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.

Thursday, 12 December 2013

Taking a break

I have decided to take a break from blogging.
I have been thinking about the direction of this blog for a while: why I am blogging, should I write about everything I think about writing about, should I focus only on healthcare (and bad hymns) (and mental illness) (and books), etc. However, since Advent began (and with the incessant bombardment that is seasonal advertising) I have realised that whilst I am not annoyed that I am a Christian, I am annoyed that everyone else isn't. I am angry that other people don't love and respect God: they forget his birthday, they cut him out of everything, they sleep around, they lie and cheat and start wars and kill babies, they ignore him at mass, they don't make a place for him in their hearts...and neither do I. There is nothing righteous or motivating about this anger. It is just anger. And impatience. And, let's face it, pride. Blogging involves looking at what's going on and passing comment. There is much more to say when what's going on is wrong or bad or silly. Right now, this means that I get more angry and impatient.
This is all bound up with recovering from depression. With depression, the world is the inside of your head in any given moment. As you get better, it expands to the size of the room you're in, the people who are in it, maybe the building, perhaps the street, perhaps for this hour, this morning, today, this week. I feel like I am waking up after spending 2 years as a zombie and I have all these new criteria for seeing, for understanding, for loving, but mostly I am just really angry. It is possible, I know, to be angry about something in a more detached way. It is possible for anger to be channelled against what is wrong in a useful way. I am not up to it. I need to calm down a bit first.
I enjoy blogging, and I like to think that I have got something to offer in the blogosphere, but right now it's not helping me grow in holiness. But I will be back because, apart from anything else, there is nothing edifying about this nativity set whatsoever  -
- and I am sufficiently opinionated to tell the world. Possibly the fact that I have always disliked Jenga isn't helping.
In the mean time, I wish you all a blessed Advent.

Monday, 25 November 2013

Craving Catholic blogs

I have just discovered (and added to my blogroll) Catholic Cravings which I would say has something for everyone, although not cat posts but that's OK because Mulier Fortis has them nicely covered.

Monday, 18 November 2013

Social healthcare and the A & E thing

I should make it clear from the start that while I don't think the NHS is perfect (not to mention the  recent shambolic develpments across the Pond) I am absolutely in favour of social healthcare. I have seen children in shanty towns in Peru with no teeth, where those living in poverty will walk out of a hospital and die two days later from appendicitis because they can't afford to pay for the surgery. But I also know a man in the USA who had a kidney transplant but is no longer in work and can't afford health insurance which means he can't afford the medication he needs to prevent his transplant being rejected. Fortunately, the local transplant patients basically pool their meds so that if one month someone can't afford their tablets, then they will be supplied by someone else; a situation which strikes me as no less tragic (although on the other side, also restores one's faith in humanity). However, one of the biggest problems with free medicine (and the Welfare State in general) is what happens on the receiving end.
Research shows that people who get free prescriptions visit their GP when they are suffering from a minor ailment in order to obtain over the counter remedies on prescription rather than paying. This has led to the establishment of minor ailment schemes, whereby those people who are exempt from prescription charges can obtain such remedies free of charge. This frees up GP time and resources for people who have more serious problems.
Recently there has been a lot in the news about the pressure which A&E departments are facing this winter, with 40% of those patients seen in A&E not needing to be there: they could have been treated earlier and/or in the community. At the weekends, A&E is often full of alcohol-related (alcohol-fueled) injuries, and sometimes people will end up there because they are seriously ill and it is one of the paths to hospital admission. A while ago I saw an ambulance which bore an explanation of what was meant by a life-threatening emergency. (I was tempted to give my brother a similar list after he woke me up extremely early to ask where Mum was.) Tales of bizarre 999 calls, which often include people who want a lift to a hospital appointment, are frequent and mind-boggling.
Often it is the elderly who suffer, whether because they didn't go to their GP in time (couldn't get an appointment or didn't want to bother them), or because nobody took them or even noticed that they were a bit off colour. The point at which someone realises you have a mild case of cystitis shouldn't be when you're admitted to hospital with a broken hip (more common than you might suspect), because if someone is suddenly acting confused (often the first symptom of cystitis in older people) then your neighbour or your friend or your carer or someone should notice. And if someone is calling the ambulance service because they need help bringing the washing in and the path is icy, or they need a lift to the supermarket, then we should be asking ourselves why. Why is it that this person had to call 999 for help with a simple task? And I fear the answer has a lot more to do with individualism, loss of community and the selfish desire not to be burdened with other people and their problems (which some might call freedom) than the fact that our healthcare is free.

