The big interview from Evangelical Times

I gave an interview last month for the October Evangelical Times ‘big interview’ column. It is posted on their website but I have also pasted it below.

The big interview – October 2011

Peter Saunders is Chief Executive of the Christian Medical Fellowship, a UK-based organisation with 4,500 UK doctors and 1,000 medical students as members. His role includes leadership training, teaching evangelism and ethics, medical mission, writing, editing and media work. Peter took some time out to answer questions from Sheila Marshall.

SM Which TV drama series — Holby City, Casualty or ER?

PS Definitely ER. As a general surgeon I loved the challenge of assessing and treating critically ill patients. Holby City and Casualty are just too ‘soapy’ and too slow-moving for me.

SM What drives your work with CMF?

PS Luke the physician tells us that Jesus sent his followers out ‘to preach the kingdom of God and to heal the sick’ (Luke 9:2). This means, to attend to the spiritual and physical needs of a suffering world. Christian doctors motivated by Jesus’ teaching and example have been profoundly influential in shaping healthcare’s history. A significant number of medicine’s pioneers were people of faith — Paré, Pasteur, Lister, Paget, Barnado, Jenner, Simpson, Sydenham, Osler, Skudder, Livingstone and many more. The CMF exists to help doctors continue in the steps of Jesus, the Great Physician. What drives me is a desire to help doctors fully integrate their faith and practice, to be witnesses to the gospel, and instruments of God’s grace and compassion.

SM Why does CMF need to promote Christian values in the church?

PS CMF’s fourth aim (after evangelism, discipleship and healthcare mission) is ‘to promote Christian values, especially in bioethics and healthcare, among doctors and medical students, in the church and in society’. As Christian doctors, rooted in Scripture and dealing daily with a host of physical, psychological and spiritual needs, we are uniquely placed to bring medicine and the Christian faith together. Members are often asked by Christian friends for guidance on end-of-life care, abortion, infertility, contraception and a host of other lifestyle and healthcare issues. Many pastors feel they lack the expertise to apply the Bible to contemporary issues of healthcare and medical ethics. Christian doctors can help fill that gap. We want to help Christians make wise decisions about their own healthcare and want to equip Christians to engage in the wider national debate on issues that have a significant effect on the most vulnerable people in our society.

SM Can Christian values be promoted in a secular society?

PS As Christians we are called to proclaim the gospel and live to honour Christ in every way. This involves bringing a Christian mind to the many issues that plague our society, and being salt and light. As citizens of a democracy, we have a responsibility both to choose our political leaders and to do what we can to ensure that the laws in our statute books are just and fair. We have a special responsibility to stand up for those who have no voice, like those who are poor, marginalised, elderly, unborn, sick and disabled. There is a growing hostility amongst some quarters of our country towards Christian faith and values. This needs to be challenged.

SM Are Christian values too expensive for our welfare system?

PS The current crisis in healthcare has complex causes. Much of the rising burden of disease is a consequence of poor lifestyle choices, such as people literally eating, smoking, drinking and drugging themselves to death. There is little money free to invest in care, because we are spending our financial resources on the wrong things or living way beyond our means. This is compounded by the breakdown of the family. I believe that the root cause is that as a society we are increasingly turning our back on God, so the supports of family, church and community are no longer there. Christian faith has huge benefits for health, because it has a huge impact on lifestyle choices; people are more likely to avoid or delay many of the diseases that are costly to our health service. If more people in Britain lived according to Christian values, there would be less medical need and much more money available to care for the sick and dependent.

SM What issue did you take with Terry Prachett’s recent BBC documentary on assisted suicide?

PS The BBC has become something of a cheer-leader for assisted suicide. This was the fifth BBC documentary in three years that portrayed assisted suicide or euthanasia in a positive light. We are disturbed by the bias of our national broadcaster, which has an obligation to remain impartial. The programme also breached both national and international guidelines on suicide portrayal and posed a great risk to vulnerable people by fuelling the well-documented phenomena of suicide contagion and copycat suicide.

SM How should the media approach this subject?

