Beyond wealth and wellbeing: how nations flourish

As GDP data is increasingly scrutinised, Ryan Gilfeather asks how to measure the true health and wealth of a nation.

Ryan Gilfeather

Ryan Gilfeather explores social issues through the lens of philosophy, theology, and history. He is a Research Associate at the Joseph Centre for Dignified Work.

Two women sit behind a press conference desk against a backdrop, one listens as the other speaks and gestures.

A recent International Monetary Fund press conference on the world economic outlook.

IMF.

Discussions of GDP loom large in our current age. As we live under the shadow of the threat of a recession in the UK, ministers and commentators anxiously follow our country’s Gross Domestic Product, to see whether we are on the right track. Measuring the total value of goods and services produced in a country, this figure is a litmus test for the health of an economy. Crucially, many policymakers and leaders in government believe this figure reveals the health of a nation.

As we will see, not all agree. Opponents rightly highlight that an increase in GDP does not necessarily mean that ordinary citizens live better lives. There are good reasons to share this opposition from a Christian perspective. However, ultimately, the Christian tradition highlights a very different way to measure the health of a society.

In 2020 The Carnegie UK Trust, a think tank campaigning for greater welfare for all, published a new measure for social progress: GDWe (Gross Domestic Wellbeing). In brief, they gathered and processed ONS (Office for National Statistics) data on a variety of domains in life, giving them a single figure on a 10-point scale to rate well-being. These domains included personal well-being, relationships, health, vocational activities, living environments, personal finances, the economy, education and skills, governance, and the environment. When they plotted GDP against GDWe from 2013-9, they revealed that the two do not always line up. As GDP steadily increased from 2016, overall welfare in society dipped. From 2013-9 GDP increased by 10.34 per cent and GDWe only 5.19 per cent. Hence, measuring GDP does not necessarily reveal whether life is getting better for ordinary.

Economic resources are not useless... However, they are not sufficient unto themselves for us to live full and good lives.

This attempt to shift the conversation about social progress from predominantly centring GDP is commendable. The Bible does not legislate on whether to use GDP or GDWe. However, scriptures within it repeatedly decouple economic wealth from flourishing. For example, in the gospel of Matthew, Jesus says the following:

Do not store up for yourselves treasures on earth, where moth and rust consume and where thieves break in and steal, but store up for yourselves treasures in heaven, where neither moth nor rust consumes and where thieves do not break in and steal. For where your treasure is, there your heart will be also.

In life, we can either focus our efforts on attaining wealth or fostering our relationship with God. Only the latter will lead us to flourish. Economic resources are not useless; they are necessary for us to thrive in certain conditions. However, they are not sufficient unto themselves for us to live full and good lives. Furthermore, when wealth becomes the focus of our hearts and minds, our lives will be hollow and fractured. GDWe is a good measure, insofar as it acknowledges that economic flourishing is not the same as a good quality of life, and it attempts to shed light on the latter. However, the Christian tradition highlights a different framework altogether to grasp the health of a society.

Gregory of Nyssa, a fourth-century theologian and bishop, frames wellbeing as a human being reflecting the image of God to the greatest of their ability. The book of Genesis says that God made us all in His image. Gregory argues that this means that we can become like God in certain ways. God is the fullness of all good things, such as love, justice, peace, joy, and courage. Consequently, Gregory argues that when we act in good ways, we begin to share those characteristics, which in turn leads us to act well in the future. For example, if I defend someone who is under attack, I will become more courageous, and more likely to repeat the same action in the future. The more we reflect the image of God, by acting well and taking on His characteristics, the more we will flourish as individuals. In this vision of human flourishing, Gregory brings together an Aristotelian account of virtue, with a Christian understanding of people as the image of God.

This framework for the well-being of an individual also provides a good barometer for the health of a society. All of these actions and characteristics are building blocks for a healthy society. So long as we have a good sense of how to act appropriately with love, justice, peace, joy and courage, then our actions will build up our common life together. They benefit all, rather than one. They are not zero-sum actions. Accordingly, a society made up of individuals who are acting well and reflecting the image of God would be very healthy indeed.

