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 These draft Bills, though likely to be dropped and superseded by the Commons Bill in the fullness of time, give an early indication of what provision might be made on behalf of clinicians and other healthcare workers who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

Charlie Kirk: the problem is not murder but anger

How to confront the rage in politics, in media, and in ourselves

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

An aerial view of a gazebo at the site of the Charlie Kirk shooting
The site of the shooting.
KSL News Utah, CC BY 4.0, via Wikimedia Commons

The killing of Charlie Kirk has shaken most of us – including me. Over the past year or so, his pop-up debates on US university campuses kept appearing on my different social media channels, and they were fascinating. Here was a young, articulate conservative, venturing into college campuses – generally left-leaning, progressive places - opening up conversation, debate and challenge. He was opinionated, provocative, unafraid to voice unpopular opinions, generated hostility, but seldom seemed to show it himself. No question was off limits, he seemed to respect those who attacked him, and he made no secret of his Christian faith.  

I agreed with some of what he said but by no means all of it – that’s the point of public debate. His views on gun control, Israel, and Donald Trump just for starters, would be some way from mine. But inviting debate on controversial issues, seeking to change other people’s minds by discussion and reasonable argument is the very heart of a well-functioning democracy. There are precious few spaces where progressives & conservatives talk – and Charlie Kirk’s campus debates were one of them. It’s tragic that they cost him his life.  

In our times, such heinous acts are not usually committed by some secret, politically-motivated cabal, but often by an unhinged or deluded self-radicalised loner, influenced by fringe groups in politics or culture. In the UK, Axel Rudakubana, who killed three young girls in Southport, turned out not to be a terrorist after all (“he did not kill to further a political, religious or ideological cause” said the judge on sentencing) but a disturbed and lonely young man who killed for no apparent reason other than mental instability. The same was true for Ali Harbi Ali who stabbed the Conservative MP David Amess, Sirhan Sirhan who shot Robert F Kennedy, James L. Ray who murdered Martin Luther King, even (despite all the conspiracy theories) Lee Harvey Oswald who killed John F. Kennedy. All of them fit this category of lonely, unbalanced people who kill because of some grievance, sometimes loosely politically motivated, but usually acting alone. Conspiracy theories are alluring, but usually unfounded.  

It's tempting when something like this happens to draw all kinds of wider political and cultural lessons. And there have been no shortage of them over these past days. “Because they could not prove him wrong, they murdered him” went one trope. The problem with that is that ‘they’ did not kill him. One young man - now in custody - did. To imply that every left-leaning person in the USA or elsewhere is somehow responsible for Kirk’s death ironically colludes with the darker motivations of this act. 

It's Jesus who explains why. “You have heard that it was said to the people long ago, 'Do not murder, and anyone who murders will be subject to judgment.' But I tell you that anyone who is angry with his brother will be subject to judgment. Anyone who says, 'You fool!' will be in danger of the fire of hell.”  

Sounds harsh. We all think murder is wrong, but losing your temper with a work colleague? Calling your neighbour an idiot because of who they vote for?  

The saying points to the root of murder as rage. And boy, is there rage around today.  

There are different kinds of anger. There is the red-hot furious kind where your blood boils and your temperature rises. Yet that kind of anger can settle into different mood - a hardened, determined malice, a fixed hatred of the person who provoked your anger in the first place and a determination to get your revenge, or to silence them once and for all. What both kinds have in common is the red mist that descends and remains, leaving an inability to see past the enmity, a refusal to see the humanity in the other person - the fact that they are, at the end of the day, a ‘brother’ as Jesus put it - a blindness to the essential commonality between you and the person you hate.  

Anger is a dangerous thing for us humans. It deceives us into thinking that because we think we are in the right it gives us license to do despicable things.

Killings like this have always occurred, from Julius Caesar, to Abraham Lincoln, to Archduke Franz Ferdinand, to Yitzhak Rabin. And they always will. No political solution will ever erase the possibility of a mentally disturbed or angry person taking it into their own hands to murder another human being, particularly one with political prominence.  

Yet we can do something. When we build algorithms that encourage the strongest and most extreme views, a media culture that highlights argument and division, refuse to see the common humanity in people we disagree with, when we demonise the opposition and blame them for all the ills of society that we see, we sow the seeds that enable this kind of tragic event to happen.  

Another deceptively simple piece of New Testament wisdom runs: “Do not let the sun go down while you are still angry, and do not give the devil a foothold.”  

It is good advice. Yes, we will get angry from time to time. But don’t let it take root. Sometimes a certain righteous anger can be a good thing – but it’s rare. Anger is a dangerous thing for us humans. It deceives us into thinking that because we think we are in the right (and we may well be) it gives us license to do despicable things. The heart of Christian wisdom on anger is that it is God’s prerogative to exercise wrath. Our anger, however initially righteous, tends to harden into something more sinister. God alone can sustain righteous anger that will truly bring justice. 

The right response to the murder of Charlie Kirk, the response that reflects the Christian faith that was so important to him, is not to blame it on an entire group of people, to tar them with the brush of the deluded young man who committed this terrible deed, but to see again the essential humanity that we share with our enemies. It is to actively cultivate a culture that encourages restraint rather than rage. It is to learn to be ruthless with our own tendency to hold grudges, our own deep-seated hostility to those whose views we find repulsive. It is to learn to hate racism, but to love the racist, to hate crime, but to love the criminal.  

To respond wisely is to recognise that even my enemy - whether progressive or conservative - is a human being created and loved by God, a fellow sinner like me, and to look for the things we have in common, more than our differences. When Jesus taught us to love our enemies, he may have asked us to do something supremely difficult, but it is the only thing that can overcome the kind of malice that led to the tragic death of Charlie Kirk. 

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