PS The BBC’s own editorial guidelines on portrayal of suicide are very clear. They call for, ‘great sensitivity’; ‘factual reporting and fictional portrayal of suicide, attempted suicide and self-harm have the potential to make such actions appear possible, and even appropriate, to the vulnerable’. The World Health Organisation’s guidance is equally unambiguous: ‘Don’t publish photographs or suicide notes. Don’t report specific details of the method used. Don’t give simplistic reasons. Don’t glorify or sensationalise suicide’.

SM Can you give examples?

PS Media stories about how people coped positively with suicidal feelings lead to a decrease in levels of suicide in the general population. Researchers have named this protective effect the ‘Papageno effect’, in honour of the character in Mozart’s opera The magic flute. When Papageno fears that he has lost his love, Papagena, he prepares to kill himself. But three boys save him at the last minute by helping him to find purpose in his suffering.

SM Are euthanasia, abortion and bioethics matters of conscience?

PS The Bible teaches us that human beings are made in the image of God and infinitely precious — meaning worthy of respect, protection, empathy and compassion. The sixth commandment ‘You shall not kill’ is based on this idea and forbids taking the lives of innocent human beings, even if they request us. For centuries the laws of our country have been based on these biblical concepts. Moral issues are not simply matters of individual conscience. It takes a huge amount of grace, courage and character to obey God in tough, costly decisions, but that doesn’t mean that it should not be clearly and unambiguously taught. That is why there is so much moral teaching throughout Scripture.

SM How can everyday believers make a difference?

PS God uses weak and ordinary people to do great things. The smallest step of faithful obedience by God’s grace can turn the course of history. God can use day-to-day decisions to advance his kingdom in and through us. Nothing done in his service is ever in vain and our job is to be faithful to him where he has placed us and trust the results to him.

SM What verses inspire you?

PS Too many to mention really, but here are just a few: Luke 4:18-19 — the Nazareth manifesto; 1 Corinthians 15:58 — never give up; 2 Corinthians 8:9 — Jesus our model; 2 Corinthians 12:9 — strength in weakness; Proverbs 31:8 -9 — speaking up for the weak.

Falconer Commission on ‘assisted dying’ soon to be put out of its misery

Even before it was launched in November 2010, commentators were asking serious questions about the status and independence of Lord Falconer’s so-called ‘independent commission on assisted dying’.

These concerns intensified when it emerged that the privately organised enquiry was the idea of campaign group ‘Dignity in Dying’ (formerly the Voluntary Euthanasia Society) and was being funded by celebrity novelist and DID patron Terry Pratchett (who like Baroness Warnock backs legalising assisted suicide for people with Alzheimer’s disease).

The pro-euthanasia lobby had evidently decided to take this ‘independent’ route because their attempts to legalise assisted suicide through the standard parliamentary processes had failed by large margins at the previous two attempts (148-100 and 194-141 in the House of Lords in 2006 and 2009 respectively).

At the commission’s launch on 30 November it was revealed that nine of the twelve commissioners were well-known names in the pro-legalisation lobby.

When the Care Not Killing Alliance and five other major stakeholders declined to give evidence to the commission on the grounds that it was ‘unnecessary, unbalanced and lacking in transparency’ Falconer attempted to resurrect its lost credibility by turning to others.

Dignity in Dying then contacted its own members asking them to give evidence to its own commission.

In the lead up to the British Medical Association annual representative meeting last June Falconer was embarrassingly dissected by Radio Four’s Ed Stourton on the Sunday Programme and confirmed the bias in composition of the commission.

Not surprisingly a week later the BMA passed a five part motion undermining the commission’s credibility.

About a month later Falconer announced that the commission was now going to start ‘considering’ its evidence. This was not meant to happen until this autumn but the very scant evidence gathered had necessitated this early roll up.

Ever since this time we have been waiting for the announcement of Falconer’s seemingly inevitable conclusion that ‘the law should be changed to allow mentally competent terminally ill people to be helped to kill themselves within strict up-front safeguards’.

Now it seems that we are finally to be put out of our agony. According to the Guardian the commission is going to report in November.

