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
Freedom of Belief
Politics
War & peace
5 min read

Iranians long for regime change, but weigh up the cost

Dreams are easier to utter than act upon

Steve is news director of Article 18, a human rights organisation documenting Christian persecution in Iran.

Smoke rises from the site of a bomb amid a high wide view of a city at twlight
Tehran.

I received an unexpected response from an Iranian friend of mine this week after asking how he and others were feeling in the wake of the ongoing crisis. 

My friend - like many, a staunch advocate of regime change in Iran - told me that despite his long-standing enmity against the Islamic Republic and its leaders, the conflict had if anything brought Iranians together against a new, common enemy. 

For while he and many others would love to live in an Iran that offered them greater freedoms, they are also fiercely proud of their country and, as he put it, will seek to defend it at all costs. 

Both this friend and other Iranians that I have spoken to since the bombs began to fall last Friday have highlighted how Iran’s “territorial integrity” has been breached by Israel, in violation of international law. 

And so while some might perceive an attack on a tyrannical regime and its nuclear arsenal to be an exception to this rule, it should hardly surprise us that those within the country affected may take a different view. 

Both the Israeli prime minister, Benjamin Netanyahu, and the exiled crown prince of Iran, Reza Pahlavi - whom many perceive to be the most realistic leader of any new revolution - have used their platforms to call on Iranians to seize this moment to rise up and reclaim their land. 

Yet, with bombs falling all around them and a weakened regime still known to be capable of brutally responding to any attempts to revolt, such dreams are easier to utter than to act upon. 

Meanwhile, as Tehranis are encouraged to flee their city and some have already seen homes, loved ones or livelihoods destroyed, it may well be that Iranians have other things on their minds at present than attempting to overthrow their oppressors. 

One very present concern for many Iranians at the moment will be the fate of loved ones who remain in prisons as the aerial bombardment continues. 

Tehran’s Evin Prison, for example, is on the edge of District 3, which residents were told they must evacuate on Monday ahead of another onslaught. 

But as the Australian-British former political prisoner Kylie Moore-Gilbert noted in an interview with Sky News, the prisoners in Evin had no option to flee and instead found themselves locked inside tiny cells, hearing the sound of bombs and rumours of what was taking place but without any real clarity. 

“Nobody's going to have a clue what's going on, and it's utterly terrifying to think that you're locked in a place, you can't flee, you hide, you can't take action to protect yourself, and you don't have access to information,” she said.  

There is not even any guarantee, Moore-Gilbert noted, that these prisoners will be being taken care of by the prison guards, who will no doubt have other things on their mind. 

“There are literally thousands, dozens of thousands, if not hundreds of thousands, of innocent people in prison in Iran, most of them Iranian civilians,” she said. “The prison population inside that country is enormous. The conditions are dire in the best of days. Do they even have electricity? Do they have running water? What on earth is going on? My heart goes out to them.” 

Among the many prisoners in Evin are a handful of Christians, detained or serving sentences on charges related to their religious activities but framed as “actions against national security”. 

Like many Iranians, Christians, as a long-oppressed minority, have every right to hope for a change in the country and a future Iran that would better embody the prophetic words from the Book of Isaiah, believed to have found their fulfilment in Jesus, of “freedom for the captives” and “good news for the poor”. 

And yet Iranian Christians must also wrestle with the biblical command to “submit to the governing authorities” and to “give to Caesar what is Caesar’s, and to God what is God’s”. 

It is, then, perhaps no surprise that in recent years, as hopes of regime change have regularly come and gone, that Iran’s Christians have tended to focus their prayers instead on the increase of “God’s kingdom”, as many more Iranians have continued to find new hope in the Christian faith. 

Such hopes, in theological terms, are built on firmer foundations than any dreams for a change in the nature and essence of tyrannical regimes like the one currently still clinging onto power in Tehran. 

And whatever the future brings, when this current crisis is over, the Iranians who have found their ultimate source of hope and joy in Jesus Christ will know that they still have something to hold onto, whatever they may have lost: the promise of God’s presence with them today and a bright future for tomorrow. 

It may be that another revolution is what many Iranians crave, but there is also something revolutionary, I believe, about the prayer that Jesus taught, which leaves the ultimate course of our lives in the hands of God. 

“Your will be done,” Christians have prayed throughout the centuries; and Iranian Christians will continue to pray this whatever the future holds for them. 

It is perhaps little wonder, then, that it is the Gospel message that Iranian Christians have continued to preach, in spite of persecution, and regardless of whichever direction the whims of popular support have turned. 

One of the passages that an Iranian colleague of mine most frequently recites in our team meetings is the call for us to “act justly, to love mercy, and to walk humbly with our God”, and I was reminded of this as I noted the response of British-Iranian bishop Guli Francis-Dehqani to the current crisis. 

The bishop, the bookies’ favourite to be the next Archbishop, prayed simply for the Lord to “have mercy”. 

As a lover of The Lord of the Rings, I am also reminded of the line from Gandalf, when Frodo is claiming that Bilbo should have finished off Gollum when he had the chance: 

“Do not be too quick to deal out death and judgment. For even the very wise cannot see all ends.” 

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