Tuesday, 20 November 2012


My brother is getting married soon, and he and his fiance have recently sent out invitations for the big day. On the reply slip there is a space to specify dietary requirements. Personally, I understand something like this to include allergies, diabetes, vegetarian, vegan, lactose intolerance, gluten free etc. Actual dietary requirements. One response states "no fish". This person has never eaten fish, and fair enough, if the main course is going to be fish they can ensure she has the vegetarian option. What is weird is that she hasn't mentioned that her husband is a diabetic. Yet weirder still is the person who wrote "no peas" on their reply. They aren't allergic to peas, they just don't like them. Apart from young children, everyone coming to the wedding is probably over the age of 26. Surely by this age you can manage to politely eat your peas, or leave them to one side if you really can't stomach them. Or is the pea-hater expecting an alternative meal to be provided?

Part of my job used to include checking the allergies of people who came into hospital. Rather than simply asking what they were allergic to, I would ask about the circumstances under which the allergy had occurred, in order to determine whether it was an allergy (in which case they wouldn't receive said medicine), an intolerance or a side effect (in which case they might, depending how much risk their illness carried). For example, I had a lot of people tell me that they were allergic to antibiotics, and the majority of these believed they were allergic because they had had a stomach ache when they took the antibiotics. Stomach aches are very unpleasant, but when the alternative is pneumonia it's probably worth it, and that's not an allergy or an intolerance, that's a side effect. One person told me she was allergic to ibuprofen and that it gave her a headache. It transpired that she had taken the ibuprofen because she had a bad cold and blocked sinuses. The headache was almost certainly due to the sinus problem.

I can't help thinking that we've become rather soft. Rather than being grateful that we have food or medicines we want to have perfect food and perfect medicines. My grandad was fond of saying that he "didn't spend three years living in a hole in the ground for this". Actually he didn't go and live in a trench because of some higher ideal either, but I believe his comment is valid: what has happened to our capacity for sacrifice? Not just sacrifice: what has happened to our capacity for minor inconvenience?

Monday, 12 November 2012

Spiritual Combat World

I am on a diet. I am on a diet because, while I realised I was putting on weight, for the first time in my life I had to buy a pair of size 16 trousers. As an adult I've always been a bit weight obsessed: the amount of exercise I did went dramatically downhill at the same time as my spending power increased when I went to university, and like many first year students I started to get heavier. In the last 18 months my weight has gone up and down like a yo-yo, mostly due to illness, and I'm now the heaviest I've ever bee (17kg more than 12 months ago). I know why I'm too heavy. I eat too much and I don't exercise enough. I'm also greedy and lazy. I often look to food for strength and consolation instead of God. I trust chocolate more than him.

I am, in short, a big fat sinner.

I'm also totally capable of justifying this to myself, because I'm neither morbidly obese nor living in a state of grave sin. I muddle along OK. With the eyes of vanity, I can tell myself I look OK, especially as the clothes I tend to wear are far from tight, and therefore leave me a lot of room for change.

I am, in fact, mediocre: frequently willing to settle instead of striving to be better.

