Chine McDonald looks at assisted dying and the underrepresented (and different) perspective of black people. 26/11/2024

Over the past few weeks, I’ve heard arguments from politicians and activists, campaigners, writers and celebrities arguing in favour of assisted dying. I can’t recall many – or indeed any – of them being black. As we approach the vote on assisted dying this week, I’ve been struck by how arguments in favour have held to very white, Western concepts of what it is to be human.  

The fact is, we are much less likely to find black people on the ‘pro’ side.  

Recent data from the Nuffield Council on Bioethics has borne this out. Their poll found that black respondents are much less likely to support assisted dying legislation: just 43 per cent of black people compared to 75 per cent of white respondents were in favour.

Why might black communities be more hesitant about assisted dying legislation? I can hazard some guesses.  

The first is of course that religious views are likely to play a part.  Ethnic minorities in the UK are more likely to belong to a religious tradition, where there are strong views about the sanctity of life. Research from the Nuffield Council found that support for assisted dying legislation was stronger among atheists (82%) compared to Christians (66%), Sikhs (52%) and Muslims (30%).  

Religious views aside, one thing is glaringly obvious to me: for many Black Britons, our sense of self straddles the divide between our cultures of origin and the Western frameworks in which we exist – the liberal versus the communitarian. Assisted dying is one of those topics in which there is a clash of cultures: a clash between the individualistic culture of 21st century Europe, and the interdependent communities from which we hail.  

Many people will be familiar with the southern African term ‘Ubuntu’, which means ‘I am because you are’. In my own community – the Igbo ethnic group of south–eastern Nigeria – there is the concept of the Umunna: the fraternity, the clan or the community. In Igbo tradition, just as in many African communities, there is a strong sense of existing not as an individual , but knitted into a family. One body, with many parts, to allude to the passage in Corinthians.  

The idea that someone who is facing death might not want to be a burden, whether due to illness or old age – as some arguments in favour of assisted dying might suggest – is anathema to West African tradition. You can’t be a burden because you are not a separate entity. You’re part of a whole.  

We live and we breathe and we create families of our own within the context of the wider, interdependent community. We die within that community too. 

Now there are, of course, challenges with this. My generation of British Nigerians will tell you of the frustrations of knowing that what might feel like our business (academic grades, who we marry, where we live, our birth stories) seems to be our whole family’s business – whether that family is here in the UK, or back home.  

Polling from More in Common found that women are on average eight points more likely than men to say that, when it comes to assisted dying legislation, safeguards are essential. I would be fascinated to see how that data differed among black women like me, in particular. 

Recent years have seen much discussion about health disparities for black women in maternity care, where they are four times more likely to die in childbirth and in the year after giving birth than white women.  

The medical profession has not done enough in recent years to allay black women’s fears about giving birth. It would be unsurprising therefore that they might not trust the healthcare system when it comes to assisted dying, either. Can we really trust that – in a stretched NHS, where there are not enough beds, not enough resource to deal with demand – enough has been done to safeguard against racial bias? Can we really be sure that when it comes to someone making a ‘choice’ about whether they live or die, assisted by medical practitioners, that these will be totally free of racial prejudice?  

There are those who would argue that such a view is pure hyperbole – that society has moved on from the days of racial discrimination. But tell that to the 65% of black people who have experienced discrimination by healthcare staff because of their ethnicity.  

And who can blame black communities for not trusting the system?  

We saw during the Covid–19 pandemic how the burden fell disproportionately on ethnic minority communities in the UK, and how some of this was down to lower vaccination uptake among them due to hesitancy about the healthcare system. An article in the British Medical Journal cited institutional racism, historical medical mistreatment of black people and cultural segregation as contributing factors.  

If assisted dying legislation passes, then one can only imagine what might happen among some of these communities. You can see how hesitation about seeking medical help might increase, for fear that one will be ‘recommended’ by two medical professionals for euthanasia. Assisted dying proponents might argue that there will be enough safeguards in place to prevent this, but there has not been enough work to allay fears of black communities thus far. We need more time to discuss the wide–ranging implications and the ripple effects into communities like my own.  

My colleagues have written on ideas around dignity, vulnerability and being a ‘burden’when it comes to the assisted dying debate.  

As Marianne Rozario has written it ‘robs loved ones the time and space to care for relatives that once cared for them… We are denying the time others get to care for us, to love us.’  This is part of the beauty of being from a community whose roots lie in Africa or the Caribbean: the idea of oneness and interdependence is up front and centre in our common life.  

I’ve seen this as I’ve witnessed my own family members rallying together, giving their time and money and prayers to relatives in need; how they have opened their homes and searched deep in their pockets for money to pay for relatives’ healthcare, even when things looked at their bleakest. This doesn’t have to be a close relative, but anyone who might be considered part of the clan, part of the Umunna. I have watched and been amazed by how they have nursed each other through the most ‘undignified’ moments.  

In my tradition, being burdened by others’ vulnerabilities is part and parcel of what it is to be human. Maybe this is exactly what it means to be family.

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