Sunday 30 November 2014

The Human Journey – Thinking biblically about health

Many people today hold to an atheist worldview – they believe that God doesn’t exist, that human beings are just clever monkeys, that morality is largely a matter of personal choice and that death is the end. 

Within this framework medical technology can become simply a tool to improve life’s length and quality without regard to any overall meaning and purpose. If we want it, and can do it, and it seems to improve our life and health then why not?

By contrast the Bible teaches that God does indeed exist, that he has clearly spoken and acted in history in a way that leaves us in no doubt about his character and intentions. He has created human beings to know him and love him.

Death is not the end at all but rather a gateway to two radically different futures – either to enjoy eternity with God in a new and perfect world, or to be excluded from his presence forever.

Under this scheme history is indeed ‘his story’ – a ‘divine drama’ worked out according to God’s will and purpose.

My new book, the Human Journey, aims to equip Christians to think biblically about health and healthcare. But it sets these issues in the greater context of God’s design for man, the universe and everything – his great plan of redemption to unite everything under Jesus Christ.

The book starts by sketching out the grand ‘metanarrative’ – the overarching great storyline of the Bible in which all our individual little stories make sense. This big story makes sense of all that follows.

But then I focus down on issues at the interface of Christianity and health under eight big themes – each accompanied by a key question:

·         Humanity - What does it mean to be human?
·         Start of Life - When does life begin?
·         Marriage and sexuality - What is marriage for?
·         Physical health - How should I live?
·         Mental health – Am I supposed to feel like this?
·         End of Life – How should life end?
·         New technologies – Are we playing God?
·         Global health – Who is my neighbour?

The overall aim is to establish a biblical framework to help Christians think about health, both to make better personal healthcare decisions and also to help their churches incorporate healthcare expertise more effectively into pastoral life and ministry.

While the book can be read alone, it is accompanied by a set of videos and a study guide for small groups, expanding on each chapter. It’s intended to be shared and discussed within the context of the Human Journey course. To help readers explore the issues I touch upon in more depth, there are also a host of articles and further resources on the Human Journey website.

My desire is to see people excited about the whole Bible, more amazed about Christ’s great work and all that it means and more confident about how to bring God’s word and healthcare together. So I have deliberately packed this book full of biblical references.

If you finish it more grateful for all God has done and is doing, more hungry to mine the depths of Scripture, more passionate about serving Jesus and more equipped to think, speak and serve for Jesus Christ then it will have achieved its purpose.

Friday 14 November 2014

Lord Falconer’s phoney war continues

Lord Falconer’s Assisted Dying Bill reached Committee Stage in the House of Lords on Friday 7 November. It seeks to legalise assisted suicide (but not euthanasia) for mentally competent adults (aged over 18) with less than six months to live, subject to ‘safeguards’ under a two doctors’ signature model similar to the Abortion Act 1967.

Opponents to the Bill had tactical choices: either to try to kill the bill dead at second reading on 18 July – as they did with a similar bill from Lord Joffe in 2006 – or to strangle it slowly in committee by amending it, if necessary with ‘wrecking’ devices. They have opted for the latter, which means clear arguments against will form part of the official record of the debate. This will effectively stop Falconer complaining that ‘we have not yet had the debate’. Peers will instead literally do it to death.

And so the House of Lords are now debating the bill line by line and considering amendments. Thus far 175 amendments to the bill have been tabled and collated into over 40 groups. Only four of these groups were considered on the first day of committee (7 November) so there is still a long way to go (you can read last Friday’s full debate here). There have even been extra amendments laid for pure comedy value!

House of Lords protocol requires that each proposed amendment has to receive the offer of debating time so given that there are only three more possible committee days this year to consider it, and none of these days have yet been allocated to it by the government whips, the bill is fast running out of time.

It may not even reach the report and third reading stages necessary for it to clear the House of Lords. And even if it does those on both sides agree that there is no time for it to go through the House of Commons before the general election on 7 May 2015.

This means almost inevitably that the bill will fall and that Lord Falconer will have to start all over again next summer – which he no doubt will do.

The debate now however is still very important as it will form part of the parliamentary record and will influence future discussions. And so we are asking all those opposed to the bill to write to members of the House of Lords urging them to reject the bill at third reading, if it should come to a vote.

One development on 7 November was the ‘acceptance’ of an amendment that judges, not doctors, should take final decisions about whether someone should be given the go-ahead to take their own life. Or at least that is how it was spun by the media. In fact, Lord Pannick (a strong supporter of Falconer), who moved the amendment, was reminded by other peers of the convention not to vote on amendments before report stage, but he pushed it to a vote regardless at a time when his supporters (many of whom left soon afterwards) were present in good numbers.

Those opposed to him then simply sat on their hands and abstained meaning that a formal division was not called for. So in effect the ‘acceptance’ means very little.  No amendment stands anyway if the bill falls at third reading and more can be moved at report stage before that.

Lords Pannick’s amendment puts a fearsome onus on judges but also demonstrates one of the weaknesses of Falconer’s bill – the fact that someone on his own side felt moved to tighten his ‘safeguards’ further is further evidence that they are not safe. A fuller analysis of the bill and a paper giving warnings from Oregon where similar legislation was passed are both available on the Care Not Killing website.

