A riposte to Tony Akkermans’ rejoinder on assisted suicide and euthanasia

I was initially pleased to see Tony Akkermans’ reply to my article on why humanists should join their Christian brethren to oppose the legalisation of assisted suicide and euthanasia (ASE). The purpose of my article was to inspire debate and open up a conversation. Akkermans’ reply to me indicates that my article was at least successful in ruffling some feathers. However, I hope that others have engaged more deeply with my article than has Mr Akkermans, who, rather than analysing my points, simply expresses exasperation that anyone could make them.

Akkermans begins by telling us all that a ‘basic humanist principle…is the belief that everybody should have agency over their own body and be able to make choices that are best for them.’ That’s a new one on me. I assumed that what unites us as humanists is that we do not believe in God or that a supreme creator is responsible for the wonderful history of humanity.

Akkermans might see that I agree that everyone should have agency over their own bodies. And if he will forgive me for the religious reference (he appears to think I am a ‘crypto-Christian’ anyway): ‘Fear not: for, behold, I bring you good tidings of great joy, which shall be to all people.’ (Luke 2:10-11). You already DO have control over your own body. No one can stop a determined suicide. No competent and free adult should be force-fed or treated against their will. Even Tony Nicklinson—who had ‘locked-in syndrome’—eventuated his own death by refusing food and drink.

What we are talking about is the choice of someone else about whether we should live or die. That is what is meant by ‘assisted’. In every euthanasia/assisted suicide regime in the world, the choice—our ultimate choice—must be approved by doctors. I argue that we must stop these third parties from deciding which lives are worth living and which are not. And I argue that when someone expresses suicidal wishes, our general position should be to assume that their life is valuable (though some aren’t) and to encourage them to live rather than give a counsel of despair or—worse—offer to push them off the proverbial ledge. That, and not because I’m a crypto-Christian or blind to people’s suffering, is why I’m opposed to legalised ASE.

Mr Akkermans lays into my book, which he admits he hasn’t read, by referencing two critical reviews. This is akin to writing critical accounts of hotels not stayed at or restaurants not eaten at on Tripadvisor. But I wish he would have read it. Had he asked, I would happily have sent him a copy. Instead of flinging terms like ‘despicable’ and ‘highly condescending and offensive’ at me, we might have engaged in real debate.

Mr Akkermans accuses me of making ‘several unsubstantiated allegations’ (without seeming to appreciate the irony, he lists just one). Perhaps I could have explained the point about utility more clearly. How do doctors decide which suicidal wishes should be honoured and which should not when faced with a request for ASE? It is on their assessment of whether a life is worth living. Otherwise, we would have to honour the suicidal wishes of a 24-year-old on the basis of unbearable suffering because of a failed love affair just as we would honour the suicidal wishes of an 86-year-old in the throes of a progressive disease. It is either the person’s choice or it is the doctor’s, and if the latter makes the decision it is based on an assessment of whether that life is worthwhile not only to the person but to the world. That—besides a simple cost-benefit analysis—is what is meant by utility.

Morally, I regard assisting a suicide as equivalent to capital punishment. There are cases where a person is clearly better off dead but that does not make the principle right. The case of a prisoner on death row is subject to intense legal scrutiny and the authorities take years to review it—but that doesn’t make it right. Nor is killing an autistic man because his life is wretched right. There may be nuanced arguments for either, but I think we should retain the principle that it’s wrong in both cases.

Mr Akkermans defends Canada, where I was born and raised (I have also lived in the Netherlands, where Mr Akkermans was born and which he also discusses). First, ASE was not demanded by the people or even by politicians but by a judge. In 2019, another single judge decided that the existing criteria were too narrow to be constitutional and that the law must be expanded to include disabled people. An obedient Canadian parliament passed legislation, though they might have used the ‘notwithstanding clause’ to stop the judge’s decision from becoming law.

What has it done to Canada? It has changed the culture to one that sees death as a solution to social problems. Mr Akkermans cites one statistic showing that 42% of Canadians support ASE for mental illness only; what he doesn’t tell us is that in that same survey, significant numbers agreed that medical assistance in dying should be extended to those living in poverty (27%, with the figure rising to 41% among people aged 18-34), the homeless (28%), and the disabled (50%).

I am certainly not the only atheist to look upon what is happening in Canada and elsewhere with horror. Readers might be interested in a film made by another atheist, recently shown on the BBC, which gives an often-ignored perspective from a disability point of view: Liz Carr’s Better Off Dead?