Monday, 15 July 2013

Assisted suicide deaths increase by 17% in one year in Washington State

The number of Washington state residents who died of physician-assisted suicide rose to 83 in 2012, up from 70 in 2011, 51 in 2010 and 36 in 2009, when the state’s Death With Dignity Act took effect.

This is an overall increase of 130% since 2009 in the most north-west US state outside Alaska.

The Washington State Department of Health reported in May that 121 patients requested and received lethal doses of drugs in 2012.

The vast majority of the terminally ill patients who received life-ending drugs feared loss of autonomy, dignity and ability to participate in activities that make life enjoyable.

97% were white, 82% had at least some college education and 73% of the patients had cancer, said the report.

Last year I highlighted the huge increase in deaths from assisted suicide in Oregon and Switzerland of 450% and 700% respectively over ten years as further evidence of the incremental extension that inevitably follows any change in the law.

In the Netherlands euthanasia numbers have increased from 15-20% per year since 2006 and in neighbouring Belgium they have increased 509% in the ten years between 2003 and 2012.

Washington is now showing the same pattern with almost a 130% increase in three years.

Careful examination of the Washington report also reveals that:

• Only 3 of the 121 people who were prescribed a lethal dose were given a psychiatric evaluation.
• One person died 150 weeks after receiving the lethal dose while 17 of the participants died more than 6 months after receiving the lethal dose.
• The physician who prescribed the lethal dose was present only five times during ingestion.
• One person died 16 hours after taking the lethal dose.

Margaret Dore, a Washington State attorney, highlights other causes for concern. She argues that the demographics of those who ingested the lethal drugs - ‘older people with money’ - are a prime target for abuse.

The report also gives no information as to whether all of the 83 people who died after ingesting the lethal dose took it voluntarily but merely records  the fact of ‘ingestion’.

Assisted suicide thankfully remains illegal in Britain and we see only a small trickle of 15-20 Britons per year going to the Dignitas facility in Zurich to end their lives.

But with an Oregon/Washington- type law we would see 1,200 deaths annually.

It is no wonder that over 100 attempts to legalise assisted suicide in other US states have failed over the last 15 years and that Oregon and Washington remain the only states to have legalised the practice on the basis of a referendum. 

Let’s not go there.

Saturday, 13 July 2013

Courageous MP thrown out of government for refusing to back legal abortion

Ireland's Europe minister quit last Thursday over plans to legalise abortion as Prime Minister Enda Kenny pressed ahead with legislation that has polarised the country.

Kenny has provoked a strong backlash by pushing for access to abortion when a woman threatens suicide, a move that opponents say could easily open the floodgates to abortion on demand.

Lucinda Creighton (pictured), once tipped as a possible leader of the Fine Gael party, was automatically expelled from its grouping in parliament for voting against an amendment to the new law and will now lose her role as minister for European affairs.

‘When it comes to something that is essentially a matter of life and death, I think it is not really possible to compromise,’ Creighton told state broadcaster RTE after the vote.

Ireland’s lower house of parliament passed the bill by 127 votes to 31 and acceptance in the upper house is considered by many now to be a formality.

Under the new bill abortions will be legal if ‘there is a real and substantial risk of loss of the woman’s life by way of suicide’ and if an abortion is the only way of averting the suicide. Three doctors must sign off on each case. No time limits are mentioned in the legislation.

Ms Creighton objected vehemently to this clause. She argued that it was unworkable and ‘has the potential to normalise suicidal ideation by enshrining suicide on our statute book for the first time’.

After the vote Ms Creighton said that she was very sad to be forced out of the party. But in a lengthy apologia, Ms Creighton told the Dail that she was not a ‘pro-life campaigner’ but that that abortion was not a ‘liberal’ cause. It was ‘a tool for the oppression of women’. She also disavowed a religious motivation for her principled stand:

‘There is an emerging consensus in Ireland which suggests that having a sense of morality has something to do with the Catholic Church…. This is deeply worrying. It is a lazy way of attempting to undermine the worth of an argument, without actually dealing with the substance. This is not just a Catholic issue, any more than it is a Protestant or Muslim issue. This is not a religious issue. It is a human rights issue… We all have the right to conscientious objection. It is enshrined in Article 18 of the United Nations, Universal Declaration on Human Rights.’

Martin Luther King Jr's argued in his influential ‘Letter from a Birmingham Jail’ - written 50 years ago in April 1963 – that conscience was the lodestar of an honourable man.

Professor John Wyatt has defended its use in medicine saying that ‘the right of conscience helps to preserve the moral integrity of the individual clinician, preserves the distinctive characteristics and reputation of medicine as a profession, acts as a safeguard against coercive state power, and provides protection from discrimination for those with minority ethical beliefs.’

But the right of conscientious objection is increasingly coming under attack from a number of prominent ethicists and writers. According to Oxford Professor Julian Savalescu, a prominent bioethicist:

'A doctor's conscience has little place in the delivery of modern medical care… If people are not prepared to offer legally permitted, efficient and beneficial care to a patient because it conflicts with their values, they should not be doctors’.

A recent article in the New England Journal of Medicine similarly stated:

'As the gate-keepers to medicine, physicians and other health care providers have an obligation to choose specialties that are not moral minefields for them. Do you have qualms about abortion, sterilization and birth control - do not practice women’s health.’  

As I have previously argued there is a strong biblical precedent for the exercise of conscience when governing authorities act to threaten innocent human life.

