Saturday, 31 March 2012

Overstretched?

As a general surgical registrar I was once helping my consultant remove a giant spleen when the patient began 'hosing' from an invisible source. After a frenzy of clamping, cutting and ligating, things stabilised and we were able to proceed at a more leisurely pace. 'It's good to see the boss sweat, isn't it?' he said, and I had to agree.

Seeing someone we admire really struggling can actually be a great encouragement, especially if the struggle has occurred because of their willingness to accept a difficult challenge. In my consultant's case it would have been far easier to avoid the giant spleen altogether, but his readiness to take it on – and sweat in the process – meant both a life saved and a trainee inspired.

As Christian doctors, most of us struggle to juggle the many demands of work, church and family successfully. Sometimes this is because we say 'yes' to extra responsibility when we should really have said 'no'. But often the struggle comes simply because we have responded in good conscience to do the right thing: choosing not to compromise, going the extra mile, being willing to help someone shoulder a burden, rising to the challenge.

The great biblical heroes of faith are inspiring because they teach us that God uses ordinary men and women who struggle in the same way that we do. Moses led his people out of slavery, performed miracles, talked face to face with God [1] and was the humblest man on earth.[2] And yet he once felt so desperately overwhelmed by the responsibility of looking after his people that he felt God was punishing him and asked to be put to death. God's response was to appoint 70 men to help him 'carry the burden of the people' so that he would 'not have to carry it alone'.[3]

Elijah felt so fearful after his heroics on Mt Carmel that he 'ran for his life' and 'prayed that he might die'. God's prescription was food, drink, a good night's sleep and a fresh filling of the Holy Spirit. God then assured him that he wasn't alone and led him to anoint a successor who would never leave his side.[4]

Esther was afraid that standing up for her threatened countrymen might lead to her own death, but she was persuaded that despite the risk, she should do the right thing and asked for her fellow Jews to fast and pray for her.[5] And God came through with the goods.

The Apostle Paul was the greatest church planter the world has ever seen, but he talked of himself, and Timothy, being 'under great pressure, far beyond our ability to endure, so that we despaired even of life'. [6] Through it he was able to know God's comfort in these trials, pass that comfort on to others [7] and learn that God's 'power is made perfect in weakness' [8].

Perhaps most striking are the words of the Servant of Isaiah, Christ himself, who could say 'I have laboured to no purpose; I have spent my strength in vain and for nothing' but then went on to declare that 'what is due to me is in the Lord's hand, and my reward is with my God' [9].

Are you feeling weighed down by bulging in-trays and looming deadlines, anxious that some of the many plates you are spinning will crash to the ground, worn down by the demands of managers or colleagues or just wondering how you are going to get through the next day? Be encouraged by the fact that even these greatest of saints at times were overcome with anxiety, fell exhausted, looked back and wondered if they had achieved anything of value, and even begged God to end their lives. And look to God as they did for the reinforcements, prayer supporters, courage, rest, fresh strength and words of hope to help sustain you. Most of all know that the God who calls you to walk in his footsteps has himself walked this earth, knows what it is like to be tempted [10] and lives in you by his Spirit. [11]

And we, who with unveiled faces all reflect the Lord's glory, are being transformed into his likeness with ever-increasing glory, which comes from the Lord, who is the Spirit. (2 Corinthians 3:18)

References

1. Numbers 12:8
2. Numbers 12:3
3. Numbers 11:10-17
4. 1 Kings 19:3-21
5. Esther 4:6-17
6. 2 Corinthians 1:8
7. 2 Corinthians 1:3,4
8. 2 Corinthians 12:9
9. Isaiah 49:4
10. Hebrews 4:15
11. 2 Corinthians 4:7

Tuesday, 27 March 2012

CNK welcomes MPs endorsement of palliative care and rejection of attempt to change assisted suicide law

Care Not Killing has welcomed MPs’ decision to encourage further development of specialist palliative care and hospice provision and their endorsement of the current law on assisted suicide.

The House of Commons debate saw MPs welcoming the DPP’s policy for prosecutors in respect of cases of encouraging or assisting suicide published in 2010 and also unanimously backing an amendment encouraging palliative care services.

Care Not Killing Director Dr Peter Saunders said,

‘MPs have today given a ringing endorsement to the need for the further development of specialist palliative care and hospice provision in which Britain is already a world leader. We welcome this move to strengthen existing services and to make the highest quality care more accessible and available.’

‘They have also today, as expected, given endorsement to the DPP policy on assisted suicide, which enables the DPP to exercise discretion in bringing prosecutions on a case by case basis, whilst upholding a blanket prohibition on all assistance or encouragement with suicide.’

‘The law in Britain thereby is seen to have both a stern face to deter exploitation and abuse, and a kind heart to temper justice with mercy in hard cases. This is the right balance. The clear evidence that it is working well is seen in the very small number of cases occurring (20 per year) and the low number of prosecutions.'

'Any attempt to decriminalise assisted suicide or euthanasia would result in a huge escalation of cases as seen in jurisdictions like Oregon and the Netherlands. As determined by a previous House of Lords enquiry, with an Oregon or Netherlands type law in Britain we would have 1,000 and 13,000 cases respectively annually.’

‘We were particularly pleased to see the Solicitor General and many MPs stressing the importance of parliament allowing the DPP to exercise independent judgement on a case by case basis and the rejection of an attempt to micromanage and fetter him through a call for a parliamentary consultation aimed at placing his guidance on a statutory footing. This resulted in an amendment to this effect by pro-euthanasia MPs being unanimously voted down.'

‘We will continue to emphasise the importance of investigating all cases of alleged assistance with suicide and appropriate application of the guidelines to ensure that the law is properly upheld and that vulnerable people are protected from being placed under pressure to end their lives.’

Assisted suicide has been repeatedly debated in British Parliaments in recent years and the DPP guidance was the subject of an adjournment debate led by Patricia Hewitt in 2010. Attempts to legalise assisted suicide by means of the Joffe Bill (2006) and Falconer amendment (2009) in the House of Lords and the Macdonald Bill (2010) in the Scottish Parliament were all defeated by large majorities and this is the third debate in the House of Commons on Assisted Suicide in as many years.

The law remains unchanged and looks likely to stay that way for the foreseeable future.

Shroud of Secrecy surrounds Assisted Suicide in Oregon

I was doing an interview on BBC Radio Wales this am on the Ottaway debate when a spokesman for Dignity in Dying (formerly the Voluntary Euthanasia Society) was again singing the praises of the law allowing assisted suicide in the US state of Oregon. The ‘Death with Dignity Act’ was passed there in 1997.

Back in 2006 the House of Lords calculated that with an Oregon-type law we would have about 650 cases of assisted suicide a year in Britain, whereas as currently we see only 15-20 going to Dignitas in Switzerland to die currently. But given the increase of numbers in Oregon the UK equivalent would now be well over 1,000.

Life Site News has just published a piece by Jonathan Imbody, which draws attention to the recent critique of the Public Health Department of the Oregon Health Authority’s report for physician-assisted suicides for the 2011 year by the Physicians for Compassionate Care Education.

They note the following:

•There were more prescriptions and deaths than in any previous year; the number of prescriptions written for lethal doses of barbiturates increased from 97 in 2010 to 114 in 2011, and the reported deaths from assisted suicide increased from 65 to 71. This is indicative of an increase in hopelessness and despair among a vulnerable population with serious illness.

•62 doctors wrote 114 prescriptions, with some writing up to 14 prescriptions each. Some doctors knew the patient for only one week before writing the prescriptions. It is known that some doctors are prominent prescribers of lethal barbiturates for assisted suicide.