These concerns about safety are further confirmed by a new Comres poll which showed that a clear majority of public says there is no safe system of assisted suicide and that more than four in ten believe assisted suicide will be extended beyond the terminally ill if the current law is changed.

Andrew Hawkins, Chairman of ComRes, has commented:

'The obvious conclusion is that while the public are broadly sympathetic to the rights-based argument in favour of ending lives at the time of a person's choice, there is widespread concern about the abuse to which any system is likely to be open. These concerns are apparent across three areas - by the medical profession... by unscrupulous relatives, and in terms of pressure to end lives prematurely and on diminishing palliative and other health care resources.'

This latest series of events has all the hallmarks of a phoney war. Regardless, Falconer and his allies will undoubtedly not let the matter rest. The first shots have indeed been fired but this battle will run and run. 

Monday 3 November 2014

Lord Falconer has suffered enough - it's time to put him out of his misery

Lord Falconer’s ‘Assisted Dying Bill’ , which reaches its Committee Stage in the House of Lords on Friday 7 November, seeks to legalise assisted suicide (but not euthanasia) for mentally competent adults (>18) with less than six months to live subject to ‘safeguards’ under a two doctors’ signature model similar to the Abortion Act 1967.

The Bill had an unopposed second reading in the House of Lords on 18 July. This is not unusual for the House of Lords and simply means that the Lords were opting to debate it line by line rather than just rejecting it on principle.

A Supreme Court ruling earlier in the year put pressure on the Lords to give the bill a proper hearing and if they didn’t, doubtless Falconer would keep bringing it back, using up more precious parliamentary time and complaining that ‘we have not yet had the debate’.

For opponents to the bill – and there are many – the tactical options were either to kill the bill dead – as they did with a similar bill from Lord Joffe in 2006 – or to strangle it slowly in committee by amending it out of recognition before putting in the boot one last time.

They have opted for the latter, a kinder and more compassionate course of action for a piece of draft legislation which is already terminally ill. And a better plan for kicking it beyond the long grass to a place where no one dare retrieve it.

When the bill was debated in July thousands of people wrote to the Lords to complain about its loopholes and inadequacies and disabled people staged a mass protest outside Westminster Palace.

The depth of feeling against the bill across the political spectrum was underlined when the Guardian newspaper – that bastion of right wing conservative values - changed its editorial policy to oppose it because of real concerns about public safety.

Already a massive fight is brewing for this Friday with peers tabling a sack load of amendments aimed at exposing the bills weaknesses and inconsistencies. More are expected later this week and the government is already talking about extending the committee stage so that they can all be heard.

But in reality this is something of a phoney war.

It is conceivable that the bill may yet come to a final vote in the House of Lords, but both sides are agreed that the chances of it clearing the Commons in the run up to the election are virtually zilch.

The most Falconer’s supporters can hope for is some sort of a ‘moral’ - albeit Pyrrhic - victory by perhaps winning a vote over an amendment or two in a poorly attended committee debate.

The real battle will happen after next May’s general election and the chances of the bill progressing then will depend very much on who is in power. It’s very clear that the current House of Commons would not pass it.

Having said all that it is crucial that those opposed to the bill make their voices heard. Peers have been buried in letters from the pro-euthanasia lobby in the run up to committee as the former Voluntary Euthanasia Society – aka Dignity in Dying – launch their attack.

Now is the time for those opposed to the bill to strike back and urge peers to put down this deficient draft legislation. 

We don’t need this bill.

Any change in the law to allow assisted suicide will place pressure on vulnerable people to end their lives for fear of being a financial, emotional or care burden upon others. This will especially affect people who are disabled, elderly, sick or depressed. The right to die can so easily become the duty to die.

The law we have at present does not need changing. The stiff penalties it holds in reserve provide an effective bulwark against exploitation and abuse, but in so doing it still allows judges to act with mercy in hard cases. It also protects vulnerable relatives from being subtly coerced into assisting a suicide against their better judgement.

The pressure people will feel to end their lives if assisted suicide 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 are real and dangerous and this is why strong laws are necessary. Where there is a will, there is an anxious relative.

Furthermore experience in other jurisdictions, such as Belgium, the Netherlands and the US American states of Oregon and Washington, shows that any change in the law will lead to ‘incremental extension’ and ‘mission creep’ as some doctors will actively extend the categories of those to be included (from mentally competent to incompetent, from terminal to chronic illness, from adults to children, from assisted suicide to euthanasia). This process will be almost impossible to police.

It’s time to put Falconer out of his misery. He has suffered enough. Let’s not draw things out too long. 

Come and stand with disabled people this Friday at 9am outside parliament.

And write some letters to peers. You’ll find all the briefing information you need on the Care Not Killing website along with the specifics of the Bill’s specific defects and the broader arguments against a change in the law.

Don’t delay.

Monday 20 October 2014

RCP surveys its membership’s views on ‘assisted dying’

The Royal College of Physicians today launched a survey to assess its members’ views on assisted suicide.

The survey consists of four multi-choice questions with the option to write a more detailed response. It closes on 17 November.

