UK’s National Health Service: Do Catholics Still Have a Place?
A recent court case highlights ethical dilemmas for medics of faith.
LONDON — Over the objections of a pregnant woman and her mother, an English judge June 21 ordered doctors to perform an abortion on the woman, a Catholic woman with developmental disabilities and a mood disorder.
In her ruling, Justice Nathalie Lieven of the Court of Protection said the order was “in the best interests of the woman.“ Four days later, the decision was overturned by an appeals court.
By law, doctors, nurses, auxiliary staff, even orderlies and administrators from the United Kingdom’s National Health Service (NHS) would be obliged act upon this decision.
No choice was afforded to the woman, 22 weeks pregnant, and her unborn baby subject to the court order. For those working in the U.K.’s NHS today there would be even less choice.
Speaking to the Register, Bishop John Keenan of Paisley, who spoke out against the recent court decision, summarized the current plight of some Catholic medical staff within the NHS.
“Two Catholic midwives lost their jobs because they asked not to manage the nursing rosters for abortions, even though it would not have been difficult for the hospital to otherwise manage it,” he said. “Medics find it difficult to get jobs in general practice if they provide only natural methods of fertility awareness.”
Bishop Keenan added, “Similarly, it is difficult to qualify and practice if you are a gynecologist who exercises your conscientious objection not to perform abortions. Other practitioners have been banned from wearing crucifixes and suspect that the system treats Christianity more negatively while their peers of other religions are allowed to wear sacred accessories.”
Mercifully, the court’s decision to force an abortion was overturned on appeal. For now, at least, the judicial threat of this has receded. Yet it poses the question: What is it like for Catholics working in today’s NHS?
Speaking to the Register about the recent court case, Mary Farnan, the national secretary for the Association of Catholic Nurses, spoke of how the case highlighted the need for Catholics to remain fully present in the NHS.
She said, “The case does highlight how vulnerable individuals are when they are under the care of professionals who do not share their own values and beliefs.”
Like many Catholic nurses, Farnan considers her work vocational. Her views, and those of her fellow Catholics, may not always chime with the prevailing medical establishment, but she says that is no reason to discount them.
“To have our voice as Catholics in the NHS better enables families and patients [with whom] we work to have their voice and values and beliefs recognized, too,” she said.
Over the last several decades, there has been an influx into the NHS of medical workers from Catholic countries such as Poland and the Philippines. Every day Catholics working in the NHS make a substantial contribution and tangible difference in U.K. hospitals.
Bishop Keenan sees this Catholic presence within and contribution to the NHS as vital. He told the Register, “Catholics make a positive contribution daily in the NHS, along with their peers, in going the extra mile, because they see it as a health care system that cares for all without discrimination. I know a number of general practitioners who manage to work without providing contraceptive services or gynecologists who exempt themselves from abortions, but take on extra roles and win the respect of their fellow workers.”
This Catholic presence is most obvious with a Catholic hospital chaplain. Bishop Keenan feels “the NHS appreciates the spiritual service our priests provide.”
In the Diocese of Paisley alone this service consists of priest-chaplains appointed to two large NHS hospitals. Daily, these men visit patients pastorally or to provide the sacraments. Bishop Keenan says they make thousands of such visits annually. Each Sunday, these priests celebrate Holy Mass in the hospital chaplaincy center for all staff, patients and visitors. Such men are often a practical bridge between patients, their families, various medical teams and the hospital administration. In addition, at times they act as a much needed, if informal, advocate and support in what can be for some a bureaucratic nightmare.
The NHS is the single largest employer in the U.K., with 1.7 million workers across England, Wales, Scotland and Northern Ireland. That makes it the fifth-largest workforce in the world.
Catholic Parliamentarian Lord David Alton told the Register, “The vast majority of NHS employees are able to get on with their high calling without impediment.” However, Alton said that, for some today, especially those working in midwifery, “it becomes impossible to reconcile their role as defenders of life with the demand that they destroy it.”
During a career spanning many decades in public life, Lord Alton has witnessed the marginalization of Catholics within certain NHS sectors.
“As a young MP I knew Catholic gynecologists and obstetricians. I don’t know any today. Brilliant people go and do other things instead,” he said. “If we introduce euthanasia, the same thing will happen to geriatric medicine and palliative care.”
Needless to say, Alton finds this trend concerning: “For centuries Christians have made a disproportionate contribution to medicine. Today’s intolerance of conscience and faith is driving them away from medicine. That’s a tragedy.”
Ryan Christopher, the senior policy officer for ADF International, a faith-based legal advocacy organization headquartered in Vienna, shares Lord Alton’s concerns.
He told the Register, “A nurse on an acute-care ward would have little to bother her from a point of ethical difficulty. The most difficult area right now is in obstetrics and gynecology or midwifery. We have seen people either leave NHS employment because of their Catholic beliefs or decide that they cannot continue to train to work in the NHS.”
Furthermore, Christopher pointed to the situation whereby a general practitioner is not required to refer a patient for an abortion, but would be required to refer a patient to another colleague or department that will provide one. He said, “For some doctors, that is something they would see as morally unacceptable.”
ADF International is apprehensive about the growing trend in both politics and law to diminish the right of medical professionals to act according to their consciences and faith.
Christopher cited the 2014 court decision Glasgow Health Board v. Doogan as an example. Effectively, this legal decision left Catholic midwives unable to serve on maternity units.
Former Glasgow midwife Mary Doogan, who lost her job as a result of the court case, feels that the professional environment in certain areas of today’s NHS is markedly different from when she trained. She told the Register, “I would think it’s generally more difficult [as] a practicing, committed Catholic, owing to the changing culture of death that now permeates society as compared to the more naturally compassionate attitudes that existed in the ’70-’80s, when I first entered the nursing and midwifery profession.”
“Some areas, such as obstetrics, have been difficult for years, though not impossible to work in,” she added, “but now, following our High Court defeat in 2014, midwifery is an [even] more hostile environment for committed Catholics.”
Even when there have been attempts to strengthen the legal protection in regard to conscience clauses for medical professionals, such as the recent parliamentary attempts by Baroness O’Loan, these have faced stiff opposition in the House of Lords as well as in the media and elsewhere.
There is a growing view within wider society — expressed in a 2017 ComRes poll, “Where Do They Stand Abortion Survey,” that a NHS employee should be compelled to act against one’s conscience or face possible job termination.
Increasingly, Bishop Keenan sees a fundamental clash of moralities — the state versus the Christian ethos that helped establish the NHS, with the state requiring NHS employees to affirm its moral codes.
“Catholics [must] continue to go on quietly working to serve the well-being and dignity of patients in the NHS and to use the freedoms that the law still provides in regard to conscience,” he said.
Whether the future means an inevitable hollowing out of the Catholic presence in modern Britain’s NHS remains to be seen.
Bishop Keenan is resolute, however, about what needs to be done currently and, perhaps more importantly, what has to be hoped for.
“Despite the present difficulties, and rather than see it abandoned,” he said, “Catholics working in the NHS still hope to see its reform and improvement as a vision compatible with Christian charity and care.”
K.V. Turley writes from London.
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