As someone it has supported assisted dying, I read Matthew Parris’ recent opinion piece in The Times (paywall) with dismay. He presents the idea that as a society we must be honest in accepting that dying people consume resources for little personal gain, and that the legalisation of assisted dying will help both them and society by facilitating their departure. Of course, opponents of assisted dying jumped on this as a clear evidence that underlying the movement towards legalisation there is a malign, economically based motive. His words evoked dystopian scenes, such as Logan’s Run and PD James’ The Children of Men (where older people are taken out on barges and drowned in the sea, a process called the Quietus).
What did Parris actually say?
As (objectors say) the practice [of assisted dying] spreads, social and cultural pressure will grow on the terminally ill to hasten their own deaths so as ‘not to be a burden’ on others or themselves. I believe this will indeed come to pass. And I would welcome it.
For a society as much as for an individual, self-preservation must shine a harsh beam on to the balance between input and output. To protect its future, a healthy society must adapt its norms, its cultural taboos and its moral codes.
This is not new territory for him. In a 2015 Spectator article, he wrote
Already we are keeping people alive in a near-vegetative state. The human and financial resources necessary will mean that an ever greater weight will fall upon the shoulders of the diminishing proportion of the population still productive. Like socialist economics, this will place a handicap on our tribe. Already the cost of medical provision in Britain eats into our economic competitiveness against less socially generous nations…
Parris appears to be above the usual pro- and anti-assisted dying arguments. He does not engage in person-level experiences, or refer to those brave (all now deceased) individuals who took this issue to UK and European courts. He allows his mind, which instinctively veers towards autonomy and assisted dying, into areas that are not relevant to the dying person. His recent article immediately shifted the focus away from the individuals whose plight has led to this point (a possibility that it will be legalised in Scotland) to economics. From pain and suffering to net productivity; from bed to spread-sheet.
There is a potential overlap between Parris’ point and established arguments against assisted dying. The main one is protection of the vulnerable. It is feared that assisted dying legislation will, through external coercion, or possibly an internal sense of obligation, push the dying into a decision to hasten their death. Critics fear that whatever the safeguards, these individuals will meet the strict criteria and will be prescribed lethal medications. Parris is open about the sense of burden, both emotional and financial:
How much is all this costing relatives and the health service? How much of a burden are we placing on those who love us? … It will become common practice to pose this question without embarrassment, and to weigh the answer up.
Could economic pressure be translated through government policy, messaging and national cultural drift such that undecided, terminally ill individuals seek to hasten their deaths? To preserve UK’s resources? Is it possible to draw add a direct line, or maybe a circuitous, dashed one, between national finances and assisted dying?
Personally, I don’t think so. The individuals involved, be they patients, their families or medical assessors and prescribers, are unlikely to be influenced. This viewpoint could be criticised as naive. Yet, the focus will be so tightly held on the experience of the patient, their diagnosis, their trajectory, their stated goals, that I do not think there will be space in which an alleged societal desire to save money could insert a lever and exert pressure.
For these reasons, I don’t think we should be influenced by Parris. He sits in a utilitarian, somewhat removed plane that is not relevant to the rest of us. Those who support assisted dying should not feel embarrassed, undermined or exposed by his view. The arguments we make are for those who are dying but who cannot die in the way that they want to. Not to help balance the books.
Illusions of Autonomy 
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