This diet has led me to reflect on my life in general and I have come to the conclusion that dieting is a lot like spiritual combat...
  1. Actions have consequences. If I eat a whole packet of biscuits I will not lose weight. If I choose to sin I will separate myself from God. The latter is obviously more serious: I want to go to heaven and be with God, I'm not interested in whether I look good in my coffin.
  2. If you're on a diet don't read the menu. That's just asking for trouble. In the same way I must avoid occasions of sin.
  3. Be watchful. Yesterday I accepted and drank a glass of orange juice without thinking when someone offered it to me. Fortunately it was a small glass and didn't put me over the allowed limits. Often we can sin through carelessness and omisison. In a moment of distraction we can end up giving in to temptation. Keep your eye on the ball.
  4. Come at it both ways. Losing weight is about eating less and exercising more. Our conversion will come about through loving God and hating sin, loving virtue and hating vice.
  5. Remember the goal. I want to be with God, I want to be as holy as I can and go to heaven. And I want my clothes to fit. You have to have the long view with both to get past the temptation of the moment.
  6. It's not easy. I am going to fail a lot! Often when I've tried dieting before I've given in and eaten (a lot) of something I shouldn't and then thought, right, well today has been a failure, so I might as well eat an entire pizza for dinner and start again tomorrow. No. The moment to start trying again is as soon as you realise you've failed. As St Augustine said, "No-one promised you tomorrow."
  7. Try to channel what you can't beat (yet). Spiritual authors such as Cassian speak of channelling the vices which you haven't yet conquered to help you get over the one you're currently working on. In the same way that my pride and vanity stop me losing my temper, or swearing, or doing things I would be really ashamed and embarrassed to say in confession, they're also going to help me stick to my diet because I don't want it announced in the group that I've gained weight this week! My diet is going to help me get over my tendency to gluttony.
  8. Take measures. I don't take more money than I need when I go to the shop so that I don't buy biscuits (which I will then eat). I try not to answer immediately becasue I have a terrible habit of reflexively lying. If I do lie, I will admit it immediately.
  9. Keep track. I write down what I eat each day. And I should really examine my conscience (and write it down) before I go to bed. The former is important so as not to accidently eat too much. The latter, so as to help me see where I need to focus my efforts (also, it's quite hard to achieve a sense of contrition when you can't remember having done anything wrong).
  10. This is all much easier with a community. I'm doing my diet with my Mum, and we go to a group. We also need spiritual friendships, so that we have support in our spiritual battles. We need ideas and encouragement for how to keep going and win!
Obviously the analogy only goes so far...dieting is way easier than spiritual combat. And in dieting, the occasional planned treat helps you stay on track, whereas the occasional planned sin would defeat the object of spiritual combat.

Thursday, 8 November 2012

The majority does not rule

A Bangor University study on assisted suicide reveals that two-thirds of people accept it. Apparently  62,000 people were included, which I first thought was quite a lot. However, it turns out that this was an international survey, and so actually this isn't a very large proportion. "Accept" is also a rather ambiguous word, which makes me wonder what people were actually asked. Careful reading shows that this study was in fact a literature review which brought together the results of studies already carried out. Hmmmmm.

Something which strikes me as interesting is the fact that this report states that a recent review shows that doctors consistently resist assisted suicide. Let's leave off the pity plea and be realistic: "assisted suicide" is an attempt at making "euthanasia" sound better. And the reason doctors are resisting it is hardly surprising, since they are the ones who would be assisting. A person might want to die, their relative might think that they should be allowed to, but if you are the one writing the prescription or supplying the drugs then you are not assisting, you are enabling.

Researchers apparently also said that 'headlines tended to feature professional arguments against celebrity campaigners, with ordinary people "less clearly represented".' When they speak of professional arguments, do they mean that they come from professional arguers (eg. Chris Moyles...I don't know his views on euthanasia but I'm prepared to bet he'd have an arguement about it, Richard Dawkins, possibly one of the most argumentative men on the planet, or anyone's youngest brother providing the person they are arguing with is an older sibling), or medical professionals. Because if it is the latter than surely this puts 'celebrity campaigners' on a level with 'ordinary people'. As Blessed John Henry Newman said:
All bow down before wealth. Wealth is that to which the multitude of men pay an instinctive homage. They measure happiness by wealth; and by wealth they measure respectability... It is a homage resulting from a profound faith... that with wealth he may do all things. Wealth is one idol of the day and notoriety is a second... Notoriety, or the making of a noise in the world -- it may be called 'newspaper fame' -- has come to be considered a great good in itself, and a ground of veneration.
One commentator said, 'The medical profession needs to recognise and have respect for this majority view even if we don't agree with it.' And a palliative care expert (who I suspect may have been quoted somewhat out of context, on the basis that palliative care is all about not walking away) said that doctors must 'never walk away from patients'. All this makes me want to label the article with a big flashing sign saying !RELATIVISM ALERT! Combining these two comments makes it sound as if doctors are neglecting their duties by not allowing the majority (otherwise known as 0.0006% of the world's population) to dictate how they do their jobs. Even if 99% of the world's population were in favour of euthanasia, it wouldn't change the fact that helping your patient to die with dignity has a lot to do with helping your patient to live with dignity and nothing to do with ending their life prematurely. It also would not affect the intrinsic wrong of killing. So-called "assisted suicide" is the final step in the wrong understanding and use of freedom. Funnily enough it's the same as the first step (when Eve took the apple): I am free and therefore I have the right to I choose death. I refuse to accept my limitations that I am a creature and am finite. I reject God. I want to be God without God.