•As has occurred in prior years, not all who attempt to take the drugs will die. Two patients ingested the medication but failed to die. Each regained consciousness and died more than a day later, 30 hours and 38 hours respectively, of their underlying illness; they were not considered to have died from the ingested drugs. These are not easy drugs to take, they are bitter and foul-tasting, and vomiting does occur despite anti-emetics.

•As in previous years, there was virtually no formal evaluation for underlying depression, anxiety or other serious mental health issue. Only one of the 71 patients was referred for psychiatric evaluation. OHSU researchers in 2008 reported that 25% of patients requesting assisted suicide were considered to be depressed.

•As in previous years, pain has not been a major concern; only one third of patients had inadequate pain control or concern about it. The most commonly expressed concerns of those dying from physician-assisted suicide were unchanged from previous reports: less able to engage in activities making life enjoyable, losing autonomy, and loss of dignity.

•In only six cases was the prescribing physician present at the time of ingestion, in 3 other cases another provider was present. Thus, very little is known or reported regarding events at the time of ingestion of the medications. For 62 patients there was either no provider present or the information regarding presence of a provider was unknown. Physicians appear to be disengaged with patients at the end.

•In essence then, complications were unknown for 59 patients, and any information regarding minutes between ingestion and unconsciousness and death was unknown for 63 patients.

•The shroud of secrecy surrounding assisted suicide is heavier than ever. With each passing year, Oregonians know less and less about what is really happening with assisted suicides in the state.


Ironic then that DID and Margo Macdonald MSP continue to pursue a law change based on the Oregon model.

Let’s learn from Oregon and not go in that direction.

Monday, 26 March 2012

Pro-euthanasia lobby faces difficult battle in DPP debate

On Tuesday 27 March MPs in the House of Commons will debate a motion by Richard Ottaway (pictured) which 'invites the Government to consult as to whether to put (the DPP’s guidance on prosecutions for assisted suicide) on a statutory basis’.

The aim is to secure immunity from prosecution for some cases of assisted suicide ahead of the event.

However the government has already made it very clear in a House of Lords debate in February this year that it is the job of the Director of Public Prosecutions (DPP) to set prosecution policy and that it intends to let the DPP get on with his job without interfering. It is not for parliament to decide on a case by case basis who should be prosecuted or to usurp his role.

Assisting or encouraging a suicide remains illegal - and only parliament can change that - but it is the DPP’s job to decide in any given case whether there is enough evidence to bring a prosecution and whether to do so would be in the public interest.

The very small number of cases that crosses his desk, less than 20 per year on average, is evidence that the law is having a strong deterrent effect and working as it is intended to. A law allowing assisted suicide, such as that in the state of Oregon, would increase this number 50-fold to over 1,000 deaths per year.

If the pro-euthanasia lobby wants a change in the law they will have to argue for a change in the law itself and not try to interfere with the DPP's prosecution policy which is his responsibility, and not parliament's, to set and administer.

But they face a very difficult battle.

Assisted suicide, contrary to the claims of the pro-euthanasia lobby, has been repeatedly debated in British Parliaments in recent years, with two debates in the House of Commons alone since 2010 (brought by Patricia Hewitt in 2010 and David Burrowes in January this year).

The last bill in the House of Commons attempting to legalise assisted suicide, brought by Joe Ashton in 1997, was defeated by 234 votes to 89 and four attempts to change the law via the House of Lords since 2003 – three by Lord Joffe – have also all failed. The last bill in the Scottish parliament was also defeated resoundingly by 85 votes to 16 in 2010.

Richard Ottaway is a member of the All Party Parliamentary Group on Choice at the End of Life, which acts as the parliamentary wing of Dignity in Dying, formerly the Voluntary Euthanasia Society. This latest move to change the law on this this issue needs to be seen for what it is – yet another attempt by a small heavily funded lobby to foist its views on parliament, when they have already been consistently rejected on grounds of the threat such a law change would pose for public safety.

The Suicide Act 1961 currently protects vulnerable people from exploitation and abuse by those who might an interest, financial or otherwise, in their deaths. Any further removal of legal protection by creating more exceptions for bringing prosecutions would encourage unscrupulous people to take liberties and would place more vulnerable people – those who are elderly, disabled, sick or depressed – under pressure to end their lives so as not impose a burden on family, carers or society. These pressures can be particularly acute at a time of economic recession.

The current law is clear and right and does not need fixing or further weakening. On the one hand the penalties it holds in reserve act as a powerful deterrent to exploitation and abuse. On the other hand it gives the DPP and judges some discretion to temper justice with mercy in hard cases. It should not be meddled with.

Cases of assisted suicide (and euthanasia) are extremely rare and hard cases make bad law. The overwhelming majority of people with severe disability or terminal illness do not wish to die but rather want support to live. Our priority must therefore be the provision of excellent support and palliative care.

Saturday, 17 March 2012

Abortionists try to unsettle peaceful vigil

Britain’s abortion industry is under pressure and industry leader BPAS (British Pregnancy Advisory Service) has been particularly under the spotlight recently, and not just for their aggressive marketing tactics aimed at increasing their ‘market share’ of the shrinking health budget.

First there was pro-abortion MP Diane Abbott’s high profile resignation from a government committee on abortion counselling after she was unable to shape proceedings to her liking.

Then there was the revelation that 98% of abortions in Britain are technically illegal as a consequence of the RC Psych enquiry finding that continuing with an unplanned pregnancy does not constitute a greater risk to the mental health of pregnant women than abortion.

Next was the Daily Telegraph’s undercover investigation into abortions for sex selection carried out at some of the country’s best known ‘clinics’. BPAS itself just escaped a police enquiry when a centre manager was able to stop an abortion that was in the process of being authorised.

And more recently BPAS revealed that was interpreting the Abortion Act in a very liberal way by conflating ‘distress’ with ‘mental ill-health’.

The latest episode in this evolving drama has seen BPAS complaining about peaceful pickets outside their abortion facility in London’s Bedford Square. Today they are calling through their press office (aka the Guardian newspaper) on the support of the Department of Health in dealing with a ‘new era of anti-abortion protests'.

Apparently a group of people from the pro-life organisation ’40 Days for Life’ (more background from Caroline Farrow) has been holding vigils outside its front door.

BPAS alleges that the group is placing pressure on its ‘clients’ and photographing them arriving at and leaving.

However, ’40 Days for Life’ dispute these claims and say that the camera is used only to record when they themselves are being harassed by centre staff.

Robert Colquhoun, a spokesman, said:

‘40 Days for Life conducts a peaceful, prayerful and legal vigil in London. The central point of our vigil is to pray for an end to abortion and show that that is a love in community that can help a woman to choose life for her unborn child.

Since our campaign started in September 2010, we estimate that more than 30 women have chosen life for their unborn children as a result of our campaign through prayer and also through an offer of love, help and support during a difficult time.’

A statement on their website gives more background.

‘We have a statement of peace that sets the tone and ethos of our prayer vigil as a peaceful and prayerful event. Since our campaign started, we have received a very large number of insults and threats. At times, members of the vigil have filmed themselves in order to protect themselves from these threats. We do not encourage anybody to film members of the public during our campaign.

Since 40 days for life started in 2007, there have been 1,633 individual 40 days for life campaigns that have taken place in 422 cities worldwide. 5,045 lives have been spared from abortions during campaigns and 21 abortion facilities have shut down following local 40 Days for Life campaigns.’

There have been over seven million abortions in Britain since the Abortion Act 1967 was passed, now over 200,000 every year. Every abortion stops a human heart and ends a human life. And as I have argued before there is no one more innocent, more vulnerable and killed in greater numbers than the unborn child.

But abortion also damages women, and many women choose it simply because they feel they have no alternative or because they are being put under pressure by partners, friends or family members.