Falconer has apparently concluded that ‘the systems in Belgium, Switzerland, the Netherlands and the US state of Oregon, where assisted suicide is legal, would be unacceptable in the UK’.

Well that’s interesting given that Dignity in Dying have been advocating the Oregon model for some years. I suspect that he probably means that he is going to tweak one or two of the Oregon ‘safeguards’ rather than taking them completely as is.

But he also tells us that his commission is set to offer a British, ‘gradualist’ alternative.

Gradualist? That’s a very interesting word. Is he telling us that he is seeing the changes his commission will recommend as a ‘first step’? It certainly does sound like it.

But it leaves us with the question of what the next step (and indeed the final step) will be.

Times newspaper launches its (largely good) ‘silver manifesto’ for elderly people

With all the bad news about elder abuse and neglect in the news lately it was (largely) refreshing to see the Times newspaper this morning launching its ‘Silver manifesto’ – 50 ways to improve age (£)

The Times sets the context as follows:

Barely a day passes without a story of maltreatment and neglect of the elderly in the news, whether in the NHS or care homes sector.

A report in The Times last week revealed that one hospital in five is failing older people so badly that it breaks the law, while stories of poor management, financial problems and abuse have surfaced in residential and nursing homes around the country in the past year.

Yet our population is ageing. The Office for National Statistics predicts that by 2050 one Briton in four will be aged 65 or over, and even with the increases in retirement age due to come into effect, nearly 20 million of us will be pensioners by that time.

It doesn’t matter what your age today, we’re all headed in the same direction. So we felt that it was time to highlight some of the major issues and minor niggles that face us as we grow older.

Here is our silver manifesto . . .

The paper then gives a fifty point plan to improve the lot of older people – here are some highlights:

1 Get the online literacy rate to 100 per cent.

2 Don’t let the Government keep your money.

4 Increase the time available to pedestrians on crossings.

13 Make text on menus bigger.

22 Give older people a role in schools

24 Treat people with respect and consideration.

27 Run care homes like homes — not hospitals.

33 Take an interest in your elderly neighbours.

38 Make education more accessible for mature students.

48 Create more public toilets. And signpost them well.

50 Phone your mum. Ring now — you know you want to.

If these suggestions were put into play it would make a huge difference.

But I was disappointed to see the Times, in accordance with its current pro-euthanasia editorial policy, also sneaking in a reference (19) to ‘clarifying’ the law on ‘assisted dying’. We all know what that means!

The Times, which many regard as the voice of the establishment was once opposed to assisted suicide and euthanasia, but it changed its editorial policy in 2009 to support an amendment by Lord Falconer which would have legalised assisted suicide.

The amendment was thankfully defeated by a heavy margin on grounds that it would undermine the safety of vulnerable people.

But with Falconer’s discredited ‘commission on assisted dying’ about to report we are seeing the pro-euthanasia campaign ratcheting up its celebrity driven campaign for a change in the law.

Be warned.

Cliff Richard and euthanasia – what did he really say and does it matter?

I’ve just done an interview on BBC Radio Humberside off the back of Sir Cliff Richard’s alleged support for euthanasia in this morning’s papers.

The headlines do certainly seem to indicate that the 71 year old entertainer wants a change in the law. The Daily Telegraph leads with ‘Cliff Richard: Why I would consider euthanasia’; the Daily Mail and Daily Express use the headline ‘I have a death pact with my sister’ and the Sun shouts ‘Kill me if I get dementia’.

The comments have been lifted from a BBC interview that Cliff Richard has recently done on the occasion of his 71st birthday, on which he was asked about his mother’s death at 87 from dementia.

The Daily Mail, which seems to be the original source of the story, reports as follows:

(Cliff) also revealed he had made a pact with the same sister to look after each other if they developed dementia.

Speaking in a BBC radio interview, he revealed: ‘I said, look if this happens to me, I’ll do the same for you if you’ll do it for me, don’t let it go on too long. And just make sure I’m looked after because I don’t want to be a burden on anybody else.’

He went on: ‘If it happened when I was 90, 20 years from now, they might well have allowed euthanasia or something like that.’

