Human, Humane, Humanity.

Incomprehensible actions comfortingly described as "inhuman" turn out, on reflection, to be all too human.

Parents who Believe in Miracles are "torturing" Dying Children.

An article published recently in The Journal of Medical Ethics, in the UK, cited over two hundred cases where the parents' religious beliefs adversely affected the care of children in intensive care. In the majority of cases there was some meeting of minds but in 17 cases no accommodation was possible between the parents and the medical staff caring for their dying children. The authors, who included medical staff at Great Ormond Street Hospital along with their chaplaincy department, expressed concern that there was an increasing number of instances where parents required futile and intrusive treatment in the expectation of a miraculous recovery. The ethical issue was whether parents had the right to 'stonewall' the medical judgement of the health professionals and impose their religious beliefs on their children with pointless medical interventions.

'Christian Nurses & Midwives' (CNM) addressed this very problem in the Spring 2007 issue of CNM News, number 17, in an article titled 'Faith in Faith or Faith in God?' I was the author of that article and given the current interest in the media I thought I would revisit this issue here. I will start with a major caveat - I have only read the abstract of the JME article and some of the media comment resulting from it. I am not a subscriber to JME so I can't comment in detail on the piece in question. But given my prior interest in this topic I hope my thoughts will be helpful to the reader.

CNM gave some consideration to the interaction of 'faith' and medical treatment in the light of some cases not dissimilar to the ones cited by JME. Those were instances I had personal knowledge of in my work in Paediatric Intensive Care over twenty years and as a committed Christian I could bring to bear some insight into the predicament the parents of dying children face in the context of their 'faith' position. I too have met parents who wished to continue medical treatment in the hope of divine intervention and wrestled with the ethical dilemma of such demands as well as having to reflect on my own understanding of my own 'faith' position. My article 'Faith in Faith or Faith in God?' arose out of these demanding challenges.

The obvious point to make is that parents who seek medical treatment in the hope of a miraculous outcome are not doing so from a considered conviction borne of their faith as the JME authors intimate. Such a position is self evidently paradoxical and conflicted; why is the hoped for miracle contingent on human effort?! Theologically it is ill-considered. In fact if a belief in miracles was the driving motivation it ought logically to give rise to the opposite problem - of parents refusing reasonable medical treatment. So the dynamic is not the superficially stated position, the true dynamic lay elsewhere.

In 'Faith in Faith or Faith in God?' I set the stated 'faith' in the context of a faith community with a self deluding and self re-enforcing faulty theology. The media reports of the JME article set the parents up as discrete individuals with little social context. However it struck me that these individuals exist in the context of a 'faith' community and one, as a committed evangelical Christian, I would argue has a faulty theology which has triumphalistic expectations and a 'party' line to be adhered to. The sheer paradox I've already alluded to should be a clue that it is faulty on every level. For every miraculous deliverance in the Biblical text there are more accounts of suffering. And while it is entirely appropriate to pray for deliverance it is difficult to reconcile the naive notion that Christians are above the common suffering of humanity with the stories of Job, Jeremiah, Jesus or Paul. The conflict JME points to is not between secular values and Christianity as it implies, it is actually between Christian values and worldly ones defined by which kingdom we seek to belong to; is it a 'this worldly one' or a 'heavenly one'? From that perspective the JME authors have far more in common with the parents they despise than either have with authentic Biblical Christianity!

I am troubled by reports of the JME article which use words like 'torturing' and 'stonewall' (these may not be in the original JME article of course) which are clearly weighted to prejudice the reader and draw them on to a particular side of the debate. The discussion actually comes to centre on 'distributive justice' - a disingenuous term which means 'health care rationing' - ie each individual is entitled to only so much of health care product at the discretion of the health care professional. That is the core issue here. I'm not sure I would want that sort of power or responsibility but that is the end point the JME authors are pointing to.... an ethical debate about whether agents of the state have the power to decide the fate of your children.

'Hard cases make bad law' means that when we make generalities based on relatively rare events we are only creating a future injustice. Even assuming that the JME article is merely attempting to stir up a debate, rather than being a tendentious polemic, the problem is that it is theologically and socially naive. No doctor is compelled to 'torture' a dying child... This is mere journalistic hyperbole! If this is to be a mature discussion then such histrionics need to be set aside.

And before you comment on this article check out the one I did in 2007!

How would I deal with these ethical situations? If I thought that there was no realistic prospect of recovery despite all our efforts in intensive care - I would tell the parents we had come to the end of all that Man can do... an acknowledgement a secular humanist is far more likely to choke on than a believer. Yet such an admission instantly resolves the clash of worldviews and focuses the discussion where it should be both medically and theologically without any contrived phoney war between the two. These parents should be treated as any other parent in a grief state of 'bargaining' or 'denial'.