The Hebrew midwives when ordered by the king of Egypt to kill all male Hebrew children refused to do so and as a result we are told that God commended and rewarded them (Exodus 1:15-22).

Rahab the harlot similarly refused to co-operate with the king of Jericho in handing over the innocent Israelite spies (Joshua 2:1-14). She is later praised for her faith in so doing (Hebrews 11:31; Jas 2:25).

Moreover conscience was often exercised at great personal cost.

The prospect of death as a consequence of disobedience to state law did not stop Shadrach, Meshach and Abednego refusing to bow down to the image (Daniel 4:6-8), or Daniel persisting with public prayer (Daniel 6:1-10). They were defiant.

In the New Testament when Peter and John were commanded by the Jewish authorities not to preach the Gospel they replied,  'We must obey God rather than men' and went right on doing it (Acts 5:29).

As Ms Creighton has argued, abortion is not just an issue that concerns Christians.

It also runs counter to the Hippocratic Oath, the Declaration of Geneva, the International Code of Medical Ethics and the Universal Declaration of Human Rights. In fact the British Medical Association once called it ‘the greatest crime’.

Ms Creighton is to be commended for her courageous stand. What a shame that more did not stand with her. 

New Berlin memorial revives memories of doctors’ role in Nazi holocaust

Officials gathered in Berlin this week to lay the foundations for a monument to the people killed as part of the Nazi ‘euthanasia’ programs.

The symbolic site at Tiergartenstrasse 4 (pictured) was chosen as it was the headquarters of the original project.

The planned exhibit will be dedicated to the victims of the ‘euthanasia’ program, codenamed ‘T4’, used by the Nazis to kill those with physical or mental illnesses.

It will be situated not far from a memorial to the six million Jewish victims of the Holocaust opened in 2005 and a memorial to the half a million Roma victims of the Nazis opened in 2012.

Between January 1940 and August 1941 about 70,000 people were killed under the T4 programme. Many were sent to gas chambers, others were killed by lethal injection.

The programme was ostensibly shut down in 1941, partly after church protests, but it continued in secret. Historians estimate that between 200,000 and 300,000 people who were either psychotherapy patients or physically disabled were killed altogether.

The planned monument will be a long, blue glass wall - designed by the architects Ursula Wilms and Heinz W. Hallman, along with the artist Nikolaus Koliusis and the federal government plans to contribute 500,000 euros ($643,200) to the costs.

The finished site is tentatively scheduled for inauguration in the second half of 2014.

Many still fail to appreciate the role of doctors in the Nazi holocaust but what ended in the 1940s in the gas chambers of Auschwitz, Dachau and Treblinka had much more humble beginnings in the 1930s in nursing homes, geriatric hospitals and psychiatric institutions all over Germany.

When the Nazis arrived, the medical profession was ready and waiting.

The medical and other healthcare staff from T4 and the early killing centres based in hospitals were later redeployed for the killing of Jews, Gypsies, Poles, Russians and disloyal Germans. By 1943 there were 24 main death camps (and 350 smaller ones) in operation.

Throughout this process doctors were involved from the earliest stage in reporting, selection, authorisation, execution, certification and research. They were not ordered, but rather empowered to participate.

Leo Alexander (pictured), a psychiatrist with the Office of the Chief of Counsel for War Crimes at Nuremberg, described the process in his classic article 'Medical Science under Dictatorship' which was published in the New England Medical Journal in July 1949:

‘The beginnings at first were merely a subtle shift in emphasis in the basic attitude of the physicians. It started with the attitude, basic in the euthanasia movement that there is such a thing as a life not worthy to be lived. This attitude in its early stages concerned itself merely with the severely and chronically sick. Gradually the sphere of those to be included in this category was enlarged to encompass the socially unproductive, the ideologically unwanted, the racially unwanted and finally all non-Germans.’ 

The War Crimes Tribunal reported that ‘part of the medical profession co-operated consciously and even willingly’ with the ‘mass killing of sick Germans’.

With the advantage of hindsight we are understandably amazed that the German people and especially the German medical profession were fooled into accepting it. The judgement of the War Crimes Tribunal in 1949 as to how they were fooled was as follows.

'Had the profession taken a strong stand against the mass killing of sick Germans before the war, it is conceivable that the entire idea and technique of death factories for genocide would not have materialized...but far from opposing the Nazi state militantly, part of the medical profession co-operated consciously and even willingly, while the remainder acquiesced in silence. Therefore our regretful but inevitable judgement must be that the responsibility for the inhumane perpetrations of Dr Brandt (pictured left)...and others, rests in large measure upon the bulk of the medical profession; because the profession without vigorous protest, permitted itself to be ruled by such men.' (War Crimes Tribunal. 'Doctors of Infamy'. 1948)

Britain’s Black Triangle Campaign, which was set up to combat discrimination against disabled people, uses as its symbol the ‘black triangle’ which the Nazis forced people with mental and other disabilities to wear in the extermination camps during the Holocaust.

The generic classification they used was ‘arbeitsscheu’ – literally ‘workshy’.

The lessons are clear. The holocaust had small beginnings and advanced in a series of imperceptibly small steps. The medical profession accepted its basic premises (that there is such a thing as ‘a life not worth living’ and that killing such people was ‘an act of mercy’) and failed to protest whilst a small section of its members actively acquiesced to involvement.

RCGP members should take these lessons to heart as they contemplate whether or not to drop their official opposition to a change in the law to allow doctors help people take their own lives.