‘Dementia does not take your life – but it removes it away from you. You don’t have a life. It just stops you living.’

No one can help but sympathise with Sir Cliff over his feelings seeing his mother die from dementia. Many of us have also been there in various ways. But what did he really say and what did he actually mean?

On the face of it he was saying three things:

1.He doesn’t want to be a burden on others and so has made a pact with one of his sisters that if either of them gets dementia the other will take on the burden of looking after the one who is affected.

Well that seems perfectly reasonable and natural to me.

2.He doesn’t want to go on suffering too long if he gets dementia and wants his sister not to prolong his life in this situation.

Well again that seems very reasonable. Having seen my own father die from dementia we often prayed that his suffering would not be prolonged. But choosing not to prolong the dying process with aggressive interventions is a far cry from starving, sedating and dehydrating someone to death or giving them a lethal injection.

3.Euthanasia might be legalised in the next 20 years.

Well there is a possibility that it might be. Belgium and the Netherlands have already done so.

It seems to me that these dramatic headlines about Cliff Richard supporting euthanasia are largely a case of media hype and spin – and I hope that Sir Cliff will clarify soon what he actually meant.

But for argument’s sake, what if Sir Cliff really does think that euthanasia should be legalised? What then?

Well, in spite of the fact that Cliff Richard is both a Christian and a great entertainer who has survived five decades in the charts, this does not make him an expert either in ethics or public policy.

Parliament has three times in the last six years rejected a change in the law to allow assisted suicide or euthanasia on grounds of public safety.

The House of Lords, in 2006 and 2009, and the Scottish Parliament in 2010, decided that to legalise assisted suicide, even with so-called safeguards, would place pressure on vulnerable people to end their lives and would make it easier for those with an emotional or financial interest in their deaths literally ‘to get away with murder’.

Parliament also decided that our really priority should be improving care for people who are elderly, terminally ill or disabled. In this connection it is refreshing to see in this morning’s Times newspaper a report (£) featuring the Silver Manifesto – ‘50 ways to improve old age’.

But we should also note why the Cliff Richard story has hit the headlines today.

It is because the media is gearing up for the release of the Falconer Commission report next month, which will recommend a change in the law to allow ‘assisted suicide with safeguards’.

Falconer’s campaign has been repeatedly discredited in the press, the broadcast media and undermined by the British Medical Association but he nonetheless presses on and on.

This is why we saw last weekend Lord Falconer trumpeting in the Guardian and Star Trek actor Patrick Stewart is campaigning in the Telegraph.

There will be a lot more of this in the next few weeks as Dignity in Dying (formerly the Voluntary Euthanasia Society) ratchets up its well-funded celebrity-driven campaign to foist euthanasia in its various forms upon us. This is all part of a softening up process. Be warned.

Managing time - lessons from the grand master

Do you wake up in the morning and ask the Lord: 'What is it that you have prepared in advance for me to do today?'Or, like me, do you often wonder how you will complete all the tasks that lie before you?

Competing time demands are an inevitable part of life, and to some extent, the more seriously we take our Christian responsibilities, the more we will face them. Jesus grappled with competing time demands but was the master in time management. He uniquely maintained a balance between worship, prayer, family, friends, work and rest. To do this he maintained an intimate relationship with God and had a clear view of his life task. Here are just four key pointers from the Great Physician.

Jesus guarded his devotional life

Jesus spent time in prayer, especially during periods of intense activity. He prayed regularly and especially before each important decision. And he withdrew from his ministry to pray after periods of exhausting ministry. In Luke 5:15-16, a good prescription for busy doctors, we read that '...crowds of people came to hear him and to be healed of their sicknesses. But Jesus often withdrew to lonely places and prayed'. The more he worked the more he prayed. He was 'too busy not to pray'. I wonder if God often creates the delays and stoppages in our busy lives; the red lights, and traffic jams, the queues and holdups so that we might have the opportunity to pray more.

Similarly he was immersed in the Word of God - so much so that when the devil challenged him in the wilderness he could answer with three quotes from the book of Deuteronomy; a book that many of us could not easily find, let alone are familiar with. Do we regularly feed on God's Word? Do we make it one of our first priorities? Jesus did.