What these parents most fear is not breaking faith with God, but breaking faith with their dying child.

Myalgic Encephalomyelitis (Chronic Fatigue Syndrome) Researchers Receive Threats From Militants.

There was a report in The Observer (UK) on 21st August 2011 which indicated that some researchers into CFS received death threats if they suggested that there was a psychological component to this condition.

I was intrigued by this report because a few years ago I wrote a critical but not unkind book review for 'Evangelicals Now' on a title called "On Eagle's Wings" which proposed a Christian perspective on ME. I took issue with some of the unhelpful aspects of this book and suggested that this was a treatable psychosomatic illness. I hasten to add that 'psychosomatic' does not mean it is unreal or that it is not distressing. But after the review was published I received a flurry of rancorous letters denouncing me personally.

Many accused me of saying things I had not said in my review. What was clear from these letters was a profound sense of shame the writers felt at being labelled as having a psychological, rather than a physical, illness. Nothing in my review intimated that I despised people with psychological illnesses but that was something these correspondents bitterly projected onto me. I couldn't help reflecting that this feeling of shame, self loathing, alienation, however one describes it, was possibly a major component of the underlying condition.

Clearly that sense of shame was an aggravating feature of the condition they suffered - and I addressed that sympathetically in my review. I hope this recent news report will give some cause for self reflection among those who press for a particular interpretation of ME and will be more gracious to those who genuinely seek to help even if they differ in opinion.

Neverland Matrix.

I was once caring for an 8 year old who was critically ill in Intensive Care; Ventilated, on multiple inotropes and on CVVH.
A relative was keeping a vigil by her bed side during the night. In the small hours when everything was quiet we got to talking. He held the young girl's hand and quietly shook his head.
'When I watch TV and I've had enough sadness - I press the doofer and its gone and everything is happy. When I'm fed up with the news and all that stuff I just go...' He mimed pointing a TV remote control. 'One click...', he clacked his tongue, '...and its gone from my life'. He sighed.
'Well... I keep clicking and it is all still here.... it doesn't go away!' he said.

The world as presented by TV is a double illusion. It not only portrays a distorted sense of reality; it also implies a distorted measure of control of that reality. Cocooned from the hardships most humans face daily a viewer drinking deeply in the media well may sincerely believe that 'all is for the best, in the best of all possible worlds'... and if it isn't we can always turn over.

It is only when real reality intervenes that our perspective is reorientated and both those perceptions, a false reality and a phoney sense of control, are shown to be illusions. How many people go through life mired in illusion, thinking that perception is the reality? What does it take to wake people up?

Back Pain Again!
There is an apocryphal story told about the time in 2006 when I was laid up for weeks with back pain. The story goes that some sanctimonious person said to me, "God must be teaching you a lot through all of this." To which I am said to have replied, "Yes, how bloody painful a back can be!"
None of this is true, but it is what I would have said!

A Father's Anger, Health Care Administration and the Philosophy of Science.

It is not unusual for parents of children in 'intensive care' to vent their anger and frustration on staff members. One accepts that people under stress can display the recognised signs of grief; "denial", "bargaining", "anger" and "acceptance". These signs are not confined to the bereaved but can also be manifested in those who grieve for their child's suffering. Thank God that the vast majority of kids on our unit do get better! Our mortality rate is about 4% which compares favourably with comparable units.

Of course, understanably, such statistics cut little ice with parents, for them a death is not a fraction it is the loss of a loved one and that is 100%. Even when seriously ill children recover it should not be inferred that the parents are unscathed psychologically; they still had the fear of loss to contend with. They may also be grieving for the 'loss of innocence' - not their child's neccesarily - but their own! People can have a rather 'Pollyannish' view of life which a visit to PICU rudely contradicts, it isn't surprising then that parents feel a deep sense of anger at society for having sold them a lie - that 'all is for the best in the best of all possible worlds'!

Recently one father had a 'go at me'. He could not comprehend 'how in this day and age' medical science had no clear cut answer to an issue he raised. He was quite angry about it and I listened - I hope with good grace - to his frustrations. Of course I had no answer to his technical question although I could have replied "do you really want to discuss The Philosophy of Science?" I suspected he did not. His frustration arose out of a misconception about science; in his worldview "science" was about concrete facts, settled knowledge which can be looked up in a text book. But the reality is "science" does not deal in such certainties, what Mankind "knows" is only ever provisional - we must constantly re-evaluate our knowledge and revise our practice in the light of new information. Medical science is no exception, especially when one is dealing with complex and dynamic disease processes.

