Column
Assisted dying
Care
Comment
4 min read

Proposed euthanasia safeguards insult our NHS

We must defend a collective sense of care and generosity.

George is a visiting fellow at the London School of Economics and an Anglican priest.

A gable end mural depicts a nurse in scrubs and a mask turning and looking towards the viewer.
A mural of an NHS nurse during COVID, Manchester.
Mural Republic

It was, I believe, the late political satirist Simon Hoggart who coined the Law of the Ridiculous Reverse, which held that, if the opposite of a statement is plainly absurd, then it was not worth making in the first place.  

This law comes to mind when Labour MP Kim Leadbeater promises that her Assisted Dying Bill will have the “strictest safeguards in the world”, one of which is that those patients who have ordered their fatal dose “would be allowed to change their mind at any time.”   

Where, exactly, has it ever been suggested that an individual, having asked for an assisted death, would not be allowed to change their mind? I’m just wondering which legislator or medical professional has proposed that once a lethal draught has been prescribed then there is no turning back.  

I’m struggling to picture the circumstance in which a terminally ill patient is pinned down and killed, the last words that they hear being: “I’m sorry Mrs Simpkins, but everyone’s gone to a lot of trouble. You asked for it and you’re jolly well going to get it.” 

This is important because, apparently, being able to change your mind about asking for help to kill yourself is one of the strictest safeguards in the world. I hope Ms Leadbeater will forgive me for pointing out that this doesn’t really stack up. 

 And what’s serious about it is that it’s also a massive straw man argument. The clear and rather devious implication is that one of the arguments being made against the introduction of an assisted suicide law is that patients won’t be able to change their minds about it, which I think we can all accept simply isn’t a fact at all. It’s absurd – a Ridiculous Reverse. 

So I’ll defend the NHS with a religious fervour. To my mind, healthcare is a holy mission. We meddle in law with the Hippocratic Oath at our very deep peril. 

It’s also hugely contemptuous of the medical profession in general and rude to the NHS in particular. That’s because there’s a snide impression behind Leadbeater’s comment there may be hundreds of budding Howard Shipmans out there, but her powerful safeguards are going to protect us from them. 

We’re in danger of becoming inured to this kind of insult from politicians directed at the NHS. And it’s worth exploring why they might think we need to be protected from unscrupulous doctors and nurses. In this case, one possible reason is that the NHS isn’t being particularly helpful in giving the euthanasia enthusiasts what they want. 

Doctors and their staff have plenty of ethical objections to assisted suicide. But leave those aside for a moment. At the practical level, the NHS has made it clear that it doesn’t have the infrastructure to operate a policy of assisted deaths safely. And it can’t afford to set one up. So a government that introduces assisted suicide is going to have to organise and regulate its own assisted death agency. 

“Oh,” the assisted dying lobbyists seem to exclaim, “we’d presumed you’d do as you’re told.” Just hand out the hemlock. Take your instructions from the legislature. 

But the NHS is better than that. And it’s that kind of high principle that so infuriates feckless politicians. It was the late Nigel Lawson who said, somewhat ruefully, that the NHS “is the closest thing the English have to a religion”. The right wing of politics regularly tells us it’s time to renounce that religion. 

To worship the NHS as a religion would, literally, be idolatrous. But it’s not so to acknowledge its religious qualities. Just look at the word – the Latin religio means something like “good faith”, the essence of who we are, what makes us good. 

The NHS, in its post-war incarnation, has been central to who we are as a people and what defines us. It’s something to do with our collective sense of care and generosity to one another. Its members, like our national Church, make up a single body. 

This is not to co-opt the NHS as the medical wing of the Church. It’s no part of the NHS’s brief to proselytize – rather the reverse; Christian medical staff have been in deep disciplinary trouble for evangelising. It is a profoundly secular organisation. 

So the NHS emphatically isn’t in the business of propagating the gospel. But that’s not to say that we can’t be in the same business. Many priests have stories of their most affirming work being in the company of people of other faiths or of none. 

The NHS’s proud heritage is to offer treatment free to anyone at the point of access. Put another way, it will seek to heal anyone who comes to it. I make no apology for saying that sounds familiar. 