Guardian health editor jumps onto suicide promotion bandwagon

The Guardian this week has run the story of a man with motor neurone disease who wants to end his life.
Paul Chamberlain, 66, a former chartered accountant from Surrey, we are told, has obtained the drugs he needs ‘from overseas’.

Health editor Sarah Boseley (pictured) uses Chamberlain’s case to promote Lord Falconer’s Assisted Dying Bill, which has been drafted by Dignity in Dying (the former Voluntary Euthanasia Society) and is due to have its second reading in the House of Lords this autumn.
A Samaritans contact phone number is given for those who might be ‘struggling to cope’ but this is a largely empty gesture aimed at giving respectability to a piece of journalistic propaganda which suggests that it can be both right and reasonable for sick people to kill themselves.
Boseley also breaks key media guidelines on suicide prevention. 
The WHO international guidelines on suicide portrayal refer to over 50 published studies, systematic reviews of which have consistently drawn the same conclusion, that media reporting of suicide can lead to imitative suicidal behaviours.
This phenomenon is variably termed suicide contagion, copycat suicide, suicide cluster or the Werther effect.

Its recommendations to media professionals include the following:

· Avoid language which sensationalises or normalises suicide, or presents it as a solution to problems
· Avoid prominent placement and undue repetition of stories about suicide
· Avoid explicit description of the method used in a completed or attempted suicide
· Avoid providing detailed information about the site of a completed or attempted suicide
· Take particular care in reporting celebrity suicides
By portraying this unfortunate man as a hero who is taking a brave and reasonable course of action, and by failing to do justice to the wider context of the debate, Boseley is steering vulnerable people toward suicide.
In so doing she has also bought into the myth that we should consider suicide in people who are sick or disabled as somehow different from suicide for those with mental health problems or who feel their lives are no longer worth living for other reasons.
But the idea that suicide should be promoted in the former group but prevented in the latter creates a false distinction and is actually profoundly discriminatory.
In reality most sick and disabled people do not want and to die and most people who do wish to die are neither sick nor disabled.  
Our response to all suicidal ideation should not be to hand over a poisoned chalice but to ask how we can manage the underlying problem better.
There are about 5,000 people in the UK with motor neurone disease (MND). About 1,000 die with the condition each year, three every day.
The vast majority do not want so-called ‘assisted dying’ (a euphemism for being poisoned with lethal drugs) but rather ‘assisted living’ until they die naturally.
But Boseley’s article gives no voice to this silent group. Nor are we told anything about the care available for people with MND.  No one representing the majority of those with the disease (like Alistair Banks) is given an opportunity to put a contrary view.
We also learn nothing about the rapid escalation of euthanasia and assisted suicide cases in the Netherlands, Oregon, Switzerland and Belgium which have legalised the practice but instead, without any evidence, are assured that such problems are imaginary.
Is it mere coincidence that this story follows hot on the heels of the visit of campaigner Philip Nitschke (aka Dr Death) who has just run a seminar in London advising attendees about how to obtain lethal drugs over the internet?
Thus far over 50 people in his native Australia have killed themselves with a drug which he promotes. One third of these were people in their 20s and 30s. Was it Nitschke, I wonder, who is also ‘helping’ Chamberlain?
Assisting suicide is illegal in Britain for good reasons.
First, 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.

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

Third, hard cases, like that of Paul Chamberlain, make bad law. Even in a free democratic society there are limits to human freedom and the law must not be changed to accommodate the wishes of a small number of desperate and determined people.

In accepting that suicide is sometimes right and that there is such a thing as a life not worth living Boseley crosses two critical and dangerous rubicons.

Her propaganda and Falconer’s bill should be given similar short shrift. 


Monday, 8 July 2013

Leading parliamentary think tank says Lord Falconer’s ‘Assisted Dying’ Bill fails public safety test

Living and Dying Well (LDW) is a public policy research organisation established in 2010 to promote clear thinking on the end-of-life debate and to explore the complexities surrounding 'assisted dying' and other end-of-life issues.

It has just published a comprehensive report on Lord Falconer’s Assisted Dying Bill which was introduced into the House of Lords on 15 May.

Lord Falconer's Assisted Dying Bill [HL Bill 24] is the fourth of its kind to come before the House of Lords in the last ten years and seeks to authorise assisted suicide for mentally competent adults with less than six months to live.

None of its predecessors has made progress and the last one (Lord Joffe's Assisted Dying for the Terminally Ill Bill) was rejected in May 2006.

LDW’s report, jointly authored by eleven members of the House of Lords, concludes that Falconer’s bill ‘is little different from Lord Joffe's - it seeks to license doctors to supply lethal drugs to terminally ill patients to enable them to end their lives’.

The authors include leading lawyers, doctors and disabled peoples’ advocates including Baroness Butler Sloss, Lord Carlile, Baroness Finlay and Baroness Campbell.

They recognise that ‘some people support legalisation of assisted suicide on grounds of autonomy and others oppose it as immoral’ but then seek to assess the bill on the ‘criterion of public safety’ - whether its enactment would ‘put seriously ill people at risk of harm’.

The bill, say the Peers, ‘contains no safeguards, beyond stating eligibility criteria, to govern the assessment of requests for assisted suicide’. Furthermore, it ‘relegates important questions such as how mental capacity and clear and settled intent are to be established to codes of practice to be drawn up after an assisted suicide law has been approved by Parliament’.

This is ‘wholly inadequate’ and on the issue of safeguards alone, they argue,  ‘the bill is not fit for purpose’.