Another naive idea which came to grief was his view, of what I will term, his "entitlement" within the UK's National Health Service. I suppose, again, I could have asked "do you really want to talk about 'Social Policy and Health Administration'?" I suspected he did not. He clearly felt that having paid more than his fair share in taxes he was entitled to more than he felt he was getting. I listened - again I hope with good grace - to his frustrations. The answer I could have given would have been inappropriate; 'however much you have paid in tax it is no where near enough! And I bet at the last election you didn't vote for higher taxation did you?!' The demand for all health care services way outstrips the supply and the electorate needs to wake up to that reality. The government is not some rich uncle who can dig ever deeper into his infinite pockets, it is the tax payer who funds the health service and in a world with 'third party payment' we can always be very generous with other people's money can't we? But we live in a democracy where politicians will promise more and more while the electorate is prepared to pay less and less. This irreconcilable conflict is taken out on the people who have to break the bad news to a naive public that the State cannot always provide what they demand and that is usually the same people who are haplessly trying to make the system work!

Western society has produced a generation with a profound sense of what life owes to them. People feel some sort of entitlement from life which is bolstered by our concepts of 'rights' - as if our 'rights' are absolute and written as immutable laws into the very fabric of the cosmos rather than relative and subject to the vagaries of humanity.

But, of course, I didn't say any of this. This father was grieving, but not for his child, who was ultimately discharged from our unit alive and well - he was grieving for the death of his naive worldview!

CHILD PROTECTION!

*

Today was a 'Team Away Day' mainly dedicated to a variety of mandatory training issues. We covered things like 'Infection Control' and 'Pain Control in the Paediatric Intensive Care Unit'.

*

We had a couple of major sessions on 'Child Protection'. One of the most distressing aspects of PICU is coping with the aftermath of a "non accidental injury". Sadly not all the kids make it!

Children Die Too.



Last night I carried a two week old baby in my arms down to the mortuary. Statistically our PICU has a better than average mortality rate compared to similar units - about 4%; which isn't much of a comfort when its your child. For parents the loss is 100%.

Euthanasia and the Arguments
of Straw Men!

From time to time one hears supporters of euthanasia pressing their case in the national media. To judge from the "debate" one would probably conclude that it is the 'accepted custom and practice' for patients to be allowed to die in pain and that health care professionals are solely concerned with employing every conceivable technology to prolong every individuals life to the last uttermost second regardless of the pain involved and the patient's (or their family's) wishes.

I have to tell you in all candour I have NEVER witnessed this scenario in over the twenty five years of my nursing career - the bulk of which has been in critical care. Funny that.

Funny that the commonly accepted "truth'"is that only those who are in favour of euthanasia are motivated by compassion and the rest of us are motivated soley by professional arrogance. There is not a little humbug attached to the argument of the euthanasia lobby.

I qualified as a registered nurse twenty five years ago. I went on to do my paediatric course and subsequently worked on a childrens cancer ward before making a move into Paediatric Intensive Care. I feel that I have earned the right to speak on the subject of euthanasia.

Advocates of euthanasia generally set up a phoney scenario of a patient dying in agony when compassion would demand that we put them out of their misery. As someone who has worked extensively in a variety of critical care settings I can tell you that I find such allegations utterly repugnant and a slur on my
profession. If someone does die in pain that is a matter of professional incompetence not (as euthanasia advocates would have it) accepted 'custom and practice'. And frankly I cannot help but feel that the public is being hoodwinked by their spurious arguments.

There is no excuse for anyone to die in pain. None whatsoever. This is a 'no brainer' as issues go. Period. If you find yourself witnessing such a scenario then I would say that that is clinical mismanagment.There is no excuse for it.

I will give as much pain relief as is required to prevent pain - if their disease process is such that that required analgesia actually foreshortens their life - then so be it. That is NOT euthanasia, that is pain control. As a Christian and a nurse I have no issue with this.... it is a none issue! (It is exactly the same situation as giving any drug with a known side-effect in such circumstances).

Perhaps it is a dated term but no-one seems to mention the principle of "double effect". This is where one carries out one action i.e. to control pain, but which secondarily foreshortens life.

Euthanasia (which is Greek literally meaning 'good death') actually means intentionally terminating a life as the primary purpose.

Now some one will say that this is splitting hairs but I will reply that speaking as someone at the coal-face of these ethical dilemmas this distinction is crystal clear... there is no ambiguity. Killing someone is murder, dying as a consequence of a pathological disorder which professional people are trying but failing to arrest is an entirely different matter.

