Skip to main content
Read page text
page 4
FEATURES / Assisted suicide A life or death question Opinion polls indicate high levels of support for assisted dying. But one of the UK’s leading pollsters warns that the public debate on the issue is framed by questions that contain dangerous assumptions and imperfect information / By ANDREW HAWKINS MOST PUBLIC opinion polls have shown consistent and generally extensive public support for assisted suicide. But the picture is not so simple. Notwithstanding that this issue is literally one of life and death, on any complex issue spanning legal, socioeconomic and medical issues, the public can be easily misled. If hard cases make bad law, they also make for sensationalist media stories which can tug on heartstrings but do not always reflect the whole story. For example, to produce a poll showing public “support” for the death penalty is easy, but to design and conduct a poll which takes account of the many complex arguments that its reintroduction would involve is far harder. Pollsters have for years posed questions which contain dangerous assumptions and imperfect information. We have a heavily misguided debate and need a renewed focus on reasoned and rational arguments. Nonetheless, apparent support for euthanasia is hard to deny. That said, several repeated and problematic semantic issues are evident. Moreover, our most recent poll shows people’s views are more nuanced than the headlines suggest. The first semantic issue arises when assisted suicide is linked to those who have an “incurable illness”, “six months to live”, or “unbearable pain”. Doctors themselves assert that patients often do not die within the forecast timescale. And what does “unbearable” pain mean in the modern era of effective palliative care? The second type of problematic phrasing is seen in questions using hypothetical emotive scenarios. Pollsters have a description for such questions and it is not a polite one: they are called “heartless bastard” questions because respondents answer in the way intended by the client or risk being regarded as cold-hearted. “Do you want your nearest and dearest to be in unnecessary agony?” No, I thought not. The third semantic problem is the guarantee that patients who receive assistance to commit suicide always express a “clear indication of a willingness to die”. As with the assumption that no miscarriage of justice can ever occur in the debate around capital punishment, the reality for assisted suicide is that informed, unpressured consent can never be guaranteed. A 2005 poll showed that even people who support assisted suicide concede that some vulnerable older people could be manipulated into it. It is clearly misleading for questions to imply that the decision to choose assisted suicide would never be influenced by external pressure. PHOTO: ALAMY/PA, DANNY LAWSON Kim Leadbeater’s private member’s bill is expected to have government backing A further problem with how the pollster puts the question is that assisted suicide is often presented as a pain-free, immediate and peaceful option. Yet deaths can take hours and, in some horrific cases, patients can regain consciousness and die days later. Polls conducted to advance a particular policy almost never address such (false) assumptions. There is also the tendency of some polls to frame a question to achieve a specific answer. One of the more egregious examples was in a 2015 poll for Dignity in Dying, the organisation that campaigns for the legalisation of voluntary euthanasia. The poll question contained a mind-numbing 139-word introduction setting out the safeguards without mention of any downsides. The poll, which found 82 per cent in support of assisted suicide, was hailed as “the largest ever”, as if a large sample size would magically compensate for its flawed wording. Worse still, Dignity in Dying claimed, by using a frankly lazy filter question to ascertain religious affiliations, that 80 per cent of “Christians” supported assisted suicide. Such poor habits tend to be used to show that a proposed change in the law is so reasonable that even “Christians” support it. ALTERNATIVELY, and strikingly, a ComRes poll in 2014 for Christian Action Research and Education (CARE) showed that opinions on assisted suicide change when the information in the question is improved. In essence, the more people know about what assisted suicide entails, the more squeamish they feel about it. Seventy-three per cent agreed with a Bill then going through the House of Lords to legalise assisted suicide. Of those who agreed, we asked a series of follow-up questions providing additional information. We then asked whether they still supported assisted suicide or if the new information had changed their mind. We told respondents that the country’s major disability rights advocacy groups all opposed a change to the law. As a result, more than one in 10 (12 per cent) previous assisted suicide supporters changed their minds and a further quarter said they did not know. We then offered respondents the claim that some vulnerable people might access assisted suicide so as not to be a burden on family (which is a consistent finding in Oregon, whose Death with Dignity Act is seen as the paragon we should follow). This led to a further decrease in support to 47 per cent among a hitherto 100 per cent supportive cohort. In other words, with just modest additional information reflecting actual experience in jurisdictions where assisted suicide is already legal, hypothetical supporters reconsidered their position very dramatically indeed. More thoughtfully designed polls consistently show two important realities about public opinion. First, the public are highly susceptible to excessively emotive language. Second, the more people are made aware of some of the unintended consequences of assisted suicide, the more support for it decreases. Indeed, the public are compassionate, but that compassion appears often wrongly directed at support for what is defined as assisted suicide by lobby groups but in reality is something altogether different. Thus, the 2021 Survation poll of 1,032 British adults asked what people understood by the term “assisted dying”. Strikingly, most of the sample – 52 per cent – thought the term meant good palliative care. Importantly, this suggests that more than half of the people answering such polls about assisted suicide or “assisted dying” might have been mistaken about the very thing they are being asked about. If half the public were to conflate assisted suicide with palliative care, we should treat all simple onequestion polling on the issue with scepticism. In our Whitestone poll conducted in June 2024 for Living and Dying Well, a think tank that “researches and analyses the evidence surrounding the end-of-life debate”, we found that public understanding of what “assisted dying” actually entails had improved, with 78 per cent correctly defining the term when asked. However, this greater understanding had not affected the public’s scepticism and concern towards assisted dying. Sixty per cent of the 2,001 people surveyed supported legalising assisted suicide. However, 46 per cent felt there were too many complicating factors to make it a practical and safe option for Great 4 | THE TABLET | 12 OCTOBER 2024 For more features, news, analysis and comment, visit www.thetablet.co.uk
page 5
