Monday 30 April 2012

Matthew Parris, iconoclast once more. But will the gay rights lobby like it?

Mathew Parris has featured on this blog before for his comments about the Christian faith, but last week he once again challenged the dogma of the gay rights lobby that sexual orientation is fixed and unchangeable.

In an iconoclastic piece in the Times, titled ‘Who’s totally gay? There’s no straight answer’(£) the former Tory MP turned columnist provocatively lamented that ‘Same-sex male attraction used to be something you do, not something you are’.

Citing the story of Chris Birch, from Wales, who has testified to turning from being heterosexual to being gay after suffering a stroke, and Anglican Mainstream's controversial bus advert campaign claiming that sexual orientation can change, he takes the cherished belief that sexual orientation is always fixed and unchangeable apart.

‘On one thing, though, these opinions all agree — people can change… I do believe that male sexual orientation is less fixed than we suppose. It may alter. We gays fought that idiotic “section 28” on dishonest grounds. Homosexuality can, as the statute implied, be “promoted”. So can heterosexuality.'

He qualifies this by stressing that for some any change will be very limited if not impossible:

‘At once must come the qualifications. I don’t think that everyone is alterable. I don’t think change is possible without shelving part of one’s nature. I think that it’s generally unwise to fight a strong orientation unless it would lead to hurt. And I absolutely don’t think that homosexuality can be “cured” in the sense of expelling some kind of disease from the system.’

He then presents a popular vision of the Kinsey scale – the observation that some people are neither exclusively homosexual nor heterosexual but somewhere in between:

‘Try an experiment. Imagine that a majority of men are more straight than gay, a minority more gay than straight. Imagine this in terms of a scatter-graph from left (straight) to right (gay), with some very close to one end, some very close to the other and plenty spread between them. Imagine that those at either pole can feel little if any attraction to the other; but that those between the poles can, depending on where they are, feel weakly or strongly the attraction of both poles. Add to this picture a strong and unremitting social pressure to be considered (and consider yourself) as being at the left-hand (straight) end.

What would be the result? Everyone who, without making themselves too frustrated and miserable, could live a straight life would move towards the left in their behaviour and self-description; a minority who felt they just couldn’t would cluster (partly for self-defence) into a sort of ghetto at the right-hand end. And all the pressure would be to “make your mind up”, ie, shift towards the nearest pole.’

He emphasises the need for evidence to support his ‘hypothesis’, but from his own experience as a gay man says:

‘I’ve slept with as many men who considered themselves basically straight, lived basically straight lives and in some cases (I think) really were basically straight, as with men who were self-identifying gays.This is not my experience alone. Most gay men manage the considerable intellectual contortion of believing that there’s nothing they could do to alter their own sexuality while at the same time believing (not without evidence) that there’s quite a lot they might do to alter a straight man’s sexuality (“five pints of lager” is the usual prescription)… Even I, who feel myself to be exclusively gay, know from dreams and from occasional involuntary physical reactions that shelved somewhere in my unconscious must be a strand of heterosexuality. Millions of gay men will have the same experiences.’

His conclusion is iconoclastic to the extreme, and no one but a gay man could have got away with saying it:

‘“I can’t help it”. The very words carry a kind of whimper. I hate this plea. It isn’t accepted as an argument for paedophilia and shouldn’t be. I’d want to be gay whether I could help it or not. The day that the battle for homosexual equality is won and over will be the day a man, straight or gay, can boast that he chose.’

There is of course nothing new in what Matthew Parris is saying and he has said it before as has leading gay rights activist Peter Tatchell.

They are not alone in thinking this way.

The American Psychiatric Association (APA) has stated, ‘some people believe that sexual orientation is innate and fixed; however, sexual orientation develops across a person's lifetime’. The APA also says that ‘for some the focus of sexual interest will shift at various points through the life span...’

A report from the Centre for Addiction and Mental Health similarly states, ‘For some people, sexual orientation is continuous and fixed throughout their lives. For others, sexual orientation may be fluid and change over time’

But whether the general population will come to believe it is another matter entirely.

Last day to respond to Margo Macdonald's flawed proposals on assisted suicide

Today is the last day to respond to Margo Macdonald's consultation on assisted suicide. The MSP is planning to bring another bill to the Scottish Parliament in an attempt to legalise assisted suicide just over a year after her last similar bill was overwhelmingly defeated by 85 votes to 16. Essentially this is a rerun of the same flawed and tired arguments.

Alex Schadenberg of the Euthanasia Prevention Coalition has published a good overview of her latest proposal's many failings but I suspect most will just be objecting to the bill in principle.

I have reproduced below the submission of the Care Not Killing Alliance, representing over 40 professional groups, faith groups and human rights groups. It says it all. Brief and to the point.

This bill like her last should be given short shrift by Scottish parliamentarians.

Care Not Killing Submission

We are opposed to the general aim of this proposed bill for the following reasons:

1. Just over a year ago, a very similar bill, the End of Life Assistance (Scotland) Bill, was comprehensively defeated in a free vote at the Scottish Parliament in December 2010, by a margin of 85 votes to 16. This should have settled the debate in Scotland for a generation.

2. The previous bill was heavily criticised by MSPs, medical practitioners, palliative care charities, religious groups and legal experts for being both unclear and unethical. Furthermore, 87% of all who made written submissions to the scrutinising committee were opposed to it. The committee also overwhelmingly recommended that it be rejected.

3. The new Bill is to be modelled on a system currently in place in the US state of Oregon where the annual number of assisted suicides has increased dramatically by over 450% since being legalised in 1997, where one in six of those dying are depressed, less than one in 20 receive psychiatric assessments and some patients have actually been denied medical care and offered assisted suicide as a cheaper alternative.

4. The terms in the proposal, especially with regard to those ‘terminal conditions’ to be included in its remit are vague, imprecise and ambiguous.

5. Any change in the law to allow assisted suicide would place pressure on vulnerable people to end their lives for fear of being a financial, emotional or care burden upon others. This would especially affect people who are disabled, elderly, sick or depressed.

6. Persistent requests for euthanasia are extremely rare if people are properly cared for so our key priority must be to ensure that good care addressing people's physical, psychological, social and spiritual needs is accessible to all.

7. The present law making assisted suicide and euthanasia illegal is clear and right and does not need changing. The penalties it holds in reserve act as a strong deterrent to exploitation and abuse whilst giving discretion to prosecutors and judges in hard cases.

8. Hard cases make bad law. Even in a free democratic society there are limits to human freedom and the law must not be changed to accommodate the wishes of a small number of desperate and determined people.

9. The pressure people will feel to end their lives if assisted suicide or euthanasia is legalised will be greatly accentuated at this time of economic recession with families and health budgets under pressure. Elder abuse and neglect by families, carers and institutions is real and dangerous and this is why strong laws are necessary.

10. The number of British people travelling abroad to commit assisted suicide is very small (150 in ten years) compared to numbers in countries and US states that have legalised assisted suicide or euthanasia.

11. If assisted suicide or euthanasia is legalised any ‘safeguards’ against abuse, such as limiting it to certain categories of people, are unlikely to work. Instead, once any so-called ‘right-to-die’ is established we will see incremental extension with pressure being applied to expand the categories of people who qualify for it.

12. The vast majority of UK doctors are opposed to legalising euthanasia along with the British Medical Association, the Royal College of Physicians, the Royal College of General Practitioners, the Association for Palliative Medicine and the British Geriatric Society.

13. All major disability rights groups in Britain (including RADAR, SCOPE, UKDPC, NCIL and Not Dead Yet UK) oppose any change in the law believing it will lead to increased prejudice towards them and increased pressure on them to end their lives.

14. Changes to the law of this kind should not be driven by public opinion but by serious informed debate. Public opinion polls can be easily manipulated when high media profile (and often celebrity-driven) ‘hard cases’ are used to elicit emotional reflex responses without consideration of the strong arguments against legalisation.


