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.

Henna Cundill

Henna is a researcher with the Centre for Autism and Theology at the University of Aberdeen.

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 These draft Bills, though likely to be dropped and superseded by the Commons Bill in the fullness of time, give an early indication of what provision might be made on behalf of clinicians and other healthcare workers who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

Church and state

Comment

Community

Trauma

5 August 2025

5 min read

After Southport: how to communicate amid tragedy, rumour, and riot

Handling the media in the aftermath brings dread, discretion and dignity

Stuart Haynes

Stuart is communications director for the Diocese of Liverpool.

A media pack await a press conference in a street.

Media covering the Southport attacks.

The Emperor of Byzantium, CC BY-SA 4.0, via Wikimedia Commons.

Working from home in the quiet town of Ormskirk, about four miles from Southport, the first I noticed was a cacophony of sirens accompanied by our local Facebook groups buzzing with speculation over what it was this time. The news started breaking. An incident in Southport, vague details at first but enough to start that feeling of unease.

Then the phone call and email. The local vicar and one of our Archdeacons seeking advice as inevitably the media would be looking for comment. I’ve taken a similar call many times over the 20 years I have worked with the church. It sets a mix of contradictory emotions. Selfishly you can’t help thinking there goes my plans for the day before you are sharply brought up to the knowledge that the reason for this is a tragedy for others.

Southport brought out a further emotion. When I was a student, I lived for a year close to the location of the stabbings. 30 years on and the suburban area I knew was seemingly unchanged. Yet everything was different.

The role of the press officer at this point involves navigating a tricky balance. You have a job to do, the journalists you deal with have a job to do. You are constantly fielding phone calls, jotting messages juggling time slots. You have a relentless barrage of people putting interview requests in and you want to ensure the right voices are heard and that those who represent aren’t worn out by interview upon interview.

Then you remember what caused the story in the first place. You think of the emergency services working hard to support those in need. Above all you think of the victims and the families – at that time not knowing how many or how serious. And the sense of gloom deepens as the rumours of how serious the situation spreads before you get word of a police conference fearing the worst before the worst gets confirmed.

At these times the mood amongst the media teams always feels strange. Acutely aware of the pain of the situation and sympathetic to what’s happened they can’t escape the job they have to do. I have seen this over many years mainly through the management of the press pens outside funerals at Liverpool Cathedral and churches across the region. You get to know some of the pack well, mainly and somewhat grimly reuniting at the next tragedy. They are massively co-operative with a strong sense of camaraderie, yet you can feel the pressure coming down to them from their news and picture desks. So, a sharing of resources and support occurs underpinned by a hint of journalistic competition.

The press officer’s role here is to feed the machine. It’s hungry. They have time to fill and very often, particularly so close to when the event happened, everyone is more speculative than informed. The machine needs feeding whatever and the church voice can be a calm voice of authority speaking the anxieties and wishes of the local community. However, we don’t want to be rent-a-voice, we are not helpful if we seem to be trying to grandstand over someone else’s grief. We need to show the compassion and love that our faith and Christian values teach us.

That became critically important on the second night when things turned ugly and the story was hijacked by rioting right wing mobs. Having been to the peaceful and respectful vigil on the afternoon I drove back past the scene of the stabbings on my way home. You could smell the tension in the air as people were converging on the streets exuding a purpose that did not seem like the sorrow from earlier that day.

The media aftermath for the church was then to support the efforts showing the community rebuilding whilst also calling for harmony, standing shoulder to shoulder with representatives from all faiths.

And on to the funerals.

There are many patterns to organising press coverage at a funeral. Usually, we need a pen to marshal the cameras in a way that enables them to get the pictures they need whilst maintaining a respectful, sympathetic distance. It feels there is a nigh on obligatory picture of the service order, my hand featuring in many of these shots. There is a lot of standing and waiting, clarifying the minutia of the service so the reporters can tell the story and capture the atmosphere.

Yet for me each funeral is different as I try to ensure the family’s wishes predominate. Southport was a case in point. Of the two funerals in Anglican churches (one victim was from a Roman Catholic family) one family wanted no coverage and my role was simply to make sure that wish was honoured. The other saw cameras in and around church and a full suite of reporters so we work hard with them to ensure respect. Mostly that involves a combination of setting consistent fair rules and supplying enough for them to tell the story. Journalists can cope with told they can’t do something provided their rivals are getting the same message. Lose the consistency you lose the pack as I experience outside Ken Dodd’s funeral when I had to scream at the press pack to get back in their pen before the cortege arrived.
I see this as a ministry. I have learnt techniques over the years, witnessed fights in graveyards, stood soaking waiting for the funeral to end and the coffin to leave so I can relax. Doing this is a privilege which spills over into the funerals I conduct as a priest. As do the learnings from those funerals that, in turn, inform my ministry. Get it right it becomes a fitting, respectful and dignified way for the wider community to say goodbye to a victim.

Then when it’s done we move on. The press pack to the next day’s story myself to the tasks from the routine job that I had to ditch. That’s easier for us. But the families and loved ones can’t easily move on from their pain and grief.

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