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When are we mature enough to make life-or-death decisions about our body?

This 16-to-17 age band can pose the most acute ethical dilemmas, as a case in my area illustrated all too starkly.

It is straightforward to provide medical care to a child of, say, four. You seek consent from a parent and usually they grant it; then, you roll up your sleeves and do what is necessary, insulating yourself the best you can from any howls of protest from the patient. Yet fast-forward ten years to when your patient has reached the foothills of adulthood and things are more complex.

It was only in 1985 that the right of a child under 16 to consent to medical treatment was legally established. Victoria Gillick, a mother of five girls, sought to prohibit doctors from providing contraception without her knowledge to any of her daughters while they were under 16. The case went to the House of Lords, where Lord Fraser ruled that, providing that a child had sufficient maturity and understanding, they could consent to medical treatment irrespective of age.

Doctors now regularly gauge this understanding and maturity – the so-called Fraser competence of a minor – and, where established, involve them in decisions about their care. While doctors are expected to encourage parental involvement, it need not be insisted on if the child does not wish their parents to be informed.

Parents cannot overrule consent given by a Fraser-competent child. Paradoxically, if a competent minor withholds consent for care that is felt to be in their best interests, a parent or a court can override their decision. Such cases are rare but they illustrate an important point: we are prepared to grant autonomy when our children agree with the prevailing orthodoxy but we are reluctant to allow them the freedom to make perverse decisions. This must have its roots in an appreciation that medical procedures are often scary and, no matter how competent our children appear to be, they may still be too influenced by fear to be allowed free rein.

No such protection applies beyond the age of 18. Once we reach adulthood, we can decide whatever we like, even if refusing consent to treatment will result in our death. Perhaps the most difficult challenge comes when dealing with patients who are 16 or 17. These adolescents are legally presumed, by virtue of their age, to have the capacity to consent. Yet, unlike over-18s, they can still have a refusal to consent overridden by someone with parental authority or by a court. This 16-to-17 age band can pose the most acute dilemmas, as a case in my area illustrated all too starkly.

The patient was a youth we’ll call Ross, whose mood had been low for some time, probably as a result of bullying. Eventually, his parents persuaded him to see his GP and accompanied him to the surgery. However, Ross wanted to consult with the doctor by himself and his parents, respecting his nascent autonomy, stayed in the waiting room.

During the consultation, it became clear that Ross was severely depressed and he confessed to the doctor something that no one, not even his parents, knew: he had recently tried to commit suicide. The GP recognised that the attempt had been no mere “cry for help” and made an urgent referral to the Child and Adolescent Mental Health Services (CAMHS).

Contact should have been made the following day but because of a transcription error, the wrong mobile number was given and Ross never received the promised call. Instead, a computer-generated letter giving details of an appointment was sent out, which Ross subsequently opened. He never attended. Before the appointment date, his body was found hanging in his bedroom by his mother.

One focus at the inquest was the GP’s decision not to breach Ross’s confidentiality and inform his parents of the depth of his depression and his suicide risk. Had they been made aware, his parents said, they would have ensured that someone was with him constantly. They were also ignorant of the details of the proposed CAMHS involvement, so they had no idea that an attempt to reach him by a phone had failed. When Ross’s appointment letter was looked at after his death, it was found to be formal and stark – a style that parents would be familiar with but was inappropriate for an emotionally vulnerable youth.

Lessons have been learned about reducing the potential for errors in the urgent referral process and about having more adolescent-friendly stationery and letter content. Many people will also have sympathy for Ross’s parents’ impassioned plea that it should be made mandatory for a 16- or 17-year-old’s parents to be informed in these cases, irrespective of the child’s wish for confidentiality. They believe an adolescent with significant depression is a special case in which only qualified autonomy is appropriate.

Set against this is the reality that mental health issues affect around 15 per cent of children and adolescents and, in many cases (though not in Ross’s), family dysfunction, sometimes even abuse, is the underlying problem – a problem that might only become apparent with time and trust. To force doctors to breach confidentiality in those circumstances could have its own equally disastrous consequences.

This article first appeared in the 13 February 2014 issue of the New Statesman, Can we talk about climate change now?

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No, Jeremy Corbyn is not antisemitic – but the left should be wary of who he calls friends

The Labour MP's tendency to seek out unsavoury comrades is a symptom of an intellectual and political malady: the long-term ideological corruption of that part of the left in which he was formed.

“The scientist is not a person who gives the right answers,” said the French anthropologist Claude Levi-Strauss. “He’s one who asks the right questions.”

The British novelist Howard Jacobson is not a scientist, but he has asked the right question about the rise of Jeremy Corbyn, the improbable-but-likely next leader of the Labour party. Here it is:  “Why can’t we oppose the inequities of a society weighted in favour of wealth, and all the trash that wealth accumulates, without at the same time having to snuggle up to Putin, pal out with Hamas, and make apologies for extremists?”

