I find painting fascinating. Search 'speed painting' on YouTube and you'll see what I mean! Typically, painters begin with an outline, and then fill in the details. I believe this is a good approach to many things, including ethics and politics.
In common with many UK medical schools, the course at Newcastle includes a number of 'Student Selected Components' (SSCs). I recently undertook one of these at the CMF office in London. After submitting my title An SSC in Ethics and Politics to the University, and giving some broad learning outcomes to the course director, I was on my way. Everything slotted into place very smoothly, and having close family living in London made accommodation much simpler. I learnt a great deal during my attachment, and hope others will benefit from a summary of what I did and learnt.
You will often hear people say 'ethics is not black and white' – but this does not mean there cannot be absolutes. Many times at medical school I found ethics hard – especially big questions such as beginning of life issues – and sometimes I felt it was almost impossible to reach a conclusion. CS Lewis said that belief is often the 'psychological exclusion of doubt, though not a logical exclusion of dispute' (1) and I feel that to be true of ethics. A short introduction to the issues faced may help us to learn, thus reducing that doubt.
the big picture
At Newcastle we are taught the 'four principles of medical ethics' – autonomy, beneficence, non-maleficence, and justice. (2) These principles can be used to reach consequential answers, but perhaps we need to question why we believe these four principles are good in the first place? Ethics essentially boils down to philosophy: issues of beliefs and values, right or wrong, good or bad.
Moral epistemology explores the questions of 'how can we know what we know?' William Lane Craig writes that objectively, if 'There is no God, (then) there is no immorality'. (3) He adds that while Christians believe principles of right and wrong are verified by God, if there is no God, morality is always determined by the individual, so can never be objectively true. Some contend that morals are a result of natural selection – but evolution only suggests a possible origin of morality, not a reason for morals to be valued. Evolution as blind chance means that there is no 'good' or 'evil', in the same way as it is not possible to call arms 'good' or legs 'evil' as they are, by logical deduction, just ordered parts in a random universe. So an atheist can have subjective moral values, and indeed have a sense of right and wrong, but this sense cannot be objectively verified. Instead, atheists can use the four principles alluded to earlier, acknowledge that many people see the principles as 'good', and presume these to argue for or against the outcome, or 'consequence' of an action. This is consequentialism.
We need to understand other people's principles, beliefs and values if we are to engage with them, otherwise we will never truly be able to understand their reasoning, and they will never be able to understand ours. Paul said he 'became all things to all men' (4) and if we are to do that, we need to understand the basics of how they might think. Doing this practically is not always easy. There are many resources out there to start to get to grips with some of these philosophical principles; I have found sites such as Wikipedia incredibly useful, especially when on a budget. If when you have been studying all day you do not feel like reading, YouTube can be a goldmine, nevertheless be discerning in what you choose to listen to and take onboard. I have found books such as William Lane Craig's Reasonable Faith (5) really useful for knowing how a Christian world view can be logically reasoned; do not be put off by the technical language, you soon pick it up!
As medics our own picture is of course principally medical ethics, although as Christians we might also be interested in other areas such as social justice and the environment. In medicine, the high profile beginning and end of life issues often tend to dominate, so it is wise to know the ideas surrounding these in a bit more detail. As the people you are engaging with will often not place much value on Christian arguments, become accustomed to some of the strong consequential arguments that support Christian perspectives.
There are a number of resources to be had in helping to give colour to these subjects. Three I would recommend include: John Wyatt's Matters of Life and Death, (6) the CMF website, (7) and the Faraday Institute website. (8) Talking to friends and other people you trust is invaluable, for even if the people you speak to do not know the answers, getting thoughts out in the open can help you to square ideas in your head.
politics – why is it important?
Medical curricula, tuition fees, job applications, pay, working hours and conditions are likely to interest most medics, along with ethics and prescribing. All of these have been altered by 'the powers that be' in the last five years, with the three main parties having differing stances on all of them.
Christians are likely to be just as interested in these issues as anyone else. Our concerns may also be broader. The Old Testament prophets were clearly aware of issues of justice, and Isaiah held those who made unjust laws responsible. (9) Characters like Daniel, Joseph and Esther were deeply involved in the politics of their time.
the big picture
I have found it harder to summarise a big picture of politics because it covers such a large canvas, summarised wonderfully by the 'no vote no voice' adverts a few years ago illustrating how if you 'don't do politics' you cannot really 'do' anything. An approach I found helpful was to consider what the values and motives behind a statement of policy or item of legislation really were; a lesson I learnt after trying to summarise and compare the various parties' health policies during my placement at CMF. In case you cannot remember, they were quite dull! Publications highlighted issues that could deceive the reader by letting them be caught up considering emotive, single policy decisions, such as funding for cancer drugs.
Eventually, it was possible to gain an understanding of where the parties' principles really stood. For example the Conservative position (10) tended to indicate a desire for more individual freedom and greater power dissolved locally, whereas Labour preferred a greater degree of centralised control. (11) We can then weigh up the pros and cons of both in relation to our beliefs, and in so doing make a more informed decision!
There is no set way to understand the big picture for ourselves, but do be aware there is much to be learnt from history. To keep up to date with current affairs, why not set your homepage to a news website and spend a couple of minutes whenever you log on skimming through the headlines? You will then already be ahead of many of your peers.
Some issues will affect you more than others, and it's sensible to understand these in a bit more detail. Examples include laws on ethical issues and policy on health and social care.
Many issues are quantified for ease of understanding and with good reason. You don't need to know exact figures, but having some concept of order of magnitude is vital. For example; take money in the NHS. Before my stint at CMF, if you had asked me what the NHS budget was, I would probably have said 'a lot'. Currently it is just over £100 billion each year. (12) Putting this in the context of the UK government's annual revenue of less than £500 billion (13) brings perspective on a whole range of other issues.
It was during my time at CMF that I began to appreciate the impact that a single person can have on policy decisions. MPs do not get a vast amount of letters from constituency members so when they do arrive, they are considered to be representative of many people, although keep in mind that emails do not carry quite the same weight.
The British Medical Association (BMA) is a strong political force which we have direct access to. Seriously consider standing to be a BMA rep or else go to meetings so as to get your voice heard. William Wilberforce (14) and Elizabeth Fry (15) were Christians who did great things for our society, since they realised that values become law via the political system. If we wish Christian values to be acknowledged, we need to be politically active like they were. In conclusion, in ethics and politics we must be 'as shrewd as snakes and as innocent as doves' (16) and by approaching them by learning the big picture and the small, we can become better informed and start making an impact.
I would also like to encourage any of you interested to consider spending some time at CMF on a short term placement such as an SSC. I learnt a great deal during my time there, not only understanding more about what CMF does, but also becoming better informed about the gallery of life we live in.