Saturday, 13 September 2014

Unplanned and therefore unwanted?

This week in our staff meeting, we had a brief talk from a local charity which provides counselling for women in crisis pregnancies. Our patient population has a very high number of women who have had abortions, and many of these have had more than one abortion (this, despite the fact that of the 7 doctors I work with, only 2 will refer for terminations). This charity is, I would say, pro-choice but their approach to choice is that it should be a considered choice, and they do play an important role locally in identifying women who are being coerced into abortion (at the point where the woman has already checked into hospital for the termination) and supporting them in keeping the baby should they decide to do so. They also provide counselling to those suffering the consequences of abortion: women, men and family members. One of the reasons I do not mention their name here is that I do not wish to endorse them - yes, some of the work they do leads women to choose not to have an abortion, and too often the long-term consequences of abortion are ignored or denied - but the fact is that they support a 'woman's right to choose' rather than recognising the evil of abortion for what it really is.

However, something very interesting (or possibly horrifying) which was mentioned during the presentation, were some statistics around abortion, namely:
- 34% of women under 30 have had an abortion
- 10% have had more than one
- one third of pregnancies end in abortion
and then the one which struck me as most interesting
- 50% of pregnancies are unplanned.
It wasn't so much that the proportion is fairly high (given our contraceptive mentality in this country) but that the person giving the presentation felt that this was a surprise, as she said, 'given everything we know'. Well, the fact is, that we surely must know by now that babies never come when they are planned. I don't know anyone who can say, yes, our baby arrived exactly when we wanted it to. I know couples who have waited years (regardless of whether they had previously used hormonal contraceptives or NFP and really wanted children), I know couples who decided not to and then went through IVF and still didn't end up with children, I know a couple who got pregnant having slept together only once, the fact is that what we actually should know is that the contraceptive mentality is not working. If it was, then there wouldn't be so many abortions and so many unplanned pregnancies. And the fact that whilst 50% of pregnancies are unplanned, only (God help us, it's still horrific) 34% are terminated means that an unplanned baby is not necessarily and unwanted baby, therefore why this conviction that planning is everything, that we must be in control of absolutely everything? 

I generally think that abortion debate comes down to the fact that people don't recognise that the unborn child is a person. But from these figures, and the accompanying attitude, it is presumably about our desperate desire to be in charge of the universe.

Friday, 22 August 2014

Professor Dawkins and the increase of the sum total of happiness

Poor Professor Dawkins has apparently caused a furore on twitter after tweeting, to a woman who said that she would face a serious ethical dilemma if she found she was pregnant with a baby who had Down's Syndrome, that she should abort it. He seems suprised by this. His apology, as reported by the Guardian, seems to be an apology for causing a riot rather than for what he actually said, claiming that those who objected did so from an emotional point of view, that twitter did not give him enough space to put his whole argument across and that because of this he left himself vulnerable to wilful misinterpretation.

However, the thing that really bugs me about this is that Dawkins claims that his response is totally down to logic. According to the Guardian, he wrote: "If your morality is based, as mine is, on a desire to increase the sum of happiness and reduce suffering, the decision to deliberately give birth to a Down's baby, when you have the choice to abort it early in the pregnancy, might actually be immoral from the point of view of the child's own welfare." I take issue with this, and in fact, I am frequently irritated by people who claim that anyone who disagrees with them is arguing emotionally, and that they themselves are basing their argument purely on logic. 

  • If your morality is based, as Professor Dawkins' is, on a desire to increase happiness and reduce suffering you should presumably never say anything that might offend anyone because offense generates suffering, even if this is a subjective response. 
  • If you believe that this life is all there is, that there is no life after or other than this one, then the abortion of an unborn child would presumably decrease the sum total of happiness, seeing that without life there cannot be happiness.
  • If your aim is to increase the sum total of happiness rather than the happiness of the individual, and given the amount of great joy which those families express regarding their children with Down's Syndrome (and indeed their children without Down's) then presumably the termination of a child would not increase happiness and the reduction in suffering (given the absence of the child and the effects on the family) could well outweigh the non-increase in happiness.
  • Given that people who are objectively suffering can experience happiness, and that people who are happy can suffer, suffering and happiness are not necessarily opposed and therefore the aims to decrease the former and increase the latter may, in fact, be conflicting.
  • By extension of his argument that it is immoral to maintain life where there is suffering, all those who suffer from any illness, or indeed with the potential to suffer from any illness, however short or long term, should be exterminated because their existence may lead to their own suffering or the suffering of others.

Given the logical outcome of his moral framework, perhaps it is time to reconsider the starting point. If the outcome is outrageous and not what he intends at all, perhaps that is because some of his reasoning is based on an emotional understanding of happiness and suffering. 

