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 These draft Bills, though likely to be dropped and superseded by the Commons Bill in the fullness of time, give an early indication of what provision might be made on behalf of clinicians and other healthcare workers who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
Education
Language
6 min read

Cutting language learning is a moral failure

Learning someone’s tongue is a deeply humble and empathetic act
A check list shows 'thank you' in different languages.

When you go abroad, how do you navigate language differences? Do you just stick everything through Google translate? Or put a few weeks into Duolingo before you go? Or maybe you just speak a bit louder in the hope that that will somehow smooth over any misunderstandings? 

Recently, my wife and I went to Italy for a week. Neither of can speak a word of Italian and we were taking our toddler Zachary with us (who can speak even less Italian), so we booked into a big resort where we knew staff would be able to speak some English if we needed anything for Zach. Even so, we tried learning a few words and phrases:  

‘please’,  

‘thank you’,  

‘could I have …?’,  

‘where is the …?,  

‘please forgive my toddler, he hasn’t learned to regulate his emotions yet’. 

That sort of thing. Just some basics to get by.  

Of course, what happened was exactly what happens every time I speak another language. I try my best to make an effort, people immediately realise I’m a struggling and they put me out of my misery by replying in English anyway.  

All this reinforces the importance of deep and rigorous language learning in society. All this makes the continued diminishment of university modern language programmes rather odd, and more than a little unsettling.  

The University of Nottingham has announced it is terminating the employment of casual staff at its Language Centre. This will see the end of numerous classes for students and others in many languages, both ancient and modern, including British Sign Language.  

Nottingham is not alone in this. The news comes in the immediate aftermath of a review into the University of Aberdeen’s decision to scrap modern language degrees in 2023, which found the decision “hurried, unstructured, and dominated by immediate financial considerations.” (Not that we needed a review to tell us this). The University of Aberdeen has partially reversed the decision, continuing its provision of joint honour degrees, if not single honour language degrees.  

Elsewhere, in January, Cardiff University announced plans to cut 400 academic staff, cutting their entire modern language provision in the process. In May, the University revealed that it would reverse these plans, with modern languages continuing to be offered (for now), albeit it a revised and scaled-down manner. 

The situation is bleak. As a theology lecturer who works for a Church of England college, I’m all too aware of the precarity my friends and colleagues in University Arts and Humanities departments face across the sector. But I was also naïve enough to think that languages might be one of the subjects that would be able to survive the worst of education’s deepening malaise given their clear  importance. How wrong I was. 

There are the obvious causes for despair at the news of language department cuts. One the one hand is the human element of all this. People are losing their jobs. Moreover, as casual workers, the University had no obligation to consult them about the changes or provide any notice period, and so they didn’t, because why would a university demonstrate courtesy towards its staff unless it absolutely had to? As well as losing jobs and whole careers, people will lose sleep, and perhaps even homes and relationships as a direct result of the financial and emotional toll this decision will take on staff. My heart breaks for those effected.  

And yet, the move is also evidence – as if more were needed – of the increasing commercialization of Higher Education. A statement from the University said the decision to cut languages in this way was the result of the Language Centre not running at a “financial surplus.” The cuts will instead allow the University to focus on “providing a high-quality experience for our undergraduate and postgraduate students.” 

And there we have it. Not even a veneer of pretence that universities operate for the pursuit of truth or knowledge. No, nothing so idealistic. A university is business, thank you very much, here to offer an “experience”. And when parts of businesses become financially unsustainable, they’re tossed aside. 

Languages aren’t just ways of describing the world we see, they’re also ways of seeing the world in the first place. 

But cutting language offerings isn’t just a personal and a societal loss, it’s also a huge spiritual and moral failure. And that’s because of what language fundamentally is. Let me explain.  

It can be tempting to think of words as simply ‘labels’ we assign to objects in the world, with different languages using a different set of ‘labels’ to describe the same objects. As a native English speaker, I might see something with four legs and a flat surface on top and call it a ‘desk’. Someone else with a different native language might call it a Schreibtisch, or a bureau‚ or a scrivania, or a tepu, or a bàn làm việc. You get the point: we might be using different labels, but we’re all ‘seeing’ the same thing when we use those ‘labels’, right? 

Well, it’s a bit more complicated than that. Languages aren’t just ways of describing the world we see, they’re also ways of seeing the world in the first place. As such, languages have the capacity to shape how we behave in response to the world, a world itself suggested to us in part by our language(s). As twentieth-century philosopher Ludwig Wittgenstein once wrote, “the limits of my language mean the limits of my world.” 

Let me give you just one example. English distinguishes tenses: past, present, future. I did, I do, I will do. Chinese does not. It expresses past, present, and future in the same way, meaning past and future feel as immediate and as pressing as the present. The result of ‘seeing’ the world through a ‘futureless’ language like this? According to economist Keith Chen, ‘futureless’ language speakers are 30 per cent more likely to save income compared to ‘futured’ language speakers (like English speakers). They also retire with more wealth, smoke less, practice safer sex, eat better, and exercise more. The future is experienced in a much more immediate and pressing way, leading to people investing more into behaviours that positively impact their future selves, because their view of the world – and their future selves’ place within the world – is radically different because of their language. 

Different languages lead to seeing the world differently which leads to differences in behaviour. In other words, there are certain experiences and emotions – even certain types of knowledge and behaviours - that are only encounterable for those fluent in certain languages. And this means that to learn another language is to increase our capacity for empathy. Forget walking a mile in someone’s shoes, if you want truly to know someone, learn their language.  

In my day job as a lecturer, when I’m trying to encourage my students – most of whom are vicars-to-be – to learn biblical Greek and/or Hebrew, I tell them it will make them more empathetic people. It may make them better readers of the Bible, it may even make them better writers too but, more than anything else, students who learn languages will be better equipped to love their neighbour for having done so. They will get a better sense of the limits of their world, and a greater appreciation for the ways in which others see it too. Show me a society that is linguistically myopic, and I’ll show you one that’s deeply unempathetic. I can guarantee you of that.   

We ought to be deeply, deeply concerned about the diminishing language offerings in the UK’s Higher Education sector. To open oneself to other languages is to open oneself to other ways of seeing the world. It is to be shown the limits of one’s own ways of seeing. Learning a language is a deeply humble and empathetic act. And isn’t humility and empathy in desperately short supply at the moment? 

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