We know that when given information and support many will change their minds.

Some years ago I spoke to a young woman in just this situation who was on the conveyor belt to abortion but changed her mind after I sent her a letter offering support. She later thanked me for helping her avoid ‘making the worst decision of (her) life’ and two years later a card with a picture of the two year old boy who was the joy of her life. I have never forgotten it.

40 Days for Life have already saved over 5,000 lives from destruction worldwide and protected a similar number of women from a lifetime of guilt and regret.

It’s not surprising that they are getting some stick from the abortion industry for it, but I commend their courage, persistence and willingness to face opposition and criticism in order to do something of eternal value.

I’m reminded of legendary cricketer CT Studd who left a promising career to do missionary work in China in perilous times and said:

‘Some wish to live within the sound of Church or Chapel bell; I want to run a Rescue Shop within a yard of hell.’

Rescue those who are being taken away to death;
hold back those who are stumbling to the slaughter.
If you say, ‘Behold, we did not know this,’
does not he who weighs the heart perceive it?
Does not he who keeps watch over your soul know it,
and will he not repay man according to his work? (Proverbs 24:11,12)

Friday, 16 March 2012

My shocking sex confession

I am fairly unshockable but a headline in the Daily Mail this morning took my breath away.

It reads,’“We abstained from having sex until we got married”: Ali Landry reveals startling wedding night secret'.

Ali Landry is a 38-year-old actress and former Miss USA who made the astounding confession on a talk show that she waited until her wedding night to sleep with second spouse Alejandro Monteverde (She annulled her first marriage just two weeks after the wedding because her husband had been unfaithful).

This, coupled with the equally astounding revelation in this morning’s Metro that a British man has been married to the same woman for 64 years (his name is the Duke of Edinburgh), has emboldened me to make a shocking personal confession.

My hope in doing this is that others might also feel able to ‘come out’ about their past sexual behaviour as, I'm sure you will agree, there is often strength in knowing that we are not alone in our personal experiences.

Ok so here goes. I lost my virginity aged 24 on my wedding night almost thirty years ago (to my first wife!) and have only had one sexual partner since (ie. my first wife to whom I am still married).

So there you have it. Has it all been plain-sailing? Of course not, and we have needed a huge amount of help and support along the way, surprisingly mostly coming from someone who never married and has never had sex.

But I think that is already enough information for now.

Thursday, 15 March 2012

Coalition for Marriage respond to Government’s 'sham consultation' on gay marriage

The Coalition for Marriage, (C4M) has issued a statement following publication by Lynne Featherstone of Government plans to redefine marriage (PA summary here).

Colin Hart, C4M Campaign Director, said: “The Government has today launched a consultation on redefining marriage. After initially relenting and promising to include a question on the principle of introducing same sex marriage it is clear from the written statement given to both Houses of Parliament by the Equalities Minister that she will simply ignore any answers to this question.

“I always thought that a consultation was about listening to people and asking them their views, before making a decision. Not only are they redefining the meaning of marriage, they're redefining the meaning of consultation.

“This consultation is a sham. It is being pushed through despite the public never having a say on this change. None of the main political parties proposed redefining marriage in their manifestos and the impact assessment misses out many of the possible problems that could occur if this institution is redefined, for example how this change will affect our schools.

“The institution of marriage is the not the play thing of the state, it belongs to society and therefore cannot be redefined by a few politicians obsessed with appearing ‘trendy’ and ‘progressive’.

“It is also bizarre that Lynne Featherstone says that she wants to end the current two tier system’, yet wants to replace this with an even more complicated system that has two options for gays, and only one for heterosexuals. That’s equality for you.

“The plain truth is marriage is marriage and should not be redefined by politicians.

“C4M and the 200,000 people who have signed our petition believe that this change is profoundly undemocratic, will have massive consequences for society and is simply unnecessary as civil partnerships provide all the legal rights of marriage.”

C4M is a grassroots campaign representing faith groups, MPs, peers, academics, lawyers, pro-family organisations and members of the public. The petition was launched at 9am on Monday 20th February and says: “I support the legal definition of marriage which is the voluntary union for life of one man and one woman to the exclusion of all others. I oppose any attempt to redefine it.”

Monday, 12 March 2012

Case of locked-in syndrome seeks to establish dangerous precedent

Legal action brought by a locked-in syndrome sufferer, who wants a doctor to be able to end his ‘intolerable’ life lawfully, can go ahead following a judge's ruling today.

The Ministry of Justice had previously argued that the case should be struck out on the grounds that it is a matter for parliament, rather than the courts, to decide.

But the judge's ruling today means that Mr Nicklinson's case will go to a full hearing, where medical evidence can be heard.

Tony Nicklinson is 57 and paralysed from the neck down after suffering a stroke. I have blogged on this case in some detail previously so will not review the background again here except to say that Nicklinson himself believes that assisted suicide should be available to anybody over 18 who wants it and not just the terminally ill.

Nicklinson's legal team will be arguing:

1.'Necessity' can, in these circumstances, be a defence to murder (see my previous blog post for details about what this means)
2. The existing law of murder, insofar as it denies Nicklinson the chance to be actively killed at his request, is incompatible with Article 8 of the ECHR (European Convention of Human Rights) - dealing with 'right to respect for private and family life'.

The key point to grasp about this case is that Nicklinson, because he is not capable of killing himself even with assistance, is not seeking assisted suicide but euthanasia. So this is an assault on the Murder Act 1965 and not the Suicide Act 1961.

Nicklinson is pushing for an even greater change in the law than either the controversial Falconer Commission on ‘Assisted Dying’ or the lobby group Dignity in Dying (formerly the Voluntary Euthanasia Society). They claim to be campaigning for assisted suicide for people who are terminally ill – but euthanasia is one step further than assisted suicide and Nicklinson is not terminally ill.

Such a change would have far reaching implications by potentially removing legal protection from large numbers of sick and disabled people.

No one can help but be sympathetic to Tony Nicklinson but cases like his are extremely rare and hard cases make bad law. The overwhelming majority of people with severe disability - even with ‘locked-in syndrome’ - do not wish to die but rather want support to live and the longer people have locked-in syndrome then generally the better they learn to cope with it and find meaning, purpose and contentment within the limits of their condition.

The desire to die is not primarily about physical symptoms but about the particular person and their ability to adapt to living with a profound disability. Most people with locked-in syndrome are happy, according to the biggest survey of people with the condition.

Nicklinson has the right to refuse treatment under existing law, and could do so, but what he is seeking to do instead is to give doctors the power to kill in specific circumstances on grounds of ‘necessity’. That would be a very dangerous precedent indeed.

The current law is clear and right and does not need fixing or further weakening. On the one hand the penalties it holds in reserve act as a powerful deterrent to exploitation and abuse by those who might have an interest, financial or otherwise, in the deaths of vulnerable people. On the other hand the law gives judges some discretion to temper justice with mercy when sentencing in hard cases. We should not be meddling with it.

Any further removal of legal protection by creating exceptions for bringing prosecutions would encourage unscrupulous people to take liberties and would place more vulnerable people – those who are elderly, disabled, sick or depressed – under pressure to end their lives so as not impose a burden on family, carers or society.

Even in a free democratic society there are limits to choice. Every law limits choice and stops some people doing what they might desperately wish to do but this is necessary in order to maintain protection for others. No man is an island and this case is about much more than Tony Nicklinson.

Sunday, 11 March 2012

Guardian editorial on same sex marriage – the full fisk

Earlier this week the Guardian published an editorial backing the legalisation of same sex marriage, titled ‘Gay marriage: torn asunder from reality’

Virtually every sentence in it contained claims that were inaccurate, distorted or simply false. It was, in short, a breathtakingly naïve and misleading piece of arrant nonsense.

