Hospitals do not just treat diseases, they treat people. How did things break down at Alder Hey?
I was thinking of writing a piece about the ethical principles behind the Alfie Evans case, but I discover that there is no need for me to do so, as the Anscombe Bioethics Centre has already produced a concise and beautifully expressed piece that just does that. One can read it here. I would urge everyone to do so, as the explication of what is at stake and why seems to me to be faultless.
Meanwhile, though the ethical principles cannot be in doubt, controversy continues to rage. There are several reasons for this. Not everyone can grasp the distinction between active killing and letting nature take its course. Meanwhile, even the Economist, one of our most respected journals, misses a very important point in its criticisms of Pope Francis: when patients (or in the case of minors, their parents) lose confidence in whoever is caring for them, they surely are entitled to move hospital if another hospital is willing to take them.
Alder Hey hospital is certainly leading in its field, but – and it is an important but – relations had broken down between it and the child’s parents. Hospitals do not just need to be expert in medicine, they also need to be expert in human relations, because they do not just treat diseases, they treat people. So there needs to be some examination of conscience at Alder Hey about the way things came to the pass they did, namely, with matters ending up in court.
There is an unspoken idea that we should all defer to experts. Indeed we should. (I am a doctor of theology, and trust me, I like deference.) But it also remains true that patients are asked for their consent to medical procedures and are free to withhold it. Except in some very extreme cases, where parents put their children’s lives at risk (which was not the case here), the idea that the courts should intervene is surely not one anyone would welcome.
The Alfie Evans case shows us not just what medical overreach looks like – “We know what is best for you” – but also what judicial overreach looks like. Do we really want to go down the American path where everything seemingly turns into a never-ending legal battle?
There lurks another controversy under the surface. In the United Kingdom you can in theory criticise whoever you like, but woe betide you if you say anything uncomplimentary about the National Health Service. Remember the way Daniel Hannan MEP was disowned by everyone when he said something about the NHS on American television which was interpreted as uncomplimentary? Remember the frankly bizarre opening ceremony of the London 2012 Olympics which glorified the NHS? Reverence for the NHS is almost religious in its fervour in the UK; so one can understand the way that some people have rushed to defend Alder Hey hospital. Here there is an important point to be made about civility: I always hope for consensus when speaking of moral matters, but some people will disagree with me, and that is something I accept, indeed, have to accept. Similarly, all parties in this case need to moderate their tone to reflect this.
Finally, it is to be noted that the Pope intervened in this matter, via a tweet, and yet his appeal was ignored. As is usually the case when Pope Francis says something that is not in tune with the zeitgeist, his words get overlooked, or, as in the case of the Erasmus column in the Economist, dismissed as wrong and ignorant of the true facts. This is sobering. The world wants to hear only what it wants to hear. The conclusion is inescapable: the Church’s pro-life discourse is deeply unwelcome to the world.
Alfie Evans represented an inconvenient life, but, as the Anscombe Bioethics centre statement reminds us, every life is important. Indeed, Alfie Evans’ life was particularly important, even though never spoke: his very existence calls into question our attitude to human rights and our failure to live up to all our talk about justice and equality.