LIZ DODD Britain, with only 36 per cent thinking it was safe (19 per cent didn’t know). Sixty per cent thought that legalisation would fundamentally change the relationship between doctors (GPs) and patients and 56 per cent thought it would normalise suicide. It is of great concern that 43 per cent agreed that introducing assisted suicide when the NHS and Social Care budgets are under such pressure would inevitably place an incentive on health professionals to encourage some people to end their lives early. Only 37 per cent disagreed; the rest did not know. There were marked concerns about the potential effects on palliative care. The power of debate on the issue is underlined by comparisons between polling of MPs and real (free) votes. In 2015, when Rob Marris MP brought his Private Member’s Bill to the House of Commons, MPs voted by 330 to 118 against legalising assisted suicide. At least one MP admitted changing their mind having listened to the debate. That, after all, is the job of a “parliament”. Parliamentary debate shows the power of reasoned argument to change minds and highlights the power of persuasion in politics. Interestingly, in the June Living and Dying Well poll, it turns out that legalising assisted suicide is not a political priority for most people. It ranked twenty-third out of 24 issues that were thought to need attention, with only four per cent of those polled thinking it should be a priority for politicians. PRO-EUTHANASIA groups have been highly effective at positioning emotive and relatable stories in the media. To an extent, it is right to envelop this debate about life and death in human terms. But once rational arguments are made, and when an informed public consider the consequences of legalising assisted suicide, they are far less willing to support it. Some will claim that it is disrespectful to argue that the public lacks the information to have an informed view about assisted suicide. I do not agree. Rather, I believe it is both disrespectful and dangerous to abuse people’s innate sense of compassion by over-simplifying this complex issue and framing questions to elicit a particular response. Polls that meet the standard necessary to inform policy makers of the public mood must take full account of public understanding of both terminology and the implications of what they are being asked about. Those implications should include the experiences of the few jurisdictions that have already legalised assisted suicide in order that any polling on the issue in the UK can see the end-point of progressive liberalisation. To make the case about public opinion on anything less than this is tantamount to deception. Andrew Hawkins is the founder and CEO of Whitestone Insight, a Westminster-based polling and research consultancy. This article is based on his chapter in The Reality of Assisted Dying: Understanding the Issues, edited by Julian Hughes and Ilora Finlay and published by Open University Press (£25.99; Tablet price, £23.39). I was the same age as this protester the first time I was arrested at the Trident base I have discovered liberation theology. I realise that, among Tablet readers, this is like telling an indigenous person that Columbus has discovered their country. Yet I am fizzing with it and I cannot stop. I had been aware of the broad themes of liberation theology, but I am in the process of writing a book – this sounds like bragging, when really it is a cry for help – and have been getting on firstname terms with Gustavo Gutierrez, both Boffs and Juan Luis Segundo. Here is Leonardo Boff in Jesus Christ Liberator: “Access to God does not come primarily from cultic worship, religious observance, and prayer. They are authentic mediations, but in themselves they are ambiguous. Unambiguous and privileged access to God comes through service to the poor, for in them God lies hidden and anonymous.” I surfaced from this magnificence to find a call to action from Just Stop Oil in my inbox. The network is reeling after a spate of sentences were doled out to activists, including two young women imprisoned for not damaging Van Gogh’s Sunflowers at the National Gallery. Phoebe Plummer, 23, and Anna Holland, 22, threw tomato soup at the work in 2022, one of a series of actions to call attention to the devastating impact of global heating. Maybe because this month’s eradefining rain ruined the end of the cricket season; or because homes near me still stained with silt from spring floods were being evacuated; or because in America people are dying from the weather. But when I read that Judge Christopher Hehir told the defendants: “You two simply had no right to do what you did to Sunflowers”, I thought, Didn’t they? Plummer said: “I chose to peacefully disrupt a business-as-usual system that is unjust, dishonest and murderous.” Boff said: “We enter the kingdom by breaking with this world and changing it, not by prolonging its existing structure.” This comes soon after Revd Sue Parfitt, a serene firecracker for climate justice and a retired Anglican priest, had her “permission to officiate” suspended because she was arrested for not damaging the Magna Carta. Parfitt, 82, grieved that she could not celebrate the eucharist, but said if the condition for reinstatement was avoiding arrestable action in future, “I wouldn’t agree to that.” You splendid woman, I thought, you are celebrating the eucharist with every action you take to call attention to the violent oppression of the earth and its most vulnerable communities. If Parfitt is jailed, she – like Plummer and Holland – will certainly celebrate the eucharist in prison. Not because they have been given permission to; because they are the incarnate presence of God in a special way – because they have the kind of “unambiguous and privileged access to God” that even Church of England bishops can’t take away. Denying Parfitt her faculties as a priest seems peculiar to me. Priests throughout history have been arrested for taking a stand against injustice – it was, not to be too heavy-handed, how our faith began. Because the Church of England is usually less cussedly dogmatic than my own beloved Catholic Church, I wonder if some internal safeguarding legislation means that currently any priest facing any charge at all cannot preside. If so, this has been applied inconsistently, as Parfitt herself has noted. “Of course, it stands as a threat to everyone else,” she said. Threats usually don’t work against kingdom people: just an hour after the sentencing, three more activists threw soup at Sunflowers. I was the same age as Plummer the first time I was arrested, at the Trident base in Faslane near Glasgow. Liberation theology makes me fizz because it puts words around what I believed when I locked myself to another student on the freezing tarmac; as Gutierrez wrote in 1971: “To place oneself in the perspective of the Kingdom means to participate in the struggle for the liberation of those oppressed by others.” I was very frightened when I was arrested and carried into a police van, so I am holding all three of our liberation theologians in prayer. I hope that this is just the beginning for Plummer and Holland. I hope that the Church of England sees sense and reinstates Sue Parfitt’s faculties. I hope I get to experience her presiding at a eucharist, perhaps at one of those lovely, raggedy windswept services that take place between the CND and Extinction Rebellion banners at demos. When I receive communion from her I will know I am in the presence of Christ. Liz Dodd is a sister of St Joseph of Peace. For more features, news, analysis and comment, visit www.thetablet.co.uk 12 OCTOBER 2024 | THE TABLET | 5