The real question is why are the advocates of euthanasia pushing a "false choice" argument? Presumably it's simply because the truth will not do.

Another 'straw man' is the implication that patients are having medical treatment "forced" upon them. But the reality is that everyone has the right to refuse treatment, to compel someone to undergo procedures they have declined is assault. (There are some rare instances where perhaps a patients mental state causes medical staff to follow through a legal process to compel a patient (or the parent of a sick child) to have treatment....but that is not the issue in view here). Sadly it is my experience that such legal proceedings that do occur are more often when a parent refuses to let go of a loved child - and insist on futile attempts at resuscitation.... it is heart breaking for all concerned. The purpose of medical treatment is to support a patient through an acute episode of illness to a point where they have recovered sufficiently not to require such support. If the consensus of opinion is that no such recovery is possible, then in my view, the removal of this life support causes no ethical problems - we are merely allowing the pathological process to takes its course. I have been involved in countless such discussions and contrary to the arguments put forward by the pro-euthanasia lobby there are no legal ambiguities about it.

Another 'straw man' is that somehow people like me are in some sort of legal limbo and therefore society should sanction euthanasia. That is yet more codswallop! If I sound irritated - I am. I detest being used as bait to manipulate an unsuspecting public.

The REAL question is this; when so many 'straw men' are being marshalled to emotionally intimidate the innocent onlooker into sanctioning the demise of our fellow human beings where do you think the REAL end point of this argument is?

If anyone wants to take issue with me the comments box is open as always.

AN APOCRYPHAL STORY.

2006 was my sciatica year when I was incapacitated for a few weeks with excruciating back pain. It took several months to resolve sufficiently for me to return to clinical work. I've been back at work properly for a year now but it was only few weeks ago that I discovered that there is a story about me doing the rounds from that period. It is entirely apocryphal, but I thought that it was so good I'd post it in my 'blog'.

While I was incapacitated and house bound some unctous visitor came to encourage me (so the story goes). Presumably she believed in the ennobling power of suffering because she is said to have said "I expect that God must be teaching you an awful lot through all of this!"

I am said to have replied, "Yes, how bl++dy painful a back can be!" The story is entirely apocryphal of course.... but it is what I would have said!!!

The rise of the
"UBER-CONSUMER"
and the decline of
PROPOSITIONAL TRUTH!

In our post-evangelical, post-modernist, post-consumerist age there is some talk about how propostional truth is passe. This is the kind of drawing room talk which only cuts much ice among the chattering classes at their dinner parties as they crack open another bottle of Chablis. "Mere words cannot convey meaning still less 'truth' - whatever that is. All truth claims are culturally bound. Yes, they say, the important thing is the debate - the dialogue is all - conclusions are so declasse!" The reality is this is a "debate" which can only truly exist (not in a post consumer age meaning they have 'moved on' from consumerism) but in an uber-consumer age when we arrogantly assume we can smorgasbord the philosophy table and select the "reality" which suits our taste. It is even possible to snack at the "Jesus" table and select the Jesus which suits us - the "another Jesus" of 2 Corinthians 11 v4! ("Uber" is a German prefix meaning "super" or "ultra", when this prefix is adopted in English it indicates quizzical disbelief. Please feel free to substitute the word Ultra if you prefer - ultra-consumer fits my meaning just as well). Reality is a human construct in this propositionless, ultra-consumer world; why not select one that is congenial? For them the "dialogue" is all and any attempt to draw universal conclusions is arrogant and mere "power politics"; any 'truth' claim is an exercise in oppression and control. Truth cannot be contained within a proposition they insist!

Of course I firmly believe this is all utter nonsense and fantasy-land thinking. If you want to dispute the point with me come and join me on the ward round on the children's intensive care unit here in London on Planet Earth. When we stand at the foot of the bed of a critically ill patient and their course of treatment is being debated why don't you chime in with your wisdom about the "meaninglessness of words" and how the "discussion is all", that conclusions are "oppressive" and how we represent an outmoded modernistic paradigm. (Don't misunderstand me; I do not believe that a reductionist scientific model describes the whole of reality - I wouldn't be a Christian if I did! - but as far as it goes it represents a model of physical reality. It is the truth and nothing but the truth, even if it is not the whole truth, because it completely misses out the spiritual dimension to reality).

Back on the ward round as we sift the results of investigations undertaken and discuss options and courses of treatment we may well not have a complete picture of the patient's condition (we rarely deal in "certainty") but we must draw some conclusions from what evidence we do have and work out an action plan - indeed it would be outrageous and morally indefensible to pass by without formulating some treatment plan even if it is only a provisional one. It may well be that over the following hours and days we will revise and refine our plans as we get a clearer picture of the disease process. Isn't this the "hermeneutical spiral" principle, constantly homing in on the truth? So do not confuse the cowardice of indecision with the virtue of humility. Do not confuse humility with merely having ceased to care! What the uber-consumer calls toleration is more likely to be indifference..... or, just possibly, despair.

