The doctors’ danse macabre

This year, Westminster will decriminalise abortion up to birth and legalised assisted suicide in England and Wales — a neat illustration of C. S. Lewis’s maxim that, “The devil always sends errors into the world in pairs”. 

Like Merlin, C. S. Lewis seemed to live life backwards. In the secularising Britain of 1930, he turned to God. Young, he looked forward to being “old enough to read fairytales again”. Old, he described his wrinkles as, “honourable insignia of long service”. This resignation to mortality sounds heretical in the age of Botox but then C. S. Lewis had something that we claim to live without: faith. 

Rights cannot exist without faith either. A fellow who supports a right does not say, “I think it’s a nice idea.” Instead he puffs out his chest and proclaims, “I believe in the right to X.” Why make the case for a thing that already exists? No one has to argue for a mountain. A mountain simply is. But rights are not like mountains. Rights are a shared fiction, like money — and you won’t get far if the shopkeeper doesn’t believe the paper in your wallet is worth something. 

Rights are also contagious. Voters in neighbouring jurisdictions soon wonder what they are missing. In Ireland, an influential minority is eager to follow Britain’s lead on euthanasia.  The groundwork has been laid by a series of incremental parliamentary manoeuvres similar to those taken in Westminster. In 2024, the Irish parliament voted 76/53 to “take note” of a committee report recommending the introduction of euthanasia. Legislation is now before the lower house, but such a radical change would normally be put directly to the people.  Unlike Britain, the referendum has a defined constitutional role in Ireland. The electorate is used to them and, on questions with profound legal and social ramifications, we expect to be directly consulted. The legalisation of gay marriage and abortion in 2015 and 2018 made referenda very popular with the government but last year’s referendum on Family and Care was roundly rejected, a humiliation that precipitated the resignation of the prime minister Leo Varadkar. The current government is loath to run the risk of another such embarrassment. 

Man, individually the most thoughtful creature in nature, is finally just another herd animal

If public opinion does force them to grasp the nettle, the risk of rejection is not great. While there is a minority militantly opposed to euthanasia, they have little influence. Polls suggest that most Irish people are either unsure or in favour. Our nearest neighbour having embraced this revolution in morality, law and medicine will likely be argument enough for that undecided middle. Man, individually the most thoughtful creature in nature, is finally just another herd animal. 

However euthanasia finds its way into law, Ireland’s haste to join the club is imprudent. Any policy, good or bad, can be implemented poorly. A step so grave should not be taken lightly. Questions superficially debated in Westminster — will the dying and doctors feel compelled to take part? Are safeguards sufficient? Will eligibility requirements be lowered after rollout? Will it save the NHS money? — can be answered only in time. Logically, Ireland should suspend judgement and watch carefully as this vast and novel experiment begins — but that is a forlorn hope. 

In modern democracies, imagined rights become legal reality not by a judicious weighing of evidence but by advertising campaigns. Sound argument has a place in this propaganda, just not a central place. The policing of language is more important. Advocates speak of dying not suicide, drawing a veil over reality with euphemisms. Phrases like “slippery slope” become taboo in polite society. If one cannot honestly name a thing, one cannot hope to understand it. Semantic sanitation is employed not only to spare us from feelings of guilt but to muddy our thinking. Having been led to legalise abortion in 2018, the Irish already know the other dance steps:  parliamentary committees, people’s assemblies, earnest op-eds in the Irish Times, emotive primetime documentaries and celebrity endorsements. 

Before assisted suicide was rammed through Westminster, British newspapers told readers to ignore doctors’ warnings that legalising euthanasia would lead to abuse. “The invocation of a slippery slope is” said Stephen Poole in The Guardian, “almost always anti-rational fearmongering.” Well, until we find a better term — invidious incline? gruesome gradient? — slippery slope will have to do. However you describe it, this most final of solutions invariably becomes more common wherever it is permitted. Holland introduced limited euthanasia in 2002. Last year 5 per cent of Dutch people died this way. In 2020, euthanasia for children under 12 was legalised there.  In Canada in 2017, a mere 2,838 died by Assisted suicide.  By 2022, the butcher’s bill had increased to 13, 241 as the homeless, drug addicts and the depressed began to avail of this most modern of conveniences.

Convenience is a key slogan. Britons also heard that it was intolerable that their fellow citizens who wished to commit suicide in a clinical setting were put to the trouble and expense of traveling to Switzerland. This popular argument is obviously unsound. Consider Francois, a French man who desperately wants to marry a child. The poor chap must travel to Burkina Faso where the age of consent is thirteen. Surely, France should not be exporting the problem? Here we see at once that the problem is not French law but the degenerate Francois. The same goes for hard drugs being legalised in other countries. These risky experiments are useful — providing empirical data about the dangers that multiply when the floodgates open — but they are not in themselves a compelling reason for other countries to leap over the same cliff. These objections won’t stop the slogan of convenience being employed. It is the sole sacred value of a consumerist society. Just ask Jeff Bezos.