This proposal is flawed in principle and Care Not Killing calls upon the Scottish Parliament to reject it at the earliest opportunity.

Sunday 29 April 2012

Disagreement amongst Christians is normal and unity does not mean uniformity

My father was a Congregationalist and my mother Anglican and after leaving home my brother joined the Baptists and I the Open Brethren. I married my Presbyterian wife in a Christian Missionary Alliance church, and during house-jobs we were members of an Apostolic Pentecostal fellowship. Later whilst working in another city we were members of a charismatic Anglican and then, following another move, went to a house church made up of mainly first generation converts from the 70s hippie movement.

After joining the Africa Inland Mission in Kenya as medical missionaries we spent two years at a multinational Bible college with 170 students from 40 countries and twice as many denominations, during which time we attended an Elim church. Now we are Free Evangelical.

Living in twelve different houses in five cities in three countries in your first ten years of marriage provides an interesting perspective on church culture; but one thing it has taught me is that Christians disagree over doctrine (what they should believe) and practice (how they should behave). In this, and other articles, I will explore why Christians disagree, and consider how they should handle disagreement when it happens.

Belief, behaviour, association, regeneration

What makes a Christian? Is it about belief, behaviour, association or something else? It is clearly important to believe certain things about Jesus Christ, but belief is not enough. After all even the demons believe - and shudder.[1] Also being a Christian does not guarantee that all our beliefs are correct; which is why the apostle Paul had to write so many letters to churches who had it wrong! Being a Christian involves repentance (change in behaviour) but there are people with good behaviour who are not Christians and people with bad (albeit improving) behaviour who are. And whilst Christians should associate with other Christians,[2] going to church does not make a person a Christian. Belief, behaviour and association are important; but it is actually regeneration that makes a person a Christian: that is Christians are people who have been 'born from above',[3] become a 'new creation'[4] and have the Holy Spirit living in them.[5]

Disagreement amongst Christians is normal

No Christian is perfect in either doctrine or practice, and disagreement is an inevitable consequence of imperfect people having to live and work together. We should not be surprised about it, but rather expect it. Our own doctrine and practice may be strongly influenced by selfish desires, pride or other temptations and sins to which we have surrendered. If a person adamantly sticks to a wrong position despite being shown the error of their ways, there will usually be a personal reason for it. This is why it is so important that disagreement is handled with patience, love and care.

Often we are unable to see where we are wrong on an issue because of sin in our own lives or because changing our opinion or actions may be very costly for us. Even leading Christians disagree. Martin Lloyd-Jones and John Stott disagreed over whether evangelicals should leave the Church of England. Luther and Calvin disagreed on a variety of issues. Even the apostles Peter and Paul had a major argument over circumcision,[6] and Paul and Barnabas had such a sharp disagreement about Mark that they had to part company and work independently.[7]

And it was not just the men. In the church of Philippi two women called Syntyche and Euodia had such a disruptive disagreement that Paul had to single them out for rebuke.[8] The Epistles are all about disagreement between Christians. So disagreement is a normal part of church, marriage and family life and we should not be surprised or upset when it happens. Some people try to escape disagreement by trying to live their lives closeted with other Christians who think the same; but, as well as being doomed to failure, this is also failing to acknowledge the diversity of Christ's body the church, and the importance of love and unity.[9]

What do Christians disagree about?

There are some Christian beliefs so fundamental to the faith that it is quite reasonable to assume that a person who doesn't hold them is not a Christian at all: God as Father, Son and Holy Spirit; the life, death, resurrection and return of Jesus Christ; Jesus' death for our sins (the atonement); the last judgment and salvation through faith. These are 'primary issues', but there are also 'secondary issues' on which genuine Christians might disagree:

Baptism: Do you believe in infant baptism or believers' baptism or both? Should you be sprinkled, dowsed or immersed? And should the venue be a lake, river, the sea, or a specially designed and heated sterile bath under some floorboards in the church hall?

Charismata (gifts of the Spirit): Are they for the first century or all centuries, or have they just been restored to the church in the 'last days'? Are they all for everybody, or just for some?

Eschatology (theology of the 'end times'): Do you believe in the rapture, and if so do you think that it will come before, during or after the tribulation, if you believe in that? What about the millennium? Are you pre-mill (dispensational or not), post-mill or a-mill, or perhaps pan-mill (ie it will all 'pan out' in the end)? Or are you just confused?

Creation: Are you a six day creationist, a special creationist or a theistic evolutionist? An old-earther or young-earther?

Worship: Are you more at home with 'happy-clappy' or 'smells and bells'? Do you prefer hymns from a book, or choruses from a data projector, pews or chairs, dancing or quiet? Is it to be the organ, or electric bass and drums?

Ecclesiology (theology of the church): What do you think about synods, councils and bishops? Should women be ordained? Should men? Should there be a clergy at all?

These issues have split churches and created the myriad denominations we have today. And we haven't yet mentioned the Lord's supper, the role of women, Old Testament prophecy, sanctification, predestination, the relation between church and state and the theology of mission.

Then there are ethical issues. Take sex: how far is too far for unmarried couples? Should Christians ever break the law? Is it wrong to lend money at interest? And at the interface of Christianity and medicine there are a huge number of issues about which there is no full consensus, even amongst Christian doctors.

As CEO of CMF I not infrequently receive letters from Christian doctors taking issue with views expressed in CMF literature and often from both sides of a particular issue.

One of the great strengths of CMF is that we are an interdenominational organisation; but this means that we do not agree on everything. Unity does not mean complete uniformity in belief and practice.


1.Jas 2:19
2.Heb 10:24,25
3.Jn 3:3
4.2 Cor 5:17
5.Rom 8:9
6.Gal 2:11
7.Acts 15:39
8.Phil 4:2,3
9.Jn 13:34,35, 17:23

Adapted from my previous Nucleus article on ‘Why Christians disagree’

Friday 27 April 2012

Let’s be completely honest, clear and truthful about healing as well as expectant

The May 2012 edition of ‘Christianity’ carries several testimonies of healing after prayer and an article about Christian MPs testifying to God’s power to heal.

Like most Bible-believing Christians the 4,000 Christian doctors who belong to Christian Medical Fellowship believe in God’s power to heal both in response to prayer and through the gift of medicine. We also believe in the positive effect that Christian faith has on health which is supported by scientific research.

Evidence from over 1,200 published academic studies and 400 reviews has shown that faith brings positive health benefits including protection from illness, coping with illness, and faster recovery from it. Christian faith also overall leads to longer life, better physical and mental health, more marital stability, less divorce, less suicide and less abuse of alcohol and other substances.

However, although God chooses to answer prayer in many ways there is very little hard objective evidence that miracles of the sort that Jesus and the apostles performed – instantaneous miraculous reversals of major diseases and disabilities which convinced even sceptical eyewitnesses - are happening with any great frequency in Britain today.

We need to be honest about this and not make exaggerated, misleading or inaccurate claims about specific healings.

I was therefore encouraged to read that Mitra Hajebi, writing in the magazine, who found that she no longer needed to use hearing aids after prayer for healing, went back to have her hearing medically tested and the improvement confirmed. This is crucially important.

If Jesus was not afraid to have his healings examined by the priests then surely Christians today should also seek proper objective verification of any healing claim by medical professionals before stopping any treatment or reporting the claim to others.

Claims of healing made by churches with hazy factual details or without objective verification will only provoke scepticism and encourage criticism or charges of ‘false advertising’.

God heals in different ways – emotionally, spiritually and physically – but often he chooses not to heal physically in this life and death, mourning, suffering and pain are part and parcel of living in a fallen and unredeemed world.

So while we look forward to that great day when these things will be no more let’s be completely honest, clear and truthful about healing as well as expectant.

(There is a much fuller treatment of this issue by Bernard Palmer titled ‘Praying for the Sick’ in the Spring 2012 edition of the CMF Student magazine Nucleus)

Wednesday 25 April 2012

Christian conscience, the Bible and the law

Are there any circumstances in which Christians should disobey the law?