But as that ward round unfolds why not discuss your insights into oppressive 'truth claims' with the parents of one of our patients? I'm sure that they would be only too interested to hear from you.... but I won't answer for how they might respond! You see we live in an uber consumer society cut off from reality but once in a while reality impinges on our illusory world that once seemed so secure; when nasty things happen then we don't want a "dialogue" with the chattering classes. When push comes to shove we recognise our need for conclusions and a course of action by experts in their field not a philosophical debate about the meaninglessness of propositions or how 'truth' is culturally determined and a
function of oppression! (Disease and misfortune are not culture bound and in fact they are a compelling international language). This whole outlook is one which can only ever arise in a complacent consumer mindset which has never had to deal with difficulty or danger as previous generations have; the uber-consumer merely wants to be left to luxuriate in a world where there are no difficult choices to make and no challenges to unsettle us. We tolerate everything not because we are caring people, we tolerate everything precisely because we have ceased to care!

Do you ever wonder why people get angry and even violent with health care workers? I've seen it happen within my own intensive care unit. It's because the health care worker tells them the truth about reality when they've always thought that they could choose their own... they are uber-consumers who bought into the post modern lie. Someone given the task of breaking bad news becomes the official representative of the society who has denied them their right to the reality of their choice! Afterall the uber-consumer's catch phrase is "I know my rights!"

It would be a shame if evangelicals buy into this sort of mentality too. The danger, as I see it, is that in an attempt to be culturally 'relevant' to the uber-consumer we tailor the Gospel message to flatter our target group - but when we do that we also cease to have anything meaningful to say, we can only reflect back the conceits of the uber-consumer and we can never challenge them. The uber-consumer does not want to be unsettled in fact they will demand (with menaces) the craven approval of the church..... for all their talk about "toleration" they will never tolerate any group not geared to flatter them.

We Evangelicals only have something distinctive to say when we are authentically counter-cultural, and we have not always been faithful in this regard, but that is something the Lord Jesus requires us to be if we are to be worthy of the name Evangelical, that is "Evangel people", literally Gospel people!

FLOODS - An "ACT OF GOD" or a Luke thirteen?

In the UK recently we have had some rather exceptional weather resulting in flooding which some Christians have interpreted as God's judgement on us as a nation. Some areas of Europe are experiencing a drought as are some other areas of the world and no doubt there too some people who fancy themselves as modern day Elijahs will draw similar conclusions as if we are still inhabiting an earlier act of the Bible timeline.

Were these floods an "Act of God"? The following comments are addressed to the British nation; if others can play Elijah why can't I?!

Some, no doubt well meaning people, have attributed certain recent weather events to God's wrath, presumably therefore the fine weather we enjoyed last Easter was a sign of God's favour - so what went wrong withYOU people out there during those few weeks!? Some of you dropped a clanger didn't you! Well I hope you feel proud of yourselves - spoiling everyone's Summer!

I take note of the fact that the weather has since perked up so all I can say is whatever it is that you are doing now keep it up!

'JESUS OF THE SCARS'...
by Edward Shillito.

"The other gods were strong;
but thou wast weak;
they rode, but thou didst
stumble to a throne;
But to our wounds only
God's wounds can speak,
and not a god has wounds,
but thou alone."

FAITH in "FAITH" or FAITH in GOD?

One of the most perplexing problems that occasionally
arises for Christian health care workers is when a
purported divine promise is quoted for a terminally ill
patient's healing.

The scenario I have in mind is a conflation of several
real incidents; combined to blur particularities and so
aid confidentiality and for dramatic effect. The situation
develops like this: a young child is admitted to intensive
care with irreparable brain damage.The senior elder in
their faith community gives a prophecy to the believing
parents that the child will recover.This is certainly the
outcome everyone wants - including the staff on the unit.
But 'the wish becomes father to the thought' and the
parents home church rejoice in the promise given. The
parents are urged to trust in "God's Word" and not give
way to the fear Satan would attack them with.

I was the senior nurse in charge when this very situation
arose. One of my colleagues was reduced to tears when
the childs mother turned her wrath on her for 'undermining
their faith' when she sought to raise the grave nature of
their childs condition. I spoke to the parents who told me
that there was a conspiracy to undermine their faith and
all the staff were party to it. If only their child were back at
their home rather than here - they "knew" all would
be well....the perceived barriers to their childs wellbeing
were the very medical and nursing staff caring for them!
(To them the child was dying because he was in hospital
- he was not in hospital because he was dying!) One
might wonder why they brought him to the Accident and
Emergency Department in the first place: they brought him
only because they realised that he needed some suction
to clear his airway, the staff had to restrain them from
removing him even as the team resuscitated him.