It ‘places responsibility for assessing applicants for assisted suicide and supplying them with lethal drugs on the shoulders of the medical profession’ but at the same time ‘ignores expert medical evidence given to Parliament in recent years regarding the unreliability of prognoses of terminal illness at the range it envisages’.

‘Other considerations aside’, they assert, ‘the bill fails the public safety test by a considerable margin’.

The report concludes that the law that we have already ‘has the discretion to deal with exceptional cases in an exceptional way’ and that Lord Falconer's bill, by creating ‘a licensing system’ for assisted suicide crosses ‘an important Rubicon’.

To create exceptions to the blanket prohibition on assisted suicide which are ‘based on arbitrary criteria such as terminal illness or mental capacity, is to create lines in the sand, easily crossed and hard to defend. No convincing case has been advanced as to why these important considerations should be set aside.'

The tightly drafted report runs to eleven pages and is well worthy of careful study. 

Why the RCGP should stand firm on opposing a change in the law to allow assisted suicide

The Royal College of General Practitioners (RCGP) is conducting a consultation about the College's collective position on ‘assisted dying’.

The College’s current position on the issue is that, with good palliative care, a change in legislation is not required.

However, last year the RCGP Council Chair Clare Gerada (pictured) made it known that she personally favoured a move to a neutral position and proposed to the RCGP Council that they consult RCGP members on the matter.   

The consultation comes just after the introduction of an ‘Assisted Dying Bill’ into the House of Lords by Lord Falconer on 15 May and just before a similar bill is introduced into the Scottish Parliament by Margo MacDonald MSP.

Only the College’s 46,000 members can take part and are being asked two key questions:

1. When should the College, as a membership body, have a collective organisational view on an ethical issue, and when should it not?

This raises subsidiary questions of whether there are issues on which the College should not express a collective view, whether split opinions preclude a collective view and to what extent positions on ethical issues should be democratically mandated.

2. What should the College’s position be on assisted dying - in favour, opposed or neutral?

Taking a neutral position would mean that the RCGP would take a position that the legality of assisted dying is a matter for Parliament, on behalf of society, to decide, and is not an issue that the College should seek to influence.

RCGP members have been asked to consider implications of each of the three possible positions for patients, including the doctor-patient relationship, GPs as individual health professionals, the RCGP as a professional body, the health system and the RCGP in its policy making role.

The consultation will run until 9 October 2013, with a debate by the RCGP's governing Council expected in early 2014.

The RCGP adopted its current strong opposition to a change in the law in 2005 after substantial discussion and consultation with its Faculties and Members as follows:

‘The RCGP believes that, with current improvement in palliative care, good clinical care can be provided within the existing legislation and that patients can die with dignity. A change in legislation is not required.’

It restated this position in 2011 saying that ‘nothing has occurred since 2005 to alter or change the ethical issues around assisted dying’.

Here are eight reasons why I hope that RCGP members will strongly support the College’s current policy.  

1. The majority of doctors are opposed to a change in the law. Opinion polls show an average of 65% doctors opposing the legalisation of assisted suicide and/or euthanasia with the remainder undecided or in favour. Palliative Medicine Physicians are 95% opposed and the Royal College of Physicians and British Geriatrics Society are officially opposed.

2. Assisted suicide and euthanasia are contrary to all historic codes of medical ethics, including the Hippocratic Oath, the Declaration of Geneva, the International Code of Medical Ethics and the Statement of Marbella. Neutrality would be a quantum change for the profession and against the international tide.

3. Neutrality on this particular issue would give it a status that no other issue enjoys. Doctors, quite understandably, are strongly opinionated and also have a responsibility to lead. The RCGP is a democratic body which takes clear positions on a whole variety of health and health-related issues. Why should assisted suicide and euthanasia enjoy a position which no other issue shares, especially when doctors will actually be the ones carrying it out?

4. Dropping medical opposition to the legalisation of assisted suicide and euthanasia at a time of economic recession could be highly dangerous. Many families and the NHS itself are under huge financial strain and the pressure vulnerable people might face to end their lives so as not to be a financial (or emotional) burden on others is potentially immense.

5. Were the RCGP to drop its opposition, and as a consequence a law were to be passed, it would also leave the medical profession hugely divided at a time when, perhaps, more than any other time in British history, we need to be united as advocates for our patients and for the highest priorities in a struggling health service.

6. Going neutral would leave the RCGP gagged with no collective voice.  The British Medical Association (BMA) rejected an attempt to move it neutral at its 2012 annual representative meeting saying that neutrality was the worst of all positions. This was based on bitter experience. When the BMA took a neutral position for a year in 2005/2006 we saw huge pressure to change the law by way of the Joffe Bill. Throughout that crucial debate, which had the potential of changing the shape of medicine in this country, the BMA was forced to remain silent and took no part in the debate. 

7. Going neutral would instead play into the hands of  a campaign led by a small pressure group with a strong political agenda. Healthcare Professionals for Assisted Dying (HPAD),  which is affiliated to the pressure group ‘Dignity in Dying’ (formerly the Voluntary Euthanasia Society) has only 520 supporters, representing fewer than 0.25% of Britain’s 240,000 doctors. But in 2012 they flooded the BMA ARM with no less than nine motions calling for the association to go neutral in an attempt to silence medical opposition ahead of new bills being introduced to parliament in 2013.

