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

Balancing safeguards and economic expediencies after the assisted dying vote.

Callum Elwood

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.

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Death & life

29 October 2024

4 min read

There’s fear or fascination as cultures confront death

If Western society discussed death more openly, would Halloween’s appeal hold such sway?

Rahil Patel

Rahil is a former Hindu monk, and author of Found By Love. He is a Tutor and Speaker at the Oxford Centre for Christian Apologetics.

A bronze statue of a resting angel sits atop a low stone grave.

A grave in a Dresden cemetery.

Veit Hammer on Unsplash.

Watching Christians jump and sing “death is defeated” was a strange experience.

As a new believer in Christianity from a Hindu background, I was struck by how Christians approached death. While I had seen reincarnation as a path to heaven, I couldn’t understand why the church either hesitated to talk about death or celebrated it so intensely. Why were Christians sometimes dancing and other times, silent about death?

During my early years in Christ if ever the topic of death arose from the fun times I was having with Christian friends it was almost always met with a dead silence - excuse the pun. On one occasion, the husband of a close friend in our small church community had passed away due to cancer. I was one of the first to make a call to his widowed wife. When my friends heard that I had done this the response was unusual, “well done Rahil!” “That’s so good Rahil.” Strange. I was sensitive over the phone, but it wasn’t that hard. Then I asked the others if they were going to make a call and the response was equally peculiar, “erm, I can’t” or “I just can’t do that... ” Puzzling.

Recently, I came across the GodPod podcast, which shed some light for me on this hesitation. In an interview with Dr Lydia Dugdale about her book The Lost Art of Dying, a surprising statistic caught my attention: “In the 18th century, one-third of church sermons were about death and eternity.” I had to play that line back multiple times. In contrast, today’s sermons often focus on personal purpose, calling, or spiritual gifts. All important, but are we missing a vital balance—one eye on eternity, the other on our present lives?

Why didn’t the British or ‘international’ media film the funerals taking place in Britain? Why hesitate with death at home and yet have a somewhat fascination with it in the East?

This avoidance of death became even more apparent during the Covid pandemic. When the Delta strain hit India in 2021 it caused a massive widespread devastation and death. The funeral pyres were filling the sacred river banks up and down the country. At one point there was no more wood left to burn the bodies. It had run out! Urban crematoriums were overrun and so people left their deceased loved ones to simply float down the nearest river in the hope that the next life would be easier.

I followed the detailed footage of the funeral pyres and bodies choking various holy rivers. It was meticulously covered by the western media. Even PM Boris Johnson at the time cancelled his trip to India because the Covid death crisis was “out of control.” It’s Interesting how the western media flippantly assumed that death could be controlled. And then an eminent academic in India wrote a remarkable article for Project Syndicate. Brahma Chellaney’s opening paragraph was,

“When reporting on any mass tragedy, a basic rule of journalism is to be sensitive to the victims and those who are grieving. Western media, which double as the international media, usually observe this rule at home but discard it when reporting on disasters in non-Western societies.”

The author’s accurate observation demanded my attention. Why didn’t the British or ‘international’ media film the funerals taking place in Britain? Why hesitate with death at home and yet have a somewhat fascination with it in the East? Although Chellaney uses the concept of ‘grieving’ for his argument, there really isn’t such a spiritual concept across Indic faiths as Christianity knows of it. Of course, there is sadness and loss but grieving in the deep spiritual sense, not really. Is that why the Western media found it easier to cover death in the East? Because the secular (although Christian) West knows of the concept of grief so well at home? Or is it because the West do actually want to confront death without hiding and when they see other cultures do it so openly (and a tad bit casually) they are drawn to it? As morbid as it sounds (and I’ll do the British thing and apologise here) there might actually be a healthy interest with the way certain cultures embrace death that the west is seeking to find an expression for.

Brahmar Mukherji chaired the Department of Biostatistics at Michigan University. In an interview with the Carnegie Endowment for International Peace in 2021 she stated that India as a society sees death differently which is why the death toll along with so many other complex and practical issues was so high in that nation during Covid. They embrace it more easily. I am not promoting reckless behaviour around rules. One can’t play with a rattlesnake and then call it faith. My hope is that the reader finds hope when confronting death with a Christian lens. Why have themes of Euthanasia and Assisted Dying become such a big thing in the West and not in the East?

Which brings me to Halloween. It’s a leap, I know, but think about it: if Western societies and churches discussed death and eternity more openly, would Halloween’s macabre appeal hold such sway? Dressing up as a ghoul or a skeleton seems to be a playful, yet safe way to confront our fear of death—something we’re eager to do from behind a mask. That lighthearted, but jarring moment in the Barbie film comes to mind: “Do you guys ever think about dying?” Maybe that’s the real question we should be asking ourselves. Not just on Halloween, but frequently. How do we truly confront death—with fear, with fascination, or with the hope of something beyond?