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 These draft Bills, though likely to be dropped and superseded by the Commons Bill in the fullness of time, give an early indication of what provision might be made on behalf of clinicians and other healthcare workers who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

Danny Kruger, Christian values, and the dangers of thin religion

Thick or thin? Christianity’s role in Britain’s cultural crossroad

Graham is the Director of the Centre for Cultural Witness and a former Bishop of Kensington.

A backbench MP stands in an almost empty chamber and speaks
Danny Kruger addressing Parliament.
Parliament TV.

In case you hadn’t noticed, a speech given to an audience of about seven people in a sparse House of Commons recently went viral. Danny Kruger’s recent call for a Christian restoration in the UK has generated a lot of attention. 

I've noticed two distinct responses in recent days. On one side, there are three (or more) cheers for Danny. He has been interviewed at Christian festivals, lauded for a brave, deeply considered and soulful appeal to the Christian heritage of the nation. He has been thinking deeply about this for some time as demonstrated in his book Covenant, sometimes seen as a manifesto for a renewed Conservatism based around the claims of family, community and nation, and summarised in this Seen & Unseen article. As one of the most prominent voices against the recent bills to permit assisted dying and the termination of full-term embryos, he is clearly reeling from the impact of these devastating recent votes in the Commons that, more than anything else, seem to demonstrate how far the nation has slipped its Christian moorings.  

Yet it’s not hard to stumble across another reaction. A former Bishop of Oxford called Kruger’s claim that the UK was a Christian nation anachronistic and counter-productive. Others have pointed out that many Jews, Muslims or hardened atheists would not be delighted to be told that ‘it is your church and you are its member.’ Others question whether there can be such a thing as a 'Christian nation'.

Some have picked up on a darker side to all this. Recent riots outside hostels for immigrants in Rotherham and Norwich showed protesters carrying flags of St George, even brandishing a wooden cross. Stephen Yaxley-Lennon, aka Tommy Robinson, and Nigel Farage have recently been speaking much more openly about the ‘Christian values’ on which Britain is founded, and many on the extreme right seem to have latched onto Christianity as at the heart of what they see as a cultural, civilisational war. Kruger’s talk of the gap left by Christianity’s demise being filled by Islam and, what worries him more, a kind of ‘wokeism’ that blends ‘ancient paganism, Christian heresies and the cult of modernism’, sets up a stark opposition. He goes on: “That religion, unlike Islam, must simply be destroyed, at least as a public doctrine. It must be banished from public life.” Does that language stray a bit too close to the aggressive language of more extreme voices on the right?  

Now I have some sympathy with this. I have written before of how I also fear the pagan gods are making a return. Like Danny Kruger, I too believe the recent votes in the House of Commons are a dark and dangerous turn toward death not life. Yet I can’t shake a nervous feeling that, without some careful thought, we might be summoning up shades we might not be able to control.  

The signs – and the solution - lie in the past. For centuries, Christianity, like all other religions, has been used as a weapon in civilisational wars. It happened in the Crusades of the eleventh to thirteenth centuries. It happened in the Balkan wars involving Serbia, Croatia and Bosnia in the 1990s and 2000. It happened in the ‘Troubles’ in Northern Ireland, where your neighbour being Protestant or Catholic was a reason to kill them.  

Theologians and sociologists sometimes talk of ‘thick’ and ‘thin’ religion. ‘Thin’ religion is simply a badge of identity. It often blends religion, politics and nationalism and serves as a motivation to unite people around a cause, such as Hindu nationalism, Muslim victimhood, or Christian supremacy. It is religion seen purely as a label, a badge of tribal identity over against other religious identities, however deeply felt. It is often nostalgic, ranged against enemies who are determined to destroy it, denigrating those who are not part of the religion as less deserving of value. It sees the Christian god as one of many gods – our god – which we must fight for against other gods, rather than, as Christian theology has always taught, the one true God who sits above all other gods, the God of the whole earth. It is paradoxically a manifestation of the kind of the kind of culture that Danny Kruger hates: “a return to the pagan belief that your value is determined by your sex, race or tribe.” Tommy Robinson’s faith seems as good an example of this as any. This is ‘thin’ religion.

I propose a simple test. If someone advocates Christian values and regularly goes to church, then they have a legitimate voice. 

‘Thick’ religion, however, is different. It is not just a badge of identity, but entails a set of distinct beliefs and practises. It means submitting yourself to the disciplines of the faith. In the Christian context, it a belief in God as Father, Son and Holy Spirit, that Jesus is the Son of God, that he died for the sins of the world, rose again on the third day and will return one day to judge the living and the dead. It involves a serious attempt to live the Christian life, to love your neighbour, and even your enemy, helping the poor and vulnerable, praying regularly, being consistently present at church worship and so on.  

Christian hymns have always had a fair amount of militant imagery, from ‘Onward Christian Soldiers’ to ‘Fight the Good Fight’, and more contemporary ones about God ‘fighting our battles’. Yet this has always meant a serious fight against enemies within – pride, greed, anger and spiritual lethargy. When it became focussed on human enemies, as it did in the Crusades, a line was crossed from ‘thick’ into ‘thin’ religion. 

It's not always easy to tell the difference between those who adopt thick and thin Christianity. I propose a simple test. If someone advocates Christian values and regularly turns up at church, then they have a legitimate voice, and are worth a hearing. If they turn up weekly to hear the Bible being read, to take part in Holy Communion alongside other people, regardless of their ethnicity, wealth or background, pray regularly, then, we can assume, they are serious about it. They are submitting themselves to the discipline of learning Christian faith, seeking to love their neighbour and trying as hard as they can to love their enemies. They may fail from time to time but these are the signs of someone who has grasped the grace of God which is the heart of Christian faith. Danny Kruger passes that test. Tommy Robinson and Nigel Farage, as far as I know, don’t.  

If some shout loudly about Christian values, about the danger of losing the heritage of our civilization and yet show no interest in going to church, living the Christian life, praying or even trying to love their enemies, then we should take what they say with a large pinch of salt. They have no skin in the game. 

When the heart of Christianity is hollowed out, it becomes moralism. It becomes the law not the gospel, as Martin Luther would say. The cross literally becomes a stick to beat others with. Paradoxically, it is only ‘thick’ religion that ends up founding and changing cultures. Early Christianity, the kind that converted the western world, was definitely ‘thick’ religion. It was not just a badge of identity. It had a whole set of distinct beliefs and practices that marked Christians off from the pagan world around them. It did not set out to advocate for political causes in the power corridors of Rome, build a Christian civilisation, lobby Caesar for ‘Christian laws’. It set out to produce people with ‘a sincere and pure devotion to Christ’ as St Paul put it, loving God, neighbour and enemy. And they changed the world by accident.  

Thin religion is a dangerous thing. It uses religion as a tool for dominance and conflict. It makes sceptics think we need less religion in public life. Thick religion is good religion. It forms good people. It builds healthy societies. It’s the kind we need more of, not less.  

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