Saturday, June 25, 2011

A new 'sanctity of life' challenge

It began with Tony Bland, who suffered brain damage in the 1989 Hillsborough football disaster. He was diagnosed as being in what has come to be known as persistent vegetative state.

Doctors said he was unaware, but not in pain. He was not dying. He was not on life support. Cared for, he could have lived for 30 years. But in 1993 the law lords decided - though not in a unanimous decision, you may remember - that doctors could withhold food and water from him, thus causing him to die.

It was the first time in history English courts sanctioned causing the death of an innocent man who was not already dying.

Since then, it has been possible to apply to the courts for permission to withdraw food and water from patients in so-called persistent vegetative state, and numbers of patients have died in this way.

I am opposed to nutrition and hydration being withdrawn in these circumstances. I do not believe it is possible to prove total lack of awareness. I do not know how it can be said there is no possibility of improvement (some patients diagnosed as being in persistent vegetative state have recovered). And whatever you think of those two points, we are still taking innocent human life.

Now there has come another sinister development. A mother is applying to the courts for permission to withdraw nutrition and hydration from a patient said to be minimally conscious. The case comes before a court in the next few weeks.

If permission to withdraw food and water is granted here, we will have crossed another rubicon; taken another important step down the slippery slope.

Thursday, June 23, 2011

109 years old - with a new nose

Human life is precious.

Human life deserves care and respect, whether the person is newly conceived, nine or 90. Because this is a particular concern of mine, this blog carries stories about things like assisted suicide, which can be depressing. So here's a story to try to restore the balance.

Meir Korner lives in Haifa, in northern Israel. There's one thing you should know about him before we go any farther. He was born in December 1901. That makes him 109 years old.

He still has good health, a clear mind and a great sense of humour. His recipe for old age, he says, is simple: do what makes you happy.

His daily routine includes sleeping well, reading, resting, regular talks with the Almighty and going to the beach. For 60 years he didn't miss his walk on the shore, where he meets friends and enjoys the sunshine.

A few months ago, Meir discovered what turned out to be a tumour on his nose. Eventually it covered some 50 per cent of his nose. A few weeks ago, he had an operation to remove the tumour and reconstruct his nose, using a flap of skin from his forehead (forehead flap rhinoplasty, for the professionals among my readership).

Meir's nose healed in a very short space of time, reports. "We are extremely satisfied with the results," said Yitzchak Ramon, the doctor who operated. "Nose reconstruction is a real challenge, yet just days after the operation, it looked like nothing happened."

Meir waits to return to the beach. "The doctors say this happened because of the sun, but I don't think I have to stop going to the beach," he said.

"I look and feel good because of the doctors and because I do what I love. The Almighty promised me many years on this earth, and the moment I can, I will return to the sea - with sunscreen."

Monday, June 20, 2011

So where are we going here?

President Obama is being described as the most anti-Israel president in US history.

Hamas has been listed by the US as a terrorist organisation. It refuses to accept Israel's right to exist and is sworn to Israel's destruction.

Just a month ago, President Obama said Israel could not be expected to negotiate with Hamas until Hamas gave up its goal to destroy Israel. He told the annual meeting of the American Israel Public Affairs Committee: "We will continue to demand that Hamas accept the basic responsibilities of peace, including recognising Israel's right to exist and rejecting violence and adhering to all existing agreements."

Despite the fact that Hamas has not changed its position, Obama now says that Israel must start peace negotiations with Hamas, now a partner with Fatah in Palestinian government, based on Israel's pre-1967 borders. This, it is suggested, would prevent the Palestinians' unilaterial declaration of a Palestinian state in September - a move which the US could prevent anyway if it had a mind.

Israel says it will not negotiate with Hamas so long as Hamas refuses to accept Israel's right to exist.

Iran, whose fanatical leadership has promised to wipe Israel off the map, has stockpiles of enriched uranium and is now said to be able to produce enough weapons-grade uranium for a nuclear bomb in about two months.

Hezbollah and Hamas are still backed by Iran. In Egypt, the radical Muslim Brotherhood is consolidating its position ahead of elections in September. The hand of al Qaeda is becoming increasingly evident in countries like Yemen. Muslims are talking about a Muslim caliphate with the former land of Israel at its centre.

