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 These draft Bills, though likely to be dropped and superseded by the Commons Bill in the fullness of time, give an early indication of what provision might be made on behalf of clinicians and other healthcare workers who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

Essay
Comment
Community
Nationalism
7 min read

I was angry and you called me Gammon: Gary from Blackpool, Charlie Kirk, and all these flags

A triptych of three faces of wrath poorly heard and poorly expressed

John is a Salvation Army officer and theologian,

Marchers carry British, English and Israeli flags
Unite the Kingdom marchers.
Met Police.

William Blake once warned: 

I was angry with my friend; 
I told my wrath, my wrath did end. 
I was angry with my foe: 
I told it not, my wrath did grow. 

Blake understood that unspoken—and, more precisely, unheard—wrath does not wither. Left untended, it grows. Its bitter roots tentacle around grievance; neglect waters it, and violence ripens as its fruit. Much like Blake’s tree, the wrath spreading through towns in this nation, and beyond, springs from seeds of anger. It is not irrational. It is cultivated in betrayal, frustration, and systemic disregard. 

This essay is a triptych. Three panels, three faces of wrath poorly heard and poorly expressed. In England, it riots in the streets and hangs from lamp posts. In America, it narrows into bullets. These are not isolated curiosities but variations on the same Western fracture — anger left unheard, curdling until it explodes. 

Wrath, of course, is not the same as anger. Anger is a natural passion, a flare of the soul in the face of injury or injustice. It can be righteous when governed by love, as even Christ was angry at hardened hearts. Wrath, by contrast, is anger left to harden — anger unspoken, unheard, or indulged until it festers into a vice. Scripture names it as both the fire of God’s judgement and, in humanity, a deadly sin. Wrath is anger that has ceased to heal and has become scar tissue. 

Panel I: Gary from Blackpool 

Enter “Gary from Blackpool”. 

He was a London commentator’s caricature of provincial ignorance—“1 GCSE, two brain cells, and three teeth.” 

A screenshot of a tweet.

The tweet was deleted, but not before the sneer had spread. Gary was a meme. He doesn’t exist, and yet he does; there are loads of “Garys” in Blackpool. 

And Gary is angry. 

His wrath first erupted in St John’s Square in the summer of 2024. When he raised a St George’s flag on a roundabout, it was not swaggering nationalism but a pathetic attempt to claim a place in a nation that no longer cares about people like him. 

Blackpool’s collapse has been much-storied: once thriving, now one of the most deprived. Reports and documentaries measure poverty, chart prospects, and speculate on futures. The town is endlessly narrated. 

Gary is not. 

Yet his story mirrors that oft-told collapse. Poverty has scarred him visibly: the teeth, failing health. Gary’s life expectancy: 69, more than a decade shorter than elsewhere. He’s scarred invisibly too, in narrowed hopes and disillusion. These are not individual failings but markers of systemic neglect: underfunded schools, crumbling services, an NHS that doesn’t reach him. Dentist appointments in Blackpool are rarer than hens’ teeth, which are in better condition than Gary’s. 

The England Gary remembers is gone. In its place stands a society he no longer recognises: multicultural, politically sensitive, shifting away from its past. A Daily Mail headline once told him, “Garys are heading for extinction” while Muhammad, in all its spelling variants, had become the most common baby name

And then the boats. Images looping on his screen: more change he cannot control. His Brexit vote promised to take back control; his refusal to vote ever again, a gesture of resignation. 

Because they don’t care about him. They hadn’t even cared for the girls. Now he saw the same system ushering them into clinics to become boys. 

Gary and those like him, through their anger, reveal a politics that has abandoned them, economics that offer no hope, and a culture that makes them strangers in their own country. Rioting is no cure; it tears open wounds without healing. But the response is illuminating: in 2011, they prompted soul-searching; in 2024 and 2025, they brought only ridicule. The tweet exposed a national reflex: to mock rather than listen. That sharpened the bitterness. 

Wrath here does not whisper or wait. It riots. 