8. The RCGP has been historically opposed to a change in the law on assisted suicide and euthanasia for good reasons. These reasons have not changed.

Going neutral on assisted dying would be inappropriate, undemocratic and potentially highly dangerous. It would also be playing into the hands of a small unrepresentative pressure group and giving an advantage to only one side of the debate. Furthermore it would communicate confused messages to the public at a critical time and divide the profession at a time when a united doctors’ voice is needed more than ever.

Saturday, 6 July 2013

Jesus in the Qur'an - What Islam affirms and denies about Christ

The whole of the New Testament, indeed the whole Bible, is about Jesus Christ.

By contrast, the Qur’an, which is about the same length as the New Testament, only mentions Jesus in a few of its 114 chapters. What little there is in the Qur’an both affirms and denies what the Bible teaches.

Jesus' birth

The Qur’an deals with Jesus’ birth in Sura 19:16-23, 29-33 and in Sura 3:42-47, 59. These verses affirm that an angel visits Mary (cf Luke 1:26,27) and indicate that God has chosen her and singled her out (cf Luke 1:28). She is said to be blessed among women (cf Luke 1:31-33) and great things are spoken of the son she will bare (cf Luke 1:31-33). The Qur’an in Sura 3:59 likens Jesus to Adam (as does the New Testament in 1 Corinthians 5:22, 45-49 and Romans 5). Most importantly the Qur’an repeatedly affirms the fact of the virgin birth (Sura 19:20). Interestingly Jesus is the only one of the prophets mentioned in the Qur’an who is said to have had a virgin birth.

Jesus' life

There are also similarities in the Qur’an and the Bible with regard to the life of Christ. Like the New Testament, the Qur’an affirms that Jesus performed miracles: in particular that he restored sight to the blind, healed lepers and raised people from the dead (Sura 3:49, 5:11). The Qur’an also affirms that Jesus brought ‘the message of the gospel’ and that he committed no sin (Sura 3:46).

Jesus' titles

There are also similarities between the titles given to Christ in the Qur’an and those in the Bible. The Qur’an calls Jesus ‘the statement of truth’ (Sura 17:24), a similar claim to Jesus calling himself ‘the Way the Truth and the Life’ in John 14:6. Similarly, the Qur’an calls Jesus the Word (Sura 10:19 cf John 1:1), the Apostle (Sura 19:31 cf Hebrews 3:1) and the servant or slave of God (Sura 4:172 and 19:31 cf Isaiah chapters 42, 49, 50 and 53). 

The servant of God was one of Jesus’ favourite terms for himself and he clearly taught that he was the person talked about in the prophet Isaiah’s ‘Servant Songs’ written many centuries before. Most remarkably, the Qur’an refers eleven times (for example Sura 3:45, 4:71, 5:19, 9:30) to Christ as the Messiah. This is particularly interesting because Messiah (or Christ in Greek) is the title repeatedly applied to Jesus throughout the Bible. In fact, much of the Old Testament is devoted to explaining the characteristics and qualities that the coming Messiah will have.

Strange stories

Other material about Jesus in the Qur’an is not in the Bible at all. For example the Qur’an tells us that a palm tree provided anguish for Mary after Jesus’ birth (Sura 19:22-26) and that the baby Jesus talked from the crib (19:29-33). Furthermore Jesus, as a child, is said to have created pigeons from clay which turned into real birds and flew away when he threw them into the air (Sura 3:49 and 5:11).

These ideas to Christians sound quite bizarre, but now with the benefit of archaeology we have some idea as to what their sources may have been. At the time of Muhammad the New Testament had not yet been translated into Arabic and so he didn’t have access to the New Testament manuscripts when recording the Qur’an. However, we know that he was in contact with a number of groups who, although calling themselves Christian, had quite bizarre beliefs. 

Some people suggest that Muhammad may have been influenced by this and simply incorporated ‘heresy’ into the text of the Qur’an and there is, in fact, very good support for this view. The story of the palm tree is found in an apocryphal document called ‘The Lost Books of the Bible’. Similarly the story of the pigeons comes from ‘Thomas’ Gospel of the infancy of Jesus Christ’ and the story of baby Jesus talking is remarkably similar to that found in an Arabic apocryphal fable from Egypt named ‘The First Gospel in the Infancy of Jesus Christ’. All these documents predate the Qur’an by several hundred years.

Plain untruths

The Qur’an also adamantly denies that Jesus is divine (Sura 5:17,75) and says that he is no more than an apostle (4:171; 5:75; 43:59, 63-64). The Qur’an’s claim that Jesus is not the Son of God (9:30) runs starkly in contrast to Jesus’ own claim to divine sonship at his trial (Mk 14:61-64), which led to him being crucified on a blasphemy charge. The Islamic Scriptures also deny that Jesus died on the cross (Sura 4:157) and also, by implication, that he was resurrected.

Perhaps most surprisingly of all we are told that God, Mary and Jesus together constitute the Christian trinity (5:116). This false belief was peddled by a heretical sect called the Collyridians which had been banished to Arabia at the time, and appears to have been unknowingly incorporated into the qur’anic text.

Conclusions

Honest Muslim seekers will want to know more about the life of Christ than the sketchy details recorded in the Qur’an some 600 years after he lived on earth. We need to encourage them to look at the eye-witness accounts of Jesus recorded in the Gospels within a few decades of his death. They can also learn about the historical fact of the crucifixion from late first and early second century documents written by non-Christian Jewish and Roman historians (such as Josephus and Tacitus).