When we talk about Israel, we are dealing not only with a geopolitical issue, but with an intensely theological and spiritual issue. The Bible speaks a great deal about Israel's history, Israel's present and Israel's future. There is not room here to quote large portions of the Bible, but consider, for instance, Ezek 28:25, 26:

"'Thus says the Lord God: "When I have gathered the house of Israel from the peoples among whom they are scattered, and am hallowed in them in the sight of the Gentiles, then they will dwell in their own land which I gave to my servant Jacob.

"'And they will dwell safely there, build houses, and plant vineyards; yes, they will dwell securely, when I execute judgments on all those around them who despise them. Then they shall know that I am the Lord their God."'"

And Amos 9:14, 15:

"'I will bring back the captives of my people Israel;
They shall build the waste cities and inhabit them;
They shall plant vineyards and drink wine from them;
They shall also make gardens and eat fruit from them.

"I will plant them in their land,
And no longer shall they be pulled up
From the land I have given them,'
Says the Lord your God."

Saturday, June 18, 2011

It's your choice

When I saw the film version of C. S. Lewis' classic tale The Lion, the Witch and the Wardrobe I was interested, but not tremendously impressed. Perhaps I had heard so much about it, actually seeing it was something of an anti-climax. On the other hand, when I heard the dramatised version of the story on the radio, I was almost in tears.

Why the difference? Perhaps because radio offers better opportunity for the imagination to function. A powerful thing, the imagination.

Someone said that the Bible doesn't tell us everything about heaven, but enough to allow us to imagine it. And look forward to it.

When God has finished what's He's doing down here, He's going to create a new heaven and a new earth. The new heaven isn't going to be up there; it's going to be down here. God Himself is going to come down to dwell among His people.

"And I saw a new heaven and a new earth, for the first heaven and the first earth had passed away. Also there was no more sea. Then I, John, saw the holy city, new Jerusalem, coming down out of heaven from God, prepared as a bride adorned for her husband. And I heard a loud voice from heaven saying, 'Behold, the tabernacle of God is with men, and he will dwell with them, and they shall be his people, and God himself will be with them and be their God'" (Rev 21:1 - 3).

Words can't describe what a wonderful place it will be. There will be no more death, nor sorrow, nor crying, nor pain. We will have fellowship there with some wonderful people, and with God Himself.

It's amazing how people imagine that everyone is going to heaven (except Hitler perhaps, and Saddam Hussein). Jesus said only a few people are going there.

And it's surprising how people believe we can get to heaven by being good. Or if the good we do outweighs the evil we do. Or if we belong to this church, or that church or the other church. Heaven is perfect; there'll be no sin in heaven. And we're all sinners, which is why we all need a Saviour. God's Son, born into human flesh, lived a perfect life and died in my place, so that He could take away my sin and give me His righteousness. He's the Saviour of the world.

"For God so loved the world that he gave his only begotten Son, that whoever believes in him should not perish but have everlasting life" (John 3:16).

The reason so many people don't go to heaven is not because they aren't invited, but because they fail to take advantage of God's offer of forgiveness and a new life in Christ.

God's done everything He can to make it possible. The choice now is yours.

Tuesday, June 14, 2011

An appalling example of propaganda

In a one-hour TV programme called Choosing to Die, the BBC last night showed a British man taking his own life at the Dignitas clinic in Switzerland.

The programme was presented by Sir Terry Pratchett, a patron of Dignity in Dying (formerly the Voluntary Euthanasia Society) and a campaigner for the legalisation of assisted suicide in the UK. It was totally biased: little more than propaganda for the campaign. It is likely to encourage others to commit suicide. The decision to show the programme was appalling.

Dr Peter Saunders, of Care Not Killing, wrote on his blog last week:

By putting their extensive public resources behind this campaign and by giving Terry Pratchett, who is both a patron on DID and key funder of the controversial Falconer Commission, a platform to propagate his views, the BBC is actively fuelling this move to impose assisted suicide on this country and runs the risk of pushing vulnerable people over the edge into taking their lives. It is also flouting both its own guidelines on suicide portrayal and impartiality.