 

Panel II: Charlie Kirk 

Gary may never have heard of Charlie Kirk, but Kirk’s rhetoric channelled the very anxieties that defined Gary’s world—about loss, displacement, and neglect. This resonance helps explain how his voice travelled so widely. 

I didn’t watch Charlie Kirk either. His reels surfaced on Instagram or YouTube now and then, but it wasn’t my algorithm that latched onto him. It was my four nephews’—aged sixteen to twenty-two, two in Kent, two in New Zealand—imagination he captured, even if not always their agreement. Young men across the globe, caught in the fast cadence of an American voice. 

When I saw the news, my reaction surprised me. It was strangely visceral for someone who had never featured in my life in the way he had theirs. I felt sick. Because he was dead. Because he wasn’t a politician behind glass or a general behind medals. He was public, certainly, but also strangely normal. And he had children, both younger than my youngest, and a wife. 

And he had the guts to speak to people. Theo Von said he “tweeted with his feet.” How many of us can say we say what we believe as vociferously face to face as we might be brave enough to do on social media? He was visible. Accessible. Flesh and blood with people, not just pixels. I think this is partly why he appealed to my nephews. I’ve seen Facebook friends of their generation posting tributes, then engaging courteously and constructively with those who insisted on quoting Kirk out of context. For them, defending him has not been rage but dialogue. 

And then the gun. 

Charlie’s killer pulled a trigger. Wrath had narrowed into single, precise bullets with slogans on them. But this was not justice, not even protest. It was wrath corrupted into murder; an execution. 

Wrath here does not riot. It narrows into bullets. It turns cannibal. 

What will this spilt blood birth in those who listened, watched, believed? 

 

Panel III: Flags in Hartlepool and Horden 

And here, in England, it is the flags. 

In America, flags are furniture. They’re on every porch, every school, every stadium. But in Hartlepool and Horden, when flags multiply on streetlights, and red crosses are painted onto white roundabouts, they do not feel ordinary. They are a display of patriotism that feels out of character here. They feel ominous. 

They do not shout; they whisper. Every day. A slow, stubborn signal of belonging and defiance. Not the riot of Gary. Not the bullet for Charlie. But something quieter, somehow more enduring. Wrath sewn into fabric, taking root in silence as surely as Blake’s tree, its persistence echoing Gary’s resentment, its quiet endurance unsettling in a way different from the bullets that struck Charlie. When they thicken in certain places, when they layer and cluster, they become atmosphere. 

A Union Jack flag on a lamppost.

Union Flags made it onto some streetlights I walk past with my daughter in Newcastle, on the way to the swimming pool. “What do they mean?” she asked. For some, pride. For others, threat. For most, perhaps nothing at all. And then they were torn down, leaving a frayed seam, a dangling strip of tattered cloth still tied to the upright metal. That felt even more ominous. Not simply a sign of division, but of reaction. And do you notice, where they are hung only as high as a ladder will reach, they look almost like flags at half-mast? As if beneath the defiance there lingers a subconscious grief. 

And so the question lingers: what will come of it all? What future is being staked out? Are these new buds on Blake’s poisonous tree? 

Some flags are celebrated, raised over civic buildings as sacraments of a new national creed. 

Other flags are torn down, left to fray on lamp-posts, almost threatening in their persistence. 

Wrath here does not riot or narrow. It takes root. 

This is England, isn’t it? 

 

A benediction: I was angry 

And how might anger, left unheard before it hardens into wrath, speak with the voice of Christ? 

I was angry, and you called me gammon. 
I was angry, and you called me woke. 
I was angry, and you heard only your politics, 
not my pain. 
 
I was angry, and you argued about tribes and sides. 
I was angry, and you measured me as vote, as threat, as cause. 
I was angry, and you did not really listen to me. 
 
Truly I tell you: 
when you saw the angry and called them only left or right, 
you understood nothing. 
You did not know me. 
 
And these will go away still unheard, 
their wrath growing strong in the shadows, waiting to erupt. 
 
But those who bore the anger of the poorly heard, 
who listened without contempt or fear, 
This too is England. I am found there. 

 

This article was first published on John Clifton’s SubStack. It is reproduced by kind permission of the author.

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