The Bible teaches us in both Old and New Testaments that it is God himself who institutes human authorities:

'..the Most High is sovereign over the kingdoms of men and gives them to anyone he wishes.' (Dan 4:25)

'The authorities that exist have been established by God.' (Rom 13:1)

Furthermore he expects us to obey them, not only because of possible punishment but also because of conscience. (Rom 13:1-7; Tit 3:1; 1 Pet 2:13-14)

This raises the issue of what we should do in circumstances where obeying the governing authority involves disobeying some other command of God. It seems in Scripture that there is a place for godly civil disobedience. Let us consider some examples.

The Hebrew midwives when ordered by the king of Egypt to kill all male Hebrew children refused to do so and as a result we are told that God commended and rewarded them (Ex 1:15-22). Rahab the harlot similarly refused to co-operate with the king of Jericho in handing over the innocent Israelite spies (Jos 2:1-14). She is later praised for her faith in so doing (Heb 11:31; Jas 2:25).

The prospect of death as a consequence of disobedience to state law did not stop Shadrach, Meshach and Abednego refusing to bow down to the image (Dan 4:6-8), or Daniel persisting with public prayer (Dan 6:1-10). They were defiant and their obedience was rewarded when God intervened miraculously on both occasions to save them.

In the New Testament when Peter and John were commanded by the Jewish authorities not to preach the Gospel they replied 'We must obey God rather than men' and went right on doing it (Acts 5:29). Many of the prophets and apostles and of course Jesus himself were killed precisely because they chose to obey God in what they said and did, in situations where his commands and those of human authorities conflicted.

In John's vision described in Revelation 13 the beast which is given (by God) authority over every tribe, people, language and nation is clearly not to be obeyed in the matter of receiving a mark to enable buying and selling (Rev 13:15-16). To the contrary, those who take the mark ultimately share the fate of the devil himself (Rev 14:9-12).

So while recognising that we have an obligation to obey the governing authorities God has instituted, our obedience to God himself takes precedence if there is a conflict.

If we decide that as Christians, for example, that we should not be ‘shedding innocent blood’ through abortion or euthanasia (and personally I believe Scripture leaves us no other option) it must follow that in spite of what governments and medical associations may decree, we must obey God first. Any ‘discipline’ that may follow simply has to be accepted as part of the cost of following Christ in an increasingly godless world.

To disobey God for fear of losing career, reputation or respect is surely to make idols of these things. We cannot say that in our hearts we worship God if our actions betray that we don't. Could we imagine Daniel, Shadrach or Jesus himself bottling out at the last moment on the grounds that the cost of obedience to God was too high?

What then of our involvement at other levels? If we decide that as Christian doctors we should not participate in the ‘shedding of innocent blood’, then surely this must have implications for other levels of involvement. If we 'participate' by filling out forms authorising abortions, preparing patients for the procedure or referring to others whom we know will do the same aren't we giving tacit approval to the whole process?

Shouldn't we rather observe the apostolic directive:

'Do not be partners with them' (Eph 5:7)?

Hasn't the time come to:

'Come out of her my people, so that you will not share in her sins' (Rev 18:4)?

Taking innocent human life is contrary to the whole strategy of medicine. It runs not only counter to Christian ethics but to the Hippocratic Oath and the Declaration of Geneva, which the BMA not so long ago embraced.

We must conscientiously object.

The same principles apply when the law commands us to do other things which we believe are wrong or to stop doing things that we believe are our duty before God.

Tuesday 24 April 2012

Abortion to save the life of the mother – how common is it?

Abortion to save the life of the mother makes up a miniscule fraction of the 200,000 abortions carried out each year in Britain but it is usually the very first question that people ask.

It is a very common question from doctors who do abortions – as if carrying out an abortion in an emergency to save life somehow justifies abortion for each and every reason.

But how common is it?

Usually when the mother's life is at risk from an ongoing pregnancy, the baby is at a viable age and so can be saved simply by bringing forward the time of delivery. However on very rare occasions it may be necessary to terminate an early mid-trimester pregnancy (13-22 weeks) in an emergency in order to save the life of the mother.

Here we are not saying that the baby's life is less important than that of the mother, but simply (since the baby will die regardless) that it is better to intervene to save one life rather than to stand by and watch two people die. Even in these situations it is often possible to deliver the baby alive in such a way that the parents can have some short time to bond with it and say their goodbyes.

In the UK it was reported in 1992 that in the first 25 years of the operation of the Abortion Act 1967 only 0.013% of all abortions were performed 'to save the life of the mother' and it is even questionable whether many of these required such radical action. The 2009 Abortion Statistics for England and Wales do not record any on these grounds.

Ireland's leading obstetricians stated in 1992: '... we affirm that there are no medical circumstances justifying direct abortion, that is, no circumstances in which the life of the mother may only be saved by directly terminating the life of her unborn child'. (Letter to Irish Times, 1 April 1992)

This was not unsubstantiated. The National Maternity Hospital in Dublin investigated in detail the 21 maternal deaths which occurred among the 74,317 pregnancies managed in 1970-1979. The conclusion was that abortion wouldn't have saved the mother's life in a single case.[1] And given the improvement in medical care since then we would expect it to even less common now.

Alan Guttmacher, former President of the pro-abortion US Planned Parenthood Federation has said:

'Today it is possible for almost any patient to be brought through pregnancy alive, unless she suffers from a fatal illness such as cancer or leukemia, and if so, abortion would be unlikely to prolong, much less save life'.[2]

So when people jump immediately to asking about abortion to save the life of the mother there is almost certainly another agenda. They are trying to divert attention from the fact that the overwhelming majority of abortions are not done for this reason.

In fact 98% of abortions in Britain are not even legal under the existing law.

1. Murphy J. Maternal Mortality - is there ever a case for abortion? Irish Medical Journal 1982; 75:304-306 (September)
2.Guttmacher A. Abortion - Yesterday, Today and Tomorrow' The Case for legalised abortion now. Diablo Press.1967

Saturday 21 April 2012

The GMC needs to explain why it is forcing doctors to provide sex change operations

The Mail on Sunday has today quoted my blog in a story titled ‘Doctors “forced to carry out sex-change ops” under rules meant to “marginalise Christian medics”’.

The article picks up on comments I made last week about new draft guidance issued by the General Medical Council which says that doctors who refuse to provide sex-change operations risk being struck off the medical register.

The new draft guidance, ‘Personal beliefs and medical practice’, was issued on Thursday and is subject to consultation. It warns that ‘serious or persistent failure’ to follow it ‘will put your registration at risk’.

The guidance recognises that ‘in some areas the law specifically entitles doctors to exercise a conscientious objection’ and opt out of ‘particular treatments or procedures’. It cites participating in abortion as a specific example.

It also allows doctors to opt out of providing other procedures or treatments provided that they ‘make sure that the patient has enough information to arrange to see another doctor who does not hold the same objection as you’.

However, the GMC makes a clear exception to this rule, with regard to sex-change operations.

Section 5 reads as follows:

‘You may choose to opt out of providing a particular procedure because of your personal beliefs and values.*’

But the asterisk refers to a footnote which states:

‘*The exception to this is gender reassignment since this procedure is only sought by a particular group of patients (and cannot therefore be subject to a conscientious objection – see paragraph 5). This position is supported by the Equality Act 2010 which prohibits discrimination on the grounds of gender reassignment.’

It then goes on to add the following:

‘But you must not refuse to treat a particular patient, or group of patients because of your personal beliefs or views about them†

Another appended footnote reads:

‘†The Equality Act 2010 prohibits discrimination on the grounds of nine protected characteristics: age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation. ‘

The Daily Mail quotes an unnamed GMC spokeswoman saying that the new guidelines only reflected the ‘law of the land’. She said the Equality Act 2010 already prohibited doctors from discriminating against people who are undergoing gender reassignment treatment.

