Humanist Heritage: Assisted Dying: a history of humanist advocacy for reform

My horizon is the known, and my estimate of life is based upon what I know of life here in this world. People should not suffer for the sake of supernatural beings or for other worlds or the hopes and fears of some future state. Our joys, our sufferings and our duties are here.
Robert G. Ingersoll, ‘The Right to One’s Life’ in Lectures of Col. R.G. Ingersoll (1898)

Humanists and freethinkers have been among the longest standing advocates for compassionate reform of the laws related to assisted dying. In the US, Robert G. Ingersoll, ‘the Great Agnostic’, and Felix Adler, founder of the Ethical movement, were two of the earliest public proponents of what was then called ‘suicide’ in the case of the incurably suffering, and in the UK, active efforts to change the laws have been spearheaded by the non-religious. Historically rooted in humanists’ rejection of traditional religious arguments about the god-given sanctity of life, and the ‘heroism’ of enduring affliction, support for the legalisation of assisted dying among humanists focuses instead on individual self-determination, emphasising the minimising of suffering and the exercise of reason and compassion in arriving at moral decisions.

In England and Wales, the Suicide Act of 1961 decriminalised suicide, but made ‘complicity in another’s suicide’ a criminal offence. From then on, ‘encouraging or assisting the suicide or attempted suicide of another person’ was punishable by up to 14 years in prison. Public debate around assisted death, however, had arisen nearly 100 years earlier, with an essay by Samuel D. Williams, a member of the Birmingham Speculative Club, published in 1870. In the UK, the organised movement for legalising assisted dying took shape during the 1930s.

Prior to Williams’ essay, the word ‘euthanasia’ (which he took as his title) had generally referred not to assisted dying but to a gentle and easy death – often linked to religious ideas of preparing for the transition to an afterlife. A compound of two Greek words meaning ‘good death’, euthanasia now took on a more active definition, and Williams ignited debate around what has been referred to since as ‘euthanasia’, ‘mercy killing’, ‘assisted suicide’, and ‘assisted death’.

Samuel D. Williams

In his 1870 essay, Williams argued that where religious opinion had once viewed the use of pain relief during childbirth as ‘evidence of impatience with the ways of Providence and symptoms of revolt against the decree “In sorrow shalt thou bring forth”, it had since come to accept such interventions ‘before the clear, indisputable benefits secured by the new discovery’. Why then, Williams argued, ‘should it not be as simple a matter of course that the medical attendant should bring relief to this last worst pang that poor human nature has to undergo’. He rejected religious arguments concerning the ‘sanctity of life’, countering that these were swiftly cast aside in the event of war. With a humanist focus on alleviating suffering in ‘this world as it exists, here and now’, Williams wrote that his arguments referred to ‘the world as it is’, leaving ‘untouched all questions of recompense and adjustment hereafter.’ Our duty, he argued, was to alleviate as much suffering as possible, using the resources available to us.

Williams’ aim was to prove the reasonableness of his proposition:

That in all cases of hopeless and painful illness it should be the recognized duty of the medical attendant, whenever so desired by the patient, to administer chloroform — or such other anaesthetic as may by-and-by supersede chloroform — so as to destroy consciousness at once and put the sufferer to a quick and painless death; all needful precautions being adopted to prevent any possible abuse of such duty; and means being taken to establish, beyond the possibility of doubt or question, that the remedy was applied at the express wish of the patient.
Samuel D. Williams, ‘Euthanasia’ in Essays by members of the Birmingham Speculative Club (1870)

Williams’ essay was much discussed in the years following, and many of the responses – such as the Pall Mall Gazette’s question: ‘Is it possible to devise sufficient precautions?’ – would be echoed in debates for the next 150 years.