The questions are:

1. Do you support a change in the law to permit assisted suicide by the terminally ill with the assistance of doctors? (Yes/No/Yes, but not by doctors)

2. We ask you to consider the following statement (this is a repeat of the question we asked when we last surveyed in 2006 and is included for comparative purposes):

'(We) believe that with improvements in palliative care, good clinical care can be provided within existing legislation, and that patients can die with dignity. A change in legislation is not needed.' (Yes/No)

3. What should the College’s position be on ‘assisted dying’ (as defined in the RCP’s consultation document)? (In favour/opposed/neutral or no stance)

4. Regardless of your support or opposition to change, in the event of legislation receiving royal assent, would you personally be prepared to participate actively in ‘assisted dying’? (In favour/opposed/neutral or no stance)

The accompanying consultation document explains that the College last surveyed its membership’s views on this issue in 2006 when the House of Lords was considering Lord Joffe’s Assisted Dying for the Terminally Ill.

At that time 73.2% of UK-based RCP fellows and collegiate members who responded did not believe a change in the law was needed, with 26% believing the law should change. The vote came out just before the Bill’s second reading in the House of Lords and helped to contribute to its defeat by 148 votes to 100.

This policy was later reaffirmed by the RCP’s Council in 2012.

This new survey has been prompted by Lord Falconer’s Assisted Dying Bill which seeks to legalise assisted suicide for mentally competent adults with less than six months to live. It has its committee stage (when amendments to the bill are considered and debated) on 7 November.

I have previously argued that the Falconer Bill is a recipe for the abuse of elderly and disabled people. Furthermore, public support for it falls from 73% to just 43% when the major arguments against it are heard.

There are also strong signals coming from the US state of Oregon, where very similar legislation was passed in 1997, that this is not the route to follow. The experience of other jurisdictions, like the Netherlands and Belgium, casts a dark shadow.

As the RCP consultation document notes, the BMA, the Royal College of Surgeons of England, the Royal College of General Practitioners and the Association for Palliative Medicine are also opposed to a change in the law on assisted dying.

Assisted suicide is unnecessary, dangerous and uncontrollable. The strong arguments against legalising assisted suicide, or any other form of euthanasia, need to be heard.

We can be sure that the vocal minority of doctors who support such legislation will do their best to skew this vote. This is why it is imperative that the majority speaks clearly.

If you have received an email from the RCP about this vote, please don’t ignore it. It takes only minutes to answer the four multi-choice questions above, and not much more to write something sensible in the comment box.

It is the very least we can do to protect our patients and keep the law safe. 

Elderly pro-euthanasia campaigner starves herself to death in high-profile attempt to advance her cause

A long-term pro-euthanasia campaigner has starved herself to death over five weeks because she could not have her life ended legally.

Jean Davies, 86, did not suffer from a terminal illness but said her life had become ‘intolerable’ after a series of fainting spells.

She died at home in Oxford on 1 October after giving an extensive interview to the Sunday Times.

Mrs Davies became involved in the right-to-die campaign as far back as the 1970s and was president of the World Federation of Right to Die Societies from 1990 to 1992 and was chair of the Voluntary Euthanasia Society UK (now Dignity in Dying).

In 1997, her book Choice in Dying argued for British law to allow doctors to end their patients’ lives.
According to her daughter she died peacefully and was ‘smiling at everyone’ the day before.

I was asked to comment on this story by the Sunday Times and my comments have been picked up in several follow up accounts in other papers (eg. Times, Express, Guardian, Daily Mail).

Essentially here, we have a long-time euthanasia campaigner attempting to use her own death to further the cause she has championed throughout her life.

Ironically her own daughter said in an interview that her case proves those who want to die already have power to take their own lives and that the law therefore does not need to be changed.

Her GP, a Christian who does not believe in assisted dying, told the Sunday Times he had treated her symptoms after consulting his defence union.

The full quote I gave the Sunday Times is below. They chose to major on the part about ‘emotional blackmail’ and not to include the reference to Helga Kuhse. But Kuhse’s comments deserve wider circulation:

‘It is not illegal to starve and dehydrate oneself to death but neither is it right. My fear is that this unusual and tragic case will be seized upon by the pro-euthanasia lobby to further their agenda of legalising assisted suicide and euthanasia.

It is the same technique used by Helga Kuhse, then President of the World Federation of Societies for the Right to Die at their 5th Biennial Congress on the Right to Die held in Nice, France, September 1984 when she said, ’If we can get people to accept the removal of all treatment and care – especially the removal of all food and fluids – they will see what a painful way this is to die and then, in the patient’s best interests, they will accept the lethal injection.’

We should recognise this ploy for what it is and reject it. However we might sympathise with this woman’s condition, by deliberating choosing to go public with it she is adopting a campaigning stance in the footsteps of Kuhse. It is, if you like, a subtle form of emotional blackmail aimed at softening opposition to a change in the law to allow assisted suicide or euthanasia.

There are good reasons for keeping the law as it is. Any change in the law to allow assisted suicide or euthanasia 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.

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.

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

Thursday 16 October 2014

The DPP needs to explain to Parliament why she has effectively decriminalised physician assisted suicide

In an astounding about face for the Crown Prosecution Service, the Director of Public Prosecutions, Alison Saunders (pictured), has today rewritten her prosecution policy so that doctors can now be involved in assisting suicide without fear of prosecution, provided they don't have a professional relationship with those they 'help' (See Daily Mail here and here,  Daily Telegraph, Yahoo, Premier, CT, ES).

The move has not surprisingly been welcomed by euthanasia campaigner Michael Irwin, and will also be music to the ears of Philip Nitschke.

