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
Assisted dying
Death & life
Ethics
Politics
4 min read

What will stop the culture of death that libertarian Britain has embraced?

Now we’re allowed to end life with impunity

Graham is the Director of the Centre for Cultural Witness and a former Bishop of Kensington.

Diane Abbott speaks in the assisted dying debate.
Dianne Abbott MP speaks in the assisted dying debate.

Just a few days apart, two debates recently took place in the House of Commons concerning life and death. In the first, MPs voted to decriminalise late-term abortions. In the second, they voted for assisted dying. Both times, the reach of death grew a little longer.

Imagine a mother about to have a baby who is suddenly having grave doubts about whether she can manage a new child as the moment draws near. It’s not hard to sympathise with many in this situation, but rather than recommend she goes through with the birth, and perhaps putting the baby up for adoption for childless parents desperate to adopt, we now have passed legislation that allows us to terminate the baby’s life instead. Proponents argued this was to relieve a small number of women who had been prosecuted for late-term abortions. The reality is, however, that it will probably become more common. In the debate, Jim Shannon MP pointed out that in New Zealand, in the first year after their parliament voted the same way, late-term abortions increased by 43 per cent.

A baby a week before and a week after birth are virtually identical. Yet as a result of this bill, it will not be a criminal act to end the life of the first, but it will be to do the same to the second. What’s the betting that the logic of this will stretch before long to allowing parents to terminate the lives of newborn babies with a new limit – say up to one month after birth? The arguments will be exactly the same – sympathy for distressed parents who suddenly realise they cannot cope with a new life on their hands, especially if the baby is discovered to be flawed in some way. When emotional sympathy, personal choice and the rights of the mother over the baby become the only moral arguments, the logic is inevitable.

Despite the argument shifting rapidly against the Terminally Ill Adults Bill – the vote passed by 314 votes to 291, with 32 MPs apparently having changed their minds - it now looks likely that this second bill will pass into law in a few years’ time, despite scrutiny in the Lords.

Here on Seen & Unseen, we have scrutinised the arguments put forward for assisted dying over past months. We have argued about the unintended consequences for the many of permitting assisted dying for the few. In The Times a while ago, I argued that if ‘dignity’ means autonomy — my ability to choose the place, the time and the manner in which I die — there is no logical reason why we should refuse that right to someone who, for whatever reason feels their life is no longer worth living, however trivial we may feel their problems to be. With this understanding of dignity as unlimited choice, the slippery slope is not just likely, it is philosophically inevitable.

In both cases the logic of the arguments used means the march of our ability to bring about death will not stop with these measures, despite their proponents’ assurances that safeguards are in place.

These two votes reminded me of something Pope John Paul II once wrote. In an encyclical, Evangelium Vitae – the Gospel of Life - he warned that “we are facing an enormous and dramatic clash between what he called a “culture of death” and a “culture of life”.

He warned that this “culture of death” would be “actively fostered by powerful cultural, economic and political currents which encourage an idea of society excessively concerned with efficiency.” It is, in effect, he argued, “a war of the powerful against the weak: a life which would require greater acceptance, love and care is considered useless, or held to be an intolerable burden, and is therefore rejected in one way or another. A person who, because of illness, handicap or, more simply, just by existing, compromises the well-being or lifestyle of those who are more favoured tends to be looked upon as an enemy to be resisted or eliminated. In this way a kind of ‘conspiracy against life’ is unleashed.”

They were strong words, and in the UK at least, back in 1995, might have seemed alarmist. Yet I couldn't help thinking of them as these two bills passed through the UK’s national parliament. In both cases, the bills were introduced very rapidly with little time for serious moral deliberation. Both depended on emotional appeals to a small number of admittedly distressing cases without serious consideration for the wider cultural and philosophical ramifications of these seismic moves. Both encouraged the steady encroachment of death on demand.

What concerns me is what these bills say about the kind of culture we are becoming. MND sufferer Michael Wenham makes the point powerfully that this is all about autonomy and independence, a spurious kind of compassion, and the fact that palliative care is more expensive than subtly encouraging the dying to take their own life. Looking behind the arguments for compassion, it's not hard to spot the iron law of libertarian ideas of freedom, where individuals have absolute rights over their own lives and bodies that trump everything else. This is the kind of libertarian freedom that prizes personal autonomy above everything else and therefore sees our neighbours not so much as gifts to be valued and cherished, but limitations, or even threats to our precious personal freedoms.

Pope John Paul was right. It does seem that we are opting for a culture of death. And my fear is that it won’t stop here.

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