I have reproduced it line by line below with my own comments in italics.

Gay marriage: torn asunder from reality’

It is surprisingly hard to find in the Bible a consistent endorsement of heterosexual marriage as we now understand it.
>> It is actually surprisingly easy for anyone who examines the Bible rather than reading what others with an agenda write about it. Marriage as ‘one man, one woman for life’ features from the first chapters of Genesis to the last chapter of Revelation. I have outlined the biblical case elsewhere on this blog.

The Old Testament is replete with stories of men like King Solomon who had 700 wives and 300 concubines.
>> No Solomon is unique in having this number of wives and concubines. Although polygamy was practised by some Old Testament characters it was nowhere commanded nor endorsed and it is difficult to find a single biblical example where it did not lead to serious family problems including jealously, favouritism, rivalry, apostasy and family breakdown.

And the New Testament is generally populated by single men and women whose domestic arrangements have little in common with the model of Christian marriage that is now being aggressively defended by Cardinal Keith O'Brien and others.
>> No again. Paul was unmarried like some New Testament leaders but this was a special (almost unique) calling. The other apostles and Jesus’ brothers were married (1 Cor 9:5). Furthermore Paul taught in the pastoral epistles that elders and deacons must be ‘husbands of one wife’ who ‘manage their families well’.

Indeed, the best that many wedding service liturgies can do to insist that Jesus himself supported the institution of marriage is to say that he once turned up at one.
>> The Gospels record that Jesus performed his first miracle at a wedding (turning water into wine) but he also upheld Old Testament teaching on marriage as ‘one man, one woman, for life’ (Matthew 19:1-12). Marriage is also used throughout the New Testament to symbolise Christ’s union with his bride the church underlining the crucial importance of the covenant.

None of which is to attack the institution of marriage, which provides many with a permanent, faithful and stable context for loving relationships.
>> Here surprisingly I find myself agreeing with the Guardian but it is marriage according to the biblical pattern which has been shown to provide a permanent, faithful and stable context for loving relationships. ‘Same sex marriage’ is by contrast an untested social experiment.

Cardinal O'Brien is, however, getting completely carried away when he speaks of gay marriage as an attempt to 'redefine reality'.
>> No because Cameron’s plan is to redefine marriage ('the voluntary union for life of one man and one woman to the exclusion of all others’) to include same sex marriage. But same-sex marriage is an oxymoron like a four wheeled bicycle or a two storeyed bungalow. This is actually a redefinition of reality.

Traditionally, the church has explained the purpose of marriage in terms of three features: that it's the proper context for raising children, that it promotes monogamy and that it exists for the mutual comfort and society of one person for another.
>> No the church has always added that it is also the union of one man and one woman (biological complementarity) with the potential of procreation (it impossible for same sex parents to procreate without invasive technology and/or donor gametes)

How can the application of these three features to gay marriage justify the cardinal's blustering hyperbole?
>> Because these are not the only factors

Of course, the cardinal has not been alone in seeking to whip up moral panic.
>> No he has been backed by the Pope, the English and Welsh Catholic Archbishops, the Archbishop of Canterbury, the Archbishop of York, hundreds of other Christian leaders, over 130,000 signatories to the C4M petition and numerous other commentators of all faiths and none.

The Archbishop of York recently described David Cameron's expressed desire to extend marriage to homosexuals as something done by ‘dictators’.
>> This was a reference to the fact that he is introducing this measure without any democratic mandate, having not mentioned it in his manifesto and without carrying out a consultation as to whether it is necessary, workable or desirable. This is what dictators do.

It is good, therefore, that a younger generation of church leaders, like the recently appointed Bishop of Salisbury and the new Dean of St Paul's are taking a different line.
>> These two men, who should never have been given a church appointment given their heretical views, are an exception. They are also hardly young! Nicholas Holtam, Bishop of Salisbury, is 56 and David Ison of St Paul’s is 57.

The argument that gay marriage undermines straight marriage is as unconvincing as it is insulting – as if the currency of marriage is devalued by extension to those who find love with members of the same sex.
>> Legalising same sex marriage is a legal can of worms and it cannot be done without changing the legal definition of real marriage and words such as husband, wife, consummation and adultery. This would have far-reaching repercussions. Marriage is also about much more than ‘finding love’. It is a life-long covenant commitment.

In fact, the reality that religious conservatives are themselves failing to face is that civil partnerships are already being understood as a form of marriage, with or without the endorsement of the church.
>> As civil partnerships already bestow all the legal rights of marriage then why is it necessary to change the definition of marriage itself?

If it looks like a duck and quacks like a duck, it is a duck.
>> A same sex couple making a commitment does not look like marriage to anyone in their right mind. In marriage the participants are of the opposite sex.

Some in the church continue to fight a rearguard action for the extension of civil partnership rights to siblings. In this way they hope to drive a wedge between marriage and civil partnership. But that ship has sailed.
>> This is perhaps true which underlines the fact that the government in legalising civil partnerships were primarily concerned with legitimising same sex sexual relationships and not concerned primarily with personal commitment, faithfulness or societal stability.

The language of marriage and of husband or wife is increasingly common parlance among those who have entered into civil partnerships.
>> Only by those who back gay marriage and as part of a campaign (‘they would say that wouldn’t they’) but most people still feel very uncomfortable about a man calling another man his husband as this changes the meaning of the word. Husband and wife are complementary terms which have meaning only in relation to their opposites.

And while some in the gay community worry about the use of what they take to be a heterosexual paradigm, this anxiety is also diminishing. Gay marriage is effectively already a reality. And Mr Cameron is right that the law needs to catch up with where people are.
>> The C4M petition by the end of next week may well have more signatures than the ‘drop the health bill’, the largest live petition in existence in Britain. It has already amassed 130,000 in less than three weeks. 51% of people oppose same-sex marriage given that civil partnerships already grant all the legal rights and 88% of conservative voters do not regard changing the law a matter of any urgency. The campaign to legalise same sex marriage is being pushed by a small group of politically correct activists. Cameron is already getting cold feet as revealed by his removing the same sex marriage bill from the Queen’s speech and introducing a question into the consultation asking whether it should be done. The pro same sex marriage lobby should not be counting its chickens.

Saturday, 10 March 2012

Biblical teaching on marriage and sexuality – a quick overview for Guardian readers

I was amused to read an editorial in the Guardian today titled ‘Gay marriage: torn asunder from reality’. It made the extraordinary claim that ‘it is surprisingly hard to find in the Bible a consistent endorsement of heterosexual marriage as we now understand it’.

I will return to a full fisk of the editorial piece later (now available here) but for the benefit of Guardian readers here is a quick overview of biblical teaching on marriage and sexuality.

Marriage is a divine invention. It was God who first said that it was ‘not good for man to be alone’ and who created the unique complementarity of the marriage relationship for companionship, pleasure, procreation and the raising of children – ‘one man, one woman, united for life’ (Genesis 2:24).

Marriage is also in this way illustrative of Christ’s own self-giving abandonment to his bride the church (Ephesians 5:31, 32) and points to a greater richness of human relationships beyond the grave of which the very best on earth are but a pale shadow (1 Corinthians 2:9, 10).

The Bible is full of references to sex and marriage -from the first chapter of Genesis to the last chapter of Revelation (Gn 1:28, Rev 22:17).

The one man and one woman for life pattern is an Old Testament creation ordinance, upheld by Jesus and Paul in the New Testament (Gn 2:24; Mt 19:3-12; Eph 5:22-33).