Both Irwin and Nitschke are medical practitioners who have become media celebrities through their high profile campaigning for the legalisation of assisted suicide, and high profile assistance to those wanting to end their own lives.

Now it will be much easier for them to do so without a backward glance.

Michael Irwin was found guilty of serious professional misconduct by the General Medical Council in 2005 and was struck off the medical register after admitting supplying sleeping pills to help a friend kill himself. He now claims to have helped at least 25 people to die at the Dignitas facility in Switzerland. 

Irwin, nicknamed 'Dr Death' for his activities, said the change was a 'wonderful softening' that would 'make life easier' for people like him. 

Nitschke, who travels the world instructing people in how to end their lives using barbiturate drugs and nitrogen, is currently being investigated by police in every Australian state over his possible role in nearly 20 deaths in the past three years. 

Both men will now be able to sleep more easily in their beds and to continue their activities in Britain with considerably more peace of mind. And the DPP will no longer have to explain why she hasn't so far made moves to prosecute them.

Under the Suicide Act 1961, assisting or encouraging suicide remains a crime attracting a custodial sentence of up to 14 years.

But in order to be prosecuted any given case must pass two tests applied by the Crown Prosecution Service. The evidence test requires that there be enough evidence to bring a successful prosecution. The public interest test involves the application of 22 criteria, 16 making prosecution more likely and 6 making it less likely.

Up until now a suspect ‘acting in his or her capacity as a medical doctor, nurse, other healthcare professional, a professional carer [whether for payment or not]’ was more likely to be prosecuted.

But the DPP has now amended this criterion so that it only applies if the victim was in his or her care.

In other words, it will not apply in the case of doctors like Irwin and Nitschke who are assisting the suicide of people who are not actually their own patients.

This is very concerning indeed. The Director of Public Prosecutions is effectively at a stroke of her pen decriminalising assisted suicide by doctors and other health care professionals as long as they don’t have an existing professional care relationship with the patient.

This weakens the protections for sick and vulnerable people and effectively gives a green signal to anyone in Europe wanting physician assisted suicide that Britain is open for business. It also opens the door to a Dignitas style death ‘clinic’ being set up in the UK.

Alison Saunders’ new guidance is an invitation to doctors who wish to push the boundaries and assist people to kill themselves to have free rein and go ahead.

The DPP’s job is actually to administer the law, not to usurp the democratic authority of Parliament, which ironically (or was it by design?) is due to discuss this issue in just a couple of weeks’ time.

The DPP has justified her position by reference to a highly contentious statement by one of the judges in last June’s Nicklinson/Lamb judgement in the Supreme Court.

But in so doing she has run roughshod over the original meaning of her own prosecution guidance.

The original prosecution guidance, developed in 2010, made it abundantly clear that any doctor or other health professional who assisted with a suicide was running the risk of prosecution.

Furthermore the General Medical Council (GMC) has warned that such doctors risk censure, including being struck off the medical register (see details of DPP and GMC guidelines here). 

Medical defence agencies have interpreted it in this same way in their advice to doctors and it has provided a strong deterrent to doctors abusing their powers.

But now the DPP has swept all of this aside with the mere stroke of a pen. In so doing she is acting way beyond her brief by effectively decriminalising physician assisted suicide by stealth.

When the guidelines were originally drafted by the former DPP, Keir Starmer, they were made subject to lengthy and rigorous public consultation. 

But Alison Saunders, rather than fulfilling her duty of upholding the law, has effectively chosen to rewrite it without apparently consulting anyone at all.

By doing this just weeks before Parliament is due to debate the matter she is raising two fingers to British democracy.   

In May 2012, the Solicitor General said in a parliamentary debate that if ‘a future DPP overturned the guidelines, (s)he would be judicially reviewed for behaving in a rather whimsical way'. 

I hope that such a judicial review will now indeed take place. 

But more than that I hope rather that the DPP will be forced to go in front of Parliament to explain why she has rewritten the current law, ignored the will of MPs and peers and put at risk the lives of many vulnerable people in our country.

Friday 3 October 2014

Sierra Leone is where British boots on the ground are really needed

As the British government convened a pledging conference for Ebola in London Thursday, a group of 34 NGOs called for the deployment of ‘military capacity’ to contain the disease in West Africa. 

There is a letter in today’s Lancet along the same lines.

Here is the Joint statement from 34 NGOs issued yesterday by the International Conference on Effective International Response to Defeat Ebola in Sierra Leone. The British government urgently needs to respond to this call.

Delivered by Sanjayan Srikanthan, International Rescue Committee, on behalf of 34 NGOs

The world is facing an unprecedented crisis in West Africa. Infection rates are growing exponentially – the number of cases is doubling roughly every three weeks. In Sierra Leone the situation is critical: Ebola has spread throughout the country, infecting at least 2,300 people that we know of; the real number is probably much higher. Many health centres and hospitals have closed and those that are still open are full to capacity, with sick people being turned away.

The international community has a window of opportunity over the next four weeks to stop the crisis from spreading completely out of control. To do so, we must support national authorities, health workers, humanitarian agencies and community groups to break transmission rates and halt the exponential increase in cases.