But do you see the problem here? She has not actually addressed the real question.

On the one hand the guidance says that doctors should not refuse to treat people because of their personal beliefs or views about them.

Absolutely right! If I have a patient who needs treating for pneumonia and or diabetes then I must treat them without any partiality or discrimination regardless of their ‘age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation’. It would be profoundly negligent to do otherwise.

But the guidance also says that doctors have no right to opt out of ‘providing’ the ‘procedure’ of ‘gender reassignment’ (ie. A sex change operation). Furthermore it claims that the Equality Act 2010 upholds this duty.

Gender identity disorder (GID) is the formal diagnosis used by psychologists and physicians to describe persons who experience significant gender dysphoria (discontent with their biological sex and/or the gender they were assigned at birth). It is classified as a medical disorder by both the ICD-10 CM and the DSM-IV TR and that is how many doctors still regard it.

On the other hand many transgender people and researchers support the declassification of GID as a mental disorder for a variety of reasons.

In other words there is a major debate going on currently between leading professionals about what Gender Identity disorder actually is. But the GMC has disregarded this and instead chosen to take one controversial view held by some people on the subject as the only acceptable view.

Gender reassignment surgery is legal in this country but remains very controversial. Many doctors in this country, for a variety of reasons, do not wish to be part of providing this procedure, either as surgeons or anaesthetists or as part of the referral pathway or pre-operative assessment.

But the GMC is now saying that they have a duty to provide it and have no right to opt out of doing so. It is also threatening them with being struck off if they do not comply.

That is a bridge too far.

This draft guidance not only imposes a duty on doctors which violates their professional freedom. But I suspect it also significantly over-interprets the law.

The GMC has some serious explaining to do. And quickly.

(A much fuller treatment of Gender Identity Disorder is available on the CMF website)

Does every doctor have a moral line he/she will not cross? Twitter discussion thread on conscientious objection

Yesterday I posted a blog on the new GMC draft guidance pointing out that doctors who won't prescribe contraception to unmarried women or provide sex-change operations risk being struck off if it goes through unchanged.

This generated a lot of discussion on twitter and in particular Dr D Jones (aka @welsh_gas_doc), a prominent member of the secular medical twitterazzi, made a critical comment about me which led to a discussion about whether he ever would refuse to carry out a treatment or procedure on moral grounds.

Many British doctors still hold to the Declaration of Geneva (1948) which includes the statement:

'I will maintain the utmost respect for human life from the time of its conception; even under threat, I will not use my medical knowledge contrary to the laws of humanity'.

This was historically the position of the British Medical Association (BMA) and the World Medical Association (WMA) but it has since been amended out of recognition.

Doctors who still hold to it refuse to participate in procedures that involve the destruction of human life such as abortion and embryo research.

Dr Jones clearly does not hold to this historic code, but I was interested to see if there was any other moral line he would not cross.

Others joined in, including my old friend Shane McKee (@shanemuk) who eventually said that he would not perform a termination of pregnancy on grounds of sex selection.

Dr Jones, however, seemed unwilling to be drawn on the question and seemed to take offence by my pressing him with extreme examples.

I am still most interested in knowing whether there is actually any procedure he would object to on moral grounds because I would then like to ask him if he would consider it wrong for the GMC, should that procedure become legal, to strike him off for refusing to do it.

I believe that for most doctors there is a moral line, other than the law, that they will not cross as true professionals. But unless they admit that such a line even exists it is not possible to explore the more interesting question of what they would do if they are threatened by some authority with dire consequences should they refuse to cross it.

There are several treatments and procedures that are now part of medicine that I and many others refuse to carry out on moral grounds. But this is creating increasing problems for us in the current regulatory environment.

Anyway here is the thread thus far word for word as it happened. It gets a little lively toward the end. I will add more if Dr Jones comes back to it.

DJ: The "silent majority" need to take part in the current GMC Consultation. It is already being misrepresented by @drpetersaunders and his ilk.

PS: Do you gas for terminations or do you object on moral grounds?

DJ: I have no moral objection to abortion; so yes, I can and do provide general anaesthesia for surgical terminations.

PS: About how many surgical terminations have you gassed for in your career thus far?

DJ: About 100 probably. Why?

PS: For what indications and what gestations are you willing to carry out terminations?

DJ: Indications and gestation for terminations is described as per the Abortion Act. This is what I follow, not my own rules.

PS: Would you gas for a sex selection abortion if all the legal paper work was in order?

DJ: Sex selection, in and of itself, is not legal. So - by definition - the legal paperwork would not be in order.

PS: So are you saying that if sex selection abortions were legal then you would have no moral objection to gassing for them?

DJ: I work to UK law as laid down by democratic statute, and within GMC guidance. It's not for me to make my own rules up.

PS: So are you willing to gas for male circumcisions carried out purely for cultural/religious reasons?

DJ: As the alternative is that the child has it done without anaesthetic/adequate analgesia - then yes.

PS: If female circumcision were legal in Britain as in many other countries would you refuse to gas for it?

DJ: What's your next straw-man argument going to be? Taking part in the death penalty?

PS: I am trying to establish whether you have any moral principles. ie. Are there any procedures you would not gas for if legal?

DJ: The patient is my sole concern; not some wider societal quest to tell others how they should/should not behave.

PS: Thank you. So you would be quite happy then to gas for female circumcision if it was legal and the patient asked for it?

DJ: There's some pretty big "ifs" there, but if you want to put words in my mouth, you go ahead. I don't care.

PS: Neither of you (including Shane McKee on parallel thread) has answered the question as to whether are any treatments/procedures you would not provide if legal

PS: Guys I need to nip out for a wedding but will be back later. Answer my question (you cowards!) Go on say it!

Later…after neither have answered the question

PS: Now answer my question. Is there any treatment or procedure you would refuse to do on moral grounds or are u just a rubber stamp?

SM: My ethics and morality are based on the 4 pillars. Would I ToP purely on grounds of sex? No. But that is not at issue here.

PS: I was simply trying to ascertain if there was any procedure you would refuse to carry out if it was legal. There is! Excellent!

PS (to DJ): You still haven't replied. Is there any treatment or procedure you would refuse to do on moral grounds even if it were legal?


Dr Jones has, since this dialogue occurred, issued many more tweets both to me and about me but has so far refused to answer the key question about whether there is any treatment or procedure he would refuse carry out on moral grounds even if it were legal to do so.

This is most curious. Is it because that to admit that there was such a treatment or procedure would leave him having to say that he would not like to be forced in such circumstances to do what he believed was morally wrong? I wonder.

Or is he really just a rubber stamp, unlike my atheist friend Shane McKee, who will do anything he is asked to do by a patient? We will have to wait and see.

He has now answered as follows:

DJ: If the procedure is a) Clinically indicated, b) Legal as per current UK law & c) To a competent adult; then I would do it.

DJ: Although that list is not exhaustive, and like a professional, I would consider things on a case-by-case basis.

Thursday 19 April 2012

Doctors who won't prescribe contraception to unmarried women or provide sex-change operations risk being struck off, says GMC

Doctors who refuse to prescribe contraceptives to unmarried women or refuse to provide sex-change operations risk being struck off the medical register according to new draft guidance issued by their regulatory body.

The new draft guidance from the General Medical Council, ‘Personal beliefs and medical practice’, has been issued today and is subject to consultation. It warns that ‘serious or persistent failure’ to follow it ‘will put your registration at risk’.

The guidance recognises that ‘in some areas the law specifically entitles doctors to exercise a conscientious objection’ and opt out of ‘particular treatments or procedures’. It cites as examples ‘the right to refuse to participate in terminations of pregnancy’ and ‘participating in any activity governed by the Human Fertilisation and Embryology Act 1990’.

It also allows doctors to opt out of providing other procedures or treatments provided that they ‘make sure that the patient has enough information to arrange to see another doctor who does not hold the same objection as you’.