Page Text

View plaintext

FEATURES / Assisted suicide

A life or death question

Opinion polls indicate high levels of support for assisted dying. But one of the UK’s leading pollsters warns that the public debate on the issue is framed by questions that contain dangerous assumptions and imperfect information / By ANDREW HAWKINS

MOST PUBLIC opinion polls have shown consistent and generally extensive public support for assisted suicide. But the picture is not so simple. Notwithstanding that this issue is literally one of life and death, on any complex issue spanning legal, socioeconomic and medical issues, the public can be easily misled.

If hard cases make bad law, they also make for sensationalist media stories which can tug on heartstrings but do not always reflect the whole story. For example, to produce a poll showing public “support” for the death penalty is easy, but to design and conduct a poll which takes account of the many complex arguments that its reintroduction would involve is far harder.

Pollsters have for years posed questions which contain dangerous assumptions and imperfect information. We have a heavily misguided debate and need a renewed focus on reasoned and rational arguments. Nonetheless, apparent support for euthanasia is hard to deny. That said, several repeated and problematic semantic issues are evident. Moreover, our most recent poll shows people’s views are more nuanced than the headlines suggest.

The first semantic issue arises when assisted suicide is linked to those who have an “incurable illness”, “six months to live”, or “unbearable pain”. Doctors themselves assert that patients often do not die within the forecast timescale. And what does “unbearable” pain mean in the modern era of effective palliative care?