While we can, and should, use what is true about Jesus in the Qur’an to lead Muslims into the fuller truth revealed in the Bible, at some stage we will also have to deal with the differences in the qur’anic and biblical accounts. Why do they believe what the ‘angel’ [claiming to be] Gabriel said above the eye-witness testimony of those who Jesus personally knew, chose and commissioned? ‘Even if we or an angel from heaven should preach a gospel other than the one we preached to you, let him be eternally condemned’. So said Paul (Gal 1:8,9) In the same way Peter affirmed, ‘we did not follow cleverly invented stories... but we were eyewitnesses of his majesty’ (2 Pet 1:16).

Thursday, 4 July 2013

French national ethics committee rejects euthanasia but President Hollande intends to legislate anyway

France's medical ethics advisory council (CNNE) has voted against the legalization of assisted suicide, as found in Swiss clinics such as Dignitas, it was announced on Monday.  

But French President Fran├žois Hollande has promised a law on the issue by the end of 2013.

The committee which had been asked to investigate the issue of euthanasia and come up with recommendations voted against Swiss style assisted suicide. 

However, the CCNE is in favour of ‘passive euthanasia,’ whereby treatment, hydration and nutrients are withdrawn at the request of an individual facing the end of their life.

'Deep sedation' is one 'end of life' care option the CCNE are in favour of which would see the patient put to sleep until the end of their life, if they have requested it and if they have asked for all treatments to be stopped.

‘With sedation, it is intended to relieve the patient, but in no event bring about their death,’ Vincent Morel, President of the French Society for support and palliative care and a doctor at the University Hospital of Rennes told Europe1 radio.

Later on Monday French president Fran├žois Hollande announced that ‘at the conclusion of debate,’ his government would introduce legislation on end-of-life care, ‘definitely by the end of the year.’

In February, the ethics council said that out of a ‘duty of humanity’, and where there were ‘persistent, lucid and repeated requests from someone suffering from an ailment for which the treatment has become ineffective,’ it should be legal to withdraw that treatment and allow that individual to die.

But it said at the time that the condition should be verified ‘not by a sole doctor but a medical team’ and did not use the term euthanasia but spoke of ‘assisted death’.

A 2005 law in France already authorises doctors to administer painkilling drugs at levels they know will, as a secondary effect, shorten a patient's life.

A poll that was released in January 2012 found that 60% of the people in France preferred improvements to palliative care rather than legalizing euthanasia.

I have previously highlighted the rapid escalation of euthanasia and assisted suicide cases in the Netherlands, Oregon, Switzerland and Belgium.

Almost half of Belgium’s euthanasia nurses have admitted to killing without consent, despite the fact that involuntary euthanasia is illegal in Belgium and that nurses are not allowed to perform even voluntary euthanasia. 

In addition, nearly half of all cases of Belgian euthanasia are not reported to the Federal Control and Evaluation Committee. Legal requirements were more frequently not met in unreported cases than in reported cases and a written request for euthanasia was absent in 88%.

recent study found that in the Flemish part of Belgium, 66 of 208 cases of ‘euthanasia’ (32%) occurred in the absence of request or consent.

According to a recent report Belgium is now the ‘world leader’ in organ removal after euthanasia with at least nine cases since 2005 but suggestions are that there would have been many more had more euthanasia patients had transplantable organs.

In the Netherlands there has been a 15-20% increase in euthanasia cases per year since 2006 and a  recent Lancet paper reports that 12.3% of all deaths in Holland are now due to ‘terminal sedation’.  

More recently both Belgium and the Netherlands have announced their intention to escalate their children’s euthanasia programmes.

We will have to wait until the end of the year to see the exact wording of Hollande’s proposed bill but French citizens, seeing the escalation in surrounding countries would be very wise to reject any further weakening of the law. 

Tuesday, 2 July 2013

Bad investments my family have made – reflections on Matthew 6:19-34

My great, great grandfather Joseph McRae used to own the Rotomahana Hotel (pictured) at a town called Te Wairoa in the central north Island of New Zealand in the late 19th century.

He’s the one on the left.

Te Wairoa was situated by beautiful Lake Tarawera and looked out over the blue water to a huge mountain of the same name.

People came from all over the world and stayed at his hotel on the way to visiting the Pink and White Terraces (see below) – unique natural limestone formations containing geothermal pools.

Some at the time referred to them as the eighth wonder of the world.

But on 10 June 1886 Mt Tarawera erupted and threw out over three cubic miles of rock and ash.

The pink and white terraces were destroyed and Te Wairoa is now known as the buried village.

My great, great grandfather’s hotel was demolished but rather miraculously he survived – which is why I am here to write this today.

The eruption bankrupted him because his insurance company would not pay out and a small piece of rotting floorboard represents the entirety of my inheritance.

It wasn’t a good investment regardless of the fact that this tiny wood fragment means a lot to me personally.

This, however, wasn’t the only bad investment my family made.

Joseph’s son-in-law, my great grandfather James Purdy, was a blacksmith who didn’t trust banks. He used to come home every pay day and throw his hard earned cash down the back of the family piano.

One day he decided to retrieve this huge wad of £5, £1 and ten shilling notes which was worth an absolute fortune.

So he pulled the piano away from the wall only to find that his precious lifetime savings had been shredded and re-organised into a rats nest.

It’s said that you can’t eat money. But it’s not true. You can, if you are a rat.

