Lord Sumption, the former Supreme Court judge and civil liberties campaigner who argues against the government’s Covid lockdown measures, stirred controversy this week by claiming that ‘all lives are not of equal value’. Is he right or wrong?
Lord Sumption was speaking on the BBC’s The Big Questions programme. He was arguing that the lockdown measures are unnecessarily harmful to the young: it’s the old who are especially vulnerable to the virus but it’s the young who are paying the price of protecting them by having their lives essentially put on hold and their prospects damaged as a consequence. He thinks that rather than impose a universal lockdown, the government should help the vulnerable elderly to isolate themselves while everyone else is allowed to get on with their lives much as normal. But he provoked a strong reaction when he said on the programme: ‘All lives are not of equal value – the older you are, the less valuable yours is because there’s less of it left.’
But another contributor to the programme took exception to his remark. Deborah James, who hosts the BBC’s You, Me and the Big C podcast is suffering, at the age of 39, from stage 4 metastatic bowel cancer and has seventeen tumours. She replied: ‘With all due respect I’m the person who you say their life is not valuable. I live with metastatic bowel cancer’. Lord Sumption interrupted to say: ‘I didn’t say your life was not valuable. I said it was less valuable.’ In other words he stuck to his point that the life of someone with less time to live is of less value than the lives of those likely to live longer. His own life was of less value than those of his children or grandchildren. But Ms James countered with: ‘Who are you to put a value on life? In my view, life is sacred and I don’t think we should make those judgment calls. All life is worth saving, regardless of what life it is people are living.’
Lord Sumption’s remarks are controversial not simply because they seem so insensitive when made to a young woman suffering from the late stages of cancer but because, on the face of it, they challenge one of the most basic tenets of belief in Judaeo-Christian societies as well as of many others. It says that human life is of absolute value. Ms James used the word ‘sacred’. That’s to say, human life is in itself of unqualified value. So not only is it the case that we cannot judge one human life to be more or less valuable than another, but the value of human life itself cannot be weighed in the balance against any other value we might espouse. It is absolute. This belief lies at the foundation of claims that human rights are universal and themselves absolute.
It is not hard to see what makes many people so determined to uphold belief in the absolute value of human life: it is the fear of what might ensue if we were to abandon it. Once we accept that some individuals or some groups of people are of less value than others, or even of no value at all, then the door is open to getting rid of them. This way lies genocide, such as the holocaust; eugenics (the belief that human society can be improved by eliminating the disabled, the mentally ill or anyone else who is not ‘up to standard’); and compulsory euthanasia (the killing of the elderly once they are deemed to be more trouble than they are worth). To make the point in general terms, once we allow the concept of the relative utility of some lives compared with others to inform how we run society, the fear is that the powerful will then act to discriminate against ‘less valuable’ human beings even to the point of doing away with them.
This fear is why belief in the absolute value of human life is so strongly defended and you won’t find many people arguing against it, at least in principle. But in practice, things have never been quite so clear cut. What, to start with, does the concept of the absolute value of human life actually mean? One meaning would be to say that it is beyond price, with the implication that no cost is too great to protect it. Yet we live in a world of scarcity, or at least in a world in which our ‘plenty’ is not infinite, so that we have to make choices about how we use our resources. That includes how much we are prepared to spend to protect life.
Take deaths through road accidents, for example. If we believe in the absolute value of life, how much are we prepared to spend to make sure we prevent every single road death? In talking of cost here, it’s not just a matter of cash but also of our freedoms. If we were really serious about the absolute value of life then in order to protect it by being prepared, to borrow Kennedy’s phrase, ‘to pay any price’, we would have to ban traffic altogether because so long as there are cars and lorries driving about, someone is going to get killed. But even to float the idea is to reveal how bonkers it is. In the real world what happens is that economists in the transport department put price tags on the value of human life. They will spend up to a certain point in trying to reduce road deaths but if the cost of going further exceeds that cost, they’ll accept the deaths. So much for human life being beyond price.
