Fear Should Not Be An Outcome

Many of us have been distressed by the news that Mr Tony Nicklinson, who suffered from Locked-in Syndrome, died from the refusal of fluids and pneumonia just days after a High Court decision that he could not be helped to die by doctors. Lord Justice Toulson and Justices Royce and Macur ruled that he could not enlist medical help to die, 'voluntary euthanasia is murder, however understandable the motives may be.' The Bishop of Bristol, Mike Hill, said that they were 'surely right not to allow Mr Nicklinson the right to die with the assistance of a doctor' because, as the British legal system is based on case law, such a ruling would have opened the way for the assisted death of other much more vulnerable groups. 'It is reported that many vulnerable and elderly people suffer abuse at the hands of their relatives.'

As readers of this blog will know, I have very grave reservations about any change in our current laws to allow assisted suicide. However, I do think that Mr Nicklinson's case and the case of another man which was heard alongside his raise all the questions about end of life care in a particularly sharp way. Let's consider both ends of the spectrum in the debate. Mr Nicklinson is reported as having described his life as a 'living nightmare' and as having said that, after the appeal court's ruling, he was left 'devastated and frightened'. We are not, in this particular case, consigning someone to a situation which they find to any degree tolerable. For those who care on a day to day basis, it is a distressing and morally undermining situation to be forced to sustain life; it raises questions about compassion in a civilized society. To allow someone to get to the point where they feel they have no recourse but to refuse food and die in fear does not seem humane to most of us. At the other end of the spectrum, the Bishop of Bristol is right. There are many people who are unable to speak for or defend themselves who would be vulnerable to other people's pressure to end their life once the legal penalty for anyone who does so is reduced. Perhaps we find this hard to believe. I picked up a copy of Good Housekeeping in the dentist's waiting room recently. In it, Jane Worroll describes how her mother, suffering from dementia, was ill treated in a care home. As her mother became more and more unhappy and withdrew into herself, Worroll had suspicions that she was being maltreated and finally caught the abuse on a hidden camera which she left in her mother's room. The shocking thing in this story is that this was a situation where all the outward signs were that 'this sort of thing could never happen here'. Moved to another home, her mother gradually regained some zest for life. How many other such elderly people are there with no near family who, if the law changed, would become the focus of suggestions about ending their life early?

As medical science finds ever more ways to ensure that life is preserved even when a person cannot perform for themselves such basic functions as breathing, eating, excreting and communicating, we are going to see more and more of these cases.  My question is why we are not doing more mid-ground work? These issues need to be tackled from both ends by the legal and therapeutic communities. Are there ways in law to ensure that relatives or medical practitioners who engage in conversations about a person's thoughts about ending their life and who decide to give assistance when asked to do so are treated with a degree of leniency? I think this in fact happens, but could there be much clearer guidelines about what charges and legal processes will be faced and about suspended sentences in such cases? Are there ways for medics and carers to be enabled to have these very difficult conversations about the end of life with those who have progressive, debilitating conditions and who wish to instigate such conversations much sooner, at much greater depth and to keep the situation under review? Death almost always involves some mental or physical suffering on the part of those who die and those who support and care for them. We cannot eradicate that. Lay people (in the medical sense) tend to believe that modern medicine can deal with every kind of mental distress and physical pain. This is simply not the case, though much more can be done than sometimes is done. Is there not some middle ground where lawyers and carers can give patients more freedom to explore what is best for them and relatives a quicker and more accurate response to questions about the penalty for their actions? Dragging such cases through to appeal with all the publicity that is involved does not appear an appropriate way to deal with these cases. They seem to call for the same kind of specialisation, body of experience and sensitivity of handling that the family courts have developed over time. 

Jane Worroll's story makes me think that education about caring for the elderly is something which should be much more widely available. We run parenting classes because we recognize that bringing children up is demanding and not everyone is a 'natural parent'. Understanding the aging process, caring for those with dementia and doing this alongside work or other family responsibilites is not something that everyone can learn to do without help. As a greater proportion of the population is involved in caring for older relatives, health and social services, churches and voluntary organisations need to give more thought to this. Attitudes to the elderly and an appreciation of ageing should be something that schools tackle in a positive light as well.

I must pay tribute to Mr Nicklinson and his family for the very courageous way they have brought this dilemma to the public's attention and to Jane Worroll for her persistence in bringing to light the truth of her mother's situation.

Bioethics at the Cathedral

Photograph taken from Ripon and Leeds Diocesan website

Very much looking forward to the Rt Revd Dr Nazir-Ali's lecture on 'Bioethics and Respect for Human Persons'  in the St Wilfrid Lecture series at Ripon Cathedral on Thursday evening (7pm). I've been immensely interested in this whole area of bioethics and genetics ever since working at Addenbrooke's Hospital, Cambridge in the 1980's where the Medical Research Council labs were producing new techniques and possibilities in response to clincal situations faster than the ethicists could address the issues such techniques raised. The clinician's dilemma is different from that of the rest of society in that he or she is both under an obligation to do the best thing possible for an individual patient and under an obligation to wider society to deliver practices that are in accord with the health of society as a whole. And, of course 'society' does not tell you what it thinks with a united voice. It therefore becomes immensely important that scientists, clinicians and members of wider society do the work of thorough ethical discussion and decision making with some urgency and according to strict rules and transparent processes. An evening not to miss, I think! 