His son, my great uncle Alec, was determined not to make the same mistake so he keep his life savings in a huge glass jar in the form of thousands and thousands of three penny pieces – made out of rat-proof metal .

I remember seeing them as a boy. But then in 1967 New Zealand went decimal and they were all rendered valueless.

Now they are kept in a museum.

I tell you these family stories – amusing but true - because they graphically illustrate one of the principle messages of Matthew 6:19-34  - that money and possessions are not nearly as safe and secure as we might think.

‘Money and possessions’ was one of Jesus’ favourite topics of conversation.

In fact he talked about money more than he talked about sex, prayer and even forgiveness.
16 of his 32 parables are about money in one form or another.

This is because the way we handle money is a very good indication of what we really believe and the state of our hearts.

Matthew 6:19-34 comes from the Sermon on the Mount which occupies Chapters 5 to 7 of Matthew’s gospel.

Matthew 5:1 tells us that the Sermon was preached to his disciples and at the very end Jesus says (7:21) Jesus gives a salutary warning:

‘Not everyone who says to me, “Lord, Lord,” will enter the kingdom of heaven, but only the one who does the will of my Father who is in heaven.’

And then he finishes with the well-known story of the two builders, one who built on sand and the other on rock: when the storms came the first fell down whilst the other stood firm.

Note the key difference between the wise and foolish builders. Both heard Jesus words, but only the wise one put them into practice.

So this is a very serious passage – we are meant to hear it and also to put it into practice. I’ve found engaging with its implications immensely challenging on a personal level and I hope that you will too.

In the Great Commission (Matthew 28:19-20) Jesus tells his disciples to make more disciples and to teach them to observe everything he has commanded them – so this certainly includes these words in Matthew 6.

‘Do not store up for yourselves treasures on earth’, he says in verse 19, ‘where moths and rust destroy and where thieves break in and steal’.

I am just about old enough to remember mothballs being put in the pockets of clothing to prevent them being eaten by moths. Rust means corrosion and thieves can take anything transportable or driveable.

Why shouldn’t we store these things up? Because all can go – we can lose them.

There is no such thing as a safe investment – because nothing in this world is secure.

As my relatives found – hotels, banknotes and coins are not secure – but actually nothing is secure.

In a post 2008 world we now know that banks are not safe; insurance companies are not safe; pensions are not safe; savings are not safe; shares are not safe; property is not safe; paper money is not safe; even gold that most solid of all investments is not safe.

And now that the world economic system is no longer based on gold money is instead represented by electrical currents in silicon chips – gold has become first paper, then plastic and now sand (silicon) – three of the most valueless commodities on earth.

So don’t store up treasure on earth – it’s just not safe…

The blog above is abstracted from a sermon I preached at Spicer Street Church on Sunday 23 June 2013. You can hear the whole sermon on the church website

The moral status of the human embryo – when is a person?

The moral status of the embryo is one of the key pressure-points in ethical debates about post-coital contraception, therapeutic cloning, pre-implantation diagnosis, artificial reproduction, embryo research and cloning.

The issue, which has profound implications for medical practice as doctors, has divided people for centuries and remains controversial.  
It is a fundamental principle both of Christian teaching and also of natural justice that human beings deserve utmost respect.

Christians believe that human beings have been individually created by God and derive their integrity and worth from the fact that they are made in the image of God - regardless of genotype, age, size, location or degree of dependence and disability.

The presence of a disability, either inherited or acquired, does not detract from a person 's intrinsic worth. All human beings are thereby worthy of the utmost respect. They must never be treated as means to an end. At the heart of the Christian ethic is self-giving love, whereby the strong make sacrifices for, and if necessary lay down their lives for, the weak.

Historical medical ethical codes, recognising the power and strength of doctors, have enshrined a view similar to the Christian one.

The Declaration of Geneva (1948) stipulates that doctors should ‘maintain the utmost respect for human life from the time of conception’.

In like manner, the International Code of Medical Ethics (1949)says that a doctor 'must always bear in mind the obligation of preserving human life from the time of conception until death'.

The Declaration of Helsinki (1975) says that in biomedical research:

 'the interest of science and society should never take precedence over considerations related to the well-being of the subject '.'In any research upon human beings,each potential subject should be adequately informed of the aims,methods, anticipated benefits and potential hazards for the study...'and 'the subjects should be volunteers '. 'It is the duty of the doctor to remain the protector of the life and health of that person on whom biomedical research is being carried out.'

By contrast the emerging view amongst contemporary ethicists (such as Peter Singer) is that human beings are nothing but the product of matter, chance and time; merely highly specialised animals.

The value of individual human beings is determined by their level of rationality or self-consciousness, physical attributes or capacity for relationship. Human life that has fewer of these qualities is of less value and can be disposed of. This 'Darwinian ethic 'with its aim of 'survival of the fittest 'places the demented, mentally handicapped, brain-injured and unborn (particularly the human embryo) in great danger.

The Human Fertilisation and Embryology Act (HFE Act) starts with a presupposition that has never been properly established - that the human embryo is not a human being with rights, and can therefore be treated as a means to an end.

In keeping with this foundation the Act sanctions embryo freezing, research and destruction along with abortifacient contraception and the disposal of abnormal embryos after genetic testing -practices that we would not countenance for human beings at any other stage of development.

Any biology textbook tells us that human development is a continuous process beginning with fertilisation; essentially the only differences between zygote and full term baby are nutrition and time.