As I speak, our agencies have hundreds of staff on the ground fighting the spread of the disease. We are involved in every aspect of response from treatment to provision of equipment to body disposal and prevention and awareness raising, as well as dealing with secondary impacts like food security. We also have dedicated teams working in neighbouring countries to prepare for the worst case scenario. Our staff say they are fighting for the very survival of their communities.

We welcome the strong commitment demonstrated by many Governments so far in responding to the crisis, and the leadership shown by the UK Government in supporting Sierra Leone and in convening today’s conference. But a further and massive increase in financial, human and material capacity is urgently needed to halt the spread of Ebola and mitigate its impacts on the hard earned development progress of Sierra Leone and other countries in the region. This is a matter of the utmost urgency.

Let me discuss six key ways the international community must respond in the next four weeks.

1. Donors must act fast in committing and disbursing funds. Like chasing a ball down a hill, every day that we delay in disbursing resources to affected countries, the more impossible it becomes to contain the disease. Only a quarter of the total required funding for the region has been committed. We urge donors to increase and quickly disburse national pledges against the UN Appeal within a two-week timeframe. Donors should ensure that funding is flexible, allowing NGOs to respond appropriately to a rapidly changing situation.

2. Donors and governments must ensure that health care workers are trained and equipped. Health care workers are our most precious resource in this crisis, but hundreds have already been infected. Health centres in Sierra Leone lack crucial tools and supplies for diagnosing, isolating and treating patients with Ebola and for protecting health workers tending to those infected by Ebola. We call on donors and governments to ensure that health workers have training in Infection Prevention & Control, and consistent supplies of basic equipment including chlorine, gloves, personal protective equipment (or PPE).

3. Governments must rapidly identify and deploy military and civilian capacity. Financing and equipment alone will not stop this crisis. There is an urgent need for human resources: Aid agencies simply do not have the medical, WASH or logistical staff we need to scale up our response. As a measure of last resort, we are calling on governments to release military capacity to set up facilities and help manage them, in accordance with the Oslo Guidelines, and to expedite the deployment of volunteers from health services and agencies. Governments must also create an enabling environment for volunteers. More people are now volunteering, but to access this huge and priceless resource requires a guaranteed medevac system, and other logistical and financial support. We call on states to solve this obvious and critical problem here today, by agreeing to operationalise and fund a dedicated medevac system for all staff, regardless of their nationality or organizational affiliation.

4. Donors, governments and INGOs must support community mobilization efforts. Treatment will never be enough unless we use effective community mobilization, including support for local media, to reduce transmission and dispel rumours and misunderstanding about Ebola. This can be done far more effectively through the many community groups and associations who are active in treatment and messaging on Ebola. Donors should support these community mobilization efforts and provide logistical support to appropriate community-based activities. Governments and INGOs must work closely with local groups, consulting them before disseminating health promotion messaging, and ensuring that communities have access to accurate information about Ebola.

5. States must urgently support preparedness and contingency planning in neighbouring countries. The UN estimates that it will cost almost $1 billion to respond to Ebola and its secondary impacts, but this projection only covers the cost of the response in the three countries with confirmed cases. It is critical to work with governments in the region to strengthen preparedness and contingency planning so they are ready to quickly respond to any potential outbreak.

6. The international community must respond holistically to all impacts of the crisis. The hidden cost of this Ebola outbreak is huge. As national resources are diverted to responding to the outbreak, health systems have collapsed. Easily treatable and preventable illnesses such as malaria and diarrhoea are claiming hundreds of lives, while mothers are dying in childbirth due to treatable complications. Children are missing vital months of education as schools have been closed. Many who are orphaned when parents die of Ebola have no one willing to care for them due to the perceived fear of transmission. We are urging donors and governments to implement a holistic response to the crisis, addressing the gender impacts of Ebola, the impacts on the wider health system, food security, protection and education.

We can turn the tide on this outbreak today, in this room. As aid agencies and campaigning organisations, we are all scaling up our work, doing all we can to support the people affected by Ebola. But we need your help. The international community needs to move faster than it has ever moved before to prevent a catastrophe in West Africa with global implications. Every new case is a testament to how much more we still need to do, and we are running out of time.

The following NGOs endorse this statement:

ActionAid UK
CARE International
Christian Aid
Children in Crisis
Concern Worldwide
Deutsche Welthungerhilfe
Handicap International
Health Poverty Action (HPA)
InterHealth Worldwide
International Health Partners
International Medical Corps UK
The International Rescue Committee
Internews Europe
Islamic Relief Worldwide
King’s Health Partners
Médecins du Monde/Doctors of the World
Mercy Corps
Mission Aviation Fellowship
Muslim Aid
Norwegian Refugee Council
The ONE Campaign
Plan UK
Royal Society for the Protection of Birds (RSPB)
Samaritan’s Purse
Save the Children
Solidarités International
Street Child
Worldwide Hospice Palliative Care Alliance
World Vision UK
Womankind Worldwide

Monday 29 September 2014

Why are the Home Secretary and Metropolitan Police allowing this man to operate in Britain?

Notorious Australian euthanasia campaigner Philip Nitschke has been in the news again.

Last week, it was reported that his organisation Exit International was establishing a London office to ‘cope with demand’ from UK citizens for assisted suicide.  

The group, which charges members a fee to access online information and attend workshops to discuss ‘peaceful’ methods of suicide, has attracted fierce criticism in Australia, where it was originally set up.