For more information including a brief biography of Dr Nazir-Ali, go to the Diocesan Website

http://www.riponleeds.anglican.org/press-449.html

Should Courts Ram Treatment Down Throats?

I must admit that I am somewhat peturbed by the ruling by Mr Justice Peter Jackson that a 32 year old patient suffering from anorexia nervosa who does not want treatmtent, and whose family support her decision, must be given treatment which amounts to force feeding, possibly for a considerable period, in order to preserve her life. I had assumed, when I heard the news, that the patient was unconscious or was not able to express a clear wish. However, reading the report of the case, this does not seem to be so. I do not want to get into the merits or demerits of the particular case - that is not appropriate - but I do want to say that the judge's decision has given me pause for thought. He appears to be arguing that the courts have grounds for becoming involved in an individual's treatment in order to save life, even when the individual concerned is opposed. Of course, the State already permits this in cases where doctors section patients and, no doubt, there are grey areas, here, when psychiatrists, patients and families disagree on whether there are sufficient grounds for sectioning a person and compelling them to have treament. However sectioning a person does not quite seem to equate with a ruling to force feed them. As far as I can tell, you would have to physically restrain someone two or three times a day in order to do this or repeatedly sedate them against their will and, if you were to do the latter you would hardly be helping to restore them to patterns of eating that would sustain a life that was to any degree 'normal'. Passing a naso-gastric tube on someone who is willing can be distressing enough; to hold someone down and do it against their will time and time again could be described as very cruel. One wonders whether the psychological trauma caused would militate against the patient ever recovering and, indeed, it would be a pretty dehumanising procedure for nursing and medical staff to have to undertake.

I've just been reading A.N. Wilson's After the Victorians; Arrow Books 2006. In the chapter The Accursed Power, he discusses the treatment of suffragettes by the Liberal government of the time. What is striking is that several members of the militant wing of the movement who had been imprisoned and were on hunger strike were straight-jacketed and force-fed on the order of the then Home Secretary (Winston Churchill), again, on the grounds that they were hysterical and did not know their own minds and that it was in their own best interests for the State to intervene to save them from themselves (not to mention the Liberal party's interests!) There is something rather disturbing about State or Courts (which certainly were in Churchcill's time and still are largely male) sanctioning this kind of treatment of women with all its overtones of physical abuse. When a person is sectioned it is usually for their own safety and so that they can have the best possible chance of being restored to health - it is for their demonstrable good. I cannot see that consigning a fully aware person suffering from anorexia to repeated interventions of a distressing nature is going to be anything other than very psychologically damaging - it might well be argued that it will work against their health or any chance of recovery that remains. Should the patient not recover, this will certainly not allow them a dignified or peaceful death.

I can see many of the arguments for intervention to preserve life, but I am uneasy about this decision to intervene in the treatment of an individual in ways that will undoubtedly cause a great deal of distress.

Orwellian Worries

Apparently, the Information Commissioners Office investigated Google in 2012 and received assurances that the company was not intentionally collecting personal information about people in the UK. However, during the course of the investigation, it did become clear that the company has the capacity to intercept and store information from the content of e mails, chatrooms and other social media sites and photographs. Now, the USA Federal Communications Commission has published a report (about a month ago) that suggests that the street view software, gstumbler, used by Google to collect information such as that needed for maps, was in fact, designed to gather information of a personal nature and has the capability to give rise to data bases which could support future Google products. Google's stated strategy has long been to tailor the information it gives its users ever more personally. Just what does Google know about our buying habits, travel patterns, financial transactions, friendships and illneses? In particular, networks that are not secured by passwords are vulnerable. Of course, we're not talking about knowing in the sense of indiviual people knowing things about other individual people - we're talking, perhaps more worryingly - about the power of vast amounts of knowledge to shape behaviour. 

Frankly, in a digital age this kind of thing is unavoidable. The garnering of personal information needs new types of policing and we need draconian penalties for those who misuse rather than simply collect data. The most worrying areas are finance and medicine. Although I cheerfully use digital communication for most things, I am a Ludite when it comes to banking. Not for me the trust that hopes that online (or worse mobile phone) arrangements will hold: give me a passbook in my hand and a personal conversation over the counter any day! In the medical field, I  have a friend who went to the doctor for a routine blood check and was refused on the grounds she'd already had it done. Investigation showed that someone, somewhere had fed someone else's blood results into her records. Mental note - if your doctor tells you something a little strange, check, check and check again!

However, the main point of what I want to say is that in a digital age where we all enjoy so many of the benefits of instant access to information, we each have to accept some responsibility. In fact, we retain much of the power to decide what we reveal, say and do online and what information we are willing to give about ourselves. Saying 'no, I won't give you that information,' may mean we can't have something but is that necessarily a problem?  Ingenuity can usually find a way round it. Or perhaps we don't need something as much as we think we do! We don't have to shop or bank online and we don't have to take the slightest bit of notice of adverts (I don't even read them). Above all, we have the power to control what we say: to ensure it's courteous and doesn't name others or drag them into digital places they don't want to be in and have no control over. Time is a crucial factor in retaining the power to regulate ourselves in digital space. As everything speeds up (banks say that people now expect immediate responses to requests for mortgages and loans, for example) we need to cultivate in ourselves and our children the resilience to resist the immediate. Take a space to think. Cool off overnight. Withdraw from a site. Restrain yourself from responding if you don't really need to. And keep challenging - asking qustions, 'Why do you need to know that about me?' 'Where did you get that information from?' 'Why is that linked to this?'