As a measure of a society, we should ask whether it leads citizens away from virtuous actions and characteristics. For example, between 2019 and 2021, gun murders in the USA rose by 45%. Earlier this year, journalist John Burn-Murdoch argued this rise is partly due to decaying public trust in that country. This tells us that a culture marked by fear of others can lead some of its citizens to commit terrible actions and live lives full of violence. GDP may rise during this time, as may other markers of welfare. However, to see the whole picture we need also consider how societal forces are leading citizens away from flourishing in their reflection of the image of God. Then, we should go about addressing these malignant forces.

In times of adversity... individuals in societies marked by high levels of trust are more satisfied with their lives and act more benevolently.

At the same time, we should also consider how a society enables its citizens to reflect the image of God. Societies with high levels of social trust create space for a variety of positive actions and characteristics. The World Happiness Report studies people’s sense of life satisfaction worldwide. It routinely finds that in times of adversity, like the Great Recession in 2008 or the COVID pandemic, individuals in societies marked by high levels of trust are more satisfied with their lives and act more benevolently than others. Again, these social forces are not the same as GDP, yet they have a significant ability to shape the extent to which citizens can reflect the image of God, and thereby flourish.

In my work for the Joseph Centre for Dignified Work, I am particularly concerned with low-wage workers’ pay and conditions. As I have argued elsewhere, low pay leads to some workers needing to take on two or more jobs. They, consequently, have no time to see their children, nourish their faith, or participate in community institutions. It is clear, therefore, that the widespread pattern of paying below the Real Living Wage (£11.94 p/h in London, £10.90 elsewhere), hinders people in their expression of love for God, family and neighbour. Pay and conditions are but one further example, amongst many, of how societal forces can hinder or help our flourishing in the reflection of the image of God.

Needless to say, GDP and GDWe are still useful and necessary tools. However, they do not tell the full story. GDP only describes the progress of the economy as a whole, and GDWe can only describe the quality of an average person’s life. In contrast, when we set a goal that each citizen should reflect the image of God, we can begin to explore how societal forces enable or squeeze out this aim. With this greater knowledge in mind, we can strive for progress in our nation by fostering good structures and stamping out bad ones, so that all may reflect the image of God to the greatest of their ability.

Article

Assisted dying

Comment

Justice

15 October 2024

5 min read

Will clinicians and carers objecting to assisted death be treated as nuisances?

The risk and mental cost of forcing someone to act against their conscience.

Henna Cundill

Henna is a researcher with the Centre for Autism and Theology at the University of Aberdeen.

A tired-looking doctor sits at a desk dealing with paperwork.

Francisco Venâncio on Unsplash.

After a formal introduction to the House of Commons next Wednesday, MP’s will debate a draft Bill to change UK legislation on Assisted Dying. Previously, a draft Bill was introduced in the Scottish Parliament in March 2024, and is currently at committee stage. Meanwhile, in the House of Lords, a Private Member’s Bill was introduced by Lord Falconer in July and currently awaits its second reading. These draft Bills, though likely to be dropped and superseded by the Commons Bill in the fullness of time, give an early indication of what provision might be made on behalf of clinicians and other healthcare workers who wish to recuse themselves from carrying out a patient’s end of life wishes on grounds of Conscientious Objection.

There are various reasons why someone might want to conscientiously object. The most commonly cited are faith or religious commitments. This is not to say that all people of faith are against a change in the law – there are some high-profile religious advocates for the legalisation of Assisted Dying, including both Rabbi Dr Jonathan Romain and Lord Carey, the former Archbishop of Canterbury. Even so, there will be many adherents to various faith traditions who find themselves unable to take part in hastening the end of someone’s life because they feel it conflicts with their views on God and what it means to be human.

