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 These draft Bills, though likely to be dropped and superseded by the Commons Bill in the fullness of time, give an early indication of what provision might be made on behalf of clinicians and other healthcare workers who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

A fan’s eye view of the fall of Sean Combs

We believed he was a good guy because we wanted to believe someone was

Giles Gough is a writer and creative who hosts the God in Film podcast.

Sean Combs sits on a golden couch.
Sean Combs, 2019.
Justiceonthebeat, CC BY-SA 4.0, via Wikimedia Commons.

As the weeks-long trial of Sean ‘Diddy’ Combs draws to an end, the world at large has seen an insight into his life that we wish we hadn’t. Combs has just been convicted of transportation to engage in prostitution. Combs had pleaded not guilty and vehemently denied all allegations against him. 

Podcasters and influencers have kept us up to date with every twist and turn of the prosecution’s case, along with a jury member being dismissed and a bizarre visit from Kanye West. Trials of powerful, successful men (and it invariably is men) have become a semi-regular occurrence in the last few years. The #MeToo movement brought justice for victims of abusers like R. Kelly and Harvey Weinstein. But something about the Diddy trial feels different. For hip hop fans of a certain age, the accusations against Diddy were both shocking and hard to accept. Let’s take a deep dive into why that might be.  

For fans who are forty or older, one night looms large in the history of hip hop; the 1995 Source Awards, which distilled the entirety of the East/West coast beef into one evening. West coast rap music was in the ascendence, and New York, the birthplace of rap music and hip hop culture, was not coping with it very well.  

The atmosphere was further exacerbated when a red-shirted man, as big as a house and twice as broad, took to the stage. Marion ‘Suge’ Knight was the head of Death Row Records, a West coast label that had been hoovering up talent like Snoop Dogg, 2pac and Dr. Dre. Suge was an intimidating presence to say the least. His red shirt was a sign of his affiliation with the ‘Bloods’, the notorious L.A. street gang. It was an image of notoriety that Suge leaned into and it was well-earned. In his award acceptance speech, Suge said the most infamous lines he was ever to utter:  

“Any artist out there wanna be a’ artist, and wanna stay a star, and don't wanna – and won't have to worry about the executive producer try’na be all in the videos, all on the records, dancin’ – come to Death Row!” 

This was widely perceived as an attack against Sean Combs, ‘Puffy’ or ‘Puff Daddy’ as he was known back then. As the head of Bad Boy Records, Puffy was not content to simply be behind the scenes; he constantly interposed himself into the songs and videos of the musicians on his label. Whilst these interventions might seem annoying to some, the success that Bad Boy’s artists had achieved couldn’t be argued with, and as a New York native, the audience at the Source Awards saw Suge’s words as an attack on one of their own. So, when Puffy took to the stage later, a response to Suge’s barbs was hotly anticipated. 

But on that occasion, Puffy took a different approach. He acknowledged that he was the executive producer in question, and added: “contrary to what other people may feel, I would like to say that I'm very proud of Dr. Dre, of Death Row and Suge Knight for their accomplishments... and all this East and West [conflict], that needs to stop. So give it up for everybody from the East and the West that won tonight. One love.” 

In this interaction, we saw the aggressive antagonist Suge be met with nothing but love and respect from Puffy. It seemed like a refreshing antidote to the perception of rap music being only violent and misogynistic. Without wishing to overstate the point, Puffy showed that hip hop could be measured, mature and positive. This was an image that, until recently, had held for decades. Yes, there was a fair amount of hedonism thrown in to his public image, but that is priced-in to the cost of being a fan of famous rappers –the excess comes with the territory. For decades we have been dealing with this false dichotomy that Suge Knight was the ‘villain’, and Puffy was the ‘hero.’  

This image of Puffy as, at the very least, a decent man, was further underscored following the deaths of Tupac ‘2pac’ Shakur and The Notorious B.I.G. aka Christopher Wallace. The murders of those two impossibly talented, painfully young men, less than a year apart, represent the point from which all other historical events are judged as ‘before’ or ‘after’. One of the things that came after was Puffy’s release of I’ll Be Missing You, a song in honour of B.I.G, his most popular artist and friend. Sampling The Police’s Every Breath You Take and featuring Biggie’s widow, Faith Evans, on the chorus, Puffy evoked explicitly biblical language with lines like:   

“It's kind of hard with you not around, / know you in heaven, smiling down / watching us while we pray for you / every day we pray for you.” 

These combined with the images in the video, hands in prayer, candles, children dressed in white all served as a fitting tribute. It could have been mawkish, but it met the moment and consolidated Puffy’s good guy image in our heads. We believed he was a good guy because we wanted to believe someone was. Other hits followed, with videos filled with shiny suits and relentless dancing; it was fun, and served as a counterbalance to the grit and grime of gangsta rap. For over two decades, Puffy, now going by ‘Diddy’, had an image that fans still associated with lightness and positivity. Critics like Murs from HipHop DX led conversations painting Diddy as the Superman to Dr. Dre’s Batman. Rumours about Diddy would occasionally surface, but without the mainstream media devoting much time to them, they were easily dismissed. That was until Cassie Ventura, Diddy’s ex-girlfriend, filed a civil lawsuit. 

If there are any lessons to be learned by his fans, they’re lessons that have sadly already been learned by fans of countless other powerful and successful men.

In late 2023, Cassie’s lawsuit accused Diddy of rape and sex trafficking. These allegations were explosive, but just one day later, both parties reached a settlement. The fire of Ventura’s accusations was dampened down by the release of the joint statement a day later. It seemed as if the whole thing was over and done with before many hip hop fans could even hear the news, let alone process it. Fans of Diddy clung to shreds of denial, whilst noticing that no-one else from the hip hop community seemed to be springing to his defence. Almost as if the people who knew him in person had a very different image from that of the persona he cultivated. 

But Cassie’s lawsuit was the first crack in the dam. Law enforcement agencies began investigating, Diddy’s property was raided and by the time CNN got their hands on the surveillance video of Diddy attacking Cassie, the dam had well and truly burst. The video from a Los Angeles hotel dated March 2016, shows Miss Ventura attempting to leave one of Diddy’s freak offs 'parties'. Only to have Diddy chase her down the corridor, grab her and violently assault her. Each kick, drag and object thrown at her slammed another nail into Diddy’s reputation. The ensuing apology he posted on his Instagram was completely invalidated by his earlier statement that his accusers were making false claims in search of a “quick pay day.”  

For those that loved Combs’ music and what it meant to us, it felt like something repellent had crawled into it and died, forever tainting those songs by association. If there are any lessons to be learned by his fans, they’re lessons that have sadly already been learned by fans of countless other powerful and successful men. Firstly, the more powerful a person is, the more they can hone and control their public image, and that they must be taken with a grain of salt. Secondly, always be ready to question a dichotomy. Is this really a hero versus a villain? Or in this case, an example of two demonstrably evil men, one with substantially better public relations.  

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