A New Economics

I've just finished a stimulating read, Prosperity Without Growth; Economics for a Finite Planet by Tim Jackson (Earthscan, 2009). Described as 'one of the most outstanding pieces of environmental economic literature in recent years', the book asks, 'What does it mean to live well within the confines of a finite world?' Science, industry, digitalization have all brought great advantages. We live longer, we are healthier and better educated and we have a much greater diversity of opportunity than we would have had 100 years ago. And yet...

Even on conservative estimates, 2 billion people are undernourished or lack clean water. A study by Sheffield University (Dorling et al, 2008) shows that, although incomes have doubled over a 30 year period, there has been an erosion of geographical (ie. location-based) community which means that the loneliness index has increased to such an extent that even the weakest communities of the 1970s were experienced as more supportive than the strongest communities of today. It seems we can neither sustain the planet so that all can live nor find happiness ourselves in the societies of the over-developed world. Ben Okri (The Times 2008) puts it well, 'Material success has brought us to a strange spiritual and moral bankruptcy. Our false oracles have failed and we need a vision to live by.'

Jackson's book sets out a thesis for how we can 'flourish within limits'. He debunks the rampant materialism that governs Western economies with its underlying dependence on shaming us into wanting to buy more and more. Shame? Well, yes. Which of us has not wanted to acquire more because of that casual remark, 'Oh, you don't use an i-pad?' 'Oh you're not going to get a new dress for your son's wedding?' 'Ah, you're still driving that?' Just as a poor worker might spend money he can ill afford to have a decent shirt for work, we all feel shamed into keeping up with others or at least keeping up enough to be in the swim of things and to know what's going on and what people are talking about. In the most affluent economies, where differences in wealth are the greatest, Jackson argues that this dynamic of 'shaming' has got so out of control that non-materialistic values are ceasing to impact on the way society is organized. We consume too much, we do not value the contribution made to society by workers who care for those who do not produce wealth and we force anyone who does not want to consume so much to make choices that lead to their partial exclusion from mainstream society (try living without a car, computer or mobile for a month.)

The book examines different types of capitalism and market-driven economics and shows how these relate to sustainable solutions to economic organisation. It attempts to make suggestions about how we could become more value-driven and less consumption-driven. If long term commitment to our near neighbours and global partners were to replace laissez-faire, short-term gratification, Jackson argues, the end result would be greater fulfilment and happiness for us all and we would prosper much more. I would argue that what Jackson says chimes in very well with what I have always thought of as 'Kingdom of Heaven economics' (or the evidence in scripture for the ways we ought to look at economic growth).  The first principle is generosity - share, talk, discover values that unite, develop trust. Wealth comes in the guise of enough - enough to live, to share, to do what is needed in our own communities and not to damage the earth by over- consumption.

I'm very grateful to the Buckfastleigh Abbey (Benedictine Community) bookshop where I chanced on this rich volume; it's a complex and wide-ranging book which covers economics, family politics, psychological motivation, social organisation and much, much more as it stacks up the evidence for its central theme, namely, that, if economic growth based on escalating consumption continues to be the sole basis for delivering prosperity, then inequity and unsustainability will be the twin forces that bring the future of humanity to the brink of annihilation. The evidence presented shows that 'more stuff' does not mean 'more happiness' and 'business as usual' is not an option. The need for a new economics is pressing. Growth is surely needed in under-developed parts of the world but, in the over-developed countries, we need a radical programme, economic, educational , social and, of course, political, that is motivated by the benefits of having less. That's the NOW challenge - what could you do to use less, to have less, to share more and to enjoy yourself more? What would you like to be free of and free for? What would travelling lighter be like? 

Clare Short on International Development and Aid

Clare Short MP

Clare Short gave a very interesting lecture, last night, which kicked off the 2012 St Wilfrid Lecture Series Questions of Right and Wrong at Ripon cathedral. The gist of her argument was that giving development aid alone is not enough, to be both effective and morally pure, it has to go hand in hand with foreign policy and a development policy which puts the needs of the country to which aid is given before the gains of the country giving aid. She gave us many examples of aid which is tied to trade and aid which is less effective than it could be because each donor country imposes conditions of their own which may look nonsensical on the ground. (For example where three separate countries give ambulances and spare parts from their own country, making it difficult to run the ambulance service coherently.) 

A foreign policy which creates markets in which developing countries find it difficult to participate or which promotes the sale of arms to unstable governments negates the positive effect of aid. Aid which simply provides a service and then withdraws is not really going to solve a country's problems - much better to work with local projects to educate and empower local populations. Where governments are corrupt, it may be better to give aid to local leaders who will ensure that it is used to transform their own community. These were some of the many challenges to change our approach to aid about which she spoke. There has, she stressed, to be a coherence between policy and, local strategy and action, 'You can’t be doing the wrong thing over here and the right thing over there.'

She used Jesus' parable of the sheep and the goats to reflect on the moral imperative to give aid but said that she would understand the threat of hell, about which the parable so graphically speaks, as continuing to see a conflict ridden world of suffering in which we draw a protective circle around ourselves and what we have in order to protect ourselves from the turbulance, trouble and terrorism that will undoubtedly overtake us if we do not learn to share resources and live in sustainable ways. Moral imperative and intelligent self interest are thus brought together; she gave lots of examples of how governments fail to grasp this.