However, there are also Conscientious Objectors who are not religious, or not formally so. Some people, perhaps many, simply feel unsure of the rights and wrongs of the matter. The coming debates will no doubt feature discussion of how changing the law for those who are terminally ill in the Netherlands and Canada has to lead to subsequent changes in the law to include those who are not terminally, but instead chronically ill. The widening of the eligibility criteria has reached a point where, in the Netherlands, one in every 20 people now ends their life by euthanasia. This troubling statistic includes many who are neurodivergent, who suffer from depression or are disabled. It is reasonable that, even if a Conscientious Objector does not adhere to a particular religion, they can be allowed to object if they feel uneasy about the social message that Assisted Dying seems to send to vulnerable people.

“You will often find that legislation that provides a right to conscientious objection is interpreted by judges these days in a way that seems to treat conscientious objectors as nuisances”

Mehmet Ciftci

Conscientious Objection clauses can themselves send a social message. A response to the Scottish Bill produced by the Law Society of Scotland notes concern over the wording of the Conscientious Objection clause, as it appears to be more prescriptive in the draft Bill than in previous Acts such as the Abortion Act of 1967. In the case of any legal proceedings that arise from a clinician’s refusal to cooperate, the current wording places the burden of proof onto the Conscientious Objector, stating (at 18.2):

In any legal proceedings the burden of proof of conscientious objection is to rest on the person claiming to rely on it.

The Bill provides no indication of what is admissible as ‘proof’. Evidence of membership of a Church, Synagogue, Mosque or similar might be the obvious starting point. But where does that leave those described above, who object on grounds of personal conscience alone? How does one meaningfully evidence an inner sense of unease?

The wording of the Private Member’s Bill, currently awaiting its second reading in the House of Lords, provides even less clarity, stating only (at 5.0):

A person is not under any duty (whether by contract or arising from any statutory or other legal requirement) to participate in anything authorised by this Act to which that person has a conscientious objection.

Whilst this indicates that there is no duty to participate in assisting someone to end their life, there remains a wider duty of care that healthcare professionals cannot ignore. Thus, a general feature in the interpretation of such conscience clauses in medicine is that that the conscientious objector is under an obligation to refer the case to a professional who does not share the same objection. This can be seen in practice looking at abortion law, where ideas around conscientious objection are more developed and have been tried in the courts. In the case of an abortion, a clinician can refuse to take part in the procedure, but they must still find an alternative clinician who is willing to perform their role, and they must still carry out ancillary care and related administrative tasks.

Placing such obligations onto clinicians could be seen as diminishing rather than respecting their objection. Dr Mehmet Ciftci, a Researcher at the McDonald Centre for Theology, Ethics and Public Life at the University of Oxford comments:

You will often find that legislation that provides a right to conscientious objection is interpreted by judges these days in a way that seems to treat conscientious objectors as nuisances who are just preventing the efficient delivery of services. They are forced to refer patients on to those who will perform whatever procedure they are objecting to, which involves a certain cooperation or facilitation with the act.

This touches everyone, even those who (if the Bill becomes law) will still choose to conscientiously object. Therefore, it is important to consider that the human conscience is a very real phenomenon, which means that facilitating an act that feels morally wrong can give rise to feelings of guilt or shame, even if one has not been a direct participant.

Psychologists observe that when feelings of guilt are not addressed, if they are treated dismissively or internalised, this can significantly erode self-confidence and increase the likelihood of depressive symptoms. But even before modern psychology could speak to the effects of guilt, biblical writers already had much to say on the painful consequences of living with a troubled conscience. In the Psalms, more than one ancient poet pours out their heart to God, saying that living with guilt has caused their bones to feel weak, or their heart to feel heavy, or their world to feel desolate and lonely.

If the Conscientious Objection clauses of the new Bill being proposed on Wednesday are not significantly more robust than those in the draft Bills proposed thus far, then perhaps that is something to which we should all conscientiously object? There is much to discuss about the potential rights and wrongs of legalising Assisted Dying, but there is much to discuss about the rights and wrongs of forcing people to act against their consciences too.