Sex in the context of marriage (Gn 2:24, Mt 19:3-12)
...is viewed as the good gift of a good creator (Pr 5:15-20, Song 4:11-16)
...and a sign of Christ’s coming marriage with the church (Eph 5:32, Rev 19:7)

Anything outside this context is seen as a disaster (2 Sa 11, 2 Sa 13, Gn 34)
... offensive to God (Lv 18:6-30, 20:7-21; 1 Cor 6:12-20)
... and accordingly judged (Lv 18:29; Dt 22:20-22, Rev 21:8)

All wrong patterns are spelt out specifically in detail (Lv 18:1-30; Lv 20:1-27; Ex 22:16-19; Dt 22:13-30) and include all homosexual acts (Lv 18:22, 20:13; Gn 19:1-29; Jdg 19:1-30; Rom 1:24-27; 1 Cor 6:9-11; 1 Tim 1:8-11)

God’s people are called to be ‘set apart’ in sexual behaviour (1 Thes 4:3-8; Mt 5:27-32)

Scripture is accordingly replete with love stories which affirm marriage: Isaac and Rebecca (Gen 24), Jacob and Rachel (Gen 29:16-30), Boaz and Ruth (Ru 3)… and similar narratives about how sex and marriage can be distorted – some examples:

Shechem and Dinah (Gen 34) - rape
Judah and Tamar (Gen 38) - prostitution
Amnon and Tamar (2 Sa 13) - incest
David and Bathsheba (2 Sa 11) – adultery
Zimri and Cozbi (Nu 25) – fornication
Sodom and Gibeah (Gn 19; Jdg 19) – homosexuality

Polygamy, whilst tolerated and permitted in Old and New Testament times (but with strict rules of faithfulness), was never endorsed or commanded and I am struggling to think of a single instance where it did not have serious consequences for the families involved in terms of jealousy, favouritism, rivalry, apostasy and family breakdown.

Lifelong, heterosexual monogamy is the consistent pattern.

Guardian readers are of course entitled to their opinions about what they think of biblical teaching but they should be aware of what the Bible actually says and similarly aware that Guardian editors are about as adept with scripture as 'a fool is with a proverb' or 'a paralysed man is with his legs' (Proverbs 26:7).

Lessons from assisted suicide campaigner’s death

A Bristol woman who launched a legal battle five years ago to force doctors to end her life has died.

Kelly Taylor, who had Eisenmenger's syndrome and the spinal condition Klippel-Feil syndrome, died of heart complications at Frenchay Hospital on 27 February.

The 35-year-old had been campaigning for more than six years to change the law on assisted dying.

Eisenmenger Syndrome, a heart and lung condition, can develop in people born with a hole in the heart if it is not treated in infancy. Mrs Taylor also suffered with the rare musculoskeletal developmental disorder, Klippel-Feil syndrome.

In 2003, after waiting nearly ten years for a heart and lung transplant, she was told a match could not be found and was taken off the transplant list.

In August 2005, to end the ‘pain and misery’ of her condition, she attempted to starve herself to death as an act of voluntary euthanasia.

But after 19 days she was in so much pain she decided it was less dignified than her medical condition and began eating again.

In 2007, she was given a year to live and launched a legal battle to force doctors to end her life. She sought permission to receive a large dose of morphine to induce coma (and render her mentally incompetent) followed by withdrawal of food and fluids (as specified in an advance directive) with the intention of ending her life.

The British Medical Association and Care Not Killing both opposed the case at the time and she later withdrew it.

The BMA said: ‘While we sympathise with Mrs Taylor's situation, we cannot support her request for doctors to sedate her, to a state of unconsciousness, with the specific intention of ending her life. In our view, this would involve the doctors in assisting her suicide, which is both unlawful and unethical.’

I was quoted at the time as saying, ‘This is a very sad case but what is really needed is not a change in the law to allow lethal injections but access to the highest quality of palliative care to those who need it.’

Mrs Taylor’s relatives and family deserve our fullest sympathy in their loss, but the case also underlines two important things.

First, it exposes the real agenda of the pro-euthanasia lobby. Dignity in Dying, (formerly the Voluntary Euthanasia Society), backed the case at the time and have never withdrawn their support, and yet they claim to support assisted suicide only for people who have less than twelve months left to live and who are mentally competent. Kelly Taylor lived more than five years after she first brought her case and was seeking being starved and dehydrated to death after being rendered mentally incompetent. So just how elastic are their real demands?

Second, it shows how inaccurate doctors’ predictions of life expectancy can be. I have previously highlighted on this blog the cases of Lockerbie bomber Abdel Al-Megrahi, Great train robber Ronnie Biggs and Cambridge physicist Stephen Hawking whose have lived on for years after being given months to live. Kelly Taylor is another such case.

Lord Falconer’s sham commission on assisted dying recently recommended legalising assisted suicide for people with less than twelve months to live. And yet in just 2004/2005 leading doctors giving evidence to a House of Lords Committee on Lord Joffe’s Assisted Dying Bill revealed just how inaccurate such assessments can be.

'It is possible to make reasonably accurate prognoses of death within minutes, hours or a few days. When this stretches to months, then the scope for error can extend into years' (Royal College of General Practitioners, HL 86 Vol II, Page 80)

'Prognostication may be better when somebody is within the last two or three weeks of their life. I have to say that, when they are six or eight months away from it, it is actually pretty desperately hopeless' (Professor John Saunders, speaking for the Royal College of Physicians, HL 86 Vol I, Paragraph 118)

'A simple bit of practical evidence is one of the benefit forms that are filled in for patients assigned to a doctor thinking that the patient has six months to live. I would not like to count how many of these forms I have signed in my life for patients still living after a year, eighteen months or even longer' (Dr David Jeffery, speaking for the Association of Palliative Medicine, HL 86 Vol I, Paragraph 119)


In 2006 an article in the British Journal of Cancer looked at cancer specialists estimates of survival in patients who died with a median survival of twelve months. The paper, titled ‘Disarming the guarded prognosis: predicting survival in newly referred patients with incurable cancer’, summarised its findings as follows:

People affected by cancer want information about their prognosis but clinicians have trouble estimating and talking about it. We sought to determine the nature and accuracy of medical oncologists' estimates of life expectancy in newly referred patients with incurable cancer… After a median follow-up of 35 months, 86 of the 102 patients had died with an observed median survival of 12 months… Oncologists' estimates of each patient's predicted survival were imprecise: 29% were within 0.67–1.33 times the patient's actual survival, 35% were too optimistic (>1.33 times the actual survival), and 39% were too pessimistic (<0.67 times the actual survival). The proportions of patients with actual survival times bounded by simple multiples of their predicted survival were as follows: 61% between half to double their predicted, 6% at least three to four times their predicted, and 4% no more than 1/6 of their predicted… Ranges based on simple multiples of the predicted survival time appropriately convey prognosis and its uncertainty in newly referred people with incurable cancer.

Predicting life expectancy in cancer patients is difficult enough. But as Ms Taylor’s case reveals, in those with other illnesses such as heart disease estimates can be wildly inaccurate.

‘Twelve months to live’ is not the ‘robust safeguard’ that pro-euthanasia campaigners claim it is. But, as in this case, they have never really shown any real concern about that in pursuing their agenda.

Tuesday, 6 March 2012

Lady Gaga on being ‘born this way’

Lady Gaga has set a new worldwide record, becoming the first person to hit 20 million followers on Twitter.

The singer has now edged way in front of her nearest rival Justin Bieber who has 18m followers.

Contemporary idols like Lady Gaga have a powerful influence, not just in becoming the obsessional preoccupation of millions of teenagers (her smash hit ‘Bad Romance’ has had over 450 million views on you tube – one view for every 15 people on the planet), but also in shaping the aspirations and beliefs of a generation.

