From assisted dying to Ukraine: don't be fixated on avoiding a specific outcome
Difficult decisions always have consequences on both sides, and we have to be prepared to acknowledge them rather than seek the comfort of simplicity
I cannot claim to be an expert on Jungian psychology (though I strongly recommend watching this extraordinary episode of the pioneering BBC interview series Face to Face, hosted by former Labour minister John Freeman, talking to Carl Jung, aged 84, at his lakeside home in the Zürich suburb of Küsnacht in October 1959). At the same time, he was one of the first psychologists of whom I ever became aware, apart from my father, and it’s all because of John Sturges’s last film, the 1976 war drama The Eagle Has Landed.
German intelligence officer Colonel Max Radl (Robert Duvall) is talking to his assistant Sergeant Karl Hofer, played by Michael Byrne, after they have made some serendipitous discoveries in the archives. (Watch the brief scene here.)
“Are you familiar with the works of Jung, Karl?” asks Radl.
“I am aware of the works of Jung, not familiar, Herr Oberst.”
“A very great thinker. A rational man. And yet he speaks of something called synchronicity, events having a coincidence in time, creating the feeling that a deeper motivation is involved.”
It’s a great scene in a pacy and enjoyable but hum-ho film, because it pauses for a moment on a thoughtful note, and really has no need to be in the film at all. It’s also—as far as I am aware from my passing understanding—a good summary of Jung’s concept of synchronicity. And it’s one of those fleeting exchanges in cinema which lodges in the brain; I must have seen The Eagle Has Landed for the first time nearly 40 years ago.
It was thinking about synchronicity recently which prompted me to notice an example of it, and the more I considered it, the more I came to the conclusion that Jung’s “coincidence in time, creating the feeling that a deeper motivation is involved” had made a valuable connection in my head and clarified two issues by the very act of linking them. Which is how we get to a discussion of assisted dying and the future of the conflict in Ukraine. Bear with me.
The right to die and the right to live
Caitlin Moran’s regular column in The Times Magazine last weekend addressed assisted dying in the context of the forthcoming debate in the House of Commons on Labour MP Kim Leadbeater’s Terminally Ill Adults (End of Life) Bill. Enabling people to end their own lives deliberately and at a time of their choosing is an emotive and controversial subject which touches on the most profound human experiences. It is, for once literally, a matter of life and death, and feelings on all sides run deep. As the debate draws closer, the arguments outside Parliament have not always, I am afraid, been conducted in the best of faith or with the calmness and mutual respect for which one would hope.
Leadbeater and her supporters have become slightly defensive at perfectly reasonable and justified scrutiny of the details of her bill. This is partly, I suspect, because an easy passage was predicted when Leadbeater first chose the subject for her Private Member’s Bill, having been drawn top of the ballot for this session’s allocation of time. Recently, though, especially since the full text of the bill was published, there has been an increasing number of questions about the process of a terminally ill person ending his or her life and the kind of safeguards and checks which would be desired for such a procedure. Members of Parliament will have a free vote, meaning the party whips will not encourage them to support or oppose the bill, and the government has taken a formal stance of neutrality. However, several members of the cabinet have made it known they will vote against it, and it is significant that they include the Health and Social Care Secretary, Wes Streeting, and the Lord Chancellor and Secretary of State for Justice, Shabana Mahmood. Since assisted dying would be a medical procedure with a degree of oversight by judges, they are the two departmental heads most directly involved.
For what it’s worth, my position is this: on principle, like three-quarters of the population, I agree that someone who is in the very last months of their life and has an incurable condition should have the freedom to decide to when they die. The number of people who actively oppose that concept is fairly small, only 13 per cent—though it is worth remembering that, in theory, that still amounts to 8.9 million Britons. But I believe strongly that this bill, more than any other I can think of in recent years, is one of which the principle can have broad approval, but its acceptability hinges overwhelmingly on the detail: the mechanisms, safeguards and oversight of the death actually being brought about.
