The BBC website is likely to shock the world today with a headline of staggeringly obvious accuracy:

Religion may influence doctors’ end-of-life care

Better sit back and absorb that one. The report begins:

Doctors with religious beliefs are less likely to take decisions which could hasten the death of those who are terminally ill, a study suggests.

So, before we go on to look further at the BBC’s report, why don’t we ask why the corollary of the headline wasn’t addressed instead. The item could – with equal validity – have begun with:

Doctors with no religious beliefs are more likely to take decisions which could hasten the death of those who are terminally ill, a study suggests.

(‘Suggests’? Why not ‘concludes’? Or would that make the story less worthy of coverage?)

The report goes on:

The London University research urges greater acknowledgement of how beliefs influence care. Doctors and campaigners described the findings as “concerning”.

I guess my question is the one I keep banging on about in various posts here: is it only religious beliefs that are to be ‘acknowledged’ or all beliefs? All human beings have a world view based on assumptions about why the world is the way it is, what matters (and why) and how moral decisions should be made. This is not the sole preserve of ‘religious’ people. Every human decision – including medical ones – are influenced consciously or unconsciously by the world view of the decision-taker. There are no exceptions.

This simply means that we should be asking of the (unidentified and unquantified) ‘doctors and campaigners’ what are the implications of their own world views on the treatment or advice they give to their patients about end-of-life options. What the report really seems to ‘suggest’ is that religious people might be more open, more honest or more clear about the moral or philosophical basis of their moral approaches.

Let’s try it a different way. I have just been in Berlin and looking afresh at the rise of the Nazis in Germany in the 1920s and 1930s. The question keeps being raised as to how human beings could possibly have done to other human beings what the Nazis did. It is dangerous to over-simplify such enormous matters, but it can be said at the very least that the disconnection came partly from an accommodation with a world view that reduced some people to (a) categories that are (b) sub-human. As we also saw in Rwanda in 1994, see people as vermin and you find it easier to treat them as vermin.

This is NOT to say that non-religious people are to be equated with Nazis or other genocidal psychopaths. Conscious atheism or agnosticism should be demonstrate equal consistency and be examined for inherent weakness in the same way as religious beliefs should be subjected to rigorous scrutiny. But, atheism cannot simply be assumed to be the neutral default position from which any other ‘belief’ is a dangerous deviation.

The point is simple. Religious beliefs and convictions should influence doctors – but so should non-religious doctors allow that their assumptions and beliefs (about the way the world is, why the world is that way, where human beings derive their value – and why – and what happens when we die… and why this matters).

The British Medical Association said: “Decisions about end-of-life care need to be taken on the basis of an assessment of the individual patient’s circumstances – incorporating discussions with the patient and close family members where possible and appropriate.

Absolutely right – except that there is no mention of the basis on which these ‘decisions’ are to be taken.

The religious beliefs of doctors should not be allowed to influence objective, patient-centred decision-making. End-of-life decisions must always be made in the best interests of patients.

The ‘best interests of patients’. According to which criteria? Who decides and who defines?

Again, the corollary of that statement is: “The non-religious beliefs of doctors should not be allowed to influence objective, patient-centred decision-making.”

The unidentified and unquantified ‘doctors and campaigners’ might well be ‘concerned’ – but so should the rest of us be concerned at their naivete, selectivity and the poor philosophical thinking behind the ‘suggestions’ or ‘conclusions’ they derive from their research. Perhaps they are simply bringing the wrong questions to the data in the first place? Perhaps this is a matter of using language properly – for the language used in these statements gives the game away.

Update  27 August 2010: Much fuller analysis to be found here.