autism of a 38-year-old woman, the other concerns the disturbing incident of an older woman with dementia who had to be held down by her family as she struggled during her final injection.

Which leads me to my second cause for concern: how do we protect vulnerable people once the state starts sliding inevitably down that slippery slope towards the place where euthanasia becomes routine?

It seemed incredible that an autism diagnosis could trigger a euthanasia decision. I discovered a quartet of British and Dutch professors who also had serious concerns, having reviewed cases of people with autism spectrum disorders or learning disabilities who were granted euthanasia. As these experts pointed out, feelings of isolation and an inability to participate in society had come to be deemed as ‘unbearable suffering’, the legal requirement for ending a life. “Suffering was described in terms of characteristics of living with an autism spectrum disorder,” according to one of their papers, “rather than an acquired medical condition.”

Suggested reading

Is Harry Potter an apologist for neoliberalism?

By Polly Mackenzie

This is a terrifying glimpse of how society fails such people – something that chills me to the core as father of a young woman with profound learning disabilities. Surely the real cause of their suffering was the lack of support that might enable them to live contentedly with their conditions, compounded by the woeful lack of acceptance of people who view the world differently which still stains so many societies.

Back in Britain, I have been investigating how hundreds of people with autism and learning disabilities are locked up in horrific and unsuitable psychiatric units. This barbarism includes being slammed in solitary confinement, fed like animals through hatches and on the floor, forcibly injected with powerful drug cocktails, and even children violently restrained by teams of adults. Remember that Belgian scientist I spoke to who was in such mental pain she was granted euthanasia? Her troubles, she told me, went back to when she was held in similar conditions as a teenage girl – yet still we incarcerate scores of teenagers today in the same way, wrecking their lives.

Private operators have moved in like vultures in Britain to exploit this trade in incarcerating human beings, while politicians make empty pledges to end such disgusting abuse. Health secretary Matt Hancock is only the latest to express horror and then kick the issue into the long grass. Sadly, this symbolises again how citizens with autism and learning disabilities are seen as lesser people – along with all the continuing abuse, the hate crimes, the bullying in residential homes, the school exclusions, the dearth of jobs and far too many early deaths in the health system.

So, yes, I remain sympathetic to the concept of assisted dying for those with chronic conditions. But as I have seen in Belgium, once the door is opened, it does not take long for a nation to normalise death on demand. And while I’m not anxious on moral grounds, I do fear for the safety of the most excluded people in society. Until our country shows it respects the human rights of all its inhabitants, then we simply cannot be trusted to handle such a potentially lethal reform.