The lecture was peppered with insights from her years as Secretary of State for International Development and from her struggles with both the Blair government and the Cameron government to get them to adopt consistent approaches to foreign policy and aid. She is certainly a politician who 'walks the talk', often to her own cost - a thinker who knows the subtleties of her own field and is therefore able to speak with authority.

I look forward to the rest of the series. menawhile, if your conscience or interest has been aroused by any of this, you might like to look on the Africa Humanitarian Action website http://www.africahumanitarian.org/  whose whole approach to aid is based on sound scholarship and a holistic approach to what are usually complex situations.

Prime Minister Praises Biblical Values

So the Prime Minister likes the resonances of the King James bible and believes that values that come from the bible should shape our society! Christians should hold their heads up high, be confident and contribute to public life. David Cameron was speaking at Christ Church Cathedral, Oxford as part of the celebrations for the 400th anniversary of the King James bible.

Well, it was an interesting and perhaps unexpected speech. It was refreshing to hear a senior politician acknowledge the central place that religion has had and still has in shaping the moral landscape we inhabit. Secular neutrality and the pretence that religion can simply be assigned to the private sphere don't measure up - they collude to tell a story about society that is untrue and misleading. Mr Cameron clearly sees crises like the recent riots in London and other cities, the MPs' expenses scandal and the collapse of parts of the banking system as symptomatic of the growing absence of a commonly accepted moral code or any sense of accountability based on coherent moral principles. And he seems inclined to look to the Church of England as well as other faith communities for help to find a set of values which will restore Britain to 'a nation whose ideals are founded on the bible' to quote Margaret Thatcher. He challenged the Church of England to be more vocal and also to be sure that it speaks to and for the whole country (he had a little go at us for our non-inclusivity) and even went as far as to say that 'the values we draw from the bible go to the heart of what it means to belong in this country.'

What are these values? According to Mr Cameron they include responsibility, hard work, charity, compassion, humility, self sacrifice, love and pride in working for the common good and honouring the social obligations we have to one another and to our families and our communities. In many ways commendable, but not all values I necessarily think come straight from the bible - or at least they don't necessarily pick up on the rich complexity of biblical morality or the priorities we find in scripture. Love, compassion, humility, self sacrifice, yes, but what about care for the marginalised, the call to care for those beyond our families, sometimes even at cost to our families, radical forgiveness of an enemy and prophetic challenge to institutions? These themes take up a large chunk of scripture. And I'm not sure I recognize pride in anything, even working for the common good if you can identify it, as a biblical value. The trouble with Mr Cameron's approach to Christianity or more specifically the bible is that it rather sounds as though he has made up his mind about what he means by proper ethical values and then looked at the biblical text to find support for them. It's a bit fuzzy about the actual content of the bible.

Now don't get me wrong. I am delighted that our Prime Minister took the opportunity to articulate what he personally finds relevant in the Christian tradition.  And perhaps especially delighted that he acknowledged a place for faith perspectives in public debate and in the ordering of the life of our country. But I think his speech showed him falling into the same trap that so many people who say 'we should get back to Christian morals' fall into. 

You can't have Christianity or a biblically shaped view of morality without the content, the commitment and the disciplines of the tradition. I would go so far as to say that I think religion can be quite damaging when we just pick the bits from tradition or scripture that support the beliefs we have anyway or would like to have. Because then we are taking fallible human wisdom and calling it the wisdom of God, investing it with a power that it has no business to have... and we all know where that can get us. People of all faiths know this. Secularists and religious dabblers usually overlook it. 

The hard fact is that the secular agenda has now taken the people of Britain so far from any serious engagement with the Christian tradition that most people really do not know what the content of the Christain faith is or what moral demands and disciplines the scriptures make. And of course these are very complex, can be apparently internally contradictory and are open to diverse interpretations. Perhaps most seriously, many people entirely miss the fact that at the heart of Christianity is a profound relationship with God, not a set of moral imperatives. The moral codes of religion that politicians so much like to talk about really don't work and can become ugly tools unless they arise out of a relationship grounded in worship and a sense of awe about who God is.

Perhaps I can put it like this - you wouldn't join a political party or a sporting or artisitc movement unless you were going to find out what the underlying principles and activites were and practice them until you were familiar with them! At least, if you did , you would probably acknowledge that your membership would not have very much meaning. So-called Christian morality only gives value in society when it is practised in a disciplined way by people of faith. We can  no more wake up one morning and decide to put society right by adopting some parts of 5,000 year old scriptures (written in languages and for a culture that we do not readily understand) than we can put society right by becoming Marxists or Keynesians and not reading Marx or Keynes. Christian morality comes of a steady, profound, lifelong engagement with all that the Christian tradition has to show and teach. It demands willingness to worship and pray, to wrestle with doubt and complexity and to be continually changed by what is grasped. So, while I partially welcome the Prime Minster's speech, I do so with some reservations. If Christianity is going to have an impact on future society in the way he suggests, two things are needed. Firstly, people who are willing to engage with the content of Christian faith rather than simply to use the Christian faith to justify the way we live anyway. (And this takes time and real commitment and immersion in the tradition.) And secondly, a relationship between people of faith and secular society that fosters two-way respect. People of faith must show that they can be trusted, that they try to live according to their beliefs especially concerning love, care for neighbour and forgiveness, and that they have the welfare of those who do not share their faith at heart. Secularists should have a care not to cariacature people of faith but to discover where they have values and ways of working in common with those who live by belief in God and transcendence.    
     