Biologically the human embryo is undoubtedly human; it has human chromosomes derived from human gametes. It is also alive, exhibiting movement, respiration, sensitivity, growth, reproduction, excretion and nutrition.

It is therefore most accurate to speak of it as a human being with potential, a human being in an early stage of development or a potential adult; rather than a potential human being.

Philosophers, biologists, politicians and even theologians, however, have advanced arguments to undermine the status of the human embryo.

Here are three of the main ones with my responses:

1. Human embryos are not human beings worthy of respect because they lack rationality or capacity for relationship

This was the thinking behind the Warnock Committee’s recommendation of no embryo research beyond 14 days, as the neural crests first form 10 days after fertilisation. Others have suggested that breathing movements (12 weeks), or 'quickening' (20 weeks), or even the first breath of air should be the end point. It has even been argued that newborn babies are not persons since they lack 'self-awareness'.

But the development of the nervous system is a continuous process beginning at fertilisation and choosing an arbitrary point on this continuum discriminates between human lives on the basis of neural function. It is therefore 'neuralist '. Neuralism varies from racism and sexism only on the basis of the non-morally significant quality selected as the basis for discrimination. It is simply another form of ageism.

Our value as human beings does not consist in our capacities or attributes but in the fact that we are human. Arguing that the value of any human life depends on its place of residence (uterus, fallopian tube or petri dish) or degree of independence similarly discriminates on the basis of non-morally significant characteristics.

2. Human embryos are not human beings worthy of respect because they have a high mortality; about 40-70% don't reach maturity

But the value of human beings is not contingent on their survival rates. We don't say that refugees in Africa, flood victims in Asia or people with cancer are less important simply because they have a high mortality. 

Similarly, if survival rates at any stage of development are low this does not justify us actively ending life. The general strategy of medicine is rather to save and preserve life. The figure of 40-70%may well be an overestimate anyway. No one really knows how many early embryos die as there is no biochemical marker for fertilisation, as opposed to implantation.

3. Human embryos are not human beings worthy of respect because many embryos that do spontaneously abort have a high incidence of genetic (particularly chromosomal) abnormality

But all of these abnormal embryos have formed from the union of two human gametes. Aren't they therefore just human lives with severe disabilities, human lives with special needs? We would not argue in any other sphere that the value of any individual human life was contingent on how ‘normal’ it was; far less that abnormality justified killing by 'disposal '.

Conclusions

The arguments used for devaluing the status of the human embryo are both unconvincing and discriminatory. The human embryo should instead be given the benefit of any doubt regarding its status.

We have a choice: we either act to ensure the protection and survival of the most vulnerable members of our society by endorsing the Christian ethic of the strong making sacrifices for the weak; or we continue to ensure the ‘non-survival of the weakest’ by politicising the 'Darwinian ethic '.

The HFE Act has politicised Darwinism by enshrining in statute law discrimination against the weakest and most vulnerable members of the human race. It is built on a fundamental presupposition that has never been established logically, philosophically ethically or morally.  

‘Presumed consent’ for organ donation is both unnecessary and unethical

Wales could become the only UK country with an opt-out organ donation system if politicians vote to change the law today.

Currently an ‘opt-in’ consent system operates across the UK.

Individuals can authorise organ removal from their bodies after death by joining the Organ Donor Register (ODR), or making their wishes known to their family.

However the Welsh government wants to introduce new legislation which would authorise doctors to remove organs and tissue from any patient declared dead, unless the deceased had formally registered their objection.

I strongly support organ donation but so-called 'presumed consent' involves neither consent nor donation – it is neither voluntary nor informed and involves taking organs rather than giving them.

It means effectively that the state will be able to overrule families and there is a very real danger that it could also prove counterproductive and undermine trust leading to fewer rather than more donations. Introducing this legislation would be a radical new step, which is both unnecessary and unethical as a way of increasing organ donation rates.

The claim that donation rates could increase by up to 30% through presumed consent legislation is disingenuous as there is little evidence that this is any better than other schemes in other countries, and there are alternative ways of increasing donation rates.

Donation rates in countries with ‘presumed consent’ laws do not actually differ from countries requiring explicit (opt-in) consent. In fact, some countries operating presumed consent systems have lower rates of organ donation!

Differences in rates are due to other factors including the numbers of potential donors, provision of intensive care facilities, end of life care, use of transplant coordinators, trust in the donation system and trust in the medical profession (particularly those treating dying patients) (See here for a BMJ article on this).

Organ donation is a generous gift and should be encouraged. It resonates strongly with the Christian principles of sacrificial generosity and love for one’s neighbour. However, consent to organ donation should always be voluntary (un-coerced), informed and autonomous. 

As Patient Concern has warned: ‘Assurance that every citizen would hear of the new law, understand it, realise its implications, grasp how to opt-out and get around to doing so – if they wish – is pure fantasy.'

The groups least likely to express their views, if they hold views on this, will include those who are disabled, less well educated or informed, lacking full capacity, of different languages and race, suffering from mental illness, dependent, those who have less ready access to information and those changing their minds. Silence in many of these cases would and should not amount to consent to donation under an opt-out system.

Organ donation should be encouraged as a gift, but this system lays the framework for the taking of organs as a right. That is a very dangerous precedent indeed.

Although this specific legislation is only for Wales, there is increasing pressure to bring in similar legislation in England and Scotland. So it is not just an issue for Wales, it is one that the rest of the UK may well soon be considering.

This is why it is so important that the Welsh government rejects this measure today.

See past CMF submissions on presumed consent here, here and here