When to stand up in an increasingly insecure world

When war is ‘othering’ by other means, the brutal realities of our world can be overwhelming. Ziya Meral contemplates what it means to take a stand.

Ziya Meral

Dr Ziya Meral is a researcher, advisor and programmes director specialising on global trends shaping defence and security, politics and foreign policies. He is a Senior Associate Fellow of the Royal United Services Institute.

Recently, I found myself sitting quietly at a cathedral buzzing with tourists, reflecting on demanding global developments and uttering a few words of prayers, not for world peace, but for guidance on how I should live my own life amidst all these.

Today’s world is a brutal reminder of timeless truths about the human condition, about continuum of violence and aggression in human affairs, about exclusion and marginalisation of the ‘other’ amidst economic downturns, about how fragile peace and prosperity are, and how the future might not always be better than the past.

There is a bitter realisation that there is no clear end ahead of us in the near future to this war of choice by Russia.

As I write these lines, Russian forces continue their brutal invasion of Ukraine, killing tens of thousands, forcing millions out of their homes, destroying town after town, and intentionally pursuing a scourge earth policy to destroy the habitability of towns and cities and sustainability of life. Ukrainians continue to bravely advance their counter offensive to push Russian forces as much as possible, while NATO leaders gear up for a summit in Lithuania in July, which will assess and discuss future support to Ukraine. There is a bitter realisation that there is no clear end ahead of us in the near future to this war of choice by Russia. Some sort of ‘frozen’ peace might be achieved by stopping or reducing violence, but no matter what Ukraine needs our prolonged support to ensure it does not face yet another wave of invasion a few years down the line. This is why even President Macron, who has been cynical about NATO, is now talking about Ukraine’s membership to the alliance as lesser of all of the risks ahead of us.

We have entered a new era, that is not simply just about Ukraine. For the last decade we have seen a major shift in global affairs as not only world’s two major powers, US and China, increasingly saw each other as a competitor and threat against national interests, a long list of medium-sized powers actively used force in invading other countries, or pursuing proxy wars and meddling into politics of other countries. From cyberwarfare to a new era of espionage to attempts at influencing other nations and altering trajectories of their politics, investments into a new generation of nuclear weapons and increasing of nuclear stocks to major investments into defence, most states in the world are gearing towards a decade of instability ahead of us.

Thus, it is not surprising that Sweden and Finland gave up historic policies of neutrality and decided to join NATO, or that Japan is pursuing a historic investment into its defence in a break away from its historic stand, or that China is going to double (or more) its nuclear stocks by 2030, or that even France is about to undertake a historic level of investment in its defence. The list goes on. All of these happen within a context of genuine existential risks to our existence. Like climate change, there are the domino effects of conflicts into our lives from faraway places. From energy prices, to food shortages, to disruption of trade and electronic parts, to new technologies like AI raising all sorts of ethical and practical questions and risks. There are hundreds of millions of human beings living in geographies and countries that are not able to care, provide and protect and give them a sustainable and meaningful life. Irregular migration, named ‘illegal’ in today’s tabloid language, is only increasing across the world, with only a small percentage ever making it to UK or Europe. Human beings do not simply leave their lives behind and take clear risks if they do not feel they have to.

We are far from being the first-generation processing news of wars and conflicts.

All of these are overwhelming realities, ones that we cannot simply ignore. It is normal for us to feel guilty as our daily lives continue in relative peace and property compared to millions of others out there, and it is normal for us to feel helpless and at times despair about all these developments that are clearly out of anyone’s control.

But as I sat there in the cathedral, I could not help but think that this is not the first time the world has gone through such a convergence of insecurities, and unlikely to be the last time, and that we are far from being the first-generation processing news of wars and conflicts and seeing nations take aggressive postures against one another. I thought about so many heroic figures across history that stood up for truth, for peace, for reconciliation, for justice in such moments and so many heroes that gave their lives to defend us against those seeking to harm us. Their legacies remind us that we all have a decision to make, a stand to take and a role to play in such historic moments. On my part, I am all aware of my limitations, and at times feeble attempts to be part of conversations that point towards solutions. I am also all aware of the deep darkness out there, but also as a Christian, a gentle hope that lies within it. The light shines into the darkness, and the darkness has not overcome it. The promise I find in the figure of Christ on the Cross is not an escape to another world, but embracing of the only one we have here and now, in prayer that all of our efforts could together amount to something much bigger than we realise. As TS Eliot put it, for us there is only trying, the rest is not our business!

Article

Assisted dying

Comment

Justice

15 October 2024

5 min read

Will clinicians and carers objecting to assisted death be treated as nuisances?

The risk and mental cost of forcing someone to act against their conscience.

Henna Cundill

Henna is a researcher with the Centre for Autism and Theology at the University of Aberdeen.

A tired-looking doctor sits at a desk dealing with paperwork.

Francisco Venâncio on Unsplash.

