I have to admit that, before Scott McKenna proposed it, it seemed to me that you could not pry the sanctity and inviolability of life apart. As he says, quite clearly:

For me, sanctity of life does not necessarily equate with inviolability.   My argument is that God has given us moral responsibility.   We cannot ever say that God desires intolerable suffering of us and, in ending our life in such circumstances, we, as co-creators with God, are exercising compassion and God-given choice.   There are no ‘disastrous consequences’:  God is bigger than that.  It is precisely because God is compassionate that we have nothing to fear.    We have real moral choice:  we are not ‘sheep’.

This is, it needs to be said, contrary to what is normally meant by the sanctity of life, and, as for moral responsibility, religions have normally seen morality as a function of their belief in and loyalty to God, not something which can be separated from that belief or that commitment.

The Roman Catholic Church puts the point with its wonted bluntness. In its Declaration on Euthanasia it is quite clearly stated:

It is necessary to state firmly once more that nothing and no one can in any way permit the killing of an innocent human being, whether a fetus or an embryo, an infant or an adult, an old person, or one suffering from an incurable disease, or a person who is dying. Furthermore, no one is permitted to ask for this act of killing, either for himself or herself or for another person entrusted to his or her care, nor can he or she consent to it, either explicitly or implicitly. nor can any authority legitimately recommend or permit such an action. For it is a question of the violation of the divine law, an offense against the dignity of the human person, a crime against life, and an attack on humanity. [my italics]

Of course, there is a qualification, bringing the principle of double effect into play, namely, that one may not intentionally bring about the death of an innocent human being. This expedient, however, is simply a band aid where a battle dressing is required. In her book The Sanctity of Life Doctrine in Medicine: A Critique, the Australian philosopher Helga Kuhse defines sanctity of life as follows:

It is absolutely prohibited either intentionally to kill a patient or intentionally to let a patient die, and to base decisions relating to the prolongation or shortening of human life on considerations of its quality or kind. [11; italics in original]

In  the light of these considerations, how can Scott McKenna claim that he supports the principle of the sanctity of life, and yet does not consider this principle absolute?

The problem here is with the idea of sanctity, sacredness or holiness. What makes something sacred or holy? The problem is central to Christian self-understanding. The paradigm example of holiness or sanctity is God himself, and it is God alone who can confer holiness upon others, and what is implied in the notion of holiness is what might be called “set-apartness.” The people of Israel are a holy people, because, in biblical understanding, they have been “set apart” by God to be his peculiar people for a specific purpose, namely, to be the sacrament of God’s purpose on earth. In the same way the church thought of itself as holy. In the first letter of Peter the church is described as “a chosen race, a royal priesthood, a holy nation.” (2.9) And in Ephesians the church is called to be holy and without blemish (5.27) In other words, the church has taken over from Israel the description of a chosen people, set apart from the nations. But, even more than that, Christians are admonished to present their bodies to be a living sacrifice, holy and acceptable to God. (Romans 12.1) This idea of holiness is essential if we are to understand what is meant by the sanctity of life. Life is sacred, just as the church is sacred, because set apart by God. Taking what Paul says in Romans about Christians offering their bodies as a living sacrifice, it is clear that, implicit in this, is the acceptance of whatever befalls the body as an aspect of sacrificial living. This has been the traditional view of the duty of the Christian since the beginning. This means that the life of the believer is inviolable, no matter what the sufferings that believer must endure. Martyrdom was highly valued, and the pains and torments of martyrdom were expected to be borne with fortitude and even joy, for in this way believers offered themselves as living sacrifices to God, and thus showed, in their unwavering faithfulness, the holiness which they were to express in their lives.

It is hard to see how an exception can be made for those who are suffering the pains and torments of disease. In traditional Christian doctrine such torments are to be borne with fortitude, knowing, as Paul also said, that God will not test us beyond what we can bear (1 Corinthians 10.13), which is, of course, nonsense, for many people are tried beyond endurance. But the point is that, for the person of faith, nothing may be allowed to overcome faith, for all that happens is something done, and done with a loving purpose, as C.S. Lewis, to his shame (in my view) concluded. If all this is true, then it seems to me very difficult to sustain the claim that the sanctity of life is violable on the basis of compassion, for this immediately suggests that God is not compassionate, and has not taken our weaknesses into account when visiting us with suffering. Intruding in what are taken to be sovereign expressions of God’s love and compassion, and God’s absolute knowledge both of our abilities and our ultimate destiny, would in fact be an overt denial of God’s goodness, and it is this that secures the inviolability of life for those who believe in its sanctity.

This does not mean that we should not accept with gladness those Christians for whom God is moved to compassion by our sufferings and approves of actions which, by ending life, also brings those sufferings to an end. This, however, is a view not widely shared by Christian theologians, nor, I suspect, by Muslim or Jewish religious experts as well. The conflict between the assumption that God is good, and will therefore not cause us to suffer needlessly, and the view that approves of assisted dying for those whose suffering can be brought to an end in no other way, is too obvious to need mentioning. Indeed, the fundamental underlying assumption at work here is that the problem of evil is insoluble, and that God is therefore not good, for if God were truly good, even though there might still be suffering, there would not be any suffering that is not to the good of those who suffer. This was C.S. Lewis’s conclusion in A Grief Observed. It has always been my view, since reading this little book, that not only is Lewis’s conclusion unjustified on his own premises, but that, by concluding as he did, he betrayed the wife he claimed to love.

In other words, while I believe that Scott McKenna is a compassionate and thoughtful man, I do not believe that he can justify assisted dying in Christian theological terms. Paul Badham, who attempts to do so, limits assisted dying in such a way as to make a mockery of the right of people to make such decisions for themselves. That does not mean that we do not want checks and balances, but, ultimately, the question comes down to the question of choice, for that alone is what removes it from the hands of the medical technologists or state officials. Once a person has decided to ask for assisted dying, the only thing that should change that person’s mind is being shown that, in fact, they can still live full and rewarding lives, and that person’s acknowledgement that this, and this alone, has led them to change their minds. The option for assisted dying must, however, even in such cases, be left open, because, even though a person may be thus convinced, it is not obvious that they will remain convinced until death should come.

Life is not sacred. It is a very great value, and one that most people treasure. The killing of someone for whom life is still valuable, and whose living of it is conceived of by a person as a benefit, is a grievous crime. However, equally grievous is the belief that life is sacred, so that no person is capable of deciding when their life is no longer of value, or has even become a disvalue to them, and inconsistent with their own conception of what a good life consists in. As Ronald Dworkin rightly points out, to force someone to live through conditions that they themselves see as inconsistent with their most deeply held values as to what life is about is an odious form of tyranny. It is the only place in the great democracies where slavery is the rule, and those who deprecate slavery should be able to see that this is a form of it. No one should be forced to die in ways prescribed by their disease. For the length of time that they are under such compulsion in law they are slaves of the state. It is a form of slavery that should appal equally with the slave trade of the eighteenth century and sadly growing traffic in women for sexual slavery. That it does not is a sign that the religious have won the first round of this debate. If they win the next round, it is because the religious think that slavery is necessary in order for society to reflect the prescriptions of their gods. May those gods die quickly, so that we can begin to order our lives in ways consistent with human reason, and not dependent, as they still so often are, on the supposed will of imagined gods.