The portrayal of suicide by the BBC, along with Pratchett's celebrity endorsement, breaches both international and BBC guidelines on suicide portrayal and risks encouraging further suicides amongst those who are sick, elderly or disabled. It is both a recipe for elder abuse and also a threat to vulnerable people, many of whom already feel under pressure at a time of financial crisis and threatened health cuts to end their lives for fear of being a burden on others. The dangers of portraying suicide on the media (Werther effect, suicide contagion, or copycat suicide) are well recognised in the medical literature.

The BBC's own editorial guidelines on portrayal of suicide are very clear and call for 'great sensitivity': 'Factual reporting and fictional portrayal of suicide, attempted suicide and self-harm have the potential to make such actions appear possible, and even appropriate, to the vulnerable.'

The WHO guidance on the media coverage of suicide is equally unambiguous: 'Don't publish photographs or suicide notes. Don't report specific details of the method used. Don't give simplistic reasons. Don't glorify or sensationalize suicide.'

The latest move by the BBC is a disgraceful use of licence-payers' money and further evidence of a blatant campaigning stance. The corporation has now produced five documentaries or docudramas since 2008 portraying assisted suicide in a positive light.

Where are the balancing programmes showing the benefits of palliative care, promoting investment on social support for vulnerable people or highlighting the great dangers of legalisation which have convinced parliaments in Australia, France, Canada, Scotland and the US to resist any change in the law in the last twelve months alone? One will not it seems, hear any of this from the BBC.

The BBC is in flagrant breach of both its own guidelines on suicide portrayal and also its public duty to remain impartial. This will inevitably lead to further criticism of bias and will only serve to place the lives of more vulnerable people at risk.

In a blog post published yesterday before the programme was shown, Peter Saunders prophesied that there were 20 things that would not be mentioned on the programme. He went on to list the 20 things. He was right on every one.

His full comments can be seen here and here.

Friday, June 03, 2011

A health service in crisis

The National Health Service appears to be in crisis.

Despite billions of pounds having been thrown at it, Health Secretary Andrew Lansley says without urgent reform the NHS faces a £20 billion-a-year black hole in funding and a potential doubling of health spending.

Almost 4,500 patients are said to have been discharged from hospital severely malnourished last year, some having illnesses more commonly seen in famines in Africa.

Dehydration is said to contribute to the death of more than 800 hospital patients each year. A report by the Care Quality Commission said some doctors were having to prescribe drinking water for patients to ensure they were given enough to drink.

One, if not two giant care home companies are said to be facing financial meltdown, with the possibility of the Government having to provide a rescue package to save thousands of care home residents from being made homeless. Meanwhile there are reports of "barbaric" abuse of patients at a privately run care home, and a review of the Care Quality Commission itself following an apparent failure to act.

While all this is going on - and not necessarily in direct connection with the above - the Royal College of General Practitioners has drawn up a charter for the care of patients nearing the end of life.

GPs are to assist such patients to make a written record of their wishes, which will be kept on the NHS database of medical records now being developed. Ambulance staff and emergency doctors will then be able to know, for instance, as well as the GP, whether or not the patient wishes to be resuscitated. The patient's wishes will be binding.

The charter may have been formulated with good intentions, but I have serious questions about its implementation. What if the information is put on the computer database incorrectly? What if it is mixed up with another patient's records?

Patients are already able to sign an advance directive (also known as a living will) stating how they wish to be treated, including whether or not they wish to be resuscitated in a life or death situation. Doctors are obliged to follow such directives.

The whole idea of living wills is flawed. An incapacitated patient who has signed a living will is not able to change his mind. How he feels when illness strikes may be very different from what he said when he was fit and well.

I recently heard of a case where doctors dealing with a life and death situation were told there was a living will and allowed the patient to die. It was later found that what was in the patient's medical records was a blank living will form that had not been filled in.

My position regarding future treatment is clear: I do not wish to be allowed to die with dignity; I want to be allowed to live with dignity until death finally and naturally intervenes. Some people who feel as I do have made living wills saying they do want to be resuscitated. I would be most reluctant to do that. Suppose my instructions were misinterpreted or misunderstood?

A doctor's calling is to save life. Unfortunately, a patient's autonomy has become the be-all and end-all.