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ss nucleus - Christmas 2011,  authority


Karim Fouad Alber is a clinical medical student at University College London.

I was keen to make a good impression. I was on my 'urology week' - one week out of my surgical module where I was attached to the urology team. The surgeons had a reputation of not having much patience with students who they deemed incompetent or a nuisance. I arrived early before the first operation, hoping to get a chance to scrub in and help. The registrar arrived and I went to introduce myself.

'The next patient is having a hydrocoele repaired', he explained. 'You'll get a chance to perform an examination on him during the operation'. I then asked him if it was okay for me to go get consent from the patient first. 'No, don't bother with that. Just wait until he's anaesthetised.'

My heart sank. I knew that if I objected, it was likely that he would not involve me in this operation. Furthermore, my chances of getting all the experience I needed throughout the week would drop considerably. Yet we had been warned countless times by the medical school that under no circumstance are we to perform an intimate examination during an operation without the consent of the patient. But I could see why often people ignored such advice: the patient knew that students were going to be present, and it was extremely unlikely that anyone else would care.

I declined his offer and instead, before the operation, I went and got consent from the patient to be examined. I was not asked to scrub in for the operation.

This is just one of many situations that often creep up in medical school where those that are in positions of authority ask us to do things we may not want to do. At other times, it is the opposite: we are told by an authority that we ought not to do something, but we do it anyway. Last year, our clinical exam took place on two consecutive days, as there are too many students to fit on just one day. Although the medical school had told those being examined the first day not to divulge any information about the stations coming up, plenty of people chose to ignore their instructions. It was obviously very tempting: finding out about any key stations beforehand could mean a big difference in results! Some people felt no need to submit to the authority of the medical school. Others thought that any authority that existed was effectively undermined by a perceived lack of justice: if others were doing it, it is only fair for them to do it too so as not to be at a disadvantage. Those of us who decided to submit (on this occasion, at least) to the demands of the medical school found that it had to be done in a pro-active way: friends had to be warned not to divulge any information directly to us or to someone else whilst we were in the room!

Submission to secular authority has always been a hot topic for Christians. Jesus himself faced many challenges regarding this issue: 'Should we pay taxes to Caesar?' he was asked once. (1) Another time, 'why do your followers not fast?' (2) Both times, Jesus' answer revealed that it mattered more whether or not your heart was in the right place. With regard to taxes, instead of falling into the trap of either agreeing with supporting a foreign invader or breaking the law, Jesus simply held up a coin with Caesar's image and proclaimed: 'Give to Caesar what is Caesar's, and to God what is God's'. (3) Those hearing him knew what he meant: like Caesar's image on the coin, God's image was engraved on man; what God demanded was far more important than simply following a set of rules. 'I prefer a flexible heart to an inflexible ritual' (4) was Jesus' final response to those arguing about fasting.

Keeping your heart in check can often be one of the best ways to go about making a decision with regards to 'grey areas' in your life, and not just with regards to submission to authority. When I am tempted to ignore a rule, I am very capable of rationalising it perfectly into either why I am an exception, or that the rule is obsolete. Answering honestly to whether or not I am making this decision for my own gain or for God's glory is often all it takes to throw out all excuses. This is particularly helpful for the times when compromising a little bit seems to go a long way in making our lives easier: getting asked to forge a signature of attendance, getting a friendly doctor to sign us off for a procedure that they did not see us perform or, once home, proceeding to download a movie we have not paid for!

When Paul wrote to advise Timothy on how to deal with authority, his top advice was something that may not come naturally to us: 'I urge, then, first of all, that petitions, prayers, intercession and thanksgiving be made for all people - for kings and all those in authority, that we may live peaceful and quiet lives in all godliness and holiness.' (5)

This does not mean we should only pray when things turn sour with those in authority. Paul says that it is a priority to pray for rulers, as the change that God brings about in their hearts will be of benefit to everyone. Praying for our consultants and senior registrars and those that make decisions that affect us in the medical school should be relevant to the prayers of a Christian medical student. Paul's advice to Timothy about prayer was not just for the benefit of said rulers – it was for Timothy's character too. Jesus' warned his disciples to pray lest they fall into temptation. (6) Temptation to subvert authority is common and will present itself frequently to us: if we pray, we will be better prepared to stand for what is right and flee from what is wrong.

It is generally accepted by most Christians that the right thing to do, which is pleasing to God, is to respect and submit to worldly authority. (7) But what happens when the law imposed by such authority contradicts God's law? We are perhaps less likely to encounter as serious a conflict in the UK (especially since Christian values underpin many of our laws, at least for now). However this is a real problem abroad: we all know about how in some countries the law forbids church meetings, sharing the gospel, or even being a Christian at all! Prayer for people facing persecution and the authorities is paramount. When it comes down to the decisions, God's laws and values, which were set out for our own benefit, always supercede. We can see various examples of it in the Bible: The Jewish midwives that refused to kill the male newborns (and lied to Pharaoh about it!) found favour with God as they had feared him. (8) Daniel faced the lion's den (9) and his friends faced the fiery furnace because of their defiance to the Babylonian kings. (10) In the New Testament, John the Baptist, Jesus, Paul and his friends all declined to submit to authorities because of their faith in God.

So, next time you feel pressure to comply with authority and the temptation to subvert it, remember that it might be a good chance to develop your character. It may even be a chance to bear good witness to others! Succeeding in keeping firm will depend on constant self-examination of our motives and where our heart lies. The importance of praying constantly, especially for those in authority over us, is what enables us to seek change and draw strength and wisdom for the decisions we make. Stories of other people's heroic defiance of ungodly authority give us hope and build our faith: they shared the same beliefs as us and relied on the same God we do. It also helps keep our perspective from becoming too self-centred and narrow; to be grateful for the authorities we currently submit to. Maybe one day we too will face greater trials.

Karim Fouad Alber is a clinical medical student at University College London.

  1. Matthew 22:172. Matthew 9:14
  2. Matthew 22:21
  3. Matthew 12:6-8, The Message
  4. 1 Timothy 2:1-2
  5. Mark 14:38
  6. 1 Peter 2:13
  7. Exodus 1:15-21
  8. Daniel 6
  9. Daniel 3
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