Other early advocates

Unless there be some good to which grievous suffering can be made instrumental, there is no warrant for enduring it. As for the Stoics, so for the philosopher of sympathy, the logical end would be suicide, at least when the pain is exceptionally intense.
Felix Adler, An Ethical Philosophy of Life (1918)

Six years after Williams’ essay was first published, Felix Adler founded the New York Society for Ethical Culture. Adler’s society, which sought to unite people on the basis of ‘deed, not creed’, gave rise to the Ethical Movement, which in the UK evolved to become the humanist movement. It focused on establishing a secular system of ethics which could unite individuals in moral action. In 1891, Adler also became the first prominent American to express support for suicide in cases of chronic illness, cementing the close relationship between the Ethical and assisted dying movements. Adler argued that people had the right to die peacefully, and his comments were reported in British newspapers.

It will not do to say that “God” has appointed a time for each to die. Of this there is, and there can be, no evidence.
Robert G. Ingersoll, ‘The Right to One’s Life’

Another plea came from Robert G. Ingersoll, ‘the Great Agnostic’, in 1894. In two letters, ‘Is Suicide a Sin?’ and ‘The Right to One’s Life’, Ingersoll argued that a man incurably sick or suffering ‘has the right to end his pain and pass through happy sleep to dreamless rest’. Like Williams before him, Ingersoll wrote ‘based upon what I know of life here in this world’:

People should not suffer for the sake of supernatural beings or for other worlds or the hopes and fears of some future state. Our joys, our sufferings and our duties are here.

The movement for assisted dying gained pace during the first decades of the 20th century, with the first dedicated organisation – The Voluntary Euthanasia Legalisation Society – founded in 1935. Both as participants in the movement, and as individuals acting and thinking on the subject, humanist voices were prominent.

One such voice was that of Olga Jacoby, who had been given a terminal diagnosis, and who ended her life in 1913. Her husband, John Jacoby, testifying before the coroner’s court, requested that her death and its cause be recorded honestly:

I distinctly wish the jury to return a verdict in accordance with the evidence. My wife only did what she felt she had a perfect right to do. If the jury returned a verdict from sentiment it would be an insult to my wife’s memory.

Jacoby’s letters, written to her physician, were published privately by John in 1919. In them, both an intense love of life and a clear-sighted acceptance of death shine through.

Another humanist advocate of the right to die was Henry Stephens Salt, author, campaigner, and founder of the Humanitarian League. He was in his 80s when he wrote a piece for The Literary Guide (now the New Humanist) arguing for the right of the individual to decide on quality of life and of death. ‘I know, of course,’ Salt wrote, ‘that the ethical justification for such a deed must depend on the circumstances of each case;’

but the absurdity of absolutely forbidding it is palpable… One would rather be disposed to believe that, if ever a real civilization is reached, advice and help will be proffered to old people, and sick people of course, on such matters as this, and that they will no longer be fooled as now with talk about the duty of “living for others”—a point on which they themselves are quite competent to judge…
Henry S. Salt, ‘Euthanasia: a right that civilization will demand’ in The Literary Guide, January 1938

Attempts to change the law

It was in the 1930s that The Voluntary Euthanasia Legalisation Society (later the Voluntary Euthanasia Society; now Dignity in Dying) was founded to campaign for assisted dying in the case of the terminally ill. Early supporters of the society included many progressive thinkers and humanists, including Havelock Ellis, Cicely Hamilton, and Laurence Housman, as well as H.G. Wells, Harold Laski, George Bernard Shaw, and Eleanor Rathbone. In 1936 the first attempt was made to change the law with a bill introduced by Lord Ponsonby, who was described by The Literary Guide on his death a decade later as having been a ‘distinguished sympathizer’ of rationalism. The Voluntary Euthanasia (Legalisation) Bill, in Ponsonby’s words before the House of Lords, attempted ‘to steer a course which will not be irksome or painful for the patient and yet at the same time will give the proper safeguard to the doctor’. As well as the opinion of prominent humanists such as Julian Huxley, he noted the significant religious support for legalising so-called ‘voluntary active euthanasia’ (when a person is helped to die by a medical professional). Nevertheless, the Bill was defeated by 35 votes to 14.