Tuesday, 6 November 2012

The poor will always be with us: seriously?

The health inequalities between rich and poor are widening, reports BBC Health.

We've known this since the Black Report was published in 1980, and as not much notice was taken at the time, it's hardly surprising that 30 years on we're faced with the same problem, only bigger.

When I lived in Peru people often asked me if I was shocked by the poverty there. And yes, it is shocking to see shanty towns built up by the sides of motorways, to see shops which sell pre-fab sheds and then see the same sheds in the desert with entire families living in them, to hear children exclaim with excitement over such simple things as grass and trees and then ask with disinterest if they will be eating today, as so far they haven't. I saw children whose teeth were no more than shells and a toddler with a paraistic infection who rarely mentioned that his tummy hurt although it was the size of a football. I met a terrified young girl whose father had beaten her because she had her first period (in her innocence she had no idea why, but apparently her teenage sister had had a baby which possibly explains her father's concern although in now way justifies his action). I heard, from a volunteer doctor, of a patient with appendicitis who went home and died because he didn't have the money to pay for the operation, and read in the paper of a man whose body was thrown off the bus and left in the street when he died on his way to the hospital.

Yes, poverty in the developing world is indeed shocking. But what is more shocking is the divide between rich and poor. I saw a school with no toilets (the children go in the playground) and half an hour away another which had facilities that would put a state primary in this country to shame. The wealthy who live alongside poverty often completely ignore it, and one can grow up in Lima and never realise that there are such things as shanty towns (I'm not sure exactly how, but I'm assured by those who did that it is entirely possible).

In Lima, if you meet a child in a shanty town whose hands and face and clothes are dirty you know that it's because when you live in a desert, everything gets dirty very quickly; there is no running water at home, certainly not hot water or washing machines; there probably isn't any soap, because food is the prioity, and very possibly these are the only clothes she has, especially in winter when the humidity seems to make the cold penetrate one's bones and wearing everything you own is a better alternative than freezing. If a boy doesn't (can't or won't) use a knife and fork, it might be because his family don't own any, but it's equally likely that having not eaten all day he just wants to get it down as fast as he can. When you have nothing, staying alive is the priority, cutlery and soap are luxuries. The only answer to this reality is love. Love until it hurts and then love more, because without love the only answer is frustration and anger that there is injustice in the world, and despair at one's helplessness in the face of it.

If you go into a school in an inner city in the UK and see pupils with dirty clothes and hair, it's not because they don't have hot water or washing machines or soap. It's because they are neglected, whether that is because they have a single parent who works all hours to make ends meet or nobody bothers to wash them or their clothes. Some people have hard choices to make, other just choose to make bad ones. If they don't use a knife and fork it's because their family doesn't sit down together and eat meals at the table, or because they always eat processed food which comes in a handy pick-me-up-and-eat-me format. You do not expect "beans on toast" to be the answer to the question, "What did you have for Christmas dinner?" (and he didn't know it was Christmas anyway because his parents hadn't bothered to mention it). There are children with mobile phones but no crayons. What a difference from a child with nothing who on being given a packet of cocoa <i>in July</i> assures you that his family are going to save it for Christmas day.

The divide between rich and poor in this country is not manifested solely in deaths from heart disease. There is a spiritual and cultural "poor gap" which has nothing to do with economics. Poverty is shocking wherever you see it, but somehow it is more shocking here where everyone has access to  education, healthcare and doesn't need to make a choice between soap and food, between clothes and beds. The lack of God, the lack of Love, in this green and pleasant land makes us poorer by far. This is the poverty that should not be with us. Everyone has the right to know God, and the riches that come from abundant life, and this is why we need the New Evangelisation.