On that issue I am less clear. I think the bill as it stands is imperfect and imprecise: Leadbeater has spoken of “a very thorough drafting process” and the text is supposedly the work of someone with significant experience of parliamentary drafting (I have heard names suggested but have no definite information). Joshua Rozenberg suggested that it had benefited from “government help”, by which I assume he means informal input from the Office of Parliamentary Counsel, the stable of lawyers who prepare government bills. It has certainly not reassured all the bill’s opponents. Constitutional lawyer Yuan Yi Zhu posted a thread of concerns on Twitter, while Sir James Munby, a former President of the Family Division of the High Court of England and Wales, has written at length and powerfully against the proposed role of judges in the process.
I understand how strongly people feel on both sides. That said, there have been a number of attempts effectively to mute arguments one way or the other, by appeals to faith or the unanswerable experience of those who have suffered because the option to end their lives when they chose was not available. This is where Moran’s article comes into play. Essentially, I think that anyone who thinks they have a single clinching argument is either misguided or insincere, and one of the problems with the discourse has been the attempt to elevate one consideration of many above all others. Let me explain.
Moran’s fundamental contention is the importance of personal choice, especially in a society which prizes—or at least pretends to prize—the freedom and autonomy of the individual.
If we have lived a life where we have curated every other aspect of our existence—where we live, whom we marry, how we celebrate, how we think—we will be horrified by the idea that, right at the end, if our dice-throw is unlucky, we will not choose how we die.
That is a slightly false analogy but the argument has a certain force. If someone who has a condition which will kill them within six months, it seems insensitive and an excessive imposition to tell them that they cannot choose to end their life, which is ending anyway, at a time and in circumstances which they prefer.
Where I part company with Moran is her elevation of that theoretical right to the exclusion of everything else. She dwells on the undoubted horrors through which some terminally ill people have to go: “years miserably dwindling—helpless, joyless and probably coughing a lot… cancer or Alzheimer’s”. Fairly, she sets aside the counter-argument that assisted dying would be all but unnecessary if the provision of social and palliative care were better, itself a slightly shaky contention, on the reasonable and realistic grounds that it will not get substantially better in the foreseeable future.
The thing about improving social and palliative care is… we’re not. It’s not happening. We don’t have the billions that would entail. We probably never will. Meanwhile, I get older every day, heading towards that improved social and palliative care that isn’t being built.
Moran also has little time for the argument that the terminally ill might be put under or put themselves under pressure to end their lives for the relief and convenience of others.
At the point where my life has been reduced to merely praying it ends soon, while also dealing with the constant, unassuageable guilt that my suffering is imposing on my children, then, yes, that does sound like a burden. A burden on me.
She returns to the principle of choice and autonomy, which she regards as overwhelming. “My boundary is: I have the last word. I decide when I die.”
I don’t think this works. To dismiss, or at least diminish, all the potential problems because you, as an individual, would not want to be in a position of suffering seems too stark, too absolute. Let is remember that these “potential problems” represent people at least sacrificing their lives under some degree of coercion, even if self-imposed. I don’t suggest it is impossible to create satisfactory safeguards (though these would not be absolutely watertight, because nothing ever is). But I do think it is short-sighted and solipsistic to reach the conclusion that, because you would want this option of ending your life if it became, to you unbearable, all other considerations are secondary and can be set to one side. Problems are for other people, second-order considerations next to your own desire.
I don’t know how I would vote if I were a Member of Parliament. It would be agonisingly difficult, and too many proponents of the bill have suggested the decision can be simplified by framing it correctly. Writing in The Guardian last month, Leadbeater effectively said there were no grounds for not supporting her bill. and MPs should not vote against it.
To do nothing would be a decision in itself. One that would leave too many people as they come to the end of their life continuing to suffer in often unbearable pain and fear of what is to come, denied the choice they deserve.
I’m afraid I am always nervous when someone says that their preferred option is the only possible or justifiable one.
“There is no avoiding war; it can only be postponed to the advantage of others”
How, you may be wondering, does this relate in any way to the conflict in Ukraine? Again, I think there is a body of opinion which elevates one consideration above all others, and seeks to persuade people that all other issues are subordinate. They are the people who argue that the war must be brought to a conclusion, and that is the end of the matter. It is so barbaric, inhuman, bloody and costly, they contend, that the overwhelming priority is finding a way, any way, to stop it.