Motivation and Ambition in Business

It is crucial to affirm the positive role of business in God's purposes and to think about the application of Christian faith and values in business' The Revd Dr Richard Higginson

The Diocese of Ripon and Leeds has been undertaking an exercise called 'Ambition for Mission' through which we hope to research and discover more about what makes churches grow and become more effective in their mission, their ability to encourage true discipleship and their ability to get into partnership with community and business organisations in their own locality. My eye was caught by the details of a conference at Ridley Hall, Cambridge, run by the Faith in Business Initiative, which clearly has something to say in this area. The organizers comment that the level of debate about the economic issues underlying the present, perceived national and international financial crisis has been disappointingly low. (This statement is borne out in the remarks of the Archbishop of Canterbury, today, in the Times where he criticises just about everybody from all sides of the debate for over-simplifying the causes of the current financial difficulties.) The aim of the conference is to explore the question of how faith impinges on motivation and ambition. Speakers include

Beverley Shepherd, a mamgement training consultant
Andrew Tunswell, CEO ToughStuff
Graham Codrington, founder TomorrowToday
Jim Wright, consultant Soterio
Harald Holt, chair Noroff AS
Richard Higginson, Director Faith in Business

Topics cover Adventuring with God, Running a Social Enterprise, Motivational Differences, Big Business and the Kingdom of God, Success and Signifiance, Motivation in China.

I have attended some of these Faith in Business conferences myself and the great thing is that I have always come away having met one or two truly inspirational people who have then gone on to affect my life or the life of the churches and organisations I work for in significant ways. I know Cambridge is the deepest south, but it just could be worth the journey...!!!  'A rich diet of inspiring talk and candid sharing lies in store for you. Attending this conference could be a life changing experience.'

If you are in business, are a church or community leader or an entrepreneur, if you care about the ethics behind business and the financial community or the pastoral care of those who work in the financial sector, this could be for you. The conference is at Ridley Hall in Cambridge from 30th March - 1st April (honest!) 2012. Cost £265 or £240 for early bookers.

To book using the secure online system go to

http://www.faith-in-business.org/programme.html

Auschwitz Project at Henshaws

Henshaw's Arts and Crafts Centre, Knaresborough, is currently hosting an exhibition of art work produced by disabled activist, Di Lofthouse MBE. Working closely with artist Shaeron Caton-Rose, Di has created an extremely powerful group of works expressing her response to a visit to Auschwitz, last summer. Those murdered at Auschwitz, of course, included many people who were sent to the camp because they were deemed disabled. In this exhibition, Di expresses her reaction to what she saw in paintings, prints, sculpture and film through which she explores the theme of humanity in the face of atrocity. Her belief in the dignity of every individual 'whatever skin you live in' has long informed her campaigning and is a prime motivational force in this very moving exhibition. Part of the exhibition can also be taken on tour and is suitable for schools and other educational groups. It would particularly fit the history and PSHE curricula, dealing, as it does in a very powerful way, with issues to do with respect and human rights.

I have visited the exhibition and found it sobering yet hopeful. The Revd Elizabeth Sewell, the Team Rector of the Knaresborough Team of churches writes, 'This exhibition at Henshaws is amazing! Very powerful in its own right but also an opportunity (I think) to explore ability rather than disability.' It closes on 2nd September, so get over to see it this week if you can, especially if you think the touring version might be a resource for your school or church.

For information about the exhibition

http://www.henshaws.org.uk/arts-and-crafts-centre/events/2011/07/18/exhibition-the-auschwitz-project

Di Lofthouse, the artist

http://www.selfdirect.org/blog/profile21/di-lofthouse-mbe.html

in conjunction with Shaeron Caton-Rose

http://www.nyos.org.uk/Artist.aspx?id=208

Riots on British Streets

In some ways the riots of the last few days seem far removed from rural North Yorkshire. But we've been looking and listening and, like everyone else, trying to make sense of this startling and bewildering development in our national life. Several members of my family live in Nottingham where 5 police stations were fire bombed or pelted with bricks and missiles and where our friends, and especially some of their children, are now nervous about going out just to do everyday shopping.

http://www.bbc.co.uk/news/uk-england-nottinghamshire-14472172

What are the reasons for the riots? It's too early to know which of several possible factors were the decisive ones in turning our streets into arenas for violence and looting. Tragically lives have been lost but the main focus seems to have been property. The reasons that are being given are

• criminality - but why? and why now?
• breakdown in family life and the morality and discipline that good parenting and schools provide.
• rampant consumerism - an attitude that pervades the whole of society and which says 'I should be able to have what I want now.'
• disenfranchised groups in society - people brought up in a consumer society with little opportunity to make choices and become legitimate consumers themselves.
• reaction against the police and against law and order - a desire by the voiceless  to take power by showing that they can break the law if they choose to.
• the atmosphere created by government cuts and the threat of the breakdown of our whole economic system which lurks behind our present lived reality. 
• the new era of tweeting, twittering and facebook and other forms of messaging which allows riots to be spontaneously organised with hundreds of people gathering in one place at a particular time - something that could not have happened until recently. This is the more sinister side of Internet democracy, perhaps akin to what we have witnessed recently in Middle Eastern countries. 