Wednesday, 6 August 2014

Eugenics, ante-natal testing and choice

Some time ago I blogged about testing for Down's Syndrome. Now, there is news about some other genetic disorders: namely Patau and Edward's sydromes. Like Down's Syndrome they are due to trisomy - where a person has three copies of one of their chromosomes instead of the usual two - caused by random genetic mutations. Like Down's Syndrome their risk increases with maternal age. And like Down's Syndrome they can both be detected by amniocentesis. Now, according to to this article, earlier testing will become available.
Now, women will be able to make important decisions earlier on, says the article. There is only one important choice that we are allowed to make, as women. Everyone tells us so. When we talk about women and choice we are talking about the choice not to. The choice not to have a child who is less than perfect, the choice not to have a child with less than perfect timing, the choice not to have a child who doesn't fit into our plans, our budget, our lifestyle. We are not allowed be radical, or make sacrifices (except of our fertility). Whilst screening for such conditions could allow a family to prepare for a disabled child, perhaps learn more about what their condition entails and engage with support services available before the baby is born, this is not what is implied. The fact that many unborn children with these conditions will not survive to full-term is a tragedy and I do not wish to negate the suffering caused by such events. But abortion is not the solution. It will not mean the baby does not suffer and it will not mean the parents do not suffer. Earlier testing will not lead to better choosing or better preparation or more research about why such things happen, it will only lead to more deaths as we gradually seek to eliminate every single inconvenience (and especially inconvenient people) from our world.

Saturday, 2 August 2014

We're all going on a summer holiday more mass for a week or two.

I have noticed, in recent years, a sharp decline in the number of families at mass during the school holidays. (This is anecdotal evidence: I have not conducted actual research.) Now, I realise that people go away during the holidays, but given the amount of elderly people in my parish, and the lack of Catholic churches in the area, there should presumably also be a counter-balancing influx of families visiting grandparents. What seems to be happening is that people don't go to mass in the holidays and certainly don't bring their children along.

I find this a bit odd.

I know people who struggle to get their teenage children to go to mass, especially with the competing demands of weekend sporting activities, but there does seem to be a prevailing idea that children (and adults) can be let off from mass attendance during the holidays. The problem with this (and I don't have children, so if you do and think I'm completely wide of the mark, ought to shut up etc etc) (aside from the whole of missing mass), is that this forms a link between school and church as concepts, presumably generating similar associations when the end of the holidays come and one has to go back to both of these ie school and church are both boring, we need breaks from both, they aren't necessary all year round and so on. Two of the three longer school holidays are based around Christian holidays, so it also seems slightly ridiculous to not go to mass at these times.

There are no holidays in the adventure that is Christian Life. There may be times when things are perhaps easier or harder, but we cannot, should not, do not get breaks from being Christians, whether from Monday to Saturday or during the school holidays. Being a Christian is not a job, or an activity, it is an identity: it is about being, not doing.

Tuesday, 15 July 2014

Blogging without a cause

Aside from being very angry and a bit spiritually lost when I decided to take a break from blogging, I was also unsure about why I was blogging (apart from wanting a sympathetic space in which to complain about terrible hymns). However after some time away from the blogosphere (including not reading other blogs), a holiday, a retreat and going back to work I think I am in more of a position to take up my keyboard again. In the midst of this I went to a talk by Paul Moore.

The combination of these last two made me think about what I am doing in life. As a lay person in the world I do not have the experience of obedience and mission which I did in community life, and yet God does still have a plan for me. Back in the world of work, and on the front line of healthcare, I am starting to realise that this plan includes a mission.

Whilst letting off steam about hymns is fun and probably necessary (and since I realised that Colours of Day has multiple authors ('written by a committee' as one of my friends put it) I've been wondering if perhaps that wrote one verse each and that is why there is a total lack of continuity) I recognise that what I am  really interested in blogging about is the role and mission of the laity (transforming the temporal sphere), and specifically in the sphere of health care.

I think this means that Recusancy is back.

Monday, 14 July 2014

Carey and Tutu should really know better

Over the weekend I found myself astonished by the comments of Lord Carey and Archbishop Tutu on assisted dying. 

As the Lords prefer to debate Lord Falconer's proposed assisted dying bill, these two prominent Anglicans have chosen to speak in favour of such a law, and have been widely reported as doing so. Unfortunately few people will read the actual statements which were made, and these certainly deserve further examination.