It struck me that their concept of 'faith' was much more to
do with 'the power of positive thinking'. Almost as if "faith"
was some sort of inanimate spiritual force to be manipulated
by sheer will power, it was certainly nothing I could describe
as biblical faith, which is always a personal expression of
trust rather than an abstraction. In many ways this view of
"faith" is more pagan than Christian. It is more akin to 'spirit
channelling' - only in this case the 'spirit' being so channelled
is, ostensiby, The Holy Spirit: as if He is an impersonal
force rather than God: if only the 'right' spiritual conditions
could be engineered then a healing must inevitably follow.
I spoke to them at some length, seeking to assure them that
we are on the side of 'health' and affirmed that their child was
in better hands than ours and no-one would be more delighted
than me for us all to be proven wrong and for God to be glorified
by their child's miraculous recovery. "We are not against miracles",
I said, "but I would be failing in my responsibility if I didn't tell you
what we are up against". They listened politely to what I had
to say but were unmoved.

A few days later some members of the church youth group
came to visit along with the senior pastor. They were visibly
shocked by what they witnessed of the patients condition;
comatose and ventilated. I spoke to the pastor who was
baffled by the conflicting reports he had heard. What had
been reported to him was the child was indeed staging a
miraculous recovery - and that the patient would be well
enough to receive visitors. My interpretation of this hearsay
was that their particular church had received back the vibes
it was transmitting. In short the parents fed back to the church
every scintilla of positive news (which was largely imaginary)
and edited out all the negative (which was overwhelming).
The parents and their church were effectively caught in a
cycle of mutual deception masquerading as 'faith building'.

At this point I want to flag up a practice common among
some faith ministries of encouraging public testimony
of a healing which has yet to occur as if it already has.
This is justiified on the dubious basis of "declaring that
which is not, as if it were!" Or by suggesting to the supplicant
that the healing will occur as the testimony is given.This in
my opinion is fundamentally dishonest and is indefensible
as a practice.True faith cannot be bolstered by such
(let's face it) manipulation. The lack of integrity belies the
Spirit of God invoked.

The pastor and I spoke together for a while. It seemed
to me that he was too keen (given his miraculous convictions)
to explore further courses of treatment and investigation. The
parting comments indicated that he felt that the onus was
wholly on the parents faith whether the child was healed or
not - he had done all he could. The youth group was ushered
out in an embarrassed silence. He was clearly positioning
himself ready for failure.

It is difficult to imagine what a parent feels when they
lose a child. It is even more difficult to imagine what it
is like to feel that their fate was determined by one's own
lack of faith and to feel estranged from the church
community one had had implicit faith in: and that is where
their "faith" does lie. Stranger still is the notion that the
unbelief' of the medical and nursing staff was the principal
cause of death. The child did die as anticipated and the
promise of miraculous recovery proved false. Unable to
countenance such a loss of face and to reconcile their
conflicting feelings the parents phoned the police to
report that their child had been murdered! Their official
theological position was that the parents and their
community were all on board for a miracle - it could only
have been thwarted by Satan using a staff member as
an agent of his will. This rationalisation was as inevitable
as it was preposterous. How do we unravel a situation
like this? First by realising that every one starts by
meaning well - everyone wants the child to get better.
But that natural wish clouds people's judgement and
problems arise because the people directly involved
do not have a theology of suffering. Don Carson in his
book "How Long, O Lord?"*, says we need to have our
theology of suffering in place before we enter such a
time of trial - unfortunately such a theology is anathema
among believers who have a theology of 'glory now'.
In their 'time-line' we are not in an in-between phase
(between the First and Second Comings of Jesus Christ)
in their minds eye it is all 'Glory' now. To reconcile reality
with their theology when 'glory' fails to materialise
requires a fundamental shift in focus - from God to
Satan as the one in ultimate control. And whether this
is a psychologically tenable position must be disputed;
regardless of the dubious theology involved.

In my own feeble way I attempted to challenge such a
view of events. Surely it is more of a comfort to know
that the child died in God's arms, and not as a
consequence of Satan's activity? Apparently not!
Over and above the usual grieving process of anger,
denial, bargaining, resignation and acceptance over
the dying patient, there was a parallel process over
their "faith", each interwoven with the other, and
conflicting with their immediate church community.