In other words, they can object, but have a duty to ensure that the patient sees another doctor who does not object.

However, the GMC makes two clear exceptions to this rule, with regard to contraception and sex-change operations.

If a doctor has a conscientious objection to providing contraception per se, then he/she can do so. But he/she ‘cannot be willing to provide married women with contraception but unwilling to provide it for unmarried women. This would be a breach of our guidance…’

Similarly although doctors ‘may choose to opt out of providing a particular procedure because of (their) personal beliefs and values’, the guidance says that ‘the exception to this is gender reassignment since this procedure is only sought by a particular group of patients and cannot therefore be subject to a conscientious objection’.

The guidance claims the support of the Equality Act 2010 for these two positions.

A recent parliamentary enquiry, ‘Clearing the Ground’, concluded that ‘Christians in the UK face problems in living out their faith and these problems have been mostly caused and exacerbated by social, cultural and legal changes over the past decade.’

I have previously highlighted the fact that recent legislation, and regulations claiming to be derived from it, are being used marginalise Christian health professionals in Britain.

This new GMC draft guidance is yet another example. It is essentially a clever piece of double-speak. On the one hand it says that 'doctors should be free to practise medicine in accordance with their beliefs', but if this involves 'denying patients access to appropriate medical treatment or services' then they must 'be prepared to set aside their personal beliefs'.

The problem is that 21st century British medicine now involves practices which many doctors regard as unethical. This latest guidance by the GMC will therefore be seen by a many as a further attack on the right to practise independently in accordance with one's conscience which lies at the heart of being a true health professional.

I suspect it will also further undermine the credibility of the GMC.

A significant number of doctors do not wish to be involved in sex-change operations or prescribing contraceptives to unmarried couples and will not want to be forced to make arrangements for patients to undergo procedures or 'treatments' which they regard as unethical.

But it appears that these doctors, if this guidance emerges from this consultation unchanged, will soon be at risk of losing their licences to practise medicine.

(See CMF submission to GMC on previous draft of 'Personal Beliefs and Medical Practice')

Wednesday 18 April 2012

How to protect your kids from internet pornography

I have just posted a blog on the report from a committee of MPs which makes recommendations about new measures to protect children from internet pornography.

Most of these are targeted at the ISP industry (and not a moment too soon!) but the real need is for parents to take steps themselves.

If you are interested about how practically to do it here is some advice from a Christian medical colleague (and computer whizz!) that I have gleaned today.

How to protect your kids (and yourself!)

Because of the proliferation of connectable devices having software just on a PC is inadequate - the entire home network needs internet filtering.

The best way to achieve this is for the ISP to do it. Out of the 4 main British ISPs (Virginmedia, Talktalk, BT and Sky) only Talktalk can do this at present.

The main system I use is ‘Covenant Eyes’. This is accountability software that I use with a friend. It monitors internet use and alerts your accountability partner if you are accessing inappropriate websites. Once installed it cannot be removed without your accountability partner being alerted. You probably know about this already but the website gives full details. It would be a brilliant thing to do with teenagers. Although there is little need for this if the OpenDNS service is used (see below), it has the advantage of monitoring a device whether it is used at home or elsewhere - OpenDNS only covers your home network.

Second, most mobile phone networks have the ability to turn on web filtering for smartphone use at a network account level. So as long as your kids have mobile phones on your account you can block the inappropriate use of mobile devices through the 3G network.

Third, and this is the really clever way of doing it, a home user can achieve network-wide site filtering by using a service called OpenDNS. A brief, simple explanation of what a DNS Server does can be found at the end of this post.

To set this up you have to create an account on, tell OpenDNS about the IP address your ISP has given your ADSL or cable modem, and then edit the settings in your router so you use OpenDNS's DNS Servers rather than your ISP's. They provide good instructions on how to do this, but it's a little technical. The service is free. (There is a more feature-rich service that you have to pay for but for most home networks the free bit is all you need).

As long as you keep the usernames and passwords for both your router and your OpenDNS accounts completely secret there is generally no way past this, even for your bright computer-savvy kids.

Check out

What a DNS server does (the technical stuff!)

Every networked device has a unique numerical address - an "Internet Protocol" (IP) address. It is a set of 4 numbers (between 0 and 255) separated by dots. The PC I am typing this on has the IP address "". My PC at work is "". When devices communicate over the network they talk to each other using these numerical IP addresses - but they are not very human-friendly! So each device also has a name - my PC is called "Saturn". At some point the IP address and the name need linking, so when I look at my network and see a PC on it called "Saturn" the software knows "Saturn" = IP address, and vice versa. This name to IP address translation is done through a database called "DNS" - "Domain Name Service". Every device has to know the address of the computers on their network that hold the DNS database (there's usually 2 - one main one and one backup). A computer holding the DNS is known as a DNS Server. With me so far? Good!

Now, this is also true on the Internet, with the condition that every device connected directly to the internet has to have a worldwide unique IP address. So the computer called "" (that responds when you type"" into your web browser) has the IP address "" - no other computer exposed on the Internet can ever have this address. When you type "" into your browser your Internet router that connects you to the Internet realises no device inside your home network has this name so it sends out a request to your ISP's DNS servers which will respond with "the IP address you need is". Your router can then find this address on the Internet and you can see the Microsoft website. Every ISP provides all their users with the IP addresses of two DNS server so your router knows were to send the request for name to IP address translation to. For example, VirginMedia provides a primary DNS Server IP address of, and a secondary IP address of Everyone using VirginMedia as an ISP will have these 2 IP addresses in the setup of their router so the network knows how to change website names into IP addresses.

A DNS server contains a huge database of website names and IP addresses - billions probably. Every single request to view a website that comes out of any device connected to your home network will go through the DNS server. Here comes the clever bit...

You don't have to use the DNS servers provided by your ISP. For example Google has a couple of public ones that you can use - their IP addresses are and Program those IP addresses into your router instead of the ones provided by your ISP and all your IP address requests will go through Google's DNS servers.

A company called "OpenDNS" provides 2 DNS server addresses for public use. They have built into them the ability to block certain website addresses from being passed back to your network. There is a massive classification database available that classifies millions and millions of websites into certain categories - hate, racist, violence, porn etc. The OpenDNS servers use this classification to allow you to filter website requests. So if I type "" into my browser, VirginMedia's DNS servers would return "" and off I go into the Playboy website. OpenDNS (assuming I have an account with them and have set up the filtering to block porn) will refuse to return an address and say the site is blocked. As you will now understand, any device connected to my network (smartphone, PC, laptop, PS3, XBox etc be they mine or guests in my home) will get the same response - "blocked".

MPs call for better protection of children against porn

A cross-party parliamentary has concluded that the government and internet service providers need to do more to stop children accessing pornography and websites showing extreme violence.

The inquiry called on the government to back moves for stronger filters of adult content and also recommended that the government appoint an internet safety tsar.

Their report, according to the Daily Mail, said that six out of ten children download adult material because their parents have not installed filters. The use of protective filters in homes has fallen from 49 per cent to 39 per cent in the last three years.

They concluded that parents were often outsmarted by their web-savvy children and felt unconfident in updating and downloading content filters. Many parents were ‘oblivious’ to the type of material available on the internet and were often shocked when they realised the content that children were accessing.

Claire Perry, the Tory MP who chaired the Independent Parliamentary Inquiry on Online Child Protection, said: ‘While parents should be responsible for their children’s online safety, in practice, people find it difficult to put content filters on the plethora of internet-enabled devices in their homes.It’s time that Britain’s internet service providers, who make more than £3billion a year from selling internet access services, took on more of the responsibility to keep children safe.’

The inquiry called for internet service providers to offer ‘one-click filtering’ for all devices within a year. This would block out adult content for all domestic broadband users and stop them accessing pornography on mobiles and iPads as well as PCs and laptops.