Probably, the true reasons for the riots are drawn from all these and from other factors that have not yet been identified. The court cases yesterday and today show that plainly this urge to violence and anarchy is not a problem confined to young people or to people who are unemployed or uneducated. Politicians seem to be falling into two camps - on the one hand, those who want to attribute it all to criminality, brook no excuses and deal with it through punitive measures and, on the other hand, those who want to find the social causes and who are fearful of punitive measures such as long prison sentences, stopping benefits and withdrawing housing as these will fuel discontent. I saw Harriet Harman on Newsnight vigorously trying to argue that both approaches are needed - a response that punishes lack of individual responsibility and a response that looks at the social forces that have made this possible and, for once, I agreed with her! 

Well, it is too early to make judgements about why all this has happened - summer madness of the most sobering kind. The worrying question is, 'Is what we have seen just the tip of a very ugly iceberg which now underlies the waters of normal social dealings in this country?'  Three things which have been concerning me for a while are not, I think, unrelated to what has happened.

Firstly, there is now greater disparity between the wealthiest and the poorest in Britain than in any other country in Europe. People are living in real poverty cheek by jowl with those who have vast resources. In the parish where I served in the early 90's in Nottingham, I can take you to places where teenagers live ferral on the streets, the care-home system, never mind their families, entirely unable to contain them, young children are so hungry they hang around the chip shop bins and eat discarded food, and homeworkers do menial jobs like assembling hangers - a house full of women working all day for perhaps £15 to be divided between them. These people are not lazy. Prositution and the drug culture are rife and are a normal part of middle class life but destroy the lives of those who are unemployed or poorly educated and who often service these habits. Within sight of parts of the parish are hotels where you can spend £800-£1,000 for a night's stay. Poverty was not the direct cause of the riots, but huge disparity between the resources available to people generates anger and lack of respect in different ways from different parts of society and the riots have played into this. The fact that groups within society are living with poverty, hunger and lack of opportunity that most of society does not acknowledge or appear to care about points to a deep degree of unhealthiness in our social order. It is wrong when we simply care about what we have got and whether we have got what we want, right now. The rioting and looting demonstrated that, in fact, this is exactly how some people from all parts of society think today.  

Secondly, in many familes and communities right across the social classes we seem to have lost the ability to exercise discipline with quite young children; the seeds of an attitude that says 'I am entitled to whatever I feel like...' are planted well before secondary school. At the same time, adults, apart from professionals who work with young people, often don't seem able to engage in conversation with and listen to youngsters - you have been able to see that in some of the interviews over the last few days where rioters and their supporters have been asked their opinion only to have it dismissed and shouted down. Where respect and real listening don't occur, problems cannot be solved. Even if someone has committed a crime, we have to try to understand what the world looks like from their perspective if we are going to take measures to prevent the same thing happening again. There is a worrying lack of willingness for different age groups to listen to one another and I think this is a growing phenomenon. 

Thirdly, we do not yet have systems of politics, government, law and order and communication that have adapted to the presence of the Internet. We do not yet realise the degree to which the Internet has changed, for ever, the nature of authority, democracy and control in society. People can now circumvent much of what formal education, politics and even the media have to offer and they can form local and global alliances which have nothing to do with recognised social or political structures; they can just as easily disrupt conventional alliances and systems. They can do this very speedily and in unpredictable ways. I suppose all this is one reason why I blog. I think it is important to learn, first hand, about the power of the Internet and of digital communication. We are all on a very steep learning curve to discover how power operates in a world where, if you just hit the right tone, you can bring 100's or 1,000's of people of all ages and backgrounds together to achieve something very noble or something very ignoble...and the outcome may indeed be frighteningly unpredictable.  
  

Osama Bin Laden

Lambeth Palace has released the following ;

The Archbishop of Canterbury on Osama bin Laden

'…Q: Do you believe that the killing of Osama Bin Laden is justice for the 9/11 attacks and indeed other attacks? And was the US morally justified in shooting him even though he was unarmed as the White House now admits?
A: I think that the killing of an unarmed man is always going to leave a very uncomfortable feeling because it doesn’t look as if justice is seen to be done, in those circumstances. I think it is also true that the different versions of events that have emerged in recent days have not done a great deal to help here. I don’t know the full details anymore than anyone else does but I do believe that in such circumstance when we are faced with someone who was manifestly a ‘war criminal’ as you might say in terms of the atrocities inflicted, it is important that justice is seen to be observed.'



My sense is that it is too early to comment definitively as we really don't understand the circumstances. But I echo the unease that is around. We have here two very unsettling notions - the idea that Pakistan's intelligence forces could have been ignorant of Osama bin Laden's presence and the idea that one nation can enter another's territory without that nation's knowledge or agreement. Is the government of Pakistan being truthful? As David Cameron challenged - are they supportive of, or opposed to terrorist acts? Where can we place our trust?  Was the operation carried out by the USA justified ? Surely, illegal or uninvited entry into another country's territory does not embody a principle we would wish to see adopted by those we consider our enemies. And might it not have been preferable to bring Osama bin Laden to justice in a court rather than to risk making him an apparently unjustly treated martyr?

However, I absolutely acknowledge that my perspective as someone who is neither American nor Muslim and who has not lost loved ones through either acts of terroism or war demands a humility and a willingness to listen to other people's wisdom and perspectives on this deeply complex and impenetrable sitaution.

September Conference

www.simeoncentre.co.uk

The Simeon Centre is a centre for prayer and spirituality at Ridley Hall Theological College in Cambridge. This event looks interesting for those involved in end of life care and associated issues - and accommodation at Ridley is good value. It's right in the middle of the city of Cambridge with plenty of opportunity for sight seeing!

Visit http://www.ridley.cam.ac.uk/  

Assisted Dying.