Recently, I bumped into an acquaintance I hadn’t seen in a while. This healthy young woman explained that she had almost died of infection. She had been rushed to a local hospital in agony. The dysfunction she described was shocking. Lapsing in and out of consciousness, she saw older patients wilt under the brutal indifference of staff. Weak, afraid and disorientated, they found speaking up difficult. If doctors deigned to answer, they were overawed by intelligible jargon. She was able to advocate for herself and, when her questions were brushed off, use Chat GPT to discover what drugs were being pumped into her. It made no difference. A few days of this treatment left her distressed. When a trainee doctor took pity on her to discuss her condition, she was overwhelmed with gratitude. If she was a few decades older, without family or money and in chronic pain, and if that kind intern suggested it was better for all concerned if she stopped being a burden, surrender would be easy. 

That prospect of giving up will seem remote to fit, young and independent readers. It once seemed remote to her. It is worth asking how we got to the point where inhumanity on an industrial scale was being smuggled into law across Europe labelled as a Human Right. It is an odd denouement to what has been an idealistic multigenerational quest. 

We the people dream rights into existence before we sign them into law. To imagine otherwise is, as Jeremy Bentham put it, “nonsense on stilts”. When Bentham began writing, active rights were few and those privileges were largely restricted to wealthy men. It was a revolutionary age obsessed with passive rights — rights from rather that rights to. This obsession is exemplified by the American Constitution of 1789. Its first four amendments, the ones which start so many quarrels today, curb Washington’s ability to pester her citizens. That laconic document is clear, to the point of cynicism, about power’s tendency to concentrate and corrupt. A more optimistic philosophy was abroad two centuries later in the interwar era when C. S. Lewis became a philosophy tutor in Oxford. The best people were confident that Europe’s remaining problems would be solved scientifically. Pioneering in the field of medicine were the Nazis. The means by which “Life unworthy of life” was removed from the body politic was euthanasia. Genetic hygiene was sold to a thrifty German electorate as sound economics as well as sound science: a “person who suffers a hereditary disease has a lifelong cost of 60,000 Reichsmarks to the National Community. Fellow German, that is your money as well.” The resultant holocaust, less well known than that perpetrated on the Jews, was no less barbaric — in a Viennese children’s clinic the brains of victims were preserved in hundreds of jars — but it did discredit Eugenics for decades after the war.

In 1945, utopianism resurfaced like a poppy from the rubble. The United Nations Charter is a document tempered with hard-won knowledge that efficient modern states can be efficiently genocidal. While the charter enumerates all the things states can and should do, it attempts to balance these powers with an expansive emphasis on Human Rights. The charter would remain aspirational without the cooperation of jurists in signatory members. It is by legislation that theoretical rights become actual. Over time, this has led to a popular belief that the main purpose of law is enunciating and vindicating rights. In Britain, doctors will soon be able to legally kill their patients in certain circumstances. In other words, a newfangled right will trespass on the oldest and gravest of laws, that against murder.  The tail is wagging the dog to death.  

The older view of law, the “thin” interpretation in the jargon, is less idealistic. Law is merely a rulebook. Laws are not inalienable, self-evident or any such fluff. They are instruments negotiated and enacted by sovereign parliaments. Laws should be publicly accessible, apply to rulers and ruled and never be retrospective. They can be repealed just as they are issued. Rights have little to do with it. But, like Jeff Bezos got rich by finding new junk to sell us every day, retail politicians win power by finding new rights with which to tempt voters. They rarely say who pays for it or admit that rights often compete with each other destructively. Here in Ireland, for instance, we are discovering that the Gender Recognition Act of 2015 does not play well with the freedom of expression proclaimed in the constitution of 1937. 

Filling the ethical hole left by the retreat of organised religion in post-war Europe, rights multiply faster than rabbits these days. Do we have more to discover? It’s a question we can only answer collectively. If we say we do, we do. Champions of the new order imagine every new privilege extends our freedom a little further. But rights, like everything else, are good only in moderation. A very small core — life, liberty, security of person, and free speech — are necessary foundations of a healthy democracy. Beyond that, it is a case of diminishing returns. A plethora of positive rights acts not as shield but as a burden, collectively reducing our liberty by empowering our already massive governments. Centralised states are, as any history of the last century shows, the most prolific rights abusers. 

The agents of TikTok totalitarianism are not goosestepping stormtroopers but dancing doctors

Still the crusaders march on, seeking new rights to proclaim. Anyone suggesting that the revolution is done, or that a pause to consolidate gains would be wise, is a backsliding heretic. The fervour of the campaigners and lobbyists, who invariably think of themselves as agents of liberal rationality, is odd until one realises that they are proselytisers for an old faith in new garb.  Like Medieval Christianity, the church of Human Rights sees itself as a panacea. Its champions are blithely unaware that its values are not merely culturally contingent but fundamentally European. 

Having witnessed the ideological excesses of the 1930s, C.S Lewis would be unsurprised to discover that good intentions are leading us once more to hell. “Of all tyrannies,” he said, “a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies.” The Covid panic gave us a glimpse of this new order of militant kindness. The agents of TikTok totalitarianism are not goosestepping stormtroopers but dancing doctors. While a few of us positively enjoyed surrendering to authority, most of us hoped that global descent into authoritarianism was an aberration best forgotten. We are about to discover that it was the dawn of a dark age. We are about to discover that some rights are wrong.