In this connection, and given the current debate on same sex marriage, I was interested to see an article titled ‘Not “born this way”’ published today on meracatornet about how Gaga has helped mould beliefs on sexuality. It reads:

‘Many people are sympathetic to persons with same-sex attraction demand for a ‘right’ to marry because they believe that such persons were ‘born that way’ and can’t change; therefore, allowing them to call their relationships marriages gives such persons their only opportunity for a recognized relationship.’

Lady Gaga’s song ‘Born this way’ expresses just this view.

No matter gay, straight or bi
Lesbian, transgendered life…
Ooh, there ain't no other way, baby, I was born this way
Baby, I was born this way


Our Prime Minister David Cameron of course shares this opinion and this is what is driving him in his campaign to legalise same sex marriage.

The problem is that there is no science supporting a ‘gay gene’ or combination of genes or hormonal cause for same-sex attraction.

‘In 1995 The Journal of Homosexuality published 4 issues (Vol 28, numbers 1/ 2. 3/ 4) on the question of biological causes for same-sex attraction. The issues were republished under the title Sex, Cells, and Same-Sex Desire: The Biology of Sexual Preference, and edited by John DeCecco and David Parker. Their conclusion: “Current research into possible biological bases of sexual preference has failed to produce any conclusive evidence.”’

And since 1995 no new scientific, replicated studies have even claimed to find a biological cause for same sex attraction (see my review)

Even leading gay rights activists like Peter Tatchell concede that the belief that homosexual orientation is biologically fixed or determined is not evidence-based.

Most researchers now accept that homosexual orientation, although it may have some genetic influences, is a complex product of genetics, environment and personal choice.

Unfortunately, as mercatornet points out, more people are inclined to believe Lady Gaga than the actual evidence.

Richard Doll teaches us that financial or ideological vested interests can be used to stifle the truth

Today is the 50th anniversary of the publication of a groundbreaking report by the Royal College of Physicians in which doctors first tried to talk directly to the public about the catastrophic dangers of smoking.

Richard Doll (pictured) and Austin Bradford Hill provided the definitive study in the 1950s that demonstrated the lethal nature of tobacco by following a cohort of smoking and non-smoking doctors. But the study had an ambivalent and even hostile response in some quarters of the government, media and society.

With social barriers coming down in the 1960s, doctors at the RCP felt it was time to speak out to the public.

In the foreword to a booklet launched today, the RCP president, Sir Richard Thompson, looks back to a world 50 years ago ‘suffocated by the swirling clouds of tobacco smoke, in pubs, cinemas, trains, buses on the streets and even in hospitals and schools. Around 70% of men and 40% of women smoked. Smoking was omnipresent, accepted, established’.

It is easy for us to forget that the now well accepted link between smoking and lung cancer has not always been known or acknowledged. The tobacco industry, because of its powerful financial vested interests, provided a major obstacle to the publication of incriminating research, and the matter was not really finally resolved until the $206 billion settlement with 46 US states which the industry made in 1998 to pay for the costs of smoking-related health care.

Financial or ideological vested interests can be used to stifle the truth when medical issues become highly politicised, and perhaps on this notable anniversary it is worth reflecting on other more contemporary examples.

I have previously reported on the Royal College of Obstetricians and Gynaecologists abortion guidance which underplays the evidence linking abortion with mental illness and pre-term delivery.

Or take the instance of the RCOG misrepresenting the evidence for fetal pain sensation in fetuses under 24 weeks. In February 2011 a senior (pro-choice) neonatologist likened their 2009 report on the matter to ‘the Emperor’s new clothes’.

Then there is the case of a Christian doctor sacked from the Advisory Committee on the Misuse of Drugs (ACMD) for claiming a link between homosexuality and paedophilia. Ironically Dr Raabe’s claims were based on peer-reviewed articles including one quoted in previous Home Office documents. But it is not acceptable to hold such views in the current political climate.

Challenging politically correct scientific views, especially those expressed in peer-reviewed journals, involves investment of time and effort and risks to reputation and career. Writing on such issues will generally not be good for one's CV and may result in ostracism by colleagues or even in lost appointments. There may be long waits on editors and frequent rejections of manuscripts.

But such challenges need to come from people who have both the credibility and the standing to make them, and also the courage to stick their heads above the parapet.

Saturday, 3 March 2012

Christianity and Co-belligerence

To what extent should Christians work together with others in a multi-faith democracy to achieve common goals?

Daniel Strange’s Cambridge Paper on the subject of co-belligerence ‘Co-belligerence and common grace: Can the enemy of my enemy be my friend?’ is an excellent review of this issue and has had direct relevance for many of the issues we have faced in Public Policy at Christian Medical Fellowship (CMF).

‘Co-belligerence’ is a political or military term referring to an alliance of different parties against a common foe; in a Christian context it describes the activity of Christians working together with non-Christians for a common political, economic or cultural cause. Within evangelicalism, the use of the term was popularised by Francis Schaeffer who emphasised the importance of being both ‘in the world ’but not ‘of the world’: ‘A co-belligerent is a person with whom I do not agree on all sorts of vital issues, but who, for whatever reasons of their own, is on the same side in a fight for some specific issue of public justice.’

Co-belligerence brought the Christian Institute, the Islamic Human Rights Commission, The Gay Times and comedian Rowan Atkinson together in opposing the government’s Racial and Religious Hatred Bill in the common interest of safeguarding free speech. Similar broad alliances have formed in the UK to combat the Mental Health Bill, counter Sunday trading, protest against the Iraq war and combat world poverty. In the US a collection of strange bedfellows consisting of environmentalists, feminists and evangelicals has waged a successful campaign together against cloning.

In 2005 CMF played a key role in bringing together a coalition of professional groups, human rights groups, healthcare providers and faith groups both to promote palliative care and to oppose the legalisation of euthanasia and assisted suicide. The Care Not Killing Alliance is still the major voice in these areas seven years later. Part of the very early fruit of these efforts was an open letter to all MPs and Peers signed by nine leaders of the six main world faith groups: Christians, Muslims, Jews, Sikhs, Buddhists and Hindus. It was surprising how easy it was to gain agreement on such a powerful and comprehensive statement from people who would disagree strongly on many fundamental issues of faith.

CMF networks similarly with likeminded charities, NGOs and members of other faiths with regard to other ethical issues or in promoting HIV care, developing world health or social justice. And most of us are members of multidisciplinary healthcare teams together with people of all faiths and none, with whom we hold some values and commitments strongly in common.

In 2010 the Westminster Declaration of Christian Conscience brought together Christian groups from different denominations around the General Election and this year the Coalition for Marriage, involving Christians, and those of other faiths or no faith, formed to oppose the legal redefinition of marriage.

Some Christians may feel uncomfortable with such joint activity, feeling that it compromises the exclusivity of Christ and dampens enthusiasm for the proclamation of the Gospel. Paul’s warning not to‘ be yoked together with unbelievers’ (2 Corinthians 6:14) seems to underline this concern. And did not Jesus himself warn that, ‘He who is not with me is against me’ (Matthew 12:30) and ‘No-one can serve two masters’? (Matthew 6:24) Co-belligerence certainly does run the risks of dilution, misunderstanding and tension.

And yet at the same time there is evidence in Scripture of believers willingly working with unbelievers towards a common good. Daniel Strange points to Joseph working with Egyptians to alleviate famine (Genesis 41), Daniel in Nebuchadnezzar’s court (Daniel 2), Jeremiah’s letter to the exiles to ‘seek the peace and prosperity of the city…’ (Jeremiah 29:7) and Paul’s exhortation to do good to all, especially the family of believers (Galatians 6:10).

The tension here is really that between the Great Commission, to preach the gospel to the ends of the earth, and the Great Commandments of loving God and neighbour in the society in which he has placed us. We are to be both the light of the world, showing the way, and the salt of the earth, flavouring and preserving.

