Proposed euthanasia safeguards insult our NHS

We must defend a collective sense of care and generosity.

George Pitcher

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.

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War & peace

1 November 2024

5 min read

Put poppy politics in the past and give Remembrance a hopeful future

Memory without hope will lead us to a dead-end.

Mark Gilbert

Mark is a research mathematician who writes on ethics, human identity and the nature of intelligence.

A woman walls along a war memorial wall covered in red poppies.

War memorial in Canberra.

Raelle Gann-Owens on Unsplash.

Remembrance Day is complicated. A nation shows its gratitude for the service and sacrifice of its armed forces and tries to connect to its history. Never far away, are poppy politics, along with anxiety about identity and forgetting, and fears about nationalism and militarism. Is this the way to remember?

Last November, protests in solidarity with Gaza dominated the headlines. On Armistice Day, hundreds of thousands of people marched through central London to demand a ceasefire. In the preceding weeks, there was vigorous debate about whether the march should be cancelled. There were several motivations for this: there were genuine fears of violence and extremism, and of disruption at the Cenotaph, but also questions of whether marching on Armistice Day was inappropriate or disrespectful.

The march itself was organised to minimise the risk of disrupting public commemorations of Remembrance. It started several hours after the two-minute silence and followed a route several miles from the cenotaph. It was mostly peaceful, although there were arrests for anti-Semitism, open support for terrorism and violent attacks on police officers. Armistice Day did see violence around the cenotaph, but this was from the self-described ‘Cenotaph Defenders’ who had organised a counter-demonstration against the Gaza march. The group of football hooligans and far-right EDL members gathered with poppy emblazoned banners declaring ‘Have some respect for British Heroes’. Within a few hours, the calls for respect had degenerated into violent attacks on serving uniformed officers, in this case the police.

The far-right’s adoption of remembrance symbolism can be seen as an extreme form of a wider entanglement of poppies and politics. The red paper poppy is a symbol of remembrance, but it has other connotations. For some it invokes patriotism and feelings of pride in their country, for others it represents conformity and militarism. Whether television news presenters are wearing them attracts disproportionate attention. In 2019, one Australian TV network had a very tasteless segment denouncing a rival station whose newscasters failed to wear poppies. The non-poppy wearing hosts were accused of failing in their duty to respect their country and to help preserve its culture and traditions. Regardless of the presenters’ actual reasons, this feels like a lot of baggage to load onto the delicate poppy, a symbol of quiet remembrance and gratitude.

Unsurprisingly, this has led many to question whether Remembrance Day has become detached from its original purposes. Twelve years after the death of the last British First World War veteran, there is little living connection to either of the two world wars. With this passage of time, there is a growing danger of mistaking the symbols of ceremonial Remembrance for the thing itself.

The focus of remembrance can shift away from the sheer horrors of war, from awe at the sacrifice of our forebears, and from the resolved ‘never again’ to fixing our gaze on the processed goods: the ceremonial silence, the poppies themselves and even the quality of our own emotional response.

Some commentators have suggested that organised Remembrance has served its purpose and is best forgotten, and that too much remembering is a bad thing, fuelling grudges and sectarian conflicts. Personally, I’m not convinced, but I do think our current Remembrance is missing something.

With a strong grounding in a shared past and a common hope, we would talk frankly about the times our country has fallen short without a sense of betraying our history or identity.

Reflecting on the importance and difficulty of memory, the writer and Holocaust survivor Elie Wiesel emphasised the importance of hope. Despite the horrific experiences of the twentieth century, for Wiesel it is hope that “summons the future”. Memory without hope would lead us to a dead-end, where we grip onto the past while feeling it slip like sand through our fingers. Many of the anxieties around Remembrance point to a hope deficit.

How can we remember with hope?

We need to broaden our perspective and engage better with our shared national story. We need to be grounded in our history, stories and myths but we also need to be drawn forward by the good things we have and will have. If this story is big enough then it will be a large tapestry of interwoven strands, and we will be able to generously incorporate new strands, other cultures with their own relationship to the past into it. We will also be better prepared for our remembering to deal with difficult questions about our nation’s history. With a strong grounding in a shared past and a common hope, we would talk frankly about the times our country has fallen short without a sense of betraying our history or identity. Hope would connect us better to our neighbours overseas and to the men and women who risk their lives to serve their country.

Last Remembrance Sunday, I helped our church’s under-7s make big paper poppies out of red paint and paper plates. The older children made origami peace cranes, and both the big red poppies and the peace cranes were placed by the altar. Here the focus is on remembering, but not just on our own memory. For me and countless other Christians, God’s memory is the real focus. God remembers us in our broken and war-torn world, and as Jesus, chose to join us in it, experiencing the worst of suffering while dying a painful death. All our personal and collective stories of pain, loss and sadness are met in this sacrifice. More than this, in the promises of restoration Jesus gave when He rose from the dead, they find a concrete hope.

What does Remembrance look like when it’s really grounded in hope? I think there would be a few noticeable signs. It would be less precious about itself. It would be more open to different emphases of remembrance such as the Peace Pledge Union and the white poppy, and excited about new creative expressions of remembrance like the ‘poppy walks’ organised by the Royal British Legion. More patient to the concerns of those who find the religious elements of Remembrance difficult. More integrated into our attitudes to current and ongoing conflict around the world. Most of all I hope it would make us really hungry for both peace and for righteousness.