After a formal introduction to the House of Commons next Wednesday, MP’s will debate a draft Bill to change UK legislation on Assisted Dying. Previously, a draft Bill was introduced in the Scottish Parliament in March 2024, and is currently at committee stage. Meanwhile, in the House of Lords, a Private Member’s Bill was introduced by Lord Falconer in July and currently awaits its second reading. These draft Bills, though likely to be dropped and superseded by the Commons Bill in the fullness of time, give an early indication of what provision might be made on behalf of clinicians and other healthcare workers who wish to recuse themselves from carrying out a patient’s end of life wishes on grounds of Conscientious Objection.

There are various reasons why someone might want to conscientiously object. The most commonly cited are faith or religious commitments. This is not to say that all people of faith are against a change in the law – there are some high-profile religious advocates for the legalisation of Assisted Dying, including both Rabbi Dr Jonathan Romain and Lord Carey, the former Archbishop of Canterbury. Even so, there will be many adherents to various faith traditions who find themselves unable to take part in hastening the end of someone’s life because they feel it conflicts with their views on God and what it means to be human.

However, there are also Conscientious Objectors who are not religious, or not formally so. Some people, perhaps many, simply feel unsure of the rights and wrongs of the matter. The coming debates will no doubt feature discussion of how changing the law for those who are terminally ill in the Netherlands and Canada has to lead to subsequent changes in the law to include those who are not terminally, but instead chronically ill. The widening of the eligibility criteria has reached a point where, in the Netherlands, one in every 20 people now ends their life by euthanasia. This troubling statistic includes many who are neurodivergent, who suffer from depression or are disabled. It is reasonable that, even if a Conscientious Objector does not adhere to a particular religion, they can be allowed to object if they feel uneasy about the social message that Assisted Dying seems to send to vulnerable people.

“You will often find that legislation that provides a right to conscientious objection is interpreted by judges these days in a way that seems to treat conscientious objectors as nuisances”

Mehmet Ciftci

Conscientious Objection clauses can themselves send a social message. A response to the Scottish Bill produced by the Law Society of Scotland notes concern over the wording of the Conscientious Objection clause, as it appears to be more prescriptive in the draft Bill than in previous Acts such as the Abortion Act of 1967. In the case of any legal proceedings that arise from a clinician’s refusal to cooperate, the current wording places the burden of proof onto the Conscientious Objector, stating (at 18.2):

In any legal proceedings the burden of proof of conscientious objection is to rest on the person claiming to rely on it.

The Bill provides no indication of what is admissible as ‘proof’. Evidence of membership of a Church, Synagogue, Mosque or similar might be the obvious starting point. But where does that leave those described above, who object on grounds of personal conscience alone? How does one meaningfully evidence an inner sense of unease?

The wording of the Private Member’s Bill, currently awaiting its second reading in the House of Lords, provides even less clarity, stating only (at 5.0):

A person is not under any duty (whether by contract or arising from any statutory or other legal requirement) to participate in anything authorised by this Act to which that person has a conscientious objection.

Whilst this indicates that there is no duty to participate in assisting someone to end their life, there remains a wider duty of care that healthcare professionals cannot ignore. Thus, a general feature in the interpretation of such conscience clauses in medicine is that that the conscientious objector is under an obligation to refer the case to a professional who does not share the same objection. This can be seen in practice looking at abortion law, where ideas around conscientious objection are more developed and have been tried in the courts. In the case of an abortion, a clinician can refuse to take part in the procedure, but they must still find an alternative clinician who is willing to perform their role, and they must still carry out ancillary care and related administrative tasks.

Placing such obligations onto clinicians could be seen as diminishing rather than respecting their objection. Dr Mehmet Ciftci, a Researcher at the McDonald Centre for Theology, Ethics and Public Life at the University of Oxford comments:

You will often find that legislation that provides a right to conscientious objection is interpreted by judges these days in a way that seems to treat conscientious objectors as nuisances who are just preventing the efficient delivery of services. They are forced to refer patients on to those who will perform whatever procedure they are objecting to, which involves a certain cooperation or facilitation with the act.

This touches everyone, even those who (if the Bill becomes law) will still choose to conscientiously object. Therefore, it is important to consider that the human conscience is a very real phenomenon, which means that facilitating an act that feels morally wrong can give rise to feelings of guilt or shame, even if one has not been a direct participant.

Psychologists observe that when feelings of guilt are not addressed, if they are treated dismissively or internalised, this can significantly erode self-confidence and increase the likelihood of depressive symptoms. But even before modern psychology could speak to the effects of guilt, biblical writers already had much to say on the painful consequences of living with a troubled conscience. In the Psalms, more than one ancient poet pours out their heart to God, saying that living with guilt has caused their bones to feel weak, or their heart to feel heavy, or their world to feel desolate and lonely.

If the Conscientious Objection clauses of the new Bill being proposed on Wednesday are not significantly more robust than those in the draft Bills proposed thus far, then perhaps that is something to which we should all conscientiously object? There is much to discuss about the potential rights and wrongs of legalising Assisted Dying, but there is much to discuss about the rights and wrongs of forcing people to act against their consciences too.