There is no doubt that Russia’s invasion of Ukraine in February 2022 inaugurated a conflict which has taken a horrifying toll. It is difficult to be certain about the accuracy of figures, but we can at least have some understanding of the scale. The Office of the United Nations High Commissioner for Human Rights attests to a minimum of 12,162 civilian deaths and 26,919 injured, but says that the real figure is almost certain to be higher than that. The UALosses project reaches a total of 60,435 Ukrainian combatants killed, but those are the deaths confirmed by name so there will without question be others. The United States intelligence services suggest a similar quantum of more than 57,500 Ukrainian soldiers killed, and in excess of 250,000 injured.
As for Russian casualties, Mediazona, an anti-Putin organisation which declares itself independent, puts total military deaths at 141,506–197,564, while the Chief of the Defence Staff, Admiral Sir Tony Radakin, told the BBC that the UK estimate was 700,000 Russian soldiers killed or injured. The Armed Forces of Ukraine have issued an estimate of 707,540 killed or injured, in line with the British tally, and the United States reaches a similar conclusion.
In very rough terms, then, Ukrainian military losses are more than 60,000 killed and 250,000-300,000 injured, while Russia’s armed forces have seen perhaps 200,000 killed and another 500,000 wounded. Civilian deaths are likely to number 15,000-20,000. It is a dreadful loss of life by any standard. (That said, context is everything: in the 20-year deployment to Afghanistan, 457 UK armed forces personnel died; on the first day of the Battle of the Somme, 1 July 1916, 19,240 British and Empire soldiers were killed.)
For some opponents of the conflict, whatever their motivation, the scale of deaths is so great that they focus on one thing: stopping the war. It has the advantage of simplicity and moral virtue, but it has consequences which they are often unwilling to accept or examine if it is placed above everything else.
Everyone would like the war in Ukraine to come to an end. Vladimir Putin, of course, is the one person who could bring it to a conclusion in a moment, by ordering his forces to cease fighting and withdraw from Ukrainian territory. But we all know there is no chance of that happening. Therefore the question is how the conflict is resolved. In the current circumstances, there is no imminent end in sight.
Last month, President Volodymyr Zelenskyy presented a “Victory Plan for Ukraine” to the Verkhovna Rada, the country’s unicameral parliament. The aim of the plan is to “change the circumstances in such a way that Russia will be forced to peace”, but its terms are ambitious and demanding of Ukraine’s Western allies: admission of Ukraine to NATO along with iron-clad guarantees of its security against Russia, increased supply of weapons and ammunition, assistance in creating “a comprehensive non-nuclear strategic deterrence package that will be sufficient to protect Ukraine from any military threat from Russia” and substantial economic and financial assistance and investment in Ukraine. Reaction from the West has been muted at best.
Meanwhile, the situation on the ground is that Ukraine is under severe pressure. An assessment issued this week by the Institute for the Study of War, a think tank based in Washington DC and headed by military historian Dr Kimberly Kagan, states that Russian forces are making “significant tactical advances” in western Donetsk Oblast, threatening Ukrainian lines of communication. Russia has also carried out a large number of drone strikes on Ukrainian cities, causing significant civilian casualties and extensive damage to essential infrastructure like power and water. It also struck the city of Dnipro last week with what at first was believed to have been an intercontinental ballistic missile but turned out to be a new model of conventional intermediate-range missile codenamed “Oreshnik”, with a claimed speed of Mach 10 (or 10 times the speed of sound). This followed a decision by Putin to change Russia’s nuclear doctrine and lower the threshold beyond which the country would feel justified in using nuclear weapons.
This is not a promising state of affairs for Ukraine. It is hard to see how its armed forces can change the course of events in any significant way without more support, and the impending inauguration for a second term of President Donald Trump suggests the opposite is more likely, given his long-standing scepticism of American with regard to Ukraine and his strange emotional attachment to and regard for Vladimir Putin.