All the big four UK ISPs, BT, Sky, TalkTalk and Virgin, have agreed to offer all new subscribers the option to install parental controls.

TalkTalk is the only major UK ISP so far to have implemented a network level filtering system which offers parental controls for all devices that are connected via the home broadband service.

For those who wish to protect their children from pornography I have posted some advice on the best way of doing it from a Christian doctor colleague friend on this blog.

There is also an excellent article on a Christian approach to the issue in CMF’s journal Triple Helix. The main points are as follows:

'The ready availability of sexual images on the internet has led to an explosion in pornography use and addiction and Christians are not immune from the pressures. By offering stimulation without consequences and intimacy without responsibility, pornography brings unreal and damaging expectations into relationships. Furthermore, by encouraging unfaithful thoughts, the use of porn clearly violates God's commandments and undermines marriage. Warnings from the Old Testament prophets are chillingly relevant today. Christians need to recognise the risks of pornography, seek God's forgiveness for involvement and embrace practical measures that will help them resist the temptation to get involved.'

I was surprised to learn at a church seminar last night that the biggest users of pornography are actually men in the 35-55 age group with salaries over £45,000.

In terms of practical advice (adapted from Christian Viewpoint for Men) I’d recommend the following:

•Place the highest level of filter on your internet.
•Only view the internet in an open place.
•Find an accountability partner to discuss your progress with honestly.
•Install a programme that sends your weekly website hits to your accountability partner (Covenant Eyes is particularly recommended)

The demographic time bomb and euthanasia

I have previously warned that unless something is done to reverse current demographic trends, economic necessity, together with the ‘culture of death’ ideology which is becoming more openly accepted, may well mean that the generation that killed its children will in turn be killed by its own children.

In other words legalised abortion will lead to legalised euthanasia as a cost-saving and population-control measure.

The Political blog ‘Turtle Bay and Beyond’ reported last week on an interview with CFAM’s Susan Yoshihara on the population crisis in China.

‘Demographic trends are poised to spoil Beijing’s plans for a Chinese century,’ said Yoshihara, co-editor (along with Douglas A. Sylvia) of the book, ‘Population Decline and the Remaking of Great Power Politics.’

‘The country is aging rapidly and it is facing a contraction in its workforce sooner than anticipated. More than a quarter of the Chinese population will be older than 65 by 2050, up from 8 percent today. And the very old — those over 80 — will increase more than five times. China will see absolute population decline by the end of the next decade.’

I have previously highlighted Sunday Times columnist Minette Marin’s proposed final solution(£) for Britain’s growing number of elderly people and another article in the same paper linking euthanasia with demographic trends.

Lois Rogers (£), reporting on a joint suicide of a British couple in Australia, wrote that ‘Assisted dying is becoming more commonplace with the rise in the number of elderly people. Projections by the government suggest 11m Britons alive today can expect to reach 100.’

In the West we have a growing elderly population supported by a smaller and smaller working population – fuelled by elderly people living longer and an epidemic of abortion, infertility and small families.

These demographic changes, together with economic pressure from growing public and personal debt, and increasing pressure for a change in the law to allow euthanasia, produce a toxic cocktail indeed.

Marin’s solution is euthanasia – ie. continue with our consumptive lifestyles and small families and kill off the elderly.

But there is an alternative.

Britain’s problem is debt. And we are in debt because as a nation and as individuals we have lived beyond our means. Our personal debt is £1,500 billion and our public debt will reach that figure by 2014 (yes its getting bigger in spite of the Coalition’s plan to ‘cut the deficit’. All we are doing is borrowing less each year than we did in the previous one)

So our total debt will be around £3,000 billion (£3 trillion) in just three years’ time.

Let’s put that figure in a global context.

The world’s poorest billion people earn less than £1 per day (£360 per year) and the next poorest two billion earn less than £2 (£720) so the total income for the poorest half of the world’s population is £1,800 billion per year – just over half our nation’s debt.

And yet ironically, it is rich people in the affluent West, rather than the poor in the Global South, who say they can’t afford to look after their dependents and are clamouring for euthanasia.

The real answer is not euthanasia. The real answer is in our grasp, but it requires a completely different mindset to that which has led us, in our reckless pursuit of affluence and personal peace to mortgage our present, bankrupt our futures, and see those who rely on us as a burden rather than a privileged responsibility.

We need instead, as a society, to stop killing our children, build up our families, live more simply, give more generously and focus our priorities on providing for our dependents, especially the older generation which fought for our freedom in two world wars, provided for our health, education and welfare, and left us the legacy of wealth, comfort, peace and security which we have squandered and taken for granted.

We are at a crossroads surveying two possible future societies.

In the first, the independence and autonomy of the individual rule absolute and the weak elderly take an ‘honorable exit’ so as not to burden the young and virile.

The other, by contrast, is an inter-dependent world, where each person, regardless of their level of infirmity or disability is loved, cherished, valued and given the very best level of care that money can buy; one where the strong make sacrifices for the weak, where resources are spent on those who most need them, where what I have is yours if you need it, and vice versa.

Which society would you prefer to live in?

The demographic time-bomb is a challenge but it does not lead me to despair.

Rather it makes me want to live more simply, give more, save more, serve more, love more, value those who are dependent, both old and young, more deeply and work harder to provide good care for all.

The solution is easily within our grasp, but we must have the will to embrace it.

Sunday 15 April 2012

Huge increase in assisted suicide cases in Oregon and Switzerland sounds strong warning to Britain

There has been a massive increase in cases of assisted suicide in both Oregon and Switzerland over recent years according to the latest figures.

The Oregon ‘Death with Dignity Act’ allows terminally-ill Oregonians ‘to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose’.

It also requires the Oregon Health Authority to collect information about the patients and physicians who participate in the Act, and publish an annual statistical report.

The latest figures show that cases of assisted suicide have gone from 16 in 1998 to 71 in 2011, an increase of 450% (see chart).

The US state of Oregon legalised assisted suicide in 1997 following a referendum. Thus far over 100 attempts to get other US state parliaments to change their laws have failed and only the state of Washington has followed suit, again on the basis of a referendum.

Switzerland has seen a 700% increase in assisted suicides over the same period. Swiss authorities have recorded a steady rise of assisted suicides in recent years, from 43 in 1998 to 297 in 2009. Earlier figures are not available, even though assisted suicide has been legal in Switzerland since 1942.

These figures include only Swiss nationals and not the growing number of people from abroad who are making use of facilities like Dignitas.

The experience of both countries demonstrates that when assisted suicide is legalised there will inevitably be incremental extension.

A major factor fuelling this increase is suicide contagion - the so-called Werther effect. This is particularly dangerous when assisted suicides are backed by celebrities as they are here and given high media profile as they are frequently by the BBC.

The Oregon and Swiss numbers may not seem large to some but we need to remember that Oregon and Switzerland have small populations relative to the UK.

Back in 2006 the House of Lords calculated that with an Oregon-type law we would have about 650 cases of assisted suicide a year in Britain. But given the increase of numbers in Oregon the UK equivalent would now be well over 1,000. Currently assisted suicide is illegal here and we see only 15-20 Britons going to Dignitas in Switzerland to die each year.

However, later this year we will see renewed attempts to change the law in this country.

Margo Macdonald is planning to present a bill based on the Oregon model to the Scottish Parliament and the pressure group Dignity in Dying (formerly the Voluntary Euthanasia) is planning a mass lobby of the Westminster Parliament on 4 July in support of a new bill they plan to introduce by means of their parliamentary wing, the All Party Group on ‘Choice at the End of Life’.

We should learn from the Oregon and Swiss experience and be resisting these moves.

Any change in the law to allow assisted suicide (a form of euthanasia) would inevitably place pressure on vulnerable people to end their lives so as not to be a burden on others and these pressures would be particularly acutely felt at a time of economic recession when many families are struggling to make ends meet and health budgets are being slashed.

And once legalised there will inevitably be incremental extension as we have seen in Oregon and Switzerland. Legalisation leads to normalisation.

