Mortal Symmetry
It is regrettably the case that, even in peacetime, human beings sometimes deliberately kill other human beings. We normally think about this in terms of the lurid murders and controversial law-enforcement events that our news media feed to us, but the scope for discussion is wider than that. Common law has always recognized the concept of justifiable homicide. One of us may kill another from causes other than malice or negligence: in self-defense, for example, or defense of others, or in carrying out capital punishment.
In civilized democracies the two most politicized categories of peacetime killings are abortion and medically-assisted dying. The former of the two generated much political noise after being yoked to identitarian passions — Women's Rights! — in the 1960s. However, since the 2022 Dobbs ruling returned legislative authority on abortion to the states, the abortion noise has retreated to the local.
Assisted dying has always been a more local issue. It is on our minds here in New York State at the time of writing, for instance. On February 6th our Governor Hochul signed into law the Medical Aid In Dying Act (MAID) for terminally ill New Yorkers with less than six months to live, making New York the 13th state — plus Washington, D.C. — where assisted dying is legal. MAID comes with a very long list of conditions and restraints. There must for example be video evidence of the patient's wish to die, with at least two witnesses to the recording.
Coincidentally the issue is also on the minds of our cousins across the pond. The Terminally Ill Adults (End of Life) Bill was launched in Britain's parliament a year and a half ago. It was approved by the House of Commons last June but has been stuck in the House of Lords since December.
Abortion … assisted dying: there is a curious dark symmetry here. Some of the same language is used to argue the two issues. Signing MAID into law, Governor Hochul vowed she was "safeguarding New Yorkers' freedoms and right to bodily autonomy" — the kind of thing we hear from abortion advocates. The loudest voices in opposition to change in both cases come from religious commentators … and so on. If you know a person's opinion on one of the two topics, you can make a high-confidence guess where they stand on the other.
My own position on abortion is somewhere close to the U.S. median: I want it fully legal in the first trimester, thereafter legal only if the mother's health is at stake. And sure enough, I also support assisted dying.
Some of that latter support was planted by my mother, a professional nurse with decades of hospital experience. When I was at home in England with my parents many years ago, assisted dying came up in a dinner-table conversation. I mentioned its being illegal. Mum responded with scorn: "Illegal, fiddlesticks! Doctors have been doing it for ever!" (The topic was in the news because it was being debated by the legislature of some European nation. I forget which nation that was; but it surely was not Switzerland, which had legalized the practice in 1941.)
Given the resources and ethos of doctors in the mid-20th century as described in Lewis Thomas' 1983 classic The Youngest Science, Mum was probably right. We actually have one well-documented case from 1936: the assisted death at age 70 of Britain's King George the Fifth. George, a heavy smoker, suffered from aggressive abscesses in his lungs. When, after long suffering, he was unconscious and plainly close to death, his personal physician Lord Dawson injected the monarch with lethal doses of morphine and cocaine "to preserve the King's dignity" and recorded the event in his diary. He suffered no legal consequences; the diary was only discovered after his own death nine years later.
I should qualify all that by noting that Lord Dawson and the doctors my mother had observed may have been expressing a characteristically English mentality. In his 2003 book Albion: The Origins of the English Imagination Peter Ackroyd gives over a whole chapter to "A Note on English Melancholy," from which:
In the nineteenth century London became known as the "suicide capital" of the world but, even before that date, there was a more general belief that the English were a race subject to melancholia. The prevailing gloom was variously ascribed to the damp climate of the island or to the diet of beef …
Having lived in several nations I can certify that in their attitude to the Pale Horse and its rider the English are indeed somewhat atypical.
It is also worth noting that along with the aforementioned abortion/assisted dying symmetry there comes a demographic asymmetry. Incurable terminal illness can of course strike at any age, but persons thus afflicted are much more likely to be old than young. The legalization of assisted dying will, therefore, disproportionally cull dependent, pensioned, unproductive senior cohorts — a good demographic result! Legalized abortion, on the other hand, only aggravates the shortage of youngsters that we are seeing in almost all civilized nations due to collapsing fertility rates — a bad demographic result!
I feel sure that somewhere in the social-media fever swamps there are demographers clamoring for much stricter rules on abortion together with much looser ones on assisted dying.