Review
Ageing
Assisted dying
Culture
5 min read

For love there is no charge

Out of mind old people are at the centre of Allelujah! Sian Brookes reviews the film adaptation of Alan Bennett’s play.

Sian Brookes is studying for a Doctorate at Aberdeen University. Her research focuses on developing a theological understanding of old age. She studied English and Theology at Cambridge University.

In a hall decorated for a celebration a person stands in front of a seated group, all have their arms raised in celebration.
Jazz hands at the hospital.
BBC Films.

Spoiler alert – this film review reveals significant elements of the plot. 

Allelujah! is not a film that shies away from the big issues. In fact, you would be hard pressed to find a big issue this comedy/political commentary/drama/part-thriller doesn’t at least make reference to (and yes, it spreads itself across all of these genres too). With such an eclectic approach it is difficult at times to keep up with the narrative, and the deeper meaning of the film. Based on the Alan Bennett play, the plot centres around The Bethlehem, a small northern hospital for geriatric patients, which is facing closure due to the Tory government’s efficiency drive. It focuses on two members of staff, Alma Gilpin, a stoic and matter-of-fact but seemingly excellent nurse who has served the hospital her entire career, and a younger Dr Valentine. Other protagonists include an ex-miner patient and his son, a management consultant who has “made it” to London and is currently advising the Health Secretary to close hospitals such as the one in question for the sake of government finances. 

Whether it’s politics or the personal, this film has it all. It deals with levelling up, the cultural and economic gap between the north and south, the challenges of budget cuts in the NHS, the problems of a national health service claiming to 'care' but with managers more preoccupied by Westminster’s economic priorities. It depicts families waiting for older relatives to die in order to grab their inheritance, the broken relationship between an ageing man and his son, and those all-important stories of the older patients’ lives well-lived. And yet as the story line develops, a plot twist emerges which comes to overshadow the entire film, and in the process speaks to what is perhaps the most poignant of the many discussions it raises. Nurse Gilpin, who, until now has appeared consistently caring and committed to her patients, has been quietly administering fatal beakers of milk and morphine to those who she deems to be on “her list” of those who most need relief from their situation. When confronted by the doctor she justifies her actions with a multifaceted answer based on the requirement to provide more beds to a broken healthcare system, but also insisting “I had ended someone’s suffering”.  

When Dr Valentine remarks, “I like old people” a visitor responds “not even old people like old people”.

The manner in which Nurse Gilpin goes about what is effectively enforced euthanasia, is deeply chilling. And yet her reasoning is not entirely foreign to us – to end suffering could be deemed a noble cause. In fact, the need to simply delete the reality of suffering, particularly the suffering of the old is one that perhaps is not so uncommon. Throughout Allelujah!,we are reminded of our tendency to run from, to detest, to reject the suffering of the elderly in our society. When Dr Valentine remarks, “I like old people” a visitor responds “not even old people like old people”. A teenage intern declares to a patient “I hope I never live to be your age”. At the same time, characters look back on the days “when the elderly weren’t farmed out”, and questions are asked of families “if they love them, why do they put them away?”. A very good question. Of course, care needs are often too great for families to endure, yet it is still important to ask why the suffering of the old has become a professionalised service, which most of us avoid at all costs. Perhaps the answer to this is that we don’t like to watch the old suffer, we don’t like to watch them die, because their suffering and their death remind us of our future selves, our future suffering, our future death. In our sanitised, anything-is-possible-with-medicine-and-science society, death and the suffering that comes with it, is something from which we flee at all costs. Instead of acknowledging and working with it, we would rather pretend it wasn’t there at all.  

And yet, even as we try to avoid it, suffering and death are both certain parts of all our futures. 100% of us will die. For Nurse Gilpin, the solution to this is to bring on death prematurely, to erase the pain, overcome the misery by offering a false hope – that it doesn’t need to exist at all. In direct contrast to this, in a film which is littered with Christian references (Allelujah, The Bethlehem), there is a different approach taken by a messiah-type figure who seems to get everything right. Dr Valentine is compassionate and understanding. He not only challenges the political systems which undermine those most at the margins of society, but also has the kind of bedside manner we would all hope for in a doctor. In a closing monologue Dr Valentine utters the words of the doctors in the NHS, “We will be here when you are old, and we would die for you, we are love itself and for love there is no charge”.  

It is this suffering with which is so compelling, this suffering with which is truly sacrificial.

Nurse Gilpin and Dr Valentine offer two fundamentally different approaches to end of life care. One hastens the end quickly, deletes the suffering as efficiently as possible in order to make way for those in less pain. The other sits with those who suffer, holds their hand, gently cares for the human person that is in front of them. Even more, and perhaps most significantly Dr Valentine does not only watch from afar, but is willing to suffer himself for the sake of those in pain - working tirelessly, giving himself over day after day, fighting on with little sleep for limited pay just to make things a little less painful. It is this suffering with which is so compelling, this suffering with which is truly sacrificial, this suffering with which speaks of something much greater than politics, efficiency or inheritance, this suffering with which is indeed “love itself”, completely free of charge.  This is the logic that Christians see in the ancient notion of the incarnation, celebrated every Christmas, of God with us. This is what our older people need, this is what we will all need when we grow old. Let us only hope that when we get there, we find the one who is willing to offer it.