In such a situation I would regard the parents as victims
of false teaching and syncretism.The onus actually lies
with the church leadership who had created an environ-
ment of unrealisable expectations in general and then
spoke a falsehood in particular invoking God's name
as their authority; and who, when confronted with the
reality of the situation, sought to shift responsibility for
their failure elsewhere rather than actually guide their
flock through a pastorally challenging time. One elder
was more concerned with saving face. It was a classic
failure of leadership. By their teaching and actions these
leaders had actually created a nightmare world for
acutely vulnerable people - I have no sympathy for
such wolves in sheeps clothing. False teaching has
nasty consequences and opposition to it is motivated
by compassion; not by dogmatic nit-picking.

A few years ago I attended a Christian convention and
during a meeting and greeting session I happened to
mention where I worked. An individual commented to
me that I must have witnessed a well known event when
a famous healer had healed everyone on the intensive
care unit. I replied that I was indeed working there at the
time and have no such recollection. We both smiled at
each other and made eye contact; my interlocutor
moved on to more fruitful conversations elsewhere.
I could not help feeling that if he had genuinely believed
in these miracles I could have expected a more robust
response: either for him to feel utterly deflated or for
him to denounce me as a liar. I could understand either
response but I cannot understand this 'easy come,
easy go' attitude to such claims. This is no casual matter
for those personally involved; and perhaps that relaxed
approach to God's honour actually belies a lack of true
faith.

Let me suggest some criteria for assessing prophetic
promises of a healing miracle: first there has to be a
confirmed diagnosis by a qualified diagnostician. I have
worked extensively as a nurse in adult and childrens
intensive care and could probably make an educated
guess about someone's symptoms, but I would never
claim to be a diagnostician: it would be unethical and
unprofessional to do so. My best guess would be no
substitute for a proper medical diagnosis. Also self
diagnoses by attention seekers known as the "worried
well" aren't good enough either. Nor is a "spiritual"
diagnosis by the healer themselves sufficient evidence
of a genuine medical problem. Secondly, the person
issuing such a prophetic promise cannot delegate
responsibility for its fulfillment elsewhere in order to
indemnify themselves against failure - they would
(I'm sure) be the first to claim some credit if a healing
did come to pass. Manipulative strategies invariably
indicate false teaching, especially when there is an
abuse of a position of trust, and even more so where
the manipulated are emotionally vulnerable.
Thirdly, a miracle proper only exists when all treatment
has ceased, for example the recovery of patients being
actively treated in Intensive Care is hardly evidence of
a visitors miraculous healing ministry whatever self
serving claims they might make for themselves! And
that brings me to my fourth point; is the "prophet/healer"
more concerned with building their own reputation than
they are about actually serving God's people? These
are some of the key issues I would flag up.

I should also mention the pastoral care of ones work
colleagues in a situation where the Gospel is seemingly
compromised and where they too have been abused in
the name of God. It is important to share that the display
of "faith" they have witnessed should not be attributed to
all Bible affirming Christians. Perhaps it may even be
an opportunity to talk about what true faith is! This may
be the only positive thing which can be redeemed from
such a situation.

As a Christian and a health care worker I see no conflict
in using my God given skills to help relieve the suffering
of others - in fact it is quite perverse to suggest otherwise.
Perhaps my decision to move into nursing was partly
motivated by a Christian urge to be part of God's answer
to a suffering world; I don't believe I am unique in this
because you will find many Christians within all the caring
professions and in public service. You will also find many
Christians serving their Lord in the voluntary sector in their
own time.

Sadly there are occasions when one has to break bad news
and that needs to be done truthfully and compassionately.
Even children die and children of believing Christians die
- we do not live in Disneyland we live in the real world. It is
entirely appropriate to pray to God for his help, and it is
also entirely appropriate to pray for those who care for our
loved ones to enable them to bring about a speedy recovery
....and when that is not possible to continue to care to enable
the patient to die in a dignified and comfortable way. In fact,
for those who die in Christ, we can by faith rejoice, knowing
that death will not have the last word. The Gospel enables
us to face reality and to do so without despair. I must add
that that has been the gracious response of the vast
majority of Bible believing Christians I've met in the course
of my career; the scenario outlined above was a minority
view.

Death and suffering are part of the common human
experience; that is the clear teaching of scripture. One
day Jesus will restore the creation and death itself will
be destroyed - but that time isn't yet. True faith looks
to the future when God himself will wipe away our tears.

Come, Lord Jesus!



* "How Long, O Lord?" by DA Carson, published by IVP.
Don Carson also wrote a helpful little book called
"The Difficult Doctrine of the Love of God" also published
by IVP.

post-script; A shortened version of the above article
was subsequently published in the Spring 2007 issue
of "CNM News" (No 17).