Jesus made time for people

In the midst of Jesus'busy ministry he did not let the urgent crowd out the important. As a surgeon I find the story of the woman with the haemorrhage very challenging. Jesus is on the way to see someone who is critically ill with an acute infection, and is stopped by a woman with chronic long-standing menorrhagia (Luke 8:40-56). She gets his full attention, and then as if to vindicate his decision God enables him to raise Jairus' daughter from the dead! In our lives as doctors we need to be ready to pause with certain individuals that God brings across our path. The gospel encounters are made up of a string of accounts of individuals who Jesus paused with. He did not pause with everyone; he healed only one man at the pool of Siloam, he spoke only to one Samaritan at the well, only one rich young ruler, only one tax collector - but he did make time for individuals.

Jesus equipped others

Jesus did not feel that he had to meet all the need himself. His strategy was rather to devote time to equipping others. This way the work carried on after he had returned to the Father. The effectiveness of a ministry is not measured by what is achieved but by what carries on after the key person leaves. Jesus spent a hugely disproportionate amount of time with those who would carry on his work.We too should always be asking how we can multiply the work God has given us by involving others. If we are given a choice between doing something ourselves or teaching someone else to do it, we should go for the latter. Jesus' response to seeing the harvest fields ripe for harvest was not to encourage the disciples to work all the more hard to bring it in. Rather he encouraged them to pray that God would raise up more workers (Matthew 9:37-38).

Jesus recognised the need for rest

Jesus was not legalistic about the Sabbath but rather recognised its true purpose. He realised that it was important to withdraw and rest, even in the face of pressing need. Burnout is a major problem for Christian doctors because we are motivated by a strong sense of responsibility and are aware of the vast amount of unmet need. But we need to timetable time for relaxation and recuperation. How we spend it will depend on our own personality and makeup.We may be alone or with others, doing a vigorous activity or a sedentary one - the important thing is that we take time out altogether from work and ministry at regular intervals.

The story is told of two men who chopped wood. One stopped for regular rests every hour while the other just kept chopping all day long. At the end of the day the one who rested had a far larger pile of chopped wood. The other was surprised until he learned that while resting, the other had been also sharpening his axe. Recognizing the need for rest is like sharpening the axe.

Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls. For my yoke is easy and my burden is light. (Matthew 11:29-30)

David Fergusson wades in to defend Coleman over abortion mental health link

Priscilla Coleman’s recent meta-analysis showing a link between abortion and mental health problems not surprisingly has created a storm, coming as it did in the middle of the recent parliamentary debate over independent abortion counseling.

Whilst the left wing press and the BBC chose to ignore it, other academics in the field have attempted to undermine it in a flurry of letters to the British Journal of Psychiatry.

But David Fergusson, veteran researcher in the field, has just waded in to Coleman’s defence.

His letter is available on the BJ Psych website but here are some key excerpts. Fergusson writes:

The letter by Louise Howard and colleagues follows a well-trodden strategy which has been used in a number of reviews to dismiss any evidence suggesting that abortion may have adverse effects on mental health. In this strategy:

a) Methodological criteria are constructed to classify studies
b) No numerical analysis combining study findings is provided
c) Strong conclusions are drawn on the basis of a small number of ‘high quality’ studies

The use of this strategy led the APA review to claim that there was no evidence of adverse effects of single first trimester abortion on the basis of a single study, the conclusions drawn by Charles et al were based on four studies. Howard et al use a similar strategy in which they question the methodological quality of studies reviewed in the Coleman analysis and draw conclusions about the absence of association between abortion and mental health on the basis of a small number of studies. If the evidence is indeed as weak and as limited as these reviewers have claimed the appropriate conclusion to be drawn is that no firm conclusions can be made about the mental health consequences of abortion until further and better research is completed.

In the meantime, Coleman has done the field a service by bringing together a quantitative review of a large number of studies that have addressed the issue of abortion and mental health. What will be clear to any alert analyst is that there is a clear statistical footprint suggesting elevated risks of mental health problems amongst women having abortions, irrespective of the comparison group used or the outcome studied. This evidence clearly challenges the conclusions drawn from the reviews cited above.