Similarly, if by the ‘absolute’ value of human life we mean something rather different – that all human life is of equal value – then the sad fact of the scarcity of resources compromises this too. The government’s health watchdog, NICE, has the task of deciding whether some treatments and medicines are so expensive that doctors should be denied the chance to prescribe them because, if they were to do so, there wouldn’t be the resources to treat many others needing perhaps cheaper treatments. It might well seem (and, indeed, be) wholly justifiable to use such a utilitarian calculus to deploy limited resources so that they help as many people as possible, but it still leaves those denied the expensive treatment seeing the value of their lives compromised. So much for their absolute value.
It is just such a calculus that doctors use all the time too in deciding which of their patients should get treatment that is limited in supply. The concept of quality-adjusted life years (QALYs), which attempts to ascribe relative values to the estimated remaining lifespans of different patients, is deployed to favour those whose QALY is higher. It does not, and cannot, treat every life as having equal value.
This is, implictly, what Lord Sumption was advocating. In his view, the ‘cost’ imposed on the young, whose QALYs are being severely reduced, is disproportionate and if the cost imposed on the elderly (in terms of tighter isolation) were to increase, this could be justified because their QALYs are relatively so much less.
To many this utilitarian way of judging human life against scarce resources is just common sense. One woman wrote to the Times, in the context of the Sumption row, saying simply: ‘I do hope that if there isn’t enough oxygen for us both that the doctor won’t chose between elderly me and a young parent with dependent children by flipping a coin.’ But to others, it remains controversial, partly because of a scepticism about the factors that go into the calculation about the potential value of the remainder of someone’s life. Just because they may not have many years left doesn’t mean their ‘value’ is itself diminished: the value of a granny to her kids and grandkids may well feel beyond price and the better way to uphold the absolute value of human life in a world of scarce resources may well be to toss a coin.
But there is a third and even more controversial aspect to the concept of the absolute value of life, depending on its meaning. This concerns the issue of who is to judge what it means. Here we are talking not about doctors or society at large making judgments about other people’s lives but about individuals making judgments about the value of their own lives. Some people reach a point in their lives when it seems to have no value at all, or to have an intolerable, negative value and they wish to die. But the law as it stands does not allow a doctor to help them.
It is not that long ago that suicide was a criminal offence. Now the focus is on assisted dying, the ability of someone who wants to end their life to ask for the assistance of someone else in order to do so. Attempts to change the law to make it possible have constantly been rebuffed, usually with large majorities in parliament. Although practical reasons are often cited (the risk, for example, that the elderly would come under pressure from relatives keen to be rid of them) there is a more fundamental objection voiced by religious leaders: the belief in the absolute value of life.
It means that we cannot be allowed to judge the value of our own lives, even when we are suffering. We must follow the injunction of Edgar, the son of the blinded Gloucester who wants to kill himself towards the end of King Lear: ‘Men must endure/Their going hence, even as their coming hither:/Ripeness is all’. The ‘sacred’ tone is unmistakable.
To many (including me) this is both nonsensical and inhuman. It is to assert the absolute value of something while paying no regard at all to the actual content of that value, which may often have dwindled to nothing, or worse. It may have become a platitude but it really is the case that in this regard we treat our pets better than we are allowed to treat our old and suffering parents. Would you or I choose a swift and painless death in preference to months or even years of being kept alive unable even to communicate, knowing there is not the slightest hope of any form of recovery? Opinion polls show a large and growing majority in favour of physician assisted suicide. It is, in my view, simply cruel to deny it based on an intransigent and blind belief in the absolute value of human life.
So who’s right? Was Lord Sumption right or wrong to say that ‘All lives are not of equal value’? Was he right or wrong to add: ‘the older you are, the less valuable yours is because there is less of it left’? Should doctors use concepts like quality-adjusted life years to determine who does and who doesn’t get treatments? Should assisted dying be made legal or not? And should we cling to the notion that the value of human life is absolute?
Let us know what you think.