Sunday, 3 November 2013

Sex, drugs and rock n roll: my parents think I'm mad

And it's not just me.
Recently I have had a few conversations with friends and acquaintances who suffer from a weird problem. Actually it was a relief to me to find I wasn't alone, because after yet another conversation with my Mum which involved her threatening to throw a book which I was reading in the bin because it had the word 'Catholic' in the title I was starting to get a bit stressed out. The only reason that book didn't end up in the bin (or the recycling, at any rate) was because I pointed out that it was borrowed. Others have had similar conversations with their parents about books written by saints or popes. We are Generation Y: hiding our spiritual reading under the bed.
The strange thing is that we were all baptised and brought up Catholic by our Catholic parents and now they don't like it.
Now, I admit that when I discerned my vocation and then entered community I didn't hand it as well as I could have done. Announcing my decision in the car as we were driving along a dual carriageway might have had a very different ending and comments such as 'over my dead body' were perhaps only to be expected. But it started long before that. When I first went to university, there was mild concern over my regular attendance at daily mass. Attending social events at the chaplaincy was also considered worrying. It was the first time in my life I had the opportunity to have friends who were also Catholic, friends who, whatever else they were getting up to at the weekend, would make sure they went to mass on Sunday. The people who thought this was odd were the same people who insisted I came home at 9am after a Saturday sleepover when I was a teenager, so that I could go to mass.
I have a crucifix on the wall and a statue of Our Lady in my bedroom which is considered excessively pious of me, and yet there is a crucifix on the kitchen windowsill (in fact, now I come to think of it, there are two). We each own a copy of the Catechism, but knowing what is written inside it is over the top.
I know that it is traditional and expected for each generation to view the other with mild irritation and bewilderment (music isn't what it was, after all) but praying the rosary, going to confession, not talking in church; these are things our parents taught us which they now hope that we don't do. And then there are the things they hoped we would do, these being 'normal', but we choose not to because we are Catholic: things like sleeping with people we aren't married to, using contraception and talking openly about the fact that we are against abortion rather than just thinking about it. We try to keep up to date with Church news, keep an eye on what the Pope is saying in his weekly audiences, and pray for episcopal appointments. We don't eat meat on Fridays, wish the clergy would dress like clergy and also hold dangerous views about such controversial things as...guitars.
Our parents brought us up to be Catholics, and now that we are, they find it worrying.

Monday, 21 October 2013

Whose conscience is it anyway?

I was browsing my September issue of Regula+e, published by the General Pharmaceutical Council, which is the regulatory body for pharmacies, pharmacists and pharmacy technicians, when I came across this article about a pharmacist who had had conditions placed on his practice, by the Fitness to Practise (FtP) committee, for 'imposing his beliefs on patients' (pp24-25).

The pharmacist, during the course of supplying the morning after pill (EHC), told a patient that it was "a chemical abortion, was ending a life, and that this would be on her conscience". The patient was shocked and felt "rotten and horrible". He did not give her the option to go to another pharmacy.

Recently I blogged, among other things, about the weirdness of the fact that while pharmacists do not have to supply EHC, they do have to tell the patient where they can obtain it. This pharmacist didn't tell his patient where they could get EHC, because he did not decline the supply. Yes, apparently he was in the habit of giving what the FtP committee deem 'an embarrassing and distressing lecture' and then giving the patient the morning after pill anyway.
There seems to be a whole lot of weird stuff going on here. The FtP committee, for their part, merely have to judge whether a pharmacist has breached the code of ethics and, if so, whether conditions should be imposed or the individual removed from the register, so I'm going to ignore them. It's the behaviour of the pharmacist in question which puzzles me. If it was for moral or religious reasons that the pharmacist gave these speeches to his patients, why did he then supply EHC? What was he hoping to achieve? Was he trying to absolutely prevent evil (ie the patient does not terminate her pregnancy) or just avoid co-operating (the patient gets upset and goes to another pharmacy instead). But if the latter, why did he then supply? It is a mystery to me (although I recogise that I don't have all of the information about the case). And then there is the patient, who reported the pharmacist because he made her feel "rotten and horrible". I'm not saying the pharmacist shouldn't have been investigated, as his actions come across as a bit odd, to say the least: was this his usual manner of advising patients? But as taking the morning after pill causes side effects of headache, nausea, abdominal pain, bleeding and fatigue (very commonly), and dizziness, diarrhoea and vomiting (commonly), the 'rotten and horrible' feeling was somewhat inevitable, if only on a physical level.
Whether you, healthcare professional, go with a straight refusal to supply or a slightly more in depth explanation as to why not, or an attempt to engage the patient in discussion as to the rights or wrongs of EHC (or whatever other substance), do so with charity and professionalism! Haranguing the inidividual is unlikely to achieve anything, and following the harangue with supply even less.
Interestingly, one of the conditions imposed is that the pharmacist is not to supply EHC in the future. Sounds like good news all round.
PS My viewing stats passed the 10,000 mark this week. The list of referring sites may suggest to me that a lot of these views are not real people, but to those actual people who are reading: thank you :-)