And these two activities of preaching and loving should be complementary; just as we are called to be faithful witnesses to the truth we are also called to be good citizens working to ensure that there is justice, care and equality, that good laws and policies are promoted and bad ones opposed. And in a democratic multi-faith society, that cannot be achieved without working closely together, with others who may not share all our convictions, toward shared goals. Indeed such cooperation should aid our gospel efforts because it will bring us into close relationships with unbelievers we may not otherwise have met, and the conversion of key decision-makers and leaders is one of the most potent ways of bringing about societal transformation.

But we must almost be wise and cautious, as shrewd as snakes and innocent as doves (Matthew 10:16), ensuring that working together with unbelievers does not silence us in our gospel witness or lead us to shrink in speaking truth that might offend in areas of disagreement.

Adapted from Saunders P. Co-belligerence – Compromise or Christian duty? Triple Helix 2006; Winter:3

Friday, 2 March 2012

Bpas’ interpretation of Abortion Act merits urgent parliamentary scrutiny

The ‘Voice for Choice’ Coalition, an assemblage of pro-abortion groups and activists, has today issued a quite extraordinary statement which can be accessed on the ‘Open Democracy’ website.

Titled ‘The Daily Telegraph is mistaken: We support doctors who provide abortion services’, it has been prompted by the Daily Telegraph’s recent investigation into sex selection abortions.

It comes shortly after a highly controversial article by two bioethicists arguing that there is no difference between abortion and ‘after birth abortion’ or infanticide.

Caroline Farrow of Catholic Voices has already published an effective and comprehensive line by line fisk but I wanted to pick on one point that deserves further investigation.

Two of the authors of the statement, Ann Furedi (pictured) and Patricia Lohr, are respectively Chief Executive and Medical Director of Bpas (British Pregnancy Advice Service), Britain’s largest abortion provider.

It is this that makes the article particularly striking because they reveal an extremely liberal interpretation of the current abortion law which I think merits the attention of parliament.

As I have noted previously, 98% of abortions in Britain are carried out on the legal grounds ‘that the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the mental health of the pregnant woman’.

And yet a major review of the literature by the Royal College of Psychiatrists last year revealed that there is no evidence that the continuance of a pregnancy ever involves risk to the mental health of the mother that is ‘greater than if the pregnancy were terminated’.

This raises an interesting question. Are those doctors who authorise abortions on these mental health grounds aware of these facts or not? In other words, when they sign these forms, are they just ignorant of the facts or are they being deliberately disingenuous?

We learn the truth in today’s statement.

‘Today, most doctors and most people recognise that women themselves do know what is best for their own lives and do take responsible decisions. Hence, most doctors are willing to provide an abortion referral for a woman if she requests it because they understand that continuing an unwanted pregnancy is not good for women or their children, and will almost always cause a woman greater distress than having an abortion.’


So the Chief Executive and Medical Director of Bpas, the country’s largest abortion provider , equate ‘risk to the mental health of the mother’ with ‘causing the woman distress’.

No wonder they are willing to provide abortion for virtually everyone who requests it!

When abortion was legalised in 1967 by the Abortion Act it provided doctors with protection from conviction under the Offences Against the Person Act for abortions carried out under a strictly limited set of conditions. This was in recognition of the fact that abortion ended the life of a human being.

But now, after over seven million abortions, it is clear that the mental health clause in the Act is being used as a catch-all to provide abortions virtually on demand, for every woman who claims to be distressed abut the fact that she has an unwanted pregnancy. And yet ‘distress’ by any stretch of the imagination does not constitute mental illness.

Health Secretary Andrew Lansley said last week that to carry out abortions on women who were distressed their babies were the ‘wrong sex’ was both ‘morally repugnant’ and ‘illegal’.

Perhaps it is time that someone asked him about Bpas carrying out the legal status of abortions carried out on women ‘distressed’ about having an unwanted pregnancy for any other reason . Especially given that they receive many millions of pounds of public money each year for doing it.

Britain’s largest abortion provider’s interpretation of the Abortion Act merits urgent parliamentary scrutiny.

Leading bioethicists conclude infanticide no different from abortion

Two bioethicists have stirred up huge controversy this week by publishing an article suggesting that infanticide is equivalent to abortion (see coverage here).

Writing in the Journal of Medical Ethics, Alberto Giubilini from the University of Milan and Francesca Minerva from Melbourne University argue that foetuses and newborns ‘do not have the same moral status as actual persons’ and conclude that ‘after birth abortion (killing a newborn) should be permissible in all the cases where abortion is, including cases where the newborn is not disabled’.

Their paper, titled ‘After-birth abortion: why should the baby live?’, has understandably been widely criticised, but its publication has been staunchly defended by Julian Savulescu, the editor of the journal.

On the BMJ blog, Savulescu claims that the arguments presented are not new and have been presented repeatedly in academic literature for years. He says, ‘The novel contribution of this paper is not an argument in favour of infanticide – the paper repeats the arguments made famous by Tooley and Singer – but rather their application in consideration of maternal and family interests. The paper also draws attention to the fact that infanticide is (already) practised in the Netherlands.’

He continues, ‘Many people will (disagree) with these arguments. However, the goal of the Journal of Medical Ethics is not to present the Truth or promote some one moral view. It is to present well-reasoned argument based on widely accepted premises. The authors provocatively argue that there is no moral difference between a foetus and a newborn. Their capacities are relevantly similar. If abortion is permissible, infanticide should be permissible. The authors proceed logically from premises, which many people accept to a conclusion that many of those people would reject.’

Savulescu is right. All these authors have done is to draw out the logical conclusions of principles which have been taught in universities by leading academic bioethicists to generations of medical students since the 1980s.

They simply start from the premise that not all human beings are persons with rights. The implications of this view are spelt out in a 2004 article ‘What is a Person?’ by John Wyatt published in the CMF journal Nucleus.

‘For centuries it was generally accepted that the terms 'person' and 'living human being' were virtually equivalent. But over the last two decades, a number of influential modern philosophers, including Peter Singer, Jonathan Glover and John Harris, have challenged traditional understandings of personhood. As we will see, this has led them to some startling conclusions.

For Peter Singer a person is a being who has a capacity for enjoyable experiences, for interacting with others and for having preferences about continued life. For John Harris a person is any being who is capable of valuing their own life.

Once this kind of definition is accepted, there are a number of logical implications. Firstly it is immediately obvious that in order to be regarded as a person, you must have an advanced level of brain function. In fact you must have a completely developed and normally functioning cerebral cortex. Secondly, there must be a significant group of human beings who are non-persons. These include fetuses, newborn babies and infants who lack self awareness, and a large group of children and adults with congenital brain abnormalities, severe brain injury, dementia and major psychiatric illnesses.

Thirdly, there are many non-human beings on the planet who meet the criteria of persons. These include at least chimpanzees, gorillas, monkeys and dolphins, but may also include dogs, pigs and many other mammals. In fact it has even been argued that within the foreseeable future some supercomputers may meet the criteria to be regarded as persons.’


Consider the following quote from Singer (pictured), former editor of the Bioethics journal and one of the most influential thinkers in bioethics today. In a seminal article titled ‘Sanctity of Life or Quality of Life?’, published in the American Journal Paediatics in 1983, he wrote the following:

'We can no longer base our ethics on the idea that human beings are a special form of creation, made in the image of God...Once the religious mumbo-jumbo surrounding the term 'human' has been stripped away, we may continue to see normal members of our species as possessing greater qualities of rationality, self-consciousness, communication and so on than members of any other species, but we will not regard as sacrosanct the life of every member of our species, no matter how limited its capacity for intelligent or even conscious life may be... If we can put aside the obsolete and erroneous notion of the sanctity of all human life, we may start to look at human life as it really is, at the quality of human life that each human being has or can achieve.'