Friday, 2 November 2012

Sterilizing our children

This week there have been two articles worth mentioning in the news about contraception and teenagers.

The first is from the Telegraph and gives the details of girls as young as 13 being given contraceptive implants (effective for 3 years) and injections (3 months) at school, or in clinics, without parental knowledge or consent. First of all, I believe that patient confidentiality is essential, regardless of the age of the patient. However, confidentiality is intrinsically tied to consent: the person consenting is entitled to confidentiality. All medical treatment (legally this includes contraception - Medicines Act 1968) requires informed consent, and those under 16 can only give informed consent if they are deemed to be Gillick competent. Competence varies with every individual and intervention and I do not believe that any teenager, however smart can be deemed to be competent where a long-acting contraceptive is concerned. We see enough adults who struggle to conceive after years on the Pill; I cannot see that a teenager, who is unlikely to be considering the probability that they will one day want to have a family, would be able to give informed consent. Actually, come to think of it, there probably aren't many adults capable of giving fully informed consent to such an intervention, but unfortunately we aren't subject to the same criteria. If you are consenting to contraception, that assumes that you are consenting to sex, and that requires a level of psychological and spiritual maturity, not just intelligence. As such, not being competent, they cannot consent and therefore they are not entitled to confidentiality.

Secondly, we have an age of consent in this country which is 16. Why do we bother if promiscuity is going to be encouraged in this manner? Who are these 13 year olds sleeping with? Granted, there may be a small proportion who seek contraception as a badge of honour (a GP I knew who also worked in a Family Planning Clinic told me that she was somewhat plagued by teenagers who wanted contraceptives for the purpose of having them rather than using them), a rite of passage if you will. But given all the concerns over internet grooming and child abuse should we not be asking more questions? Teenage girls are not usually interested in boys their own age; even if a girl is 15 and her boyfriend is 16 that is still illegal.

This strategy is derived from the desire to decrease the incidence of teenage pregancy (I get it) at all costs (I don't). Given the current rates of STDs, especially the chlamydia epidemic, why aren't we thinking outside the box? What we need is a culture of openess: parents should not be their childrens' best friends or their worst enemies, but children should be able to talk to their parents. And the only guarenteed way to prevent pregnancy and STDs is through abstinece and I do not think we can promote abstinence without teaching young people about their own intrinsic dignity. Of course we have a problem in that we are now in the 2nd generation of permissive behaviour, the belief that freedom is all about doing what you want when you want, and the total absence of God which leads to seeking value in pleasure.

The other article states that girls are choosing the pill over condoms. Around 2006, the student newspaper in Manchester published the results of a survey which found that female students didn't want to go on the pill because they didn't want to be considered "easy". (It also discovered that a significant proportion of students believed that it was not possible to conceive whilst standing up, which says something about the level of education they had received, but I digress.) This suggests that they were not considering the pill because they were already in a sexual relationship but because they were expecting to have what I think could be termed 'random' sexual encounters. Someone who knows you is not likely to be judging you on being easy.

What am I bothered about? Well, firstly, these articles are about girls. No-one is talking about boys. Granted there are not so many contraceptive options available to them, but it appears that the current strategy is completely targeted at young women, and comes from an anti-life basis rather than the promotion of health and well-being. There was recent outcry when it was proposed that girls be taught abstinence. I agree that it is rather ridiculous, because boys also need to know about their dignity and worth (and sadly, teaching only one half of the population about abstinence would likely lead to an increase in the use of prostitutes). It could be argued that girls choosing these longer-acting forms of contraception are sleeping with their long-term boyfriends. But I think it could equally be argued that actually what is happening, extrapolating from the prevailing attitude of Manchester undergraduates, is that at least some girls are effectively sterilizing themselves in the expectation of casual sex. It is time that sex education was based on something real (anything! but preferably good anthropology) rather being completely out of context and taking sex out of context. Bring on existential sex education.