Its activities include:

  • Advising members on how to source  a lethal drug used to kill US Death  Row prisoners;
  • Selling test kits so members can check the purity and potency of this controlled Class B drug in their own homes;
  • Providing instructions on how people can gas themselves using a ‘DIY’ kit;
  • Giving tips on how those assisting a suicide might avoid prosecution.
Today it has been further reported that Nitschke has enraged victims of crime groups by his suggestion that killers serving life sentences should be able to choose the timing of their own ‘peaceful’ deaths behind bars.

Yesterday the Sydney Morning Herald reported that he is being investigated by police in every Australian state over his possible role in nearly 20 deaths in the past three years, all of them apparently suicides.

The latest investigation, by Victoria Police, concerns the death of a 55-year-old Geelong man who allegedly killed himself using a do-it-yourself kit bought though a company affiliated with Exit International, the pro-euthanasia organisation founded by Dr Nitschke. 

All of the deaths being investigated involved the use of the two suicide methods promoted by Dr Nitschke, the lethal drug, Nembutal or a nitrogen inhalant device.

Nitschke currently faces expulsion by the Australian Medical Association when its Northern Territory branch Council meets in November, after a move to suspend him last month failed after an error in the paperwork.

The Medical Board of Australia suspended him in July. The decision which used the board's emergency powers to  ‘protect  public health and safety’ came after he admitted in an interview with the ABC that he had supported a 45-year-old Perth man, Nigel Brayley, in his decision to commit suicide, despite knowing the man was not terminally ill.

The AMA has cited the same ‘adverse event’, saying Dr Nitschke's ‘professional behaviour … was not consistent with the high professional and ethical standards for the Australian medical profession promoted by the AMA’.

Documents obtained by The Sunday Age reveal there are currently five separate medical board investigations, one dating as far back as 2011, into Dr Nitschke's conduct.

Nitschke (aka Dr Death) is an extremist and self-publicist whose presence in the UK puts the lives of vulnerable elderly, depressed and disabled people at grave risk. 

The British Suicide Act, as amended in 2009, states that ‘an act capable of encouraging or assisting the suicide or an attempted suicide of another person’ is illegal, ‘whether or not a suicide, or an attempt at suicide, occurs’; the emphasis is on whether the accused ‘intended to encourage or assist suicide or an attempt at suicide’.

What Nitschke is doing must surely fall within the scope of these offences. The information shared by his organisation in his London seminars and on the internet is surely capable of encouraging or assisting people to commit suicide and his activities are clearly intended to encourage or assist people to commit suicide by offering them advice about the ‘best way’ of doing it.

Nitschke’s activities present a real and present risk to vulnerable members of the British public.

With the growing elderly population, failure of the care system and worsening economic situation a growing number of frail, disabled, ill and depressed people in Britain will be feeling under even greater pressure to end their lives, either for fear that they will not cope, or so as to be less of a burden to relatives.

They deserve better protection from suicide predators like Nitschke than they are currently getting.

Quite why the Home Secretary and Metropolitan Police allow him into the UK to conduct seminars and continue his activities remains a mystery but Britain deserves a full explanation.

Euthanasia deaths in the Netherlands continue their relentless rise

According to Dutch media reports today, euthanasia deaths in the Netherlands in 2013 increased by 15% to 4,829. This follows increases of 13% in 2009, 19% in 2010,18% in 2011 and 13% in 2012.

In fact from 2006 to 2013 there has been a steady increase in numbers each year with successive annual deaths at 1923, 2120, 2331, 2636, 3136, 3695, 4,188 and 4,829 – an overall increase of 151% in just seven years.

Almost 3,600 people were helped to die because they had cancer, the report said.

Euthanasia now accounts for over 3% of all Dutch deaths.

In total, there were 42 reports of people who underwent euthanasia because they suffered severe psychiatric problems, compared with 14 in 2012 and 13 in 2011.

Dementia was the reason behind 97 cases, mainly early stage dementia in which patients were able to properly communicate their wish to die.

There were five cases in 2013 where doctors were reprimanded for not properly following the protocol. None of these led to legal action.

But as alarming as these statistics may seem they tell only part of the full story.

On 11 July 2012, The Lancet published a meta-analysis study concerning the practice of euthanasia and end-of-life practices in the Netherlands in 2010 with a comparison to previous studies done in 1990, 1995, 2001 and 2005. 

The Lancet study indicated that in 2010, 23% of all euthanasia deaths were not reported meaning that the total number of deaths last year may not have been 4,829 but rather 5,939. 

The 2001 euthanasia report also indicated that about 5.6% of all deaths in the Netherlands were related to deep-continuous sedation. This rose to 8.2% in 2005 and 12.3% in 2010. 

A significant proportion of these deaths involve doctors deeply sedating patients and then withholding fluids with the explicit intention that they will die. 

As I have reported previously, although official euthanasia deaths are rising year by year in the Netherlands, these deaths represent only a fraction of the total number of deaths resulting from Dutch doctors intentionally ending their patients’ lives through deliberate morphine overdose, withdrawal of hydration and sedation. 

Euthanasia in the Netherlands is way out of control. 

The House of Lords calculated in 2005 that with a Dutch-type law in Britain we would be seeing over 13,000 cases of euthanasia per year. On the basis of how Dutch euthanasia deaths have risen since this may prove to be a gross underestimate. 

