Column
Assisted dying
Care
Comment
4 min read

Proposed euthanasia safeguards insult our NHS

We must defend a collective sense of care and generosity.

George is a visiting fellow at the London School of Economics and an Anglican priest.

A gable end mural depicts a nurse in scrubs and a mask turning and looking towards the viewer.
A mural of an NHS nurse during COVID, Manchester.
Mural Republic

It was, I believe, the late political satirist Simon Hoggart who coined the Law of the Ridiculous Reverse, which held that, if the opposite of a statement is plainly absurd, then it was not worth making in the first place.  

This law comes to mind when Labour MP Kim Leadbeater promises that her Assisted Dying Bill will have the “strictest safeguards in the world”, one of which is that those patients who have ordered their fatal dose “would be allowed to change their mind at any time.”   

Where, exactly, has it ever been suggested that an individual, having asked for an assisted death, would not be allowed to change their mind? I’m just wondering which legislator or medical professional has proposed that once a lethal draught has been prescribed then there is no turning back.  

I’m struggling to picture the circumstance in which a terminally ill patient is pinned down and killed, the last words that they hear being: “I’m sorry Mrs Simpkins, but everyone’s gone to a lot of trouble. You asked for it and you’re jolly well going to get it.” 

This is important because, apparently, being able to change your mind about asking for help to kill yourself is one of the strictest safeguards in the world. I hope Ms Leadbeater will forgive me for pointing out that this doesn’t really stack up. 

 And what’s serious about it is that it’s also a massive straw man argument. The clear and rather devious implication is that one of the arguments being made against the introduction of an assisted suicide law is that patients won’t be able to change their minds about it, which I think we can all accept simply isn’t a fact at all. It’s absurd – a Ridiculous Reverse. 

So I’ll defend the NHS with a religious fervour. To my mind, healthcare is a holy mission. We meddle in law with the Hippocratic Oath at our very deep peril. 

It’s also hugely contemptuous of the medical profession in general and rude to the NHS in particular. That’s because there’s a snide impression behind Leadbeater’s comment there may be hundreds of budding Harold Shipman out there, but her powerful safeguards are going to protect us from them. 

We’re in danger of becoming inured to this kind of insult from politicians directed at the NHS. And it’s worth exploring why they might think we need to be protected from unscrupulous doctors and nurses. In this case, one possible reason is that the NHS isn’t being particularly helpful in giving the euthanasia enthusiasts what they want. 

Doctors and their staff have plenty of ethical objections to assisted suicide. But leave those aside for a moment. At the practical level, the NHS has made it clear that it doesn’t have the infrastructure to operate a policy of assisted deaths safely. And it can’t afford to set one up. So a government that introduces assisted suicide is going to have to organise and regulate its own assisted death agency. 

“Oh,” the assisted dying lobbyists seem to exclaim, “we’d presumed you’d do as you’re told.” Just hand out the hemlock. Take your instructions from the legislature. 

But the NHS is better than that. And it’s that kind of high principle that so infuriates feckless politicians. It was the late Nigel Lawson who said, somewhat ruefully, that the NHS “is the closest thing the English have to a religion”. The right wing of politics regularly tells us it’s time to renounce that religion. 

To worship the NHS as a religion would, literally, be idolatrous. But it’s not so to acknowledge its religious qualities. Just look at the word – the Latin religio means something like “good faith”, the essence of who we are, what makes us good. 

The NHS, in its post-war incarnation, has been central to who we are as a people and what defines us. It’s something to do with our collective sense of care and generosity to one another. Its members, like our national Church, make up a single body. 

This is not to co-opt the NHS as the medical wing of the Church. It’s no part of the NHS’s brief to proselytize – rather the reverse; Christian medical staff have been in deep disciplinary trouble for evangelising. It is a profoundly secular organisation. 

So the NHS emphatically isn’t in the business of propagating the gospel. But that’s not to say that we can’t be in the same business. Many priests have stories of their most affirming work being in the company of people of other faiths or of none. 

The NHS’s proud heritage is to offer treatment free to anyone at the point of access. Put another way, it will seek to heal anyone who comes to it. I make no apology for saying that sounds familiar. 

So I’ll defend the NHS with a religious fervour. To my mind, healthcare is a holy mission. We meddle in law with the Hippocratic Oath at our very deep peril. 

And when NHS professionals tell us where we can stick our assisted suicides, I respectfully suggest we give it our solemn attention, rather than patronisingly offering a Law of the Ridiculous Reverse.

Snippet
Comment
Identity
Justice
Politics
3 min read

Deeper conversations on gender will continue after this court ruling

Can the whole mystery of gender be conceded to brute biological fact?
A paiting shows four panels featuring women lawyers over a century
Legacy, by Catherine Yass, hangs in the Supreme Court and celebrates one hundred years of women in law.
The Supreme Court.

Every now and again, a society has to have a word with itself about something. Most social changes happen quite organically without a need for this kind of self-conscious dialogue. Hat-wearing in public was almost ubiquitous, for example, until about the middle of the twentieth century, when it simply stopped. No major debate happened about this - the hat simply sidled out of fashion. Western society just sort of internally worked out that the absence of a hat was not improper.  

Whether or not gender is something real is not like whether it is polite to wear a hat. It requires a very hard conversation - one which pushes on some of the most fundamental differences people can have about politics, the world, and perhaps things even bigger than that. Whether one agrees with it or not, yesterday was a significant development in that very public conversation: the Supreme Court of the United Kingdom ruled that the Equality Act is predicated on a classic gender ontology (i.e. the ‘realness’ of male and female).  

What is at stake here? For some, the expansion of categories like ‘man’ and ‘woman’ to those who have undergone a clinical transition, and those who have an official certificate legally recognising their self-identified gender, is a crucial bellwether of our commitment to equality and freedom. They cite the rates of depression and suicide in this demographic, where an imposed gender causes deep distress. 

Opponents of this move (like J. K. Rowling, who will be celebrating right now, no doubt) cite the dangers that de-anchoring gender from biological markers, like chromosomes or reproductive organs, will have. The justification of single-sex spaces is at least partially balanced on the idea that men and women are different, and separation of them is key for our sense of dignity or safety.  

But both sides agree that we need copper-bottoms for our terms. All humans want to feel like our words are not empty gestures. Biological sex realists want to hold out for fundamentals which can be observed scientifically. This tallies with lots of observable features, history, and culture - but those who hold out for a definition of gender rooted in self-identification are not wrong to point out that overly medicalised definitions will struggle to divide all of the data without remainder. There are genuine cases of intersex people, for example. 

What does a Christian like me think? Someone who is tied to what the Church has historically taught might look to the New Testament, where Jesus, for example, teaches that ‘male and female’ is a good, given aspect of our reality by God. That much might be consoling about the court’s decision. But a Christian may also feel a little cold about conceding the whole mystery of gender to brute biological fact. Surely there is something about being a woman or a man that is more than merely possession of certain physical features, as gender-critical activists claim? 

St Paul, in one of his New Testament letters, says that men and women are an expression of something even more fundamental than chromosomes: “I speak of Christ and the Church”. But this does not make our genders into shadowy symbols. Rather, it says our gender difference is more real for pointing at is something beyond the physical. It is rooted in the most real thing a Christian knows: that God reconciles the world to himself through Jesus as if it was a cosmic marriage. On this view, maleness and femaleness is not a tick-list of attributes, but a goal at which we are all striving. It will require humility, mutual service, and love. 

Society will keep on having its conversation about what exactly men and women are. But if it is to make sense of what things are really like, it may have to keep digging yet. 

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