Column

Assisted dying

Care

Comment

14 November 2024

4 min read

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.

Article

Comment

Mental Health

Poetry

15 October 2024

4 min read

Auden and our anxious age

While the tropes of trauma are still with us, how to not die in our dread?

Jack Nicholson

Jack is a graduate of Peterhouse, University of Cambridge and Blackfriars, University of Oxford. He works in local government.

An outdoor vigil is lit by people holding up mobile phone lights.

Oxford's peace vigil.

BBC News.

Faces along the bar

Cling to their average day:

The lights must never go out,

The music must always play . . .

Lest we should see where we are,

Lost in a haunted wood,

Children afraid of the night

Who have never been happy or good.

This week, we mark the 85th birthday of W. H. Auden’s poem ‘September 1st, 1939’. He describes four solitary drinkers in New York on the cusp of the Second World War. September 1st, 1939: Hitler invades Poland. Those four faces struggle to find meaning in their lives.

In a later, much longer poem of 1947 (first UK edition, 1948) Auden built on this theme, having lived through the War, to identify an ‘Age of Anxiety’. He wrote, ‘We would rather be ruined than changed / We would rather die in our dread / Than climb the cross of the moment / And let our illusions die.’

I have been reflecting on this of late, especially in light of a recent night vigil for peace, remembrance, and unity at Bonn Square, Oxford, where I live. This took place on 7 October, the anniversary of the Hamas attack on Israel in 2023: the darkest day in Jewish history since the time that Auden wrote his poems.

In an Age of Anxiety, Auden wrote, ‘the world needs a wash, and a week off’. The gathering in Oxford was especially poignant because some 250 people chose to go out in the rain, on their Sunday-evening time off, and in the darkness, to hear prayers and readings from different communities. It was as if the world was awash with people coming together.

The Bishop of Oxford the Rt Rev’d Dr Steven Croft said, ‘Our purpose is simply to be together.’ People simply had to do ‘something in the face of the helplessness that we all feel, in the face of these terrible events’. Louise Gordon, co vice president of the Oxford Jewish Congregation, described people ‘clinging to hope’. Imam Monawar Husain stressed that togetherness as such is a ‘symbol’, a symbol of hope.

Symbols abounded. Candles were lit. In ‘September 1st, 1939’, Auden described ‘Ironic points of light’ which

Flash out wherever the Just

Exchange their messages:

May I, composed like them

Of Eros and of dust,

Beleaguered by the same

Negation and despair,

Show an affirming flame.

The crowd spontaneously joined in with the protest song ‘Where Have All the Flowers Gone’, which was first sung in 1955.

It is striking that so many of the tropes and themes concerning what has gone wrong with the world, from our perspective, were already apparent and received clear expression from 1939 through to the mid- to late-1950s, in terrible events, then in thought, poetry, and protest song, in an age of anxiety.

If there are similarities between Auden’s age and our own, then we should be encouraged by that.

Sociologists described the ‘lonely crowd’ in 1950. This suggests that people seek more approval and acceptance from others as the physical distance between them diminishes and society becomes increasingly geared toward consumption. The capacity to come together for peace, remembrance, and unity becomes far less likely.

Philosopher Max Picard lamented the loss of the ’World of Silence’ in 1952: the capacity to be still. And later, in 1958, the word ‘meritocracy’ was first used to describe a dystopian world in which merit (IQ + effort) reigns, replacing previous relational bonds, a sense of togetherness, exemplified in the gathering in Oxford in 2024.

C. S. Lewis, in Oxford in the late 1950s, identified friendship as a kind of love which is regarded 'in the modern world' as 'quite marginal; not a main course in life's banquet', which is especially true if we bypass the banquet and spend our time at the bar (or, worse, online, at home). Louise Gordon, at the vigil, also spoke of the way in which people were counterculturally 'clasping hands in friendship'.

When sociologists today describe the ‘lonely century’ (Noreena Hertz) or when so many sigh over our inability to sit, or stand, in silence, in some sense at least they have not identified anything new. War crimes are, sadly, all too familiar to us. And recently, the lawyer Stephen Toope identified an ‘age of anxiety’ today.

It is not as simple, however, as saying that we have been anxious for the last seventy years. Auden’s age was also one of creativity of which the Anglosphere has been proud, for instance, around the foundation of the National Health Service in 1948. His generation stared into the abyss. They did not die in their dread.

If there are similarities between Auden’s age and our own, then we should be encouraged by that. Lamentation is as old as love, and the choice is as stark as he put it in his poem 85 years ago: ‘love one another or die’.

The notion of vigil is equally old. Today, vigils are held for peace, remembrance, and unity. In Christian liturgy, however, a vigil is specifically a watch during the night, looking forward to the dawn of a new day. ‘As the night watch looks for the morning’, likewise the people wait for Christ, their saviour.

That silent watch is far removed from the solitary ‘faces along the bar’ who ‘cling to their average day’. Horrible events such as those which took place on September 1st, 1939 or October 7th, 2023 bring people together in common purpose, simply to be together and to cling instead to hope for a better tomorrow.

Anxiety is replaced by hope.

Candles are lit. It may well rain. But song will be sung. And people of good-will, having climbed ‘the cross of the moment’, will show what Auden described: that great ‘affirming flame’.