What we are seeing in the Netherlands is 'incremental extension', the steady intentional escalation of numbers with a gradual widening of the categories of patients to be included. 

previously described the similar steep increase of cases of assisted suicide in Oregon (450% since 1998), Switzerland (700% over the same period) and Belgium (509% in ten years from 2003 to 2012).

The lessons are clear. Once you relax the law on euthanasia or assisted suicide steady extension will follow as night follows day. 

Britain needs to take warning as debate on the Falconer bill continues.  

Sunday 21 September 2014

Vicky Beeching’s challenge to evangelicals about same-sex marriage

Christianity magazine has just published an interview by editor Justin Brierley with British Christian singer-songwriter Vicky Beeching (left), who self-identified as ‘gay’ in a high profile ‘coming out’ on 14 August.

Beeching, who is a media personality in her own right and has over 52,000 followers on twitter, has listed over 70 almost exclusively positive media reports covering the event on her website.

Earlier this year she joined the group Accepting Evangelicals, who back same-sex marriage, as a patron.

At one level it is not at all unusual today for Christians to admit to feelings of same-sex attraction or to identify as ‘gay’.

Furthermore, those who do, perhaps unlike in earlier generations, are in my experience, generally now treated in evangelical churches with warmth, grace and understanding. Having said this I fully accept that this is not always the case and Vicky's own early experience bears this out.  

I personally know many Christians who would describe themselves as either same sex attracted or having a homosexual or bisexual orientation.

In fact a number of prominent evangelical leaders, in order to help others, launched the Living Out website last November to share their testimonies about their own personal experience of same sex attraction and to explain how they had handled it.

But whilst the ‘Living Out’ leaders express their intention to remain committed to biblical teaching on sexual morality in practice (see my earlier post ‘Should ‘gay’ Christians be true to their feelings?’), Vicky Beeching says she intends to marry a same sex partner.

‘My goal is to find a soulmate and get married; that is what most of us are made to do. God said it is not good that people are alone.’

Furthermore she believes she can do this without relinquishing her claim to be an evangelical. This is what has attracted so much media attention.

‘People have told me that I don’t have the right to that name (‘evangelical’) any more as I’ve spoken in support of same-sex marriage, but for me evangelicalism is rooted in many things: loving the Bible; having a high view of scripture; a passion for social justice; wanting to share the good news about Jesus.  These are all things I hold true to. So I don’t see why there should be a black and white issue that casts me out.’ 

I do not doubt Vicky’s sincerity and indeed share her professed love for the Bible, passion for social justice and her desire to share the good news about Jesus. But I believe she has crossed a significant rubicon with respect to her expressed views and proposed actions on sexual behaviour. At the same time she has laid down a significant challenge to evangelical Christians and must not be simply ignored.

I’ve previously reviewed the Bible’s teaching on sexuality on this blog and Robert Gagnon and Ian Paul (see here and  here) have more recently published some helpful reflections responding to Beeching’s biblical arguments in support of her stand.

I’ve also previously listed on my blog six excellent resources giving an evangelical perspective on homosexuality.

In short, the Bible teaches that the only moral context for sex is within a life-long monogamous heterosexual marriage relationship. All sex outside this context constitutes sexual immorality (Greek porneia). This includes all sex between two people of the same sex whether legally 'married' or not. 

‘But among you there must not be even a hint of sexual immorality, or of any kind of impurity, or of greed, because these are improper for God’s holy people.’ (Ephesians 5:3)

‘It is God’s will that you should be sanctified: that you should avoid sexual immorality;  that each of you should learn to control your own body in a way that is holy and honourable….For God did not call us to be impure, but to live a holy life. Therefore, anyone who rejects this instruction does not reject a human being but God, the very God who gives you his Holy Spirit.’ (1 Thessalonians 4:3-8)

I am not intending to revisit this teaching in detail here. Rather, especially for those who accept the biblical teaching on this issue at face value, I want to look at what the Bible teaches about Christians endorsing or practising what it classes as sexual immorality.  I have deliberately included Bible quotes rather than just giving references as I am convinced that many evangelicals are genuinely not aware of what the Bible actually says. 

First, the Bible is clear that sexual morality is not a ‘secondary issue’ on which Christians may legitimately disagree and on which there are a variety of acceptable views. Rather continuing in sexually immoral behaviour can put one’s own salvation at risk:

‘Do you not know that wrongdoers will not inherit the kingdom of God? Do not be deceived: Neither the sexually immoral nor idolaters nor adulterers nor men who have sex with men… will inherit the kingdom of God.’ (1 Corinthians 6:9,10)

This is not to suggest that we are saved by good works. Rather it upholds the biblical teaching that genuine faith is evidenced in moral behaviour (more on this here). Furthermore, the Apostle Paul makes it clear that God views sex between two women in the same way that he views sex between two men.