Following the Coleman meta-analysis we have conducted a more refined analysis which addresses some of the concerns raised by Howard and colleagues. In this we confined the analysis to only those studies using an unwanted/unintended comparison and data was extracted from the original sources by two reviewers. This search yielded a total of eight studies reporting 14 results. These findings were used to conduct a series of meta-analyses for five separate outcomes: anxiety disorder; mood disorder; alcohol misuse; illicit drug use/misuse and suicidal behaviours. The results tell a clear story in which, with the exception of depression, there are significant small to moderate associations between abortion and increased risks of mental health problems.

The implications of this analysis are inescapable: despite the claims made in previous reviews about the absence of association between abortion and mental health, when data are pooled across studies there is consistent evidence suggesting that women having abortions are at modestly increased risks of mental health problems when compared with women coming to term with unplanned/unwanted pregnancies.

Fergusson is modest in his conclusions but his intervention is significant.

He promises a further review to be published soon.

Cometh the hour, cometh the man – Aaron Cruden is no stranger to challenge and adversity

Aaron Cruden may be New Zealand’s fourth choice fly half after Carter, Slade and Evans but he is no stranger to challenge and adversity and should not be underestimated going into the World Cup semifinal tomorrow against Australia.

The 22 year old made his provincial debut for Manawatu Turbos in 2008 and captained New Zealand to the 2009 IRB Junior World Championship title in 2009 in Japan, as well as being named IRB Junior Player of the Year 2009.

He made his Super 15 Hurricanes debut on 29 January 2010 against the Brumbies in Porirua and on 30 May last year was named as one of four new caps in the All Blacks squad to play test matches against Ireland and Wales.

On 12 June he made his All Blacks debut in the 66–28 victory over Ireland in New Plymouth, subbing for Dan Carter, and later took part off the replacement bench in two victories over Wales, then made his Tri Nations debut against the Springboks in Wellington on 17 July.

He missed out on the All Blacks Tri Nations and World Cup squad this year but played superbly during the Air New Zealand Cup and with the adductor injuries to Carter and Slade now finds himself starting at number 10 in the biggest test of his sporting life.

Cruden kept a cool head when coming on as a replacement in the All Blacks' 33-10 World Cup Quarter Final victory over Argentina, at Eden Park, and contributed a conversion to the score.

Now the nation’s hopes rest upon his young shoulders.

Without Carter there will always be question marks ahead of an All Blacks Aussie clash but Cruden has the potential to make it on the big stage. He has the talent, the confidence and the support to step up to the big occasion and has his Super 15 team mates around him. The injury to Carter now leaves the All Blacks with a Hurricanes backline from halfback to wing with Weepu, Cruden, Nonu, Smith and Jane at 9, 10, 12, 13 and 14 respectively.

And Cruden has shown that he also has the character to meet tough challenges.

He will be unfazed at being thrust into the World Cup pressure cooker after surviving a cancer scare three years ago, according to his father.

His father, Stu, said his son matured after being diagnosed with testicular cancer in 2008 and was ready for any challenge. He had to take time out from rugby to undergo surgery and an intensive nine-week chemotherapy course before receiving the all-clear by medics at the end of 2009.

‘He was a pretty well-balanced lad before that, pretty focussed on things he wanted to do and we can't really explain what came to him, or from him, from that cancer,’ Cruden senior said. ‘But we've certainly seen a changed person, he's more mature, he's more balanced and he just takes every opportunity he gets now. He doesn't get down when anything goes wrong, he just believes that every day's another day to be alive.’ He'll be the first to tell you that he's now past that part of his journey – his cancer's in remission and that's where he wants it to stay, he's just getting on with life,’ his father added. ‘Whatever life throws at his now, he's prepared to take the challenge.’

Cruden, who on the All Blacks' website lists cyclist and six times Tour de France winner Lance Armstrong, a fellow cancer survivor, as the person he would most like to meet, is now preparing to play the biggest game of his life.

Cometh the hour, cometh the man.