Let’s not go there.

Saturday 14 April 2012

How British society marginalises Christian health professionals

Earlier this year Christians in Parliament, an official All-Party Parliamentary Group (APPG), chaired by Gary Streeter MP, launched an inquiry called ‘Clearing the Ground’, which was tasked with considering the question: ‘Are Christians marginalised in the UK?’

The inquiry was facilitated by the Evangelical Alliance and the report was published in February 2012. (You can read the executive summary here)

The inquiry’s main conclusion was that ‘Christians in the UK face problems in living out their faith and these problems have been mostly caused and exacerbated by social, cultural and legal changes over the past decade.’

I gave both written and oral evidence to the inquiry and part of my oral evidence is quoted in the report. Unfortunately my written evidence was not acknowledged or included, I suspect due to an administrative error but it is available on the CMF website.

I have pasted below the answers I gave to two key questions in the report.

What key issues face Christians in public life today?

With the rise of the secular humanism and, in particular, the new atheism, there is in British society generally a loss of historically held belief in the existence of a transcendent communicating God incarnate in Jesus Christ, in biblical authority and in biblical ethics, which is combined with an active agenda to impose an alternative secular world view through our laws, institutions and media. This is leading to an erosion of laws that were based on a biblical worldview and to some loss of Christian freedoms.

For Christian doctors the major impact has been felt in the areas of sharing Christian faith (evangelism), expressing beliefs about Christian doctrine or ethics or manifesting Christian behaviour especially in the areas of prayer and/or sexual and life ethics.

Conflicts arise when Christians are:

1. Prevented from sharing, expressing or manifesting their beliefs
2. Required to perform tasks or conform in ways which go against their beliefs
3. Excluded from consultation or decision-making or advisory roles because of their beliefs.
4. Prevented from meeting on public or institutional premises for worship/prayer/teaching/events.

These are the key issues in public life not because they are more important than other areas of Christian faith and practice but because they are the specific areas where recent laws, or regulations/guidelines based on those laws, have impacted.

The main laws implicated are:

1. Employment Equality regulations on religion and belief and sexual orientation (2003)
2. Equality Acts 2006 and 2010
3. Section 5 of the Public Order Act (less applicable to Christian doctors)
4. The Abortion Act 1967 and Mental Capacity Act 2005 also have some influence through interpretation by official bodies about the scope and application of their provision for conscientious objection.

Guidelines based on these laws by the Department of Health, NHS trusts and professional bodies like the GMC and BMA also have an impact on how legal policy is interpreted and implemented. Examples of such guidelines include:

1. Religion or belief: a practical guide for the NHS (Department of Health, January 2009)
2. Sexual orientation: a practical guide for the NHS (Department of Health, February 2009)
3. Personal beliefs and medical practice - guidance for doctors (GMC, March 2008)
4. The law and ethics of abortion (BMA, November 2007)
5. Treatment and care towards the end of life: good practice in decision making (GMC, July 2010)

Which specific aspects of law, or its interpretation, do you consider unfair?

1. The Employment Equality regulations on religion and belief and sexual orientation (2003) and the Equality Acts 2006 and 2010
A. The requirement for Christian organisations with a Christian ethos to employ people who either do not hold to Christian faith
B. The definition of harassment is too broad and too open for misinterpretation or perverse action: ‘unwanted conduct which takes place with the purpose or effect of violating the dignity of a person and of creating an intimidating, hostile, degrading or humiliating environment.’

2. The Department of Health practical guides on ‘religion and belief’ and ‘sexual orientation’ over-interpret the law with respect to evangelism and expression of Christian belief about sexuality and have created an environment where normal Christian behaviour is inappropriately open to censure or discipline. These documents were not made open to full consultation or review when implemented but are being used by NHS employers. Both these documents should be reviewed and opened to consultation.Examples of problematic clauses are given below.

3. The implementation of the Abortion Act 1967 and Mental Capacity Act 2005 conscientious objection clauses needs to be kept under regular review to ensure that Christians are not being unlawfully discriminated against.

Examples of problematic clauses in Department of Health documents which can be used to discriminate against Christians:

Members of some religions... are expected to preach and to try to convert other people. In a workplace environment this can cause many problems, as non-religious people and those from other religions or beliefs could feel harassed and intimidated by this behaviour… To avoid misunderstandings and complaints on this issue, it should be made clear to everyone from the first day of training and/or employment, and regularly restated, that such behaviour, notwithstanding religious beliefs, could be construed as harassment under the disciplinary and grievance procedures.(Department of Health, Religion and Belief)

Any NHS employer faced with an employee who by virtue of religion or belief refuses to work with or treat a lesbian, gay or bisexual person, or who makes homophobic comments or preaches against being lesbian, gay or bisexual, should refer to its anti-discrimination and bullying and harassment policies and procedures, which should already be in place… If the conduct has the purpose or effect of violating a person’s dignity, or creating an intimidating environment, and it is reasonable for the complainant to take offence, then it is harassment. (People) should not be subjected to discrimination or harassment on any grounds whatsoever. It should be made clear that such behaviour is unlawful and could result in legal proceedings being brought. (Department of Health, Sexual Orientation)

Friday 13 April 2012

Changing views about sexual orientation - 'A more fluid approach'

Many people believe that homosexual and heterosexual are distinct biological categories like race – unchangeable, biologically fixed and genetically determined. It is on the basis of this view that the gay rights lobby and sections of the media argue that 'homophobia' is a form of discrimination akin to racism.

But this view is being increasingly challenged, not least by gay rights activists themselves. In a recent Huffington Post article that has generated a huge amount of attention, 'Future Sex: Beyond Gay and Straight', (1) Peter Tatchell affirms both the spectrum and also the fluidity of sexual attraction.

Regarding bisexuality he says: 'We already know, thanks to a host of sex surveys, that bisexuality is a fact of life and that even in narrow-minded, homophobic cultures, many people have a sexuality that is, to varying degrees, capable of both heterosexual and homosexual attraction.'

Then he challenges the traditional view that gay and straight are distinct categories:

'Research by Dr Alfred Kinsey in the USA during the 1940s was the first major statistical evidence that gay and straight are not watertight, irreconcilable and mutually exclusive sexual orientations. He found that human sexuality is, in fact, a continuum of desires and behaviours, ranging from exclusive heterosexuality to exclusive homosexuality. A substantial proportion of the population shares an amalgam of same-sex and opposite-sex feelings - even if they do not act on them.'

Tatchell, however, grossly inflates the true incidence of exclusive homosexuality. The best evidence (2) (3) (4) suggests that only a very small percentage of men (1-2%) and women (0.5-1.5%) experience exclusive same-sex attraction throughout their life course. But bisexuality appears to be more prevalent than exclusive homosexuality.

What is the relative ratio of bisexuality to exclusive homosexuality? For each man who is 'completely homosexual' (Kinsey score 6) there are three with varying shades of bisexuality; but for women the ratio is 1:16. (5)

Sexual attractions are therefore best understood as lying on a spectrum rather than in terms of a simple dichotomous binary categorisation, and mixed patterns of sexual desire, including attraction to both sexes at the same time, appear to be more common than exclusive same sex attraction, especially among women.

But the concept of a spectrum of sexuality–known for decades, but often ignored–also calls into question simplistic analogies between sexual orientation and race.

Conflating sexual orientation and race is not really comparing like with like. It is what is called a 'category error'.


1. Huffington Post; 10 January 2012
2. Dickson N, et al. Same-Sex Attraction in a Birth Cohort: Prevalence and Persistence in Early Adulthood. Soc-Sci and Med 2003; 56 (8):1607-15.
3. Savin-Williams RC, and Ream GL. Prevalence and Stability of Sexual Orientation Components During Adolescence and Young Adulthood. Arch Sex Behav 2007;36:385-94.
4. Laumann EO, et al. The Social Organization of Sexuality: Sexual Practices in the United States. Chicago: University of Chicago Press, 1994.

