This article is taken from the June 2026 issue of The Critic. To get the full magazine why not subscribe? Find our subscription offers here.
In P.D. James’s Children of Men, published in 1992 but set in 2021, coachloads of the elderly are deposited on the beach at twilight, dressed in white robes and handed a small bunch of flowers. Soldiers herd them onto barges, a band plays “Abide With Me”, and the boats are sent out to sea to be sunk along with their burdensome cargo.
All much too elegant and well-managed for 2020s Britain, of course. Far more plausible is Kathleen Stock’s dystopia, in which the deterioration of public services and the crushing cost of social care make assisted suicide seem a frankly admirable choice. “References to assisted death will be used by content-makers and influencers to get attention,” Stock speculates, and over time a sentimental mythology will take root.
“Self-sacrificing heroes prepared to die early will be lionised, perhaps making public goodbye videos. Families may be interviewed about how proud they are of a departing loved one. And, as people start to be socially rewarded for doing their ‘duty’, stubborn refusers will start to be blamed. Again, this is what tends to happen when a moral cause really gets going: a negative incentive to conform to popular opinion is generated alongside the positive ones.”
Stock is one of Britain’s keenest-eyed social observers, an acerbic and unillusioned commentator on the way we live now. She is also a philosopher trained in the dry-as-dust analytic tradition, the kind who obsess over minor grammatical distinctions and are forever pondering whether an argument “works” instead of just clobbering opponents with facts and common sense like the rest of us. This book exemplifies the usefulness of the philosopher’s pedantic mind.
On the face of it, the case for assisted suicide is almost too obvious to need stating. Some people at the end of life suffer terribly, in ways that could be shortened with a dose of lethal drugs; and contemporary society has generally accepted that individuals should be able to take decisions over their own lives.
Stock’s insight is that there are actually two arguments here. For “Freedom Lovers”, as Stock distinguishes them, death is your choice and nobody has the right to intervene. “Merciful Helpers”, conversely, feel a compassionate impulse to relieve the suffering of others.
These motives might complement each other in the kind of case presented by assisted death campaigners: the sufferer in their very final days whose pain is simply beyond the reach of medicine. But in practice, that is not really what assisted suicide laws are about. As Linda Ganzini, the leading academic expert on Oregon’s law, has remarked: “Everybody thought this was going to be about pain. It turns out pain is kind of irrelevant.”
Stock’s point is about the majority of assisted deaths: those who might have been helped by better palliative care; or are depressed or lonely; or are being subtly pressured by family, society or a slightly-too-eager medical professional; or can’t access the treatment and support they need; or have anorexia or PTSD or some other mind-altering condition; or whose real motivation is financial trouble, or the sense of being a burden on relatives, or feeling oppressed by their changed life circumstances; and so on.
In those cases, the Freedom Lover and the Merciful Helper cancel out each other’s best instincts. The Merciful Helper says that people should be given a way out of their suffering; but when somebody asks whether they should first be provided with medical, psychological and social support, the Freedom Lover says, “Stop interfering with their choice.”
Meanwhile, the Freedom Lover’s saving grace, if that’s the expression, is their rugged simplicity: they are trying to give rights to the individual, not to found some new social norm of suicide. But no sooner have they established a “right” to assisted death than the Merciful Helper has begun to erect a whole infrastructure of doctors, pharmacists and administrators to supply the drugs to as many people as are in “need”. In Quebec, nearly eight per cent of deaths are now assisted ones.
Stock’s book was written before the Terminally Ill Adults (End of Life) Bill sailed at full tilt into the constitutional iceberg known as the House of Lords. But what happened in the upper chamber has exactly confirmed her analysis. First peers began to inquire where the bill’s limits lay. Let’s say somebody has the requisite six-month prognosis (which is as likely to be wrong as right), but they only want an assisted death because they are in poverty: would they qualify? Lord Falconer, the bill’s sponsor, confirmed they would: “Choice is the key thing. Your financial position might be an element.”
What if the reason is a lack of access to good palliative care? Falconer: “We have to give everyone this choice on the basis of the way the world is for them.” Or that care is too expensive? “They might well apply because there is only a limited amount of money to go around.” In other words, the state can offer lethal drugs simply because no other solution seems available.
The proponents of assisted suicide, talking like Freedom Lovers, have been evasive about the impact on the NHS, but as the former NHS CEO Lord Stevens pointed out, one of the bill’s provisions amounts to “a Trojan horse clause for fundamental change to the National Health Service by the back door”. What happens when and if people start choosing assisted death to “protect the NHS” (as Stevens has warned), and doctors leave the medical profession in dismay, and palliative care funding is diverted to assisted suicide, and hospices have to close because they won’t countenance this new service? “Don’t look at me,” the Merciful Helper will say. “I just wanted to make sure everyone had access to a compassionate end.”
Much debate over assisted suicide concerns the idea of “good intentions” and “unintended consequences”. It took a philosopher to show us that the incoherence of the intentions leads by a short route to the disturbing consequences. By promoting a right to be helped to die, the Freedom Lover is already paving the way to a state suicide service. And by suggesting that certain categories of people are so “undignified” that they should be put out of their misery, the Merciful Helpers are already beginning to devalue the lives of the vulnerable.
This formidably argued and acutely perceptive book has already moved one prominent assisted suicide advocate, Bel Mooney, to abandon her position (“I gladly admit she has all but persuaded me”). You do, though, sometimes wish Stock would cheer up a bit: she sees everywhere the advance of “hyperliberal” individualism and, leaning into her Dylan Thomas-inspired title, urges us to rage, rage against the encroaching darkness.
Fair enough, but the failure of the Westminster and Holyrood bills shows that nothing here is inevitable; and some of us, if we had to choose, would pick a different Thomas poem: “Though lovers be lost love shall not;/ And death shall have no dominion.”