Last night, Debbie Purdy spoke at the Legal, Medical, Clerical dinner in Harrogate. Debbie suffers from MS and campaigns for freedom from prosecution for relatives who help a loved one, at their request, to an assisted suicide. 92 people in Britain have helped a relative travel abroad to die and some have been charged on their return though as yet none have been prosecuted. Debbie views this as a matter of life and is, herself, full of life, asserting that she can only live her life fully if she knows that, should her pain become unbearble, she can ask for help to end her life and know that her husband will not be prosecuted or end up serving a prison sentence. She feels that, without this assurance, she would have to end her life before she wants to in order to be able to take it without physical assistance from her husband who may then be prosecuted. Most of us cannot even begin to imagine being in this position. Everyone who heard her speak was, I think, both struck by her wonderful liveliness and zest for living and moved by the poignancy of her plight. In 2009 Debbie took her case to the law lords and it was refered for appeal. The result? That the Director of Public Prosecutions was required to publish the facts and the circumstances that would be taken into account in the decision whether or not to prosecute someone for assisting a person in an act of suicide. As the law stands, anyone who is found guilty of 'aiding, abetting, counselling or procuring' the suicide of another can be sentenced to up to 14 years in prison.

Debbie's argument is that, because the suicide rate is relatively high among those with progressive debilitating diseases, more lives would be saved by removing prosecution for, particularly, counselling in connection with suicide. She claims that at present doctors, health care professionals and clergy are too constrained by the law and many will not even talk to patients about suicide. She believes therefore that people end their own lives who could in fact be reached and helped by counselling and an honest discussion about suicide. She pianted a vivid picture of the silence that meets those in great pain and fear about their desire to do something to relieve the intolerable situation they find themselves in.

There was an interesting discussion after her talk. This is an ethical dilemma which is truly beyond human wisdom to fathom. It is seemingly impossible to find a law that both protects from intolerable pain and protects from exploitation and abuse of the vulnerable. It is also very difficult to know when an individual has reached an irrevocable decision - there are huge risks of minds being changed and mistakes being made about someone's intentions. Even when there is something like a living will, it is often far from clear when a person has reached the point at which it should be enacted.

Like Debbie, like all of us, I am influenced by my own experience. I nursed for 9 years and I remember patients who clearly wanted to end their lives and who told relatives and staff that they could no longer bear the pain they were in on a daily basis for weeks and months. I know that in a few cases medicine does not have the capacity to control pain. I have suffered from a very painful condition (endometriosis) myself which can temporarily reduce you to feeling that you would do absolutely anything to escape the pain. But I also remember people who begged not to be rescusitated or who said they wanted to die and clearly meant it, only to move to another point in their disease where they fervently thanked God (or the medical staff) that they had not died. I have seen that people with chronic progressive disease, people with accute (very severe but not permanent) disease and frail and very ill elderly people have different vulnerabilities and need different kinds of help, care and protection. And who is to make judgements in all these cases? It seems to me that wherever the law comes down on the spectrum of preserving life at all costs or allowing or assisting death, mistakes will be made. We will not get it right in every case. Medics already have a variety of approaches to the impossibly difficult delineations  between not preserving life and allowing or assisting death. 
  
What I found very insightful in Debbie's talk was her insistance that doctors, nurses, counsellors, lawyers and clergy must be able to have honest conversations with patients about intolerable pain and other symptoms, about what suicide would involve and about how their disease will progress. There must be freedom to explore whatever the person wants to explore without fear of being reported and prosecuted. Some doctors seem to do this anyway. Others avoid the difficult area of what suicide would mean and the dreaded area of 'too much pain' because of where it might lead. Yet Debbie pointed out that being able to talk about these things was sometimes precisely what enabled people to want to live rather than die. I also agreed with Debbie that clarity in law about what is and what isn't going to lead to prosecution for relatives is important.

However, I think that the law has to maintain the utmost vigilance and there has to be the possibility of prosecution for any kind of coercion towards suicide. I also do not want to see the law changed in any way that requires medical staff to assist death directly; the notion that a doctor or nurse might under certain (even very controlled) circumstances deliberately end life changes the entire patient/medic relationship. It puts health care professionals in the position of making impossible judgements and puts patients in the position of not being able to trust the motives of those who should unconditionally be caring for them. Palliative care and more research into how to avoid prolonging life when this is not wanted seem to me to offer a way forward. However, even as I write this, I can think of patients I have nursed whose conditions and whose suffering make me question what I write. 

I come down in my own judgement in a place where the law errs on the side of stringent protection of life but is exercised in a way that allows for the greatest possible compassion and leniency for those who have been caught up in these terribly difficult places. There must also be extensive training and support for professionals who find themselves having to accompany patients on these kinds of journeys.Twenty five years after leaving nursing, I still have the names and fates of patients etched on my memory because they didn't have a good or easy ending no matter what we tried. Patients, relatives and staff have to be able to talk honestly to someone and even say, 'Perhaps we made a mistake, perhaps we didn't get it right, perhaps you didn't get it right for me,' and to know that there is humane understanding and forgiveness for the extreme places they find themselves in from time to time. 

A very sobering topic and not easy to know how to write about (or even whether to write). But Debbie communicated a love of life and her whole demeanour was that of someone living the gift of her life to the absolute fullest extent possible. And her message was, I think,  'please talk about it.' 