So I’ll defend the NHS with a religious fervour. To my mind, healthcare is a holy mission. We meddle in law with the Hippocratic Oath at our very deep peril. 

And when NHS professionals tell us where we can stick our assisted suicides, I respectfully suggest we give it our solemn attention, rather than patronisingly offering a Law of the Ridiculous Reverse.

Article
Community
Creed
Sin
3 min read

In the city of broken windows

Our fractures become fractal, breaking bigger and bigger windows.

Jamie is Associate Minister at Holy Trinity Clapham, London.

a multi-paned window mural shows people while amid it are broken window panes.
A broken window mural, Ellis Island Immigrant Hospital.
Rhododendrites, CC BY-SA 4.0, Wikimedia Commons.

We weren't expecting a knock on the door from our next-door neighbour on New Year's Day. It was pouring with rain, and said rain was pouring into the boot of our car, with the window smashed. Thanks for letting us know. Annoying, inconvenient and expensive. But just how expensive is a smashed window? 

The 'broken windows theory', that visible signs of crime, antisocial behaviour and civil disorder begets more serious crimes, was introduced American sociologists James Q. Wilson and George Kelling: 

'Social psychologists and police officers tend to agree that if a window in a building is broken and is left unrepaired, all the rest of the windows will soon be broken. This is as true in nice neighborhoods as in rundown ones. Window-breaking does not necessarily occur on a large scale because some areas are inhabited by determined window-breakers whereas others are populated by window-lovers; rather, one un-repaired broken window is a signal that no one cares, and so breaking more windows costs nothing. (It has always been fun.)' 

This is not an academic theory. Where I live in London, i took the local council 1,315 days to replace a local resident's broken window. The sense of decay extends beyond borders, with fewer than half the residents thinking they live on clean streets, with rubbish and weeds gone unchecked. It is also one of the worst boroughs in London for varying types of crime, and over the past few years often being the worst. It's hard not to think the little things and the big things are linked. In other news, the now-resigned CEO of the council has pleaded guilty to drink-driving, failing to stop after a car crash and driving without insurance, and not guilty to possession of cocaine. 

Our problems in society all found their greenhouses somewhere inside of us.

Crime is on the move. As homes have become more difficult to burgle, crime has been pushed out onto the streets with shoplifting and bike theft. The Economist recently reported that 'stolen bikes and e-bikes have also become the getaway vehicle of choice for thieves, according to the Merseyside police. In one way or another, some 80 per cent of acquisitive crime in Liverpool involves a nicked bike.' It's going to be fascinating to see the wider impact, but simply by stopping suspicious riders and marking thousands of bikes across Liverpool, reported thefts have fallen by 46 per cent between July 2023 and July 2024 compared with the previous year. 

These problems can't be solved by overstretched police or the council. Everyone's responsible so no one's to blame. Practical implementations of the broken windows theory have not been without controversy. But for those of us who live in urban environments, to look out from our homes is to see a city of broken windows. The impact is more than weeds 'uprooting' pavements: it's an uprooted society. Correlation and causation might be blurred, but that's the point. In Christianity, sin is understood as having a polluting effect. Just as fossil fuels in China will pollute the atmosphere for someone in Scotland, sin is not hermetically sealed. Our problems in society all found their greenhouses somewhere inside of us. 

Jesus said 'what comes out of you is what makes you 'unclean'. For from within, out of your hearts, come evil thoughts, sexual immorality, theft, murder, adultery, greed, malice, deceit, lewdness, envy, slander, arrogance and folly. All these evils come from inside and they make you 'unclean'.' They pollute our lives. And they pollute the world around us. 

The Christian church, much like many institutions, is reckoning with prioritising competency at the expense of character. Little sins are not so little when they permeate and promote a culture where certain sins are permissible. Our fractures become fractal, breaking bigger and bigger windows. 

All this sounds pretty bleak and Dickensian when of course there's always another city to see: full of life, vibrancy and joy. But we'd be wilfully ignorant to ignore the disorder of broken windows and broken lives all around us. It might overwhelm us, or our eyes might glaze over as we see those broken windows. But we'd do well not to ignore the broken windows within us too. For our sake, and the sake of our streets.