But where a man is in great and constant pain from an incurable illness… it is not a question of tiding over temporary trouble: he has no prospect of getting anything more out of life. If, then, having weighed the whole matter up he comes to the conclusion that there is no point in struggling further, and asks his fellow citizens to sanction his release, surely in the name of reason he should be allowed to go.
Lord Chorley, ‘Voluntary Euthanasia’ in The Literary Guide, April 1951

The second attempt at changing the law was made by legal scholar, public servant, Labour politician, and President of the Ethical Union (now Humanists UK) Lord Chorley in 1950. Chorley introduced a motion to the House of Lords making direct reference to the 1936 Bill, but withdrew it following significant opposition.

In 1961, the Suicide Act decriminalised suicide, but established criminal liability for complicity in that of another person. In 1969, the atheist Lord Raglan’s Voluntary Euthanasia Bill was defeated, and in 1970 MP Hugh Gray’s effort to bring a voluntary euthanasia bill before the House of Commons failed. Gray argued that ‘the choice of life or death should always be with the individual concerned, and that the things that happen to him should be in accordance with his values and not the values of others’.

In 1985 another humanist, Lord Jenkins of Putney (a member of the British Humanist Association’s Advisory Council) introduced an amendment to the Suicide Act, to defend those who acted ‘on behalf of the person who committed suicide and in so acting behaved reasonably and with compassion and in good faith’, but was defeated. In making his argument, Lord Jenkins had referred to the growing realisation since the 1961 Suicide Act ‘that to help another to leave this world was not necessarily a criminal act. Indeed, there were circumstances in which a reasonable person might regard it as brave and compassionate’. He referenced an earlier attempt by fellow humanist Barbara Wootton, who a decade before had introduced the Incurable Patients Bill: ‘to enlarge and declare the rights of patients to be delivered from incurable suffering’. This too had been rejected.

More humanist voices

Throughout the 1960s and 1970s, many humanists had been vocal in their support for the legalisation of assisted dying, inside and outside of Parliament. Writing for The Humanist in 1963, Hector Hawton made reference to the humanist belief in the one life, and our responsibility to minimise suffering in the here and now.

The prerogative of mercy should not be deferred until the hereafter; it should be exercised here and now. There is no need for life to end so distressingly. We have the power to remove part of the sting of death and it is only superstition that prevents us from doing so.
Hector Hawton, ‘Living Death’ in The Humanist, February 1963

In 1974, prominent American humanists Paul Kurtz and Marvin Kohl penned ‘A Plea for Beneficent Euthanasia’, published in The Humanist (US). This was signed by a number of other notable figures, including Harold Blackham, known as the architect of the UK humanist movement. This arose from the National Commission for Beneficent Euthanasia, established by the American Humanist Association. The groundbreaking statement, signed by medical, legal, and religious leaders, called for ‘a more enlightened public opinion to transcend traditional taboos and move in the direction of a compassionate view toward needless suffering in dying.’ It stated:

We believe in the value and dignity of the individual person. This requires respectful treatment, which entails the right to reasonable self-determination. No rational morality can categorically forbid the termination of life if it has been blighted by some horrible malady for which all known remedial measures are unavailing.

In the decades since, humanists have consistently championed legal reform on assisted dying. Humanists UK has regularly briefed UK Parliament, urging decision makers to support the private members’ bills of Rob Marris MP and Lord Falconer, as well as supporting the cases of individuals, including Tony and Jane Nicklinson, Paul Lamb, Noel Conway, and Omid T. In 2019, Humanists UK co-founded The Assisted Dying Coalition, a cross-section of campaigners seeking legal recognition of the right to die for individuals who have a clear and settled wish to end their life and who are terminally ill or incurably suffering.

Individual humanists too have brought personal stories before the wider public, perhaps none more famously than Sir Terry Pratchett. Diagnosed with a form of Alzheimer’s disease, Pratchett wrote and spoke widely about the need for reform in the laws governing assisted death, and presented the documentary Choosing to Die in 2011, which featured 71-year-old motor neurone disease sufferer Peter Smedley, dying at the Swiss assisted dying organisation, Dignitas. For Pratchett, the security of knowing that death could be on his terms was central to his wellbeing until then.

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Assisted Dying: a history of humanist advocacy for reform

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