Education for Women in Afghanistan

I welcome the news, yesterday, that Farooq Wardak, one of Hamid Karsai's ministers, has reportedly said that the Taliban are lifting their ban on education for women and girls and that this indicates a cultural and behavioural shift on their part. They have not (and probably will not) anounce anything themselves but this statement seems in line with the fact that, since the draconian bans in the 1990's, there has been a drift back to educating girls at the insistance of local populations. For example, in Chadara, in the Taliban dominated Kunduz province, there are said to be a considerable numbers of girls' schools.

Western feminists and campaigners for women's human rights are often accused of misunderstanding Islamic culture and trying to impose unwanted patterns of behaviour on a culture they don't appreciate and which is far more subtle and nuanced than we, in the West, often understand. There are values about community and family and about educating the sexes separately that are at odds with the values of a liberal western democracy. I  hope and pray that any peace deal which is eventually done in Afghanistan does not, in practice, jeopardize the access of women to education and health care and does not threaten their ability to earn a living or curtail their access to a justice system that defends them from abuse. It is vital, therefore, that any such peace process is shaped by the educated views of the women of the region and that their voices are heard. Peace processes that are negotiated and imposed on the women of Afghanistan by all male groups, or by western diplomacy are not going to work. So, a return to education for all girls is, at least, a step in the right direction.

Societies and groups where decisions about the way general life is ordered are made without the direct contribution of women seem to me to lack a roundedness and a charity and, often, to overlook information and perspectives that are pertinent. We have plenty of examples of this in the Christian churches down the ages. Yet the wisdom tradition within the Judaeo-Christian tradition has always portrayed Wisdom as both male and female and has imaged Wisdom as a woman, in a way that gives as central a place to specifically female concerns and social perceptions as to those of men. 

For more information about women in Afghanistan
www.womenforwomen.org/ Put 'Afghanistan' in the search box (near the bottom of the page) - this brings up lots of articles.

Help women in Afghanistan
www.womenforwomen.org/global-initiatives-helping-women/files/Afghanistan-Country-Sheet.pdf

Did you know that U.N. Security Council Resolution 1325, passed on 31st October 2000 calls for women to participate equally in all processes of conflict resolution, peacemaking and reconciliation?   

  

Grumpy Old Woman?

January seems as good a time as any to have a bit of a moan about how life is changing! Or at least to express some concern about what kind of values are creeping into our everyday dealings. Am I getting too old to adapt or should I be worried? I have encountered three things which have given me pause for thought recently.

The first was reading a report that the Musicians' Union have given advice in a training video that touching children can expose teachers to charges of inappropriate behaviour and therefore teachers should avoid all physical contact with pupils. Although some music teachers now insist a parent is present for lessons, many may be in one to one situations with pupils. I can understand the dangers both from the child's point of view and the teacher's. However, I just can't see how you can teach things like how to hold an instrument or a bow, or hand and arm positioning, or aspects of breathing without ever making physical contact. This is madness! Michael Gove, the education Secretary, accused the MU of playing into (I'm not sure if he intended a pun?) a culture of fear. What is our increasing fear of any contact at all outside (and sometimes even inside) the family doing to our children, to their spontaneity and creativity, to their emotional development, to their proper, healthy sense of being at home in their own skins and bodies? Medics and hairdressers, therapists and coaches find ways to ensure that physical contact can be monitored and professionals trusted or chaperoned. Touch is one of the five senses. Without it, we experience sensory deprivation. Isn't it time that we made sure we employ it properly in education too, so that children can be taught skills appropriately, comforted when they need it and, above all, so they can learn to be physically confident and spontaneous? 

The second incident occurred when I learned from a friend that large quantities of well stored, unopened and unused nursing equipment and sealed medication could not be returned or re-used when no longer needed. The remote possibility of tampering, whether deliberate or accidental, renders all these extremely costly resources fit for nothing other than scrapping. As I surveyed the boxes, I couldn't help feeling that there is something deeply wrong with our priorities. Is it the threat of being sued that makes the unlikely possibility that hygeinically stored and re-used equipment will cause harm carry more weight than the scandal of throwing away costly items that, in many countries, would be gratefully used? The drugs industry is deeply dependent on oil and contributes a great deal to the twin problems of the peak oil scenario and carbon emission. I quite see that there are issues around infection control but, as with my first scenario, I object to an approach to the problem that refuses to see the sheer madness of the situation and accepts waste without question.

Visitation

The third scenario was described to me; in a secondary school class, the students had been talking generally about greeting people and being helpful and how far you could reasonably be expected to go, in the context of Jesus' sayings about going the extra mile and sharing the coat on your back. The teacher's comment was that it was OK to do these kinds of things in school, but they should be avoided out of school. Again, one immediately sees where the teacher is coming from in terms of protecting children from strangers. But these were 15-16 year olds and I find myself asking, is there a point at which it becomes too late, or at least very difficult, for people to reconsider the habits of non communication which are being so well taught, early in their lives, for protection? How and when and where do people move into a zone where they may choose to question some of these values? They may decide for themselves that spontaneous communication with other people, with the risks that always involves, is a vital part of what it means to be human and to respond to the humanity of others - a means of deep joy and unexpected friendship?  

Of course, I can see both sides in all these situations but my gripe is about what all this adds up to. I don't relish living in a society that (a) fears and abuses touch, (b) removes all risk to our own wellbeing at the expense of the environment and of other people who live in places where resources are scant (c) supresses and teaches people to avoid natural communication even where there is an element of help or kindness.