All of this means that if you want the war to end immediately, and that is your overriding priority, you are accepting that Ukraine must acknowledge Russia’s current occupation of around a fifth of its territory and probably a veto on its membership of NATO, which Putin regards as an unacceptable threat to Russia’s security. As I wrote in The Hill in September, J.D. Vance, now Vice-President-elect, has already sketched out some of the elements of the kind of peace plan a Trump administration foresees, and it is heavily to Ukraine’s disadvantage. I said then and still believe that it would be a catastrophic and morally bankrupt course of action.
The vision set out by Vance would amount to the biggest unilateral betrayal of an ally since the Munich Agreement in 1938, when Britain and France abandoned Czechoslovakia to Nazi Germany. It would broadcast to the world that a commitment by the U.S., written or spoken, had no weight or meaning. It would not be “America First” but “America Only”—and everyone else must look after themselves.
Nevertheless, if your priority is to see the fighting end, and if you regard any other considerations as subordinate to that, then you must accept something like the Trump/Vance plan, an outcome which rewards Russia’s aggression, sets aside its war crimes and crimes against humanity and tacitly endorses the idea of its legitimate influence in, to the point of domination of the so-called “near abroad” (blizhneye zarubezhye, ближнее зарубежье), the area surrounding Russia and including the other former states of the Soviet Union. This outcome also heavily penalises Ukraine, giving Russia a virtual veto over great swathes of its foreign policy and reducing it in many ways to a Russian client state.
This may be unpalatable, to say the least, but the fact is that the only realistic way in which the war in Ukraine would be terminated quickly would be for Ukraine to submit to virtually any demands Russia wishes to make. Remember, too, that we know very well how Vladimir Putin views Ukraine. His 2021 essay, On the Historical Unity of Russians and Ukrainians, a startling work of pseudo-history, braggadocio and garbled assertions, argues that Russians and Ukrainians are essentially the same people, and that Ukraine has no separate or distinctive language, ethnic history, religion of legitimate statehood. He believes that Ukraine occupies what is historically Russian territory, and that its very existence is the result of an “anti-Russia project” which began in the 17th century and is intended to destabilise and threaten Russia. For these reasons, he asserts that Russia has a right to involve itself in the affairs of Ukraine, which he does not see as a legitimate independent political or ethnic entity. Putin is not a reliable neighbour.
You can argue that Ukraine is a long way from us, that we have no particular connection with the country, that states go to war around the world and we do not intervene everywhere. But this is not simply about Russia and Ukraine: it is about Russia’s expansionism in general, and, more broadly, about the interaction between states everywhere. Vladimir Putin sees the world in paranoid terms, interpreting every geopolitical development through the lens of a threat to Russia, and therefore a provocation to which Russia is entitled to respond.
He had intervened militarily in Georgia (in response to provocation, of course); conducted cyber attacks and physical incursions against Estonia and placed its then-prime minister, Kaja Kallas, on a list of people wanted on criminal charges (again, all in response to aggressive acts); is engaged in an ongoing territorial dispute with Japan over the Kuril Islands (of which the Soviet Union’s seizure in August and September 1945 apparently equates to an unanswerable claim of sovereignty); and maintains an unfriendly countries list (officially Presidential Executive Order No. 243 On Measures (Countermeasures) in Response to Unfriendly Actions of Foreign States) which currently stands at 47—that is around a quarter of all countries in the world.
Given the nature of Russia’s foreign policy and its concept of the “near abroad”, the implications of Putin effectively “winning” in Ukraine would be calamitous. It would demonstrate that the international community lacked the strength and determination to counteract the most blatant acts of military aggression, including a straightforward war of conquest, and send the message to Vladimir Putin that, while the cost in his people’s lives may be high, he can achieve his ends by military means if he is sufficiently aggressive and persistent.
Supporting Ukraine’s independence and right to self-defence and self-determination does not equate to being a warmonger. It does mean accepting, reluctantly, that soldiers and civilians will continue to be killed and injured. The responsibility for that lies at the door of Putin, but anyone who supports Ukraine must acknowledge the butcher’s bill. But to elevate peace above all other considerations, even if that “peace” is not as eirenic as might be hoped, is to resign yourself to the law of the jungle and the primacy of military aggression. We now regard it as impossible folly that other European leaders persuaded themselves to believe Adolf Hitler when he said in September 1938 “the Sudetenland is the last territorial demand I have to make in Europe”. Abandoning Ukraine to Russian domination would not mean that there would be no more conflict and no more killing, merely that it would be postponed and happen elsewhere.
