Article
Care
Comment
Economics
Ethics
4 min read

NHS: How far do we go to feed the sacred system?

Balancing safeguards and economic expediencies after the assisted dying vote.

Callum is a pastor, based on a barge, in London's Docklands.

A patient eye view of six surgeons looking down.
National Cancer Institute via Unsplash.

“Die cheaply, protect the NHS” It sounds extreme, but it could become an unspoken policy. With MPs voting on 29th November to advance the assisted dying bill, Britain stands at a crossroads. Framed as a compassionate choice for the terminally ill, the bill raises profound ethical, societal, and economic concerns. In a nation where the NHS holds near-sacred status, this legislation risks leading us to a grim reality: lives sacrificed to sustain an overstretched healthcare system. 

The passage of this legislation demands vigilance. To avoid human lives being sacrificed at the altar of an insatiable healthcare system, we must confront the potential dangers of assisted dying becoming an economic expedient cloaked in compassion. 

The NHS has been part of British identity since its founding, offering universal care, free at the point of use. To be clear, this is a good thing—extraordinary levels of medical care are accessible to all, regardless of income. When my wife needed medical intervention while in labour, the NHS ensured we were not left with an unpayable bill. 

Yet the NHS is more than a healthcare system; it has become a cultural icon. During the COVID-19 pandemic, it was elevated to near-religious status with weekly clapping, rainbow posters, and public declarations of loyalty. To criticise or call for reform often invites accusations of cruelty or inhumanity. A 2020 Ipsos MORI poll found that 74 per cent of Britons cited the NHS as a source of pride, more than any other institution. 

However, the NHS’s demands continue to grow: waiting lists stretch ever longer, staff are overworked and underpaid, and funding is perpetually under strain. Like any idol, it demands sacrifices to sustain its appetite. In this context, the introduction of assisted dying legislation raises troubling questions about how far society might go to feed this sacred system. 

Supporters of the Assisted Dying Bill argue that it will remain limited to exceptional cases, governed by strict safeguards. However, international evidence suggests otherwise. 

In Belgium, the number of euthanasia cases rose by 267 per cent in less than a decade, with 2,656 cases in 2019 compared to 954 in 2010. Increasingly, these cases involve patients with psychiatric disorders or non-terminal illnesses. Canada has seen similar trends since legalising medical assistance in dying (MAiD) in 2016. By 2021, over 10,000 people had opted for MAiD, with eligibility expanding to include individuals with disabilities, mental health conditions, and even financial hardships. 

The argument for safeguards is hardly reassuring, history shows they are often eroded over time. In Belgium and Canada, assisted dying has evolved from a last resort for the terminally ill to an option offered to the vulnerable and struggling. This raises an urgent question: how do we ensure Britain doesn’t follow this trajectory? 

The NHS is under immense strain. With limited resources and growing demand, the temptation to frame assisted dying as an economic solution is real. While supporters present the legislation as compassionate, the potential for financial incentives to influence its application cannot be ignored. 

Healthcare systems exist to uphold human dignity, not reduce life to an economic equation.

Consider a scenario: you are diagnosed with a complex, long-term, ultimately terminal illness. Option one involves intricate surgery, a lengthy hospital stay, and gruelling physiotherapy. The risks are high, the recovery tough, life not significantly lengthened, and the costs significant. Opting for this could be perceived as selfish—haven’t you heard how overstretched the NHS is? Don’t you care about real emergencies? Option two offers a "dignified" exit: assisted dying. It spares NHS resources and relieves your family of the burden of prolonged care. What starts as a choice may soon feel like an obligation for the vulnerable, elderly, or disabled—those who might already feel they are a financial or emotional burden. 

This economic argument is unspoken but undeniable. When a system is stretched to breaking point, compassion risks becoming a convenient cloak for expedience. 

The Assisted Dying Bill marks a critical moment for Britain. If passed into law, as now seems inevitable, it could redefine not only how we view healthcare but how we value life itself. To prevent this legislation from becoming a slippery slope, we must remain vigilant against the erosion of safeguards and the pressure of economic incentives. 

At the same time, we must reassess our relationship with the NHS. It must no longer occupy a place of unquestioning reverence. Instead, we should view it with a balance of admiration and accountability. Reforming the NHS isn’t about dismantling it but ensuring it serves its true purpose: to protect life, not demand it. 

Healthcare systems exist to uphold human dignity, not reduce life to an economic equation. If we continue to treat the NHS as sacred, the costs—moral, spiritual, and human—will become unbearable. 

This moment requires courage: the courage to confront economic realities without compromising our moral foundations. As a society, we must advocate for policies that prioritise care, defend the vulnerable, and resist the reduction of life to an equation. Sacrifices will always be necessary in a healthcare system, but they must be sacrifices of commitment to care, not lives surrendered to convenience. 

The path forward demands thoughtful reform and a collective reimagining of our values. If we value dignity and compassion, we must ensure that they remain more than rhetoric—they must be the principles that guide our every decision. 

Article
Comment
Language
Politics
5 min read

Our public discourse needs responsible rhetoric before it is too late

The right turn of phrase can turn a nation, the wrong one can destroy

Tom has a PhD in Theology and works as a hospital physician.