The second type of problematic phrasing is seen in questions using hypothetical emotive scenarios. Pollsters have a description for such questions and it is not a polite one: they are called “heartless bastard” questions because respondents answer in the way intended by the client or risk being regarded as cold-hearted. “Do you want your nearest and dearest to be in unnecessary agony?” No, I thought not.

The third semantic problem is the guarantee that patients who receive assistance to commit suicide always express a “clear indication of a willingness to die”. As with the assumption that no miscarriage of justice can ever occur in the debate around capital punishment, the reality for assisted suicide is that informed, unpressured consent can never be guaranteed.

A 2005 poll showed that even people who support assisted suicide concede that some vulnerable older people could be manipulated into it. It is clearly misleading for questions to imply that the decision to choose assisted suicide would never be influenced by external pressure.

PHOTO: ALAMY/PA, DANNY LAWSON

Kim Leadbeater’s private member’s bill is expected to have government backing

A further problem with how the pollster puts the question is that assisted suicide is often presented as a pain-free, immediate and peaceful option. Yet deaths can take hours and, in some horrific cases, patients can regain consciousness and die days later. Polls conducted to advance a particular policy almost never address such (false) assumptions.

There is also the tendency of some polls to frame a question to achieve a specific answer. One of the more egregious examples was in a 2015 poll for Dignity in Dying, the organisation that campaigns for the legalisation of voluntary euthanasia. The poll question contained a mind-numbing 139-word introduction setting out the safeguards without mention of any downsides. The poll, which found 82 per cent in support of assisted suicide, was hailed as “the largest ever”, as if a large sample size would magically compensate for its flawed wording. Worse still, Dignity in Dying claimed, by using a frankly lazy filter question to ascertain religious affiliations, that 80 per cent of “Christians” supported assisted suicide. Such poor habits tend to be used to show that a proposed change in the law is so reasonable that even “Christians” support it.

ALTERNATIVELY, and strikingly, a ComRes poll in 2014 for Christian Action Research and Education (CARE) showed that opinions on assisted suicide change when the information in the question is improved. In essence, the more people know about what assisted suicide entails, the more squeamish they feel about it. Seventy-three per cent agreed with a Bill then going through the House of Lords to legalise assisted suicide. Of those who agreed, we asked a series of follow-up questions providing additional information. We then asked whether they still supported assisted suicide or if the new information had changed their mind. We told respondents that the country’s major disability rights advocacy groups all opposed a change to the law. As a result, more than one in 10 (12 per cent) previous assisted suicide supporters changed their minds and a further quarter said they did not know. We then offered respondents the claim that some vulnerable people might access assisted suicide so as not to be a burden on family (which is a consistent finding in Oregon, whose Death with Dignity Act is seen as the paragon we should follow). This led to a further decrease in support to 47 per cent among a hitherto 100 per cent supportive cohort. In other words, with just modest additional information reflecting actual experience in jurisdictions where assisted suicide is already legal, hypothetical supporters reconsidered their position very dramatically indeed. More thoughtfully designed polls consistently show two important realities about public opinion. First, the public are highly susceptible to excessively emotive language. Second, the more people are made aware of some of the unintended consequences of assisted suicide, the more support for it decreases.

Indeed, the public are compassionate, but that compassion appears often wrongly directed at support for what is defined as assisted suicide by lobby groups but in reality is something altogether different. Thus, the 2021 Survation poll of 1,032 British adults asked what people understood by the term “assisted dying”. Strikingly, most of the sample – 52 per cent – thought the term meant good palliative care. Importantly, this suggests that more than half of the people answering such polls about assisted suicide or “assisted dying” might have been mistaken about the very thing they are being asked about. If half the public were to conflate assisted suicide with palliative care, we should treat all simple onequestion polling on the issue with scepticism.

In our Whitestone poll conducted in June 2024 for Living and Dying Well, a think tank that “researches and analyses the evidence surrounding the end-of-life debate”, we found that public understanding of what “assisted dying” actually entails had improved, with 78 per cent correctly defining the term when asked. However, this greater understanding had not affected the public’s scepticism and concern towards assisted dying. Sixty per cent of the 2,001 people surveyed supported legalising assisted suicide. However, 46 per cent felt there were too many complicating factors to make it a practical and safe option for Great

4 | THE TABLET | 12 OCTOBER 2024

For more features, news, analysis and comment, visit www.thetablet.co.uk

read next page

My Bookmarks

Buy this Book
Skip to main content