THE GOSPEL ACCORDING TO LUCA.

My name is Luca and I am a stray cat.I think my
previous owners must have got bored with me.
It's not uncommon for Humans to take us to a
strange part of town and drive off. I had to live
rough for a while.

One rainy day I wandered into someone's garden
and peered in through the french windows. I must
have looked a sorry sight - dripping wet and half
starved.

I don't blame Pete & Helen for not feeding me
straight away because they probably thought I
had a home to go to. I stayed in their garden in
the meantime cos it's quiet there. Anyway they
gave me some food when they could see how
thin I'd become. After that I couldn't keep away.
I'd eat anything back in those days. I love roast
chicken - definately my favourite - let me know
the next time you're cooking and I'll drop in for
dinner! I suppose it is fair to say that I've become
a bit more picky about my food these days; I'm not
so keen nowadays on 'Whiskas' Cod - if that's put
out for me I'll wander down the street to Shirley's
to see if there is a better offer!

Pete & Helen called me 'Lucas' at first until they
realised that I was a girl! I have a lovely black
and white coat which is nicely complemented by
a new red collar - it is so nice to feel that I 'belong'
to someone again!

What gets me is how capricious these Humans are.
One day just when I was beginning to feel a bit
more confident I was whisked away to an evil
place called the Veterinary Surgeon.

I was stabbed, poked, de-fleaed, de-wormed,
vaccinated and had THREE teeth extracted because
they had gone
" bad "

.......whatever that means. I was hopping mad
and sulked for days! They said
" it was for my own good "
- yeah right. They said all this
" treatment "cost them £300 - I have no comprehension
whatsoever what this means. I suppose I just have to
take their word for it on
" faith "!

It's enough to make you doubt the goodness of Man!



PostScript: 26th October 2006.
I might have misjudged Luca by implying that she is an
ungrateful cat. This morning when I returned home after
a night shift there was the biggest, deadest MOUSE laid
out on our doorstep!
Personally its not my taste, but I appreciate the sentiment!
To everyone out there in blog-world - I hope that your day
starts as fruitfully as mine!

Signed: a shamefaced cat owner.

Niall Ferguson and
"The War of the World".

Earlier this week the revisionist historian Niall
Ferguson concluded his TV series on Channel 4
in the UK. His contention is that the conflicts of
the 20th Century were not ideological in nature
but fundamentally ethnic. Human ability to
treat other people as "alien" enables them to
indulge in "ethnic cleansing" without the empathy
of fellow feeling. How are we able to treat each
other as if we have come from another planet?
I often wonder if at heart all evil is actually a lack
of empathy - the inability to put oneself in someone
else's shoes.

I have to say that Ferguson's thesis seems to me
to be a re-hash of Samuel Huntington's "The Clash
of Civilizations" rather than anything desperately
original as the TV promo promised. [I've looked at
Huntington's ideas in a blog back in March '06 if
you're sufficiently interested!]

Having concluded that the world's conflicts often
defy simple explanation Ferguson goes on to attempt
a simple explanation = 'too many young men needing
economic prospects'. This is rather too simplistic in
my view, I think (for what it's worth) that young, poor
men are not so much the cause of conflict as the
unwitting foot soldiers of events outside of their
control. But then why should a historian have any
particular insight into the future?

Ferguson's final remarks which made an appeal to our
common humanity were belied by the lack of common-
ality his programmes highlighted. As a Christian I
can understand his attempt to appeal to some higher
concept which will enable us to treat each other as fully
human, but such a concept -it seems to me- cannot be
centred in humanity - we must look beyond ourselves
to truly understand ourselves. Indeed Ferguson's
appeal rests on the ability to empathise - yet to build
a philosophy on ourselves, as all Humanists do, is
actually a subtle denial of the need for empathy. How
often have you heard someones crime described as
"inhuman"? Or have you called someone "inhuman"?
The truth is what we pointlessly call "inhuman" is in
reality all too human. By calling it "inhuman" we are
making a vain attempt to distance ourselves from it
by "alienising" it [what I call "otherising" it!] I am a
Christian because the Gospel of Jesus helps me see
the world as it actually is, and Jesus does not seek to
comfort me with silly notions of my own innate
goodness but confronts me -and us all- with our
alienation from the One who is the source of all love.

"If only there were evil people some where insidiously
commiting evil deeds and it were necessary only to
separate them from the rest of us and destroy them.
But the line dividing good and evil cuts through the
heart of every human being." Alexander Solzhenitsyn
in 'The Gulag Archipelago'.