A crowd of people stand in the side steps of the Lincoln Memorial
Easter services, Lincoln Memorial.
George Pflueger, via Unspash.

When was the last time a brilliant piece of rhetoric made the headlines? 

“Empty rhetoric.”  

“Form over function.”  

“Sloganeering.” 

These—and other accolades—are stock trade when it comes to the art of denouncing public discourse. Red flags are rightly waved in the face of baseless claims and insincere promises. Scroll through a news reel; open a newspaper: language far stronger in style than in substance is not hard to find. 

Nowadays we are sensitive to these kinds of abuses of public platforms. When Donald Trump speaks of the ‘Great Big Beautiful Bill’ or Elon Musk of the ‘Big Ugly Bill’ we know the cogs at BBC Verify are likely to be turning. Fact-checking is an established trade.  

Sometimes political turns of phrase are just careless, inadequately thought through. Granted, a politician’s public address is often put together at a pace. Time is so remarkably tight that phrasing and formulations are not interrogated as fully as they might be. (Krish Kandiah recently picked up the Prime Minister’s “island of strangers” line and its unfortunate resonance) 

But of course, the critiques I’ve listed above are themselves sharply rhetorical. They are punchy. Not drawn-out logical deductions. They aim to make us sit upright and win us over. Or move us to a course of action. 

So: is rhetoric the problem? No. Its misuse is the problem. This isn’t always clear. And it’s the reason why simply decrying “rhetoric” won’t get us very far.  

I am sympathetic to the suspicion. When efficiency and pragmatism tower high among the canons of public discourse, it is easier to trade in polarising x versus y expressions. Being guarded in the face of such potent idiom is understandable.  

And yet the most remarkable public discourses in human history have been rich in rhetoric.  

Martin Luther King at the Lincoln Memorial: “I have a dream.”  

Churchill in the House of Commons: “we shall fight them on the beaches.”  

Lincoln’s Gettysburg address: “government of the people, by the people, for the people.”  

All these speakers knew that bare understanding doesn’t typically move people to action. An impassioned speech, a plea to respond, or beautifully woven prose often serve as the tipping point for social engagement. 

Which leads me to wonder, what if a suspicion of smart speech-making ends up stunting social engagement, rather than fostering it? Perhaps political discourse today has gone too far; perhaps rhetoric is beyond repair. And yet: abuse doesn’t mean there isn’t proper use. There is a better way.

When persuasive powers are uncoupled from sound argument, then rhetoric obscures understanding and has become irresponsible. 

In the classical era, training in rhetoric was a prominent feature of an education. You might say it was the way to avoid the charge: “All substance, no style”. It was about turning a sound argument into an art form. For Aristotle, rhetoric was about making use of the tools of persuasion—substance with style. But skill in persuasion was not a virtue of itself; it never stood alone. As Roger Standing has reminded us, “the function of rhetorical skills was not to persuade in and of themselves.” Indeed, training in rhetoric was training in responsibility.  

In his classic 1950s text Ethics of Rhetoric, Richard Weaver put his finger on this. He highlighted that “rhetoric passes from mere scientific demonstration of an idea to its relation to prudential conduct.” True rhetoric, then, is this: the art of lighting up the path that leads from sound logic to good action

Today, it seems that when it comes to the rules of rhetoric, communicators are answerable to polls and popularity. These ends justify the means, which makes fancy formulations fair game. If style secures votes, then it’s a good job done. But this means the communicator has no real accountability for his or her language. Pragmatism is in the driving seat. In a sense, responsibility has been handed over to the hearer.  

This is problematic. When persuasive powers are uncoupled from sound argument, then rhetoric obscures understanding and has become irresponsible. Language is no longer illuminating, but misleading. It is trading on falsehood, or perhaps half-truths, instead of magnifying what is true for the sake of what is good. 

Take an example. In the recent parliamentary debate over amendments to the assisted dying bill, the proceedings opened with the claim that “if we do not vote to change the law, we are essentially saying that the status quo is acceptable.” I don’t for a moment doubt the good intent in this claim—securing the most compassionate care possible for terminally ill adults. But let it be said: no, those who do not advocate assisted dying are not “essentially” saying this. This claim is a non sequitur: the conclusion does not follow the premise. It is logically unsound. 

Like many tools, the art of persuasion can be wielded carelessly; sometimes maliciously. But rhetoric-free public discourse would make for a colourless and lifeless thing indeed. What we need now is rhetoric that is responsible—responsible to what is true and responsible to good outcomes. These should not be split; as soon as they are, speech-making becomes sterile or hollow. I recently heard the neat phrase: “Some people reach your mind by going through the heart, and some people reach your heart by going through your mind.” Yes, as the Christian faith has always maintained: mind and heart belong together. Give us words that awaken both, like those once spoken by that obscure wandering rabbi, Jesus of Nazareth, in one of the most studied and penetrating speeches in human history:  

Blessed are the poor in spirit, for theirs is the kingdom of heaven. 

Blessed are those who mourn, for they will be comforted. 

Blessed are the meek, for they will inherit the earth. 

Blessed are those who hunger and thirst for righteousness, for they will be filled. 

I pray for public discourse brimming with both substance and style. It might help lead us to better things. 

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