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.

Essay
America
Comment
Leading
Politics
6 min read

Democracy, hypocrisy and us

A deep dive into the pitfalls of political vision and our response to them.

Josh is a curate in London, and is completing a PhD in theology.

Donald Trump holds his arms out to his side while speaking.
Trump addresses a faith leader event.
x/realdonaldtrump.

Coverage of the Republican candidate for Vice-President, J.D. Vance can't help but return again and again to his Christian intellectual influences. Whether it's an interview with Rod Dreher or an analysis of Patrick Deneen and other 'New Right' thinkers, many US political journalists are having to give their readers a crash course in some of the most controversial ideas in contemporary theology. One recent Politico article stands out because it didn't just introduce an unsuspecting audience of political obsessives to an obscure theologian, it also told them (us) about contradictory ways one might read said obscure theologian. And yet these contradictions force us to confront a difficulty facing anyone engaged in democratic debate.  

In the article , Ian Ward sought to explore the impact of Rene Girard's scapegoat mechanism on Vance. In doing so, Ward underlines the importance of Girard's ideas in the intellectual circles around J.D. Vance and his mentor, Peter Thiel.  

Girard, a French academic who died in 2015, is remembered foremost for his analysis of the relation between desire and conflict. Girard proposes that desire is ‘memetic, that is to say, it mimics; I want what I see that others want. This naturally leads to conflict, a conflict that can only be resolved by a scapegoat. Identifying a scapegoat, an out-group, is a force powerful enough to create a sense of solidarity between those would otherwise be in conflict over shared desires. 

The Politico take considered how Vance's reading of Girard might relate to Vance's defence of his running mate's false suggestion that Haitian immigrants are eating their neighbour's pets in Springfield, Ohio. It went as far to suggest that—rather than a rejection of Girard's analysis— Vance could be understood to be applying a pragmatic reading of Girard. Ward writes:  

Though Girard never said so outright, some of his interpreters have argued that Girard’s idea of the Christian ethic — which in theory offers an alternative to ritualistic violence as a basis for social cohesion — cannot in practice serve as the basis for a large, complex and modern society. 

Scapegoating is inevitable, deploy it to your advantage. We cannot know how exactly this or any reading of Rene Girard factors into his political tactics. What we can know is that Vance's public fascination with big ideas opens him up to a charge upon which a healthy democracy depends: hypocrisy.  

In contrast, there is often a surprising transparency to Trump's appeals to self-interest, Addressing a audience in July, Trump declared:  

Christians, get out and vote, just this time. You won't have to do it anymore. Four more years, you know what, it will be fixed, it will be fine, you won't have to vote anymore, my beautiful Christians. 

As much as Vance and others try to change this, there is little ideological content, no substance behind ‘Make America Great Again’ insofar as Trump tells it. It is politics at its most transactional and what Trump offer his supporters, beautiful or otherwise, is so often a scapegoat. Trump tends to be pretty open about this and, as ugly as this kind of politics is, there is a strange kind of honesty to it. But Vance is different. He has big ideas. And however weird you may think these ideas are, and however much tension there seems to be between his love of Rene Girard and his scapegoating of Haitian immigrants, democracy is better for that tension. Constructive democratic debate, in some sense, depends on hypocrisy. Without it, democracy would be nothing more than a negotiation around mere self-interest.  

A politician with an ideological vision is one that can be held accountable. Keir Starmer's recent decision to pay back £6,000 worth of gifts is a case in point. Had he not sought to set himself as a contrast to the Boris Johnson of Partygate, the criticism of his accepting clothes and tickets would not have had the same bite. 

Stumbling into politics haunted by a sense that things could be better will make us hypocrites on impact.

The first generations of Christians encountered a similar problem. The law they believed that they had received from God showed them a vision for the good life just as it revealed all the ways they fell short. As the early church leader Paul wrote: “through the Law comes the knowledge of sin.” We might add that through political ideology or aspiration comes the knowledge of political hypocrisy.  

Had Vance never publicly explored Girard's theory, if he were only an opportunist more like Trump, we would have one less means by which to hold him to account. Every politician will be found lacking when judged by their public ideological aspirations. And the more ideological aspirations, the greater the charge of hypocrisy. Hypocrisy will always be found wherever we find people debating and aspiring to ideas more perfect than they are.  I'm not defending any individual hypocrisy; the residents of Springfield, Ohio and newcomers across the US deserve so much better. Hypocrisy is always disappointing, but it is less disappointing than the alternatives: either a naked pursuit of self-interest or a naïve expectation of ideological purity. 

The question for each of us in a democracy is how we live with hypocrisy, expecting it while still expecting more from those who wish to serve us in public office. And a moment's introspection reveals that it is a charge that confronts each of us also: the shaming gap between my aspirations for my life and the reality. To ask how we live with these hypocritical politicians is really to ask how we live with ourselves? 

With that we return to Girard. He claimed that Jesus Christ willingly became a transparently innocent scapegoat and in doing so undermined the mechanism. In the Politico article, Vance is quoted as follows:  

In Christ, we see our efforts to shift blame and our own inadequacies onto a victim for what they are: a moral failing, projected violently upon someone else. Christ is the scapegoat who reveals our imperfections, and forces us to look at our own flaws rather than blame our society’s chosen victims. 

The exacting logic of the crucifixion prevents us from scapegoating even the scapegoating politicians. 

But Jesus’ death is more than an embodied social critique. In coming to us and dying in the person of Jesus, God showed his love for imperfect people struggling under the weight of perfect ideas. He came to give the home and safety we all desire, offered freely to hypocrites.  The point of Christ's death is not, at least in the first instance, to inspire me to treat others better. It is God's unconditioned offer to the broken and hypocritical, as the broken and hypocritical, not as he'd rather we be. 

Paul puts it like this: "God demonstrates his own love for us in this: While we were still sinners, Christ died for us." Yes, God's grace is too dramatic, too strong not to provoke us and empower us to change, but his love comes to us before any change. It comes to us as we are, nursing our pitchforks and that self-righteous sense that it's all really someone else's fault.  

Stumbling into politics haunted by a sense that things could be better will make us hypocrites on impact. We must not excuse this hypocrisy; we should hold ourselves and our leaders to account. And yet we can do so gratefully haunted and gratefully held by a God who came for hypocrites.