Carey started the ball rolling with his article in the Daily Mail (his original article is at the end, the first section is a review both of his comments and the Bill). He makes several points:

  • Modern medicine is capable of ending life as well as prolonging it.
  • The law (and the Church) need to catch up with reality.
  • Arguments of the slippery slope type 'lack power and authority'.
  • Benevolence and compassion are more important than doctrine: Christian theology needs reinterpreting. 
The ability to cause death is not new (see history). Carey claims that the fact that drugs such as morphine, given to ease pain, may hasten a person's death and argues that given that this may happen, we could and should use them to cause the patient's death. This is merely an extension. In fact 'modern medicine', as lauded by the former Archbishop of Canterbury himself, is capable of controlling doses so carefully that such a 'double-effect' is now negligible. He also fails to recognise that as it is the primary intention which has changed (causing death vs analgesia) this is not a mere extension of an unavoidable effect but a completely different action. First, do no harm. The former 'first' is the alleviation of pain. The latter is to actively seek to end the patient's life. 

Then we have the reflecting reality/moving with the times argument. There is only one thing to say about this: Dictatorship of Relativism. In this country we seem to like this argument. People are having abortions, let's legalise them. People want to marry others of them same sex, go for it. 

As to the lack of authority in the slippery slope argument, I present for his Lordship's inspection the same cases I cited in the previous paragraph (in reverse order). Repeal of section 28, civil partnerships, assurances of no change to marriage, change to marriage law. Slippery slope or what? The Abortion Act 1967 allowed for pregnancy to be terminated if the pregnancy presented greater risk to the mother's mental or physical health than its continuation (as judged by two medical practitioners). And yet, and yet we have doctors who were prepared to carry out sex selective abortions not being prosecuted. Clearly this is beyond the original intention of the 1967 Act.

As to the last point, I think this has already been covered by the mention of the dictatorship of relativism and the Hippocratic Oath. The ethical principle of beneficence has to go hand in hand with non-maleficence. Jesus did indeed show compassion to lepers (as Carey points out) but he did not say 'well, Mr Leper, you are clearly going to die and slow and painful death, so allow me to put you out of your misery right now'. He also didn't always do exactly what people asked him to. Neither did God decide to end Job's misery by ending his life.

Carey's article is appears full of inconsistencies and contradictions: on the one hand he commends the work of hospices, on the other he uses the lack of hospice care as further reason to support the Bill. He reviews reports of the effect of similar bill in Holland, and then casually dismisses them. And given that his change of heart was prompted by the case of Tony Nicklinson, he presumably thinks that the proposed bill doesn't go far enough, given that Nicklinson suffered locked-in syndrome for years and Lord Falconer's Bill only applies to those with less than 6 months to live. 

Archbishop Tutu, writing in the Observer, points out that 'the words euthanasia and suicide carry negative connotations'. Well yes, they do. But when we talk about 'assisted suicide' or 'assisted dying' we are still discussing the same concept. Lay off the doublespeak, and tell it like it is: we are talking about killing people! However, his main issue (although it is not clear if he himself has realised this) seems to be with the artificial prolongation of life, rather than advocating its premature end (indeed, he states that dying in old age is a privilege in Africa). He criticises the lack of dignity granted his friend Mandela in the last days of his life. And I agree with him. Political opportunism in the form of photoshoots with a man kept alive by machines have nothing to do with dignity. In his own advancing years Archbishop Emeritus Tutu does not want to be treated thus. At this point we can all, fortunately, reach for the Catechism and find that, unsurprisingly, the Church in her wisdom has already considered this point:
2278 Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of 'over-zealous' treatment. Here one does not will to cause death; one's inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.
And then we have the Bill itself. On the one hand, in healthcare we seek to prevent suicide, seeing it as something never in a person's best interest. We can even section those who threaten to harm themselves in this way. Now, we propose to legalise it. And I, for one, having been on the other end of mental illness, am glad that we do. I am glad that everyone was clear, myself, the people around me, the healthcare professionals who supported me (psychiatrists, psychologists and GPs), were all clear that a thought of suicide was not a normal or natural thought, a thought that the world would be better without me in it, a thought life was not worth living, that these thoughts were a product of illness, not a fruit of my will. How long will it be before those who have seven months to live declaim their right to die. What of those frail octa- and nonagenarians who might be expected to just drift off in their sleep at any time, simply from having been alive for so many years, without being acutely and specifically dying, are they being denied their rights? How long before those with mental illnesses which  cause suffering and anguish and require intensive care decide that they too want the right to die? What of the fact that predicting death is an extremely imprecise science even for experts. And since when was death a private act anyway?

But even this is not  the whole of the point. Life is indeed sacred, and that should be enough. But, thought the incarnation, passion, death and resurrection of the Lord Jesus, suffering and pain have a redemptive quality, uniting us with Christ in his passion, giving us the opportunity draw closer to him and experience his closeness to us. And, furthermore, giving both patient and carers the opportunity to grow in love. Please, don't deny us this opportunity.