The days have gone where the NHS could act as a secret society. It cannot operate behind closed doors. It cannot keep patients in the dark. It has to take patients into its confidence. It has to actively earn the trust of patients in life and it has to actively seek the consent of relatives in death.’[1]
Alan Milburn’s provocative speech was made on the eve of the release of the Redfern Report into the organ stockpiling scandal at Alder Hey Hospital in Liverpool. There can be little doubt that the affair has huge ramifications for the medical profession. However, in the midst of both media and political hysteria it has been difficult to draw rational lessons from the events that have occurred, and particularly to examine them from a biblical perspective.
The present situation
The facts of the case are indeed shocking. The Redfern Report[2] into the situation at Alder Hey found that Professor Dick van Velzen ordered unethical and illegal retention of all children’s organs when he took up his post in 1988 and falsified records and post-mortem reports. He failed to catalogue organs and when he left he took away medical records. Both Alder Hey and Liverpool University had known that there were risks in appointing Professor van Velzen but but they failed to monitor his work or follow up complaints. They also missed numerous chances to discipline him. Close scrutiny of his work would have revealed unethical organ retention, but it never happened. Michael Redfern QC concluded: ‘There can be no doubt that Professor van Velzen failed parents and doctors at every level. Organs were retained so that parents unwittingly buried 'shells' of their children, causing immense distress when discovered’.
The net has been thrown wider than the criticism (extending to all teaching hospitals) of the ‘hoarding’ of organs. ‘Lack of informed consent’ and ‘age-old paternalism’ are becoming keywords in the debate. In a speech at University College London in January[3] the Lord Chief Justice, Lord Woolf chose this exact topic, criticising the over-deferential ‘doctor knows best’ attitude embraced by the courts. Similarly in a speech to mark the 200th Anniversary of the Royal College of Surgeons last October,[4] the Archbishop of Canterbury, Dr George Carey, called on surgeons to exercise the ‘gift of humility’ as they made life-or-death decisions. It would seem that the Alder Hey scandal is the tip of a much larger and more sinister iceberg.
Issues raised
Many doctors I have spoken to are scathing about the Alder Hey affair. They are unhappy with the adverse publicity Alder Hey has raised, the misunderstandings compounded by one-sided press coverage, the apparent ‘witch-hunting’ of the profession. It is easy to forget that behind the media furore lie real people trying to come to terms with real loss. During our studies, all of us have seen examples of medical anomalies preserved in jars for generations of medical students to learn from. It is often difficult to believe that the tuberculous lung in front of you once had a body, a life, and a grieving family. Perhaps we think it is ridiculous for a mother to hold a funeral to bury microscope slides holding cells of her dead child. However it is our duty to respond in a caring way to the emotions of such people, and as Christians our faith gives us a unique opportunity to do so. What does happen when we die? Does it matter if our liver lies pickled in formalin? The media’s coverage of the Alder Hey affair has thrown light on the public’s general perception of death, which appears confused to say the least. Parents seem convinced that their dead child has not been truly ‘resting in peace’, attaching an almost spiritual significance to their remains. It is heart breaking to read stories of parents trying to cling to every last vestige of hope.
The Biblical view
The issue of human mortality is addressed throughout the Bible. Death entered the world through Adam (Gn 3:19) and remains with us as a symbol of human disobedience. Death is inevitable for all (Ec 8:8), indeed life is so fragile and transient, the psalmist compares men to grass blown down by the wind (Ps 103:15-16). However, Christ has conquered sin and thus death (Rom 6:9). Jesus has risen from the dead, and in him we have hope of eternal life (Jn 3:16): a life in heaven where there will be ‘no more death or mourning or crying or pain, for the old order of things has passed away’ (Rev 21:4).
God lovingly created our bodies in his image (Gn 1:27) - he breathed life in to us (Gn 2:7). As Christians, our bodies are not our own, but temples for God (1 Cor 6:19). The body is a powerful metaphor in the New Testament, used by Jesus as he broke the bread at the Last Supper (Mt 26:6), and by Paul describing the church; ‘In Christ we who are many form one body’ (Rom 12:4-5).
In short, we as Christians have a hope, which can outweigh the concerns of this world. As Dr Carey expressed it: ‘Death consigns us to futility unless we have reason to believe that it is not the ultimate word on our human story’. We do not need to attach a spiritual significance to our physical remains, because ‘we know that if the earthly tent we live in is destroyed, we have a building from God, an eternal house in heaven, not built by human hands’. (2 Cor 5:1) Paul continues on this theme, ‘For while we are in this tent, we groan and are burdened, because we do not wish to be unclothed but to be clothed by our heavenly dwelling, so that what is mortal may be swallowed up by life’ (2 Cor 5:4). Here he turns the secular approach on its head. Whilst the hope of the parents involved in the Alder Hey scandal has been swallowed up by death, our hope rests in the fullness of life beyond this seemingly final hurdle.
Where now?
Alan Milburn did nothing to hide his misgivings with the present doctor-patient relationship. God’s Word calls us to even higher standards. As Christians we can do more than ‘actively seek ...consent’, and ‘not keep patients in the dark’ as Alan Milburn suggested. Rather the Bible urges us to ‘...shine like stars in the universe as we hold out the word of life...’ (Phil 2:15-16). Those who desperately cling to the remains of their loved ones are tragically missing the point. Our faith offers us hope of a better life after death, a hope that we can convey to these patients as they grieve.