One answer to the Jacobson Question has been offered by Yasmin Alibhai Brown, a defender of Corbyn. His “tendency for unchecked inclusiveness”, as she delicately puts it, is due to his “naivety”. But that explanation will not do. We won’t find the answer in one man’s naivety, especially not a 67-year-old with a lifetime of political experience behind him.

We must go deeper, reading Corbyn’s undoubted tendency to snuggle, to pal out and to apologise as a symptom of an intellectual and political malady: the long-term ideological corruption of that part of the left in which he was formed.

This corrupting ideology can be called “campism”. It has caused parts of the left to abandon  universal progressive values rooted in the Enlightenment and sign up instead as foot soldiers in what they see as the great contest between – these terms change over time, as we will see – “Progressive” versus “Reactionary” nations, “Imperialism” versus “Anti-Imperialism”,  “Oppressed” versus “Oppressor” peoples, “The Empire” versus “The Resistance”, or simply “Power” versus “The Other”.

Again and again, the curse of campism has dragged the political left down from the position of intellectual leader and agenda-setter to that of political irrelevance, or worse, an apologist for tyranny. 

Only when we register the grip of this ideology will we understand why some leftwingers march around London waving placards declaring “We are all Hezbollah now!”. Only the power of the ideology accounts for the YouGov poll that showed 51 per cent of Jeremy Corbyn’s supporters believe America is the “greatest single threat to world peace”, and one in four think a “secretive elite” controls the globe.

The intellectual history of campism has three chapters.  

In the short 20th century, it took the form of Stalinism, a social system that was at once anti-capitalist and totalitarian, and that spread a set of corrupting mental habits that utterly disorientated the left.

Clinging to the dogma that it must have been some kind of socialism that had replaced capitalism, many imagined themselves to be involved in a “great contest” between the capitalist camp and the (imperfect) socialist camp. And that ruined them. They became critical supporters of totalitarianism – notwithstanding their knowledge of the show trials, mass killings, gulags, political famines, and military aggressions; notwithstanding the fact that they themselves were not totalitarians.

The result was the slow erasure of those habits of mind, sensibilities and values of an older leftwing culture rooted in the Enlightenment. In its place the Stalinist-campist left posited lesser-evilism, political cynicism, power-worship, authoritarianism, and sophisticated apologias for tyranny.

In the Sixties and Seventies, the New Left created liberatory social movements that changed the face of the western world for the better. But the New Left was also a cheerleader or apologist for one third world authoritarian “progressive” regime after another, including Maoist China, a monstrous regime responsible for the deaths of tens of millions of “its own” people. Believing the world was divided into an imperialist “centre” exploiting a “periphery”, the New Left thought its duty was to support the latter against the former.

And when the baby boomers grew older and made their way into the universities and publishing houses, they formed the global creative class that has been reshaping every aspect of our intellectual culture ever since. Again, much of that reshaping has been a boon. Schooling us all in the anti-imperialism of idiots, and the romantic cult of the transformative power of revolutionary violence, has not.

After 1989, much of the left didn’t miss a beat. It quickly developed a theory that the world was now made up of a “Resistance” to “Empire”. Here was yet another reductive dualism. But this time there was barely any positive content at all, so campism took the shape of spectacularly inchoate and implacable negativism.

The result has been immense political disorientation, political cross-dressing, and moral debasement across swathes of the left. How else to explain the leftwing social theorist Judith Butler’s astonishing claim that, “understanding Hamas, Hezbollah as social movements that are progressive, that are on the left, that are part of a global left, is extremely important”?

When we understand how campism creates that kind of ideology-saturated and captive mind, we can better understand Corbyn’s choice of comrades and answer the Jacobson Question. 

The ideology demands two commitments. First, “Down With Us!” – the commitment to oppose the West as malign. Second, “Victory to the Resistance!” – the commitment to side with, or to apologise for, or to refuse to criticise, any “resistance” to the West.

The commitment to oppose every projection of force by the West as malign underpins Corbyn’s commitments to unilateral nuclear disarmament and withdrawal from Nato, his attitude to the IRA, and to Putin, and his false equating of the actions of Isis and the coalition in Iraq.

Corbyn will withdraw the UK from Nato because it is the military organisation of the West and therefore “imperialist”. He turns the world inside out and “blames the USA and Nato rather than Putin’s imperialistic Russia for the crisis in Ukraine,” notes Labour MP Mike Gapes.

I believe Corbyn would lead Britain into a warmer relationship with Putin’s Russia, and even thinks it was a bad thing that Poland was ever “allowed” to join Nato.