Conclusion: hard choices have hard consequences
I am not suggesting that supporting assisted dying is equivalent to being an apologist for the Putin régime. The connection I am proposing, the Jungian synchronicity which affected me, is the process of reasoning: to identify one element or outcome, often with the most noble and high-minded of reasons, and make that an absolute priority does not obviate or minimise negative consequences. Very few profound and important questions have simple solutions, and the ability to condense a stance into a virtuous slogan does not insulate it from other considerations.
Most people have principles, and most people’s principles stem from a basic, if messy and compromised, sense of goodness. I don’t think I am a naïve person, but I do believe that the majority of human beings, given equal circumstances, will try to do the right thing. Of course it is tempting to make our principles as uncomplicated as possible, because that allows us to uphold them without hesitation or doubt. But it does not reflect the complexity of the world or of competing moral imperatives. If we can try to remember that, try to rein in our urge for clarity over texture, it may make us see the world as more tangled and variegated, but it will also show us much more than the narrow focus of partial idealism.
You will be unsurprised to learn that I oppose the Assisted Dying bill both in principle, as well as on the procedural grounds that you outline here: though I think the two are not unrelated, and the procedural difficulties demonstrate the problem of the principle. One might in theory accept the proposition that any given person should be able to end their own life at a time and in a manner of their choosing (I don't), but if it is impossible to legislate for that position without it effectively coercing certain people to end their own lives at a time of somebody else's convenience (a cost-driven NHS, a greedy heir or inheritor, a manipulative spouse - q.v. Canada) then the principle itself is self-defeating.
Your insights into the potential Trump-Putin entente really help to clarify matters. Thank you. You made me wonder how St Thomas Aquinas might approach the same questions, since he would reach a very different conclusion to the first but largely the same to the latter.
Both ethical conundra would invoke the primary precept of promoting and preserving life. The Angelic Doctor's answer to the first problem would therefore be clear. The second would not simply be a utilitarian matter of calculating the number of lives lost, however, which seems to be the ethical system to which the USA's President-elect subscribes. The Ukrainians are, after all, seeking to preserve their own lives and protect their nation. Their self-defence is justified, subject to the proportionality of their response. Although the enemy death toll is huge, these are military casualties of war in defence of one's homeland, not bombardments of civilian areas. The issue is clouded by the matter of Russian conscription, since many of the dead presumably had no choice in serving. Nonetheless, as far as I know, Ukraine is not attacking civilians, unlike the aggressor. Their war is therefore just, and the proper ethical response is to support them militarily, rather than cede victory to the aggressor. You are therefore on the side of the angels, but for one caveat: the defence of Ukraine is right regardless of Russia's putative intentions for further expansion.
Perhaps the West's inconsistency in approaching both of these matters rests on a lack of any agreed means for making ethical decisions. There is an unspoken assumption of a utilitarian calculus, based on the greatest happiness of the greatest number of atomised individuals. I am not sure that your pragmatic response to Ukraine - namely, the main reason we should continue to offer support is because failure to do so will increase suffering later on - is robust enough a defence against the tyranny of the majority. It is not enough to protect the vulnerable from coerced legal suicide, the disabled from abortion, or the politically undesirable from being silenced, imprisoned or worse.
Your recognition of the basic desire of humans to do what is good rests on assumptions very close to St Thomas' broadly Platonic-Aristotelian position, and I applaud it; but this, I fear, is incompatible with the hedonistic path you wish to tread regarding assisted dying, which implies that the good equates to the avoidance of personal suffering. That way lies a majoritarian utilitarianism, and further down the path, Marxism. Might we not say rather that the absolute claims that natural law makes, along Thomistic lines, about the inherent and inalienable value of life are foundational to Western ethics, not least the doctrine of human rights, first of which is the right to life? It should be no surprise that when those foundations are undermined, the entire edifice of Western civilisation becomes so shaky that it loses the confidence of those both inside and outside it.