To Singer and many influential thinkers like him, man is nothing but the product of matter, chance and time in a godless universe; merely a highly specialised animal. The value of an individual human being is determined by his level of rationality, self-consciousness, physical attributes or capacity for relationships. Human life that has fewer of these qualities is of less value and can be disposed of. This Darwinian ethic with its aim of 'survival of the fittest' leads to the conclusions outlined above and obviously puts the demented, mentally handicapped, brain-injured, unborn and now newborn in danger.

These bioethicists this week have actually done us a service. If we don’t like their conclusions, then it should actually lead us to reject the premises from which they logically flow.

Is it actually the qualities of rationality, self-consciousness and communication that make human beings special and give them value? Or is it something else?

The Christian view of the sanctity of life, which Singer and others reject, is that human beings have value not because of any ‘intrinsic’ qualities, but for two main ‘extrinsic’ reasons. First, that they are made in the image of God for an eternal relationship with him, and second because God himself became a human being in the person of Jesus Christ and thereby bestowed unique dignity on the human race.

If we follow that view through to its logical conclusion it leads us to say that any human being, regardless of its age, appearance, degree of deformity or mental capacity, is worthy of the highest possible degree of protection, empathy, wonder and respect.

It is easy to dismiss Singer and others because their conclusions make us feel uncomfortable. But we must at least admire their willingness to be consistent with their beliefs. Most people are not, and many of those shocked by the comments about infanticide this week actually share these bioethicists’ views about what makes human beings valuable but haven’t fully thought through the implications.

In the same way many Christians have not through the full implications of a Christian worldview.

Alberto Giubilini and Francesca Minerva are right that infanticide is morally no different to abortion. But we can draw one of two conclusions from that – either we should embrace infanticide on demand or we should stop doing abortions.

Which we ultimately opt for will depend on whether we embrace a secular or a Christian worldview. Are human beings simply an advanced form of life, special only because of their higher neurological capacities? Or are they special creations made in the image of God with an eternal destiny? That is the real question.

And whatever view we opt for on the basis of the available evidence, we should have the courage of our convictions to draw out its full practical implications as these bioethicists have done.

Thursday, 1 March 2012

Catholic midwives, abortion and the cost of conscience

Two Roman Catholic midwives have lost a legal battle to avoid taking part in abortion procedures on grounds of conscientious objection.

Midwifery sisters Mary Doogan, 57, and Concepta Wood, 51, (pictured) said being forced to supervise staff taking part in abortions violated their human rights. The women had sought to challenge NHS Greater Glasgow and Clyde on the issue.

But a judge at the Court of Session ruled the midwives did not have ‘direct involvement’ in terminating pregnancies.

The case brings further ‘clarity’ to the conscientious objection clause in the Abortion Act 1967.

The midwifery sisters were employed as labour ward co-ordinators at the Southern General Hospital in Glasgow and had given notice of their conscientious objection under the abortion law many years ago, but became concerned when all medical terminations were moved to the labour ward in 2007.

They claimed that previously they were not called on to delegate, supervise or support staff engaged in the care of patients undergoing terminations.

The midwives also claimed that the health board decision also breached their rights under Article 9 of the European Convention on Human Rights which guarantees the right to freedom of religion.

But Lady Smith, the judge, said she was not satisfied that their Article 9 rights were being interfered with and that their right of conscientious objection was not unqualified and they had agreed to take up the roles of labour ward co-ordinators, although they now took objection to the job content.

She added that because ‘the nature of their duties’ did not ‘require them to provide treatment to terminate pregnancies directly’ they were not covered by the conscientious objection clause in the Abortion Act either.

Section 4 of the Abortion Act 1967,’Conscientious objection to participation in treatment’ reads as follows:

(1) Subject to sub-section (2) of this section, no person shall be under any duty whether by contract or by any statutory or other legal requirement to participate in any treatment authorised by this Act to which he has a conscientious objection.


The full scope of this clause has not been fully tested in the courts but centres around what meaning is given to the word ‘participate’. Whilst it is clear that it covers those directly involved in the abortion itself, the Janaway case ruling (see note below) held that it did not cover a receptionist who refused to type an abortion referral letter.

It appears now that it does not cover those who are asked to ‘delegate, supervise or support’ staff carrying out abortions either.

This obviously creates real difficulties for anyone with a moral objection put in this position, many of whom (including myself) would view delegation, supervision or support as participation.

Imagine for example had they been working in another country and been asked to ‘supervise’ activities that were legal there but that most people in Britain would regard as highly unethical – such as euthanasia of people with dementia, amputation for stealing, female circumcision or the torture of political prisoners.

Most Britons I suspect would back their right to refuse. It is only because abortion is regarded as trivial in Britain that a case like this does not generate huge public outrage. But that tells us far more about the eroded conscience of the British public than it does about morality of abortion.

Part of being a good citizen involves exercising our democratic rights to ensure that unjust laws are kept off the statute books.

But if unethical laws like the Abortion Act, which has led to over seven million babies losing their lives since 1967, are passed, then obeying such laws involves disobeying God and the Bible is clear that there is a place for civil disobedience.

'Supervising' the shedding of innocent blood is not an option for Christians, even if the law does not allow us the option of conscientious objection.

When the King of Egypt ordered the Hebrew midwives to kill all male Hebrew children they refused to do so and God commended and rewarded them (Exodus 1:15-22).

Rahab the harlot similarly refused to co-operate with the king of Jericho in handing over the innocent Israelite spies and was later praised for her faith (Joshua 2:1-14; Hebrews 11:31; James 2:25)

The prospect of death did not stop Shadrach, Meshach and Abednego refusing to bow down to the image of the king or Daniel persisting with public prayer (Daniel 4:6-8, 6:1-10).

When Peter and John were commanded by the Jewish authorities not to preach the Gospel they replied, 'We must obey God rather than men' (Acts 5:29).

So whilst recognising that we have an obligation to obey the governing authorities God has instituted (Romans 13:1-7; Titus 3:1; 1 Peter 2:13-14), nonetheless our obedience to him takes precedence if the law of the land requires us to disobey him. It is striking that these biblical examples include refusals to participate in shedding innocent blood.

Daniel and his three friends were rescued miraculously from their respective predicaments; but there is of course no guarantee that God will turn things in our favour if we are in a situation of having to disobey the law. The long list of heroes of faith in Hebrews 11 contains those who were delivered from the consequences of civil disobedience but also those who paid the price. And paying the price through facing discipline, job-loss, a fine or even imprisonment may be what God requires us to do.

I expect that in coming days we will increasingly be calling on Christian colleagues to support us, and Christian lawyers to advise and protect us in such circumstances.

We will no doubt win some battles and lose others – but regardless we have the confidence that we follow in the footsteps of a Saviour who in facing everything the greatest Empire on earth could throw at him, willingly carried the cross and emerged ultimately victorious.

I understand the Catholic midwives plan to appeal. I hope they do. The legal principle is worth fighting for. But whether they win or not, by making a stand on this issue, they have set a good example for others to follow.

'Blessed are those who are persecuted because of righteousness, for theirs is the kingdom of heaven. Blessed are you when people insult you, persecute you and falsely say all kinds of evil against you because of me. Rejoice and be glad, because great is your reward in heaven, for in the same way they persecuted the prophets who were before you.' (Matthew 5:10-12)

NOTE: For a thorough explanation of the current law on conscientious objection to abortion see ‘Conscientious objection to abortion - ethics, polemic and law’ by Charles Foster in the CMF journal Triple Helix