Astonishingly, given recent history, he also argues that Poland should have, “gone down the road Ukraine went down in 1990”. Corbyn opposes all military support to Ukraine and seems quite uninterested in the Ukrainian bid for freedom from Russian control. What matters much more to him is adherence to the campist ideology: “The self-satisfied pomposity of western leaders in lecturing the world about morality and international law has to be challenged,” he rails.

Campism also explains Corbyn’s comparison of the actions of Isis today and the actions of the coalition forces during the Iraq war. And those comments have a precedent of sorts. Corbyn was national chair of Stop the War during the Iraq war when the leadership circulated a statement that supported the “right” of the “resistance” to use “whatever means they find necessary”. At that point, the so-called resistance was targeting democrats, including the free trade union leader Hadi Saleh.

The second commitment of the campist left has been to side with, or apologise for, or refuse to sharply criticise, the so-called resistance camp. Without understanding this, Corbyn’s apologies for the Muslim cleric Raed Salah remain a mystery, his attitude to the IRA or the antisemitic Islamist terror groups Hamas and Hezbollah will seem harmless, even ahead-of-his-time diplomacy, and the idea that he indulges antisemitism will appear to be a “slur” by a “lobby”.

Corbyn has defended the antisemitic Raed Salah in these terms: “He represents his people extremely well and his is a voice that must be heard . . . I look forward to giving you tea on the terrace because you deserve it.”

In fact, Salah was found guilty of spreading the blood libel – the classic antisemitic slander that Jews use the blood of gentile children to make their bread – reportedly during a speech on February 2007 in the East Jerusalem neighbourhood of Wadi Joz.

Corbyn said he has no memory of meeting Dyab Abou Jahjah. Within minutes, Twitter was running photographs of Corbyn sitting next to Abou Jahjah – the Lebanese extremist who said, “I consider every death of an American, British or Dutch soldier as a victory” – at a public meeting.

Jahjah then boasted on Twitter of his “collaboration with Jeremy Corbyn” and insisted that Corbyn was “absolutely a political friend”. Again, it seems that Jahjah, being part of the “resistance camp”, according to the ideology, was simply beyond criticism.

It did not seem to matter that Jahjah reportedly referred to gay people as “Aids spreading fagots”, and was arrested in Antwerp for organising a riot. Or that he claimed to have published anti-Jewish cartoons showing Hitler and 15-year-old Anne Frank naked in bed with the caption: “Put that in your diary Anne”.

As the Community Security Trust commented: “I am sure that Corbyn would be the first to condemn Holocaust denial. The problem is not that Corbyn is an antisemite or a Holocaust denier – he is neither. The problem is that he seems to gravitate towards people who are, if they come with an anti-Israel sticker on them.”

Hezbollah comes with the mother of all anti-Israel stickers. That is why – although Corbyn knows that it is a radical Shia militant group that has subverted Lebanese democracy, actively supported Bashar al-Assad's brutality in Syria, and seeks the destruction of Israel – he nonetheless (and campism is a politics of “nonetheless”) tells the left that Hezbollah are our “friends”.

Hamas too. Corbyn also calls the Palestinian Islamist group his “friends” and argues that the organisation should not be called “terrorist”. Yet Corbyn knows that Amnesty International believes Hamas to be guilty of war crimes, torture, abductions, and summarily killing civilians. He knows that when five Jews praying in a synagogue were murdered, along with the heroic Druze policeman who came to their aid, in 2014, Hamas welcomed the attack, calling it a “quality development”. They even called it a “terror attack” – embracing the label Corbyn says they do not deserve.

The problem is not that Corbyn agrees with what all these people say. It is that he agrees with who they are: the Resistance to Empire. The apologies and the contortions and the evasions all begin there.

And then there are the Jews.

The concern here is not that Corbyn indulges in antisemitism. He does not. The concern is that he is has associated with others who have. The concern is that, when he is faced with what is called the “new antisemitism”, he is lost. At best, he is an innocent abroad who – oddly, in the age of “Google it!” – can’t seem to work out who is who, or what is what.

Writing for openDemocracy about Corbyn, Keith Kahn-Harris expresses scepticism about Corbyn’s explanation of his choice of comrades. “Although he has defended his contacts with Islamists, the IRA and others as a contribution to peace-making,” Kahn-Harris notes. “Corbyn does not have the deep relationships across the spectrum [or] the even-handedness that this would entail.”

What strikes Kahn-Harris most about Corbyn’s record is something else entirely: that he “is constantly predisposed to be at least convivial towards a broad swathe of those who see themselves as opposed to ‘the west’.”

He goes on: “Much of what appears to be [Corbyn’s] openness does indeed reflect engrained political pathologies.”

And that has been the claim of this essay, too: we have to look to those ingrained political pathologies – I have used the short-hand label “campism” to describe them – to answer the Jacobson Question.

Alan Johnson is the editor of Fathom: for a deeper understanding of Israel and the region and senior research fellow at the Britain Israel Communications and Research Centre (BICOM).