From the Spring 2012 edition of Triple Helix

Tuesday 10 April 2012

BBC and Guardian leap to defence of abortion industry

The abortion industry has been under a lot of pressure in recent weeks – first with revelations about illegal abortions for sex selection, then with a Care Quality Commission (CQC) report showing breaches of the law in 20% of 300 ‘clinics’ examined and more recently with peaceful prayer vigils run by ‘40 days for life’.

It is not surprising therefore that they have been attempting to fight back with the assistance of sympathetic journalists working for the BBC and the Guardian.

First we had the publication of a ‘secret’ letter from CQC chairman Dame Jo Williams complaining to the Department of Health that carrying out the inspections meant ‘a total of 580 inspections foregone and a total of 16 inspectors being utilised on a full year basis at an estimated cost of £1.0m’. Ann Furedi, Chief Executive of the British Pregnancy Advisory Service was given a free BBC platform on the Today Programme to tell us that it was ‘absolutely wrong for the government to order the CQC to abandon all of the other work, in order to prioritise inspections of 500 clinics’. (See Cristina Odone’s commentary)

The BBC, unsurprisingly, did not however report the Health Secretary’s response. One commentator described the incident as follows:

‘A newspaper uncovers widespread criminality in health clinics. The minister responsible requests an immediate investigation, which takes only three days and costs a mere £1 million — less than one ten-millionth of the Health Department’s £105 billion budget. The scandal is stamped out, the guilty face punishment . . . and instead of patting the Health Secretary on the back, the BBC swoops down on him like an avenging angel, flaming with wrath.’

Pre-signing batches of abortion forms to authorise abortions on women that have not even yet been assessed, as doctors at these ‘clinics’ allegedly did, is perjury and it is quite right that both the police and the General Medical Council are currently carrying out an investigation.

Next we had the Guardian running a story about a US ‘charity’ paying for UK medical students to have elective ‘experience’ in BPAS abortion centres, on grounds that the government is not providing enough training for doctors to do late abortions. 'Medical Students for Choice' plans to set up summer 'externships' with BPAS for UK and Irish students to groom a new crop of abortionists. Expect the BBC to pick up the story soon.

I have already argued on this blog that the main reason more doctors don’t do late abortions is that they find it profoundly distasteful to be killing and then dismembering what is so obviously a baby.

Abortion also runs contrary to the Hippocratic Oath and every existing historic code of medical ethics. It is therefore not surprising that so many doctors, of all faiths and none, do not want to be involved in a procedure which they believe should not be part of medical care.

Sadly, the inclusion of abortion as a routine component of Obstetrics and Gynaecology is in large part responsible for many new graduates choosing not to enter that specialty today.

In 1947 the British Medical Association called abortion ‘the greatest crime’.

The fact that the BMA now defends current practice of 200,000 abortions a year in Britain, mostly carried out by its own members, is a measure of how far we have fallen as a profession.

Sunday 8 April 2012

Egg donation mania – probing beneath the journalistic hype

There are two stories about egg donation in the papers this week.

First is the HFEA’s drive to recruit sperm and egg donors. Apparently it is bringing together a National Donation Strategy Group to look at how to ‘raise awareness’.

The BBC gives an advertorial gloss to the story but the Daily Mail tells us that the payment to women donating their eggs for use in IVF has tripled from £250 to £750 this week and that the extra money on offer is said to have led to a five-fold increase in women approaching clinics to donate their eggs to infertile couples.

Under the change, egg donors will be given free treatment to retrieve the eggs plus a payment of £750 per cycle, no matter how many eggs are collected. Tempting during a recession and the question has to be asked, ‘how many of these women would choose not to take the risk if it were not for the money?’

It is noteworthy that the infertility industry in the United States has now grown to a multi-billion dollar business, its main commodity being human eggs. Young women all over the world are solicited by ads—via college campus bulletin boards, social media, online classifieds—offering up to $100,000 for their ‘donated’ eggs, to ‘help make someone’s dream come true.’

Second is the news that scientists in Edinburgh are intending to seek permission from the HFEA to fertilise eggs grown in a laboratory from stem cells. The tests are understood to be aimed at eventually generating an unlimited supply of human eggs that could assist women to have babies later in life.

Stories like these of course make alluring headlines and journalists reproducing uncritical press releases from those with vested interests seldom ask questions about the deeper ethical issues around egg donation – such as the health dangers of egg harvesting, the huge numbers of human embryos destroyed in the process of refining new techniques and the problem of children with confused identities and parentage as a result.

Even less do they ask the ‘elephant in the room’ question of why there is such a huge demand for donated eggs in the first place, but it is precisely that which I want to shed some light on.

The primary problems driving egg donation are the rising incidence of infertility and the huge decrease in babies available for adoption.

Infertility is the most common reason for women aged 20–45 to see their GP, after pregnancy itself. It is estimated to affect around one in six or one in seven UK couples – approximately 3.5 million people – at some point.

Around 1.5% of all births and 1.8% of all babies born in the UK are the result of IVF and donor insemination and 45,264 women had IVF treatment in 2010. These women had 57,652 cycles of treatment, an increase of 5.9% on the previous year. There were 12,714 babies born in 2009 as a result of IVF treatment using women’s own fresh eggs.

There are of course many different treatments for infertility depending on the cause and only a small percentage of these use donated eggs but there were 1,506 treatment cycles with donated eggs in 2010 - and 593 children were born from donated eggs in 2009.

The latest figures (2009) show that 25.2% of IVF treatments using a woman's own fresh eggs resulted in a live birth but infertility in women is strongly linked to age.

The biggest decrease in fertility begins during the mid thirties. For women who are 35, 95% will get pregnant after three years of having regular unprotected sex. For women who are 38 the equivalent figure is 75%.

The following figures give the average success rate for IVF and ICSI treatment using a woman’s own fresh eggs in the UK in 2009.

•32.3% for women under 35
•27.2% for women aged 35-37
•19.2% for women aged 38-39
•12.7% for women aged 40-42
•5.1% for women aged 43-44
•1.5% for women aged 45+

Add to that the fact that women are delaying childbirth and having babies later and later and we see why there is such a high demand for IVF and donor eggs. In England and Wales, the average age at first birth was around 24 during the 1960s, compared with around 28 in 2009 (see graph of maternal age at birth in 2010).

Along with the increase in infertility there are fewer and fewer babies for adoption for two main reasons – abortion (which kills babies that might otherwise have been adopted) and state support for single parent families (which means that babies that would have previously been given up for adoption now are not).

There is currently only one baby adoption in the UK for every 2,235 abortions.

The new adoption tsar has tried so far unsuccessfully to promote adoption as an alternative to abortion but an in depth examination of UK adoption data reveals the following:

Total adoptions in England and Wales fell steadily from 22,502 in 1974 to 4,725 in 2009. Adoptions involving babies under one year fell from 5,172 in 1974 (23% of all adoptions) to just 91 in 2009 (2%). That is a huge reduction in baby adoption.

During the same period abortions on UK residents rose from 119,123 in 1974 to 203,444 in 2009.

The number of abortions on UK residents in 1968, the first full year after legalisation was 23,991. I can’t find an adoption number for that year but suspect it was considerably higher than 22,000.

There are also now three million children living in a single parent household (23% per cent of all dependent children).

Just over a quarter (26 per cent) of households with dependent children are single parent families, and there are 2 million single parents in Britain today. About half of these had their children outside marriage.

In 1971 just 8 per cent of families with children were single parent families but this had increased to 24 per cent by 1998 and 26 per cent by 2011.

So when you next read about egg donation, before jumping on the bandwagon and trumpeting it as a wonderful advance remember the deeper ethical issues (embryo destruction, health risks of harvesting, confused identities and commercial exploitation) and the societal changes (abortion, delayed childbirth and single parenthood) which have contributed to the demand.