Article
AI - Artificial Intelligence
Attention
Culture
5 min read

Will AI’s attentions amplify or suffocate us?

Keeping attention on the right things has always been a problem.

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

A cute-looking robot with big eyes stares up at the viewer.
Robots - always cuter than AI.
Alex Knight on Unsplash.

Taking inspiration from human attention has made AI vastly more powerful. Can this focus our minds on why attention really matters? 

Artificial intelligence has been developing at a dizzying rate. Chatbots like ChatGPT and Copilot can automate everyday tasks and can effortlessly summarise information. Photorealistic images and videos can be generated from a couple of words and medical AI promises to revolutionise both drug discovery and healthcare. The technology (or at least the hype around it) gives an impression of boundless acceleration. 

So far, 2025 has been the year AI has become a real big-ticket political item. The new Trump administration has promised half a trillion dollars for AI infrastructure and UK prime minister Keir Starmer plans to ‘turbocharge’ AI in the UK. Predictions of our future with this new technology range from doom-laden apocalypse to techno-utopian superabundance. The only certainty is that it will lead to dramatic personal and social change. 

This technological impact feels even more dramatic given the relative simplicity of its components. Huge volumes of text, image and videos are converted into vast arrays of numbers. These grids are then pushed through repeated processes of addition, multiplication and comparison. As more data is fed into this process, the numbers (or weights) in the system are updated and the AI ‘learns’ from the data. With enough data, meaningful relationships between words are internalised and the model becomes capable of generating useful answers to questions. 

So why have these algorithms become so much more powerful over the past few years? One major driver has been to take inspiration from human attention. An ‘attention mechanism’ allows very distant parts of texts or images to be associated together. This means that when processing a passage of conversation in a novel, the system is able to take cues on the mood of the characters from earlier in the chapter. This ability to attend to the broader context of the text has allowed the success of the current wave of ‘large language models’ or ‘generative AI’. In fact, these models with the technical name ‘Transformer’ were developed by removing other features and concentrating only on the attention mechanisms. This was first published in the memorably named ‘Attention is All You Need’ paper written by scientists working at Google in 2017. 

If you’re wondering whether this machine replication of human attention has much to do with the real thing, you might be right to be sceptical. That said, this attention-imitating technology has profound effects on how we attend to the world. On the one hand, it has shown the ability to focus and amplify our attention, but on the other, to distract and suffocate it. 

Attention is a moral act, directed towards care for others.

A radiologist acts with professional care for her patients. Armed with a lifetime of knowledge and expertise, she diligently checks scans for evidence of malignant tumours. Using new AI tools can amplify her expertise and attention. These can automatically detect suspicious patterns in the image including very fine detail that a human eye could miss. These additional pairs of eyes can free her professional attention to other aspects of the scan or other aspects of the job. 

Meanwhile, a government acts with obligations to keep its spending down. It decides to automate welfare claim handling using a “state of the art” AI system. The system flags more claimants as being overpaid than the human employees used to. The politicians and senior bureaucrats congratulate themselves on the system’s efficiency and they resolve to extend it to other types of payments. Meanwhile, hundreds of thousands are being forced to pay non-existent debts. With echoes of the British Post Office Horizon Scandal, the 2017-2020 the Australian Robo-debt scandal was due to flaws in the algorithm used to calculate the debts. To have a properly functioning welfare safety net, there needs to be public scrutiny, and a misplaced deference to machines and algorithms suffocated the attention that was needed.   

These examples illustrate the interplay between AI and our attention, but they also show that human attention has a broader meaning than just being the efficient channelling of information. In both cases, attention is a moral act, directed towards care for others. There are many other ways algorithms interact with our attention – how social media is optimised to keep us scrolling, how chatbots are being touted as a solution to loneliness among the elderly, but also how translation apps help break language barriers. 

Algorithms are not the first thing to get in the way of our attention, and keeping our attention on the right things has always been a problem. One of the best stories about attention and noticing other people is Jesus’ parable of the Good Samaritan. A man lies badly beaten on the side of the road after a robbery. Several respectable people walk past without attending to the man. A stranger stops. His people and the injured man’s people are bitter enemies. Despite this, he generously attends to the wounded stranger. He risks the danger of stopping – perhaps the injured man will attack him? He then tends the man’s wounds and uses his money to pay for an indefinite stay in a hotel. 

This is the true model of attention. Risky, loving “noticing” which is action as much as intellect. A model of attention better than even the best neuroscientist or programmer could come up with, one modelled by God himself. In this story, the stranger, the Good Samaritan, is Jesus, and we all sit wounded and in need of attention. 

But not only this, we are born to imitate the Good Samaritan’s attention to others. Just as we can receive God’s love, we can also attend to the needs of others. This mirrors our relationship to artificial intelligence, just as our AI toys are conduits of our attention, we can be conduits of God’s perfect loving attention. This is what our attention is really for, and if we remember this while being prudent about the dangers of technology, then we might succeed in elevating our attention-inspired tools to make AI an amplifier of real attention. 

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