Article
Assisted dying
Comment
Justice
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.
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 These draft Bills, though likely to be dropped and superseded by the Commons Bill in the fullness of time, give an early indication of what provision might be made on behalf of clinicians and other healthcare workers who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.  

Article
Comment
Freedom of Belief
Politics
5 min read

No George, Christians aren’t free to worship in Iran

Apologists make a mockery of the real costs of freedom of belief.

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

A couple stand on the steps of a cathedral in Iran.
On location with George Galloway.

I guess it’s a good job he’s no longer a member of parliament, or George Galloway may be facing the same scrutiny Nigel Farage came under for his trips to the United States. 

It probably won’t surprise you to hear that the former MP for Rochdale didn’t head to the Land of the Free on his own extracurricular jaunt the other week, but instead to Tehran and Moscow.  

And no, George wasn’t there to remind Iran of its obligations to provide human rights for its citizens - as some might expect of a British MP - nor did he go to Russia to put pressure on Putin to end the war in Ukraine. 

No, George was simply visiting his comrades - distinct as they may be - and doing his bit for their distinct causes. 

Mr Galloway published two videos during his visit to Iran - both published on his X account - and both showing him standing outside the buildings of a recognised religious minority (meaning, in Iran, Jews, Zoroastrians and Assyrian or Armenian Christians. Not converts or Baha’is). 

In the first video, the man in the black hat is standing outside a synagogue in Tehran, which he tells his audience doesn’t even have a guard outside “because they don’t need one”, as the “millions” of Jews who live in Iran (actually there are less than 10,000) are so “honoured” and “cherished”. 

They even have their own members in the parliament, he tells us (actually it’s just the one), and “you didn’t know any of this, did you? Because they don’t want you to know.” 

Well, now you do.  

And, thanks again to the former Member for Rochdale, two days later you were also able to discover, much to your surprise, that Iran is also home to “so many Christian churches.” (For the record there are around 300, but none of them open to converts.) 

This time, Mr Galloway is speaking to you from outside an Armenian cathedral, still wearing the same outfit and therefore presumably recorded on the same day but published two days later - perhaps to give you enough time to digest your first lesson. 

Inside the cathedral, George assures us, there are “many worshippers quietly going about their religious obligations,” which is “quite different from the picture that is painted of Iran in Western countries,” don’t you think? 

And what would that picture be, eh, George? 

That Christians are routinely arrested and imprisoned for meeting together to worship, and in years past the leaders of their churches - including Armenians - were even murdered on those same Tehran streets on which you are now standing? 

But no matter, here at least is clear proof that one church in Iran is still functioning - as well as that synagogue; don’t forget the synagogue! - and as Mr Galloway proudly informed us 24 hours after his first video, nearly one million people (according to X it was closer to 50,000) had watched it. 

So, job done. Let’s not worry about the details. They take too much time to research, and can also trip one up when trying to make a point - especially regarding Iran’s treatment of religious minorities or, well, anyone really. 

But no matter, one can guarantee that most viewers won’t have bothered to look into it, nor scroll down far enough to reach the dissent. 

Now, I don’t know whether it was because George hadn’t quite lived up to his billing, but a few days later some “real journalists” arrived from the Grayzone website to add their own insights. 

The Brits had been told; now it was the turn of the Americans.  

“Americans may be surprised to know Christians exist in Iran and are allowed to practice their religion freely.” 

So wrote Grayzone News’ Anya Parimpil on X, alongside a post showing a short video from inside - wow, they actually let the Americans inside! - another Armenian cathedral, this time in Isfahan. 

And alongside a few more pictures of the church, Ms Parimpil posted some photographs of “ancient bibles” - no capital ‘B’ needed, it would seem, nor explanation that today in Iran Bibles are often used as evidence of a “crime” in court cases against Christians. 

Meanwhile, Ms Parimpil’s husband, Max Blumenthal, posted a long video interview with the Islamic Republic of Iran’s favourite interviewee, Mohammad Marandi, as they walked around a Tehran cemetery. 

You can watch it on YouTube if you like, but I wouldn’t recommend it; not only is it over an hour long, but in the wake of the axing of Stephen Sackur’s BBC news show HARDtalk, this one is more like an episode of SOFTtalk, in which the presenter asks only two questions of real interest - regarding the nuclear programme and popular support for the regime - to which there is never any danger of a follow-up probe. 

To paraphrase, Marandi’s answers were that the regime is wildly popular and well able to make a nuclear weapon if it wanted to but that it doesn’t because such things are “inhumane” and the Islamic Republic of Iran is, of course, renowned for its decency. 

Mr Blumenthal also posted videos of an Iranian man singing while embracing him underneath one of Isfahan’s famous bridges - with the message, “Iran is not your enemy” - and of the return of water to the local river, failing to mention, as one responder noted, that “due to the corruption and mismanagement of the horrific mullah regime, the river is basically dry all the time”. 

But no matter, one can guarantee that most viewers won’t have bothered to look into it, nor scroll down far enough to reach the dissent. 

Certainly, the overwhelming reaction to all the videos and photographs posted over the past week has been positive: essentially, a “thanks for showing us what Iran is really like and not only what the biased mainstream media (MSM!) says about it!” 

These are the days of SOFTtalk, it would appear, so I suppose we’d better get used to it. 

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