This weekend, the courts made the decision that Archie Battersby’s life support should be switched off. This was not the ruling that his friends and family wanted to hear. Our first thoughts and prayers should be with them. It is natural, right and good that a parent will do everything that they can to fight for their children and it is concerning to hear that they have been attacked on social media.
As hard as it may be, there are some difficult questions and things we need to consider.
First, there is a presumption by some that any criticism of those involved in healthcare is wrong. These are of course the people who put their own lives at risk on the frontline during the pandemic. However, whilst there are many thousands of fantastic people working within the NHS, the system often feels as though it’s working against the patient and sometimes family members can be made to feel like they are an inconvenience. In terms of end of life, palliative care can enable peaceful goodbyes, but I’ve also witnessed deeply distressing end of life situations. It was commented during the Charlie Gard case a few years back that particularly those from working class backgrounds are less likely to see the system working well for them. There’s a sense of powerlessness against the machine.
Secondly, whilst it is clear that, liberal/left leaning parts of the media have responded negatively to the case being taken, and particularly to the Christian Legal Centre, there are important legal and ethical questions at stake here. Advances in medical care and technology increasingly place doctors and families in situations where tricky decisions have to be made.
In this specific situation, the specific question being asked was whether or not the criteria for determining if someone is brain dead should be on “on the balance of probabilities” or the stricter “beyond reasonable doubt.” You can understand at this stage why the family would push for “beyond reasonable doubt” wanting to do everything to keep their loved one alive. You can also see why doctors having to make complex, difficult decisions might prefer “balance of probabilities.”
The complexity of decisions like this and the painfulness of them is exacerbated because the patient’s families can see all the evidence of life such as heart beat but the clinicians are saying that the patient is brain-dead. This raises questions about how we determine and define death. In Archie’s case some of the tests around brain stem activity were not possible but is brain activity the correct measure for life and death when a person’s heart is still functioning? In this case, it seems that the question was probably moot because without artificial intervention, it seems that Archie’s other organs could not function.
For those reasons, I do not think we should be dismissive of either the family or the Christian Legal Centre for their actions. Families like Archie’s need to know that their voices will be heard and that there are people around who are willing to stand up for them and with them. Big ethical issues cannot simply be swept under the carpet with a command to “trust the experts.”
However, at the same time, I think that organisations like the Christian Legal Centre need to think carefully about how and why they are involved in cases. There is a risk, when big ethical questions are being debated that the patient, their family and the doctors and nurses involved can appear to be pawns in bigger battles being fought over their heads. What was the main priority in this case? Was it that Archie’s needs were met? Was it that his family’s voice was heard? Or was it that the ethical question was considered?
This has not been helped by the reputation that The Christian Legal Centre and their sister organisation Christian Concern have developed over the years. This was seen during the Charlie Gard case when they were strongly criticised for their conduct. Similarly, CC didn’t exactly cover themselves with glory during the COVID pandemic. At times, it seemed that their position on restrictions was driven more by partisan political motives around libertarian ideology rather than a concern for what the right thing for Christians to do was. Indeed, at times, those who pushed that libertarian agenda seemed as much to have Christians who took the cautious approach to ;lifting restrictions more in their sights as though they were somehow compromised in their faith by agreeing with the Government approach. So, admittedly, I’m not personally well disposed towards CC and the Christian Legal Centre. Having said that, we should be careful about allowing prejudices about past actions to influence our perception of difficult decisions now. Indeed, it is clear that they are particularly unpopular with the likes of the Guardian because of their strong pro-life position on abortion and their prominent position in defending freedom of speech concerning human sexuality and gender.
However, I do think that Christians need to be careful and open to challenge when they get involved in advocacy. Is The Christian Legal Centre’s primary concern at this stage, the welfare of Archie’s family or is it the big ethical issues?
Furthermore, I think there are some pastoral challenges for us. At times, particularly as the medical science has moved, I’ve wondered if our expectations have also moved beyond belief that taking a life is morally wrong to insisting that life must be preserved at all costs. If we take the latter position, then we risk being the ones making medical science into a god and failing to hear the doctors when they tell us that we are asking things of them beyond their limits.
What concerns me is that in these situations, Christians and pastors of all people should be the ones able to have those difficult but loving conversations with a family. We should be the ones helping loved ones prepare for the worst news. Whilst we’ve heard a lot about fighting for life from those speaking publicly over the past few days and weeks, what we’ve not heard is the uniquely Christian message of hope that there is life beyond death, that switching machines off isn’t the end, that death does not have the last word.
I hope that there have been people around Archie’s family that have been able to offer them that only true and certain hope, the sure and certain resurrection of the dead.