‘Because of this, God gave them over to shameful lusts. Even their women exchanged natural sexual relations for unnatural ones. In the same way the men also abandoned natural relations with women and were inflamed with lust for one another. Men committed shameful acts with other men, and received in themselves the due penalty for their error.’ (Romans 1:26, 27)

The writer to the Hebrews makes it clear that God views those with a Christian testimony who willfully return to habitual sin very seriously indeed:

‘ It is impossible for those who have once been enlightened, who have tasted the heavenly gift, who have shared in the Holy Spirit,  who have tasted the goodness of the word of God and the powers of the coming age and who have fallen away, to be brought back to repentance. To their loss they are crucifying the Son of God all over again and subjecting him to public disgrace.’  (Hebrews 6:4-6)

‘If we deliberately keep on sinning after we have received the knowledge of the truth, no sacrifice for sins is left,  but only a fearful expectation of judgment and of raging fire that will consume the enemies of God... How much more severely do you think someone deserves to be punished who has trampled the Son of God underfoot, who has treated as an unholy thing the blood of the covenant that sanctified them, and who has insulted the Spirit of grace?’ (Hebrews 10:26-29)

‘If they have escaped the corruption of the world by knowing our Lord and Saviour Jesus Christ and are again entangled in it and are overcome, they are worse off at the end than they were at the beginning. It would have been better for them not to have known the way of righteousness, than to have known it and then to turn their backs on the sacred command that was passed on to them.’ (2 Peter 2:20,21)

Whilst the Bible is very clear that Christians should not judge those outside the church, dealing with those inside the church is a different matter altogether:

‘I wrote to you in my letter not to associate with sexually immoral people— not at all meaning the people of this world who are immoral, or the greedy and swindlers, or idolaters. In that case you would have to leave this world. But now I am writing to you that you must not associate with anyone who claims to be a brother or sister but is sexually immoral or greedy, an idolater or slanderer, a drunkard or swindler. Do not even eat with such people.’ (1 Corinthians 5:10-11)

It might be objected that Vicky Beeching, and others who share her views, have not yet moved from publicly endorsing same sex marriage (and all that it involves) to participating in it herself.

But the Bible is equally clear that teaching a specific sin is admissible is at least as serious as practising it:

‘Not many of you should become teachers, my fellow believers, because you know that we who teach will be judged more strictly.’ (James 3:1)

Jesus was very clear about the seriousness of leading young ones astray through false teaching:

‘If anyone causes one of these little ones—those who believe in me—to stumble, it would be better for them to have a large millstone hung around their neck and to be drowned in the depths of the sea.’ (Matthew 18:6)

The epistle of Jude warns about ‘ungodly people, who pervert the grace of our God into a license for immorality’ (1:4) and warns that ‘Sodom and Gomorrah and the surrounding towns gave themselves up to sexual immorality’  and ‘serve as an example of those who suffer the punishment of eternal fire’ (1:7).

In a similar vein the Apostle Peter warns that ‘if God did not spare angels when they sinned, but sent them to hell…’ and ‘condemned the cities of Sodom and Gomorrah by burning them to ashes, and made them an example of what is going to happen to the ungodly’ then ‘the Lord knows how to rescue the godly from trials and to hold the unrighteous for punishment on the day of judgment. This is especially true of those who follow the corrupt desire of the flesh and despise authority’. (2 Peter 2:4-10)

It is striking that in both these instances (both in Jude and 2 Peter) there is a specific reference to Sodom and Gomorrah where the sexual immorality involved was homosexual (see also Leviticus 18:22 and 20:13).

The Apostle John in Revelation records Jesus’ words to the seven churches. Two of them (Pergamum and Thyatira) he warns specifically about not tolerating teaching which endorses sexual immorality:

‘Nevertheless, I have a few things against you: There are some among you who hold to the teaching of Balaam, who taught Balak to entice the Israelites to sin so that they ate food sacrificed to idols and committed sexual immorality.’  (Revelation 2:14)

‘Nevertheless, I have this against you: You tolerate that woman Jezebel, who calls herself a prophet. By her teaching she misleads my servants into sexual immorality and the eating of food sacrificed to idols.’ (Revelation 2:20)

I was told recently by a Church of England Bishop that Scripture nowhere commands us to stop people teaching heresy (false teaching which puts personal salvation at risk) in the church. But it seems to me that this is exactly what Paul instructed Titus to do:

 ‘For there are many rebellious people, full of meaningless talk and deception, especially those of the circumcision group. They must be silenced, because they are disrupting whole households by teaching things they ought not to teach….’ (Titus 1:10-11) 

From the above Scriptures it is clear that:

1. All sex outside (heterosexual) marriage constitutes sexual immorality
2. Continuing in sexual immorality puts one’s salvation at risk (see also Revelation 21:8 and 22:15)
3. Teaching that sexual immorality is acceptable is very serious and deeply damaging
4. Tolerating such teaching is also contrary to the explicit teaching of Jesus Christ
5. Those who teach or practise such things whilst claiming still to be Christians should be subject to church discipline.

The implications are clear.

I do not know Vicky Beeching personally and as I have said earlier I do not doubt her sincerity. But my fear is that as a result of the warm affirmation she has already received for her endorsement of same sex marriage, including from many Christians, she is heading on a very dangerous and damaging course indeed – both for herself and for others.

I understand that she has so far ignored the sincere but serious warnings she has received from well-meaning Christian brothers and sisters.

We need to pray that she changes her course and that her teaching does not lead others astray. But more than this, those responsible for her pastoral oversight must ensure that her teaching is not tolerated in the church and that she is appropriately disciplined.

We owe it to our young people, many of whom will have been confused by what she is saying, and not least to Vicky herself.