Preview: Richard Dawkins interviews Christopher Hitchens

Exclusive extracts from the writer's final interview.

Exclusive extracts from the writer's final interview.{C}

Update: Christopher Hitchens has died of oesophageal cancer at the age of 62. This was his final interview.

As we revealed earlier this week, this year's New Statesman Christmas special is guest-edited by Richard Dawkins (copies can be purchased here). Among the many highlights is Dawkins's interview with his fellow anti-theist Christopher Hitchens, who began his Fleet Street career at the NS in 1973.

The great polemicist is currently undergoing treatment for stage IV oesophageal cancer ("there is no stage V," he notes) and now rarely makes public appearances but he was in Texas to receive the Freethinker of the Year Award from Dawkins in October. Before the event, the pair met in private to discuss God, religion and US politics. The resulting conversation can now be read exclusively in the New Statesman.

I'd recommend pouring yourself a glass of Johnnie Walker Black Label and reading all 5,264 words but, here, to whet your appetite, are some short extracts. As they show, though physically frail, Hitchens retains his remarkable mental agility.

"Never be afraid of stridency"

Richard Dawkins One of my main beefs with religion is the way they label children as a "Catholic child" or a "Muslim child". I've become a bit of a bore about it.
Christopher Hitchens You must never be afraid of that charge, any more than stridency.
RD I will remember that.
CH If I was strident, it doesn't matter - I was a jobbing hack, I bang my drum. You have a discipline in which you are very distinguished. You've educated a lot of people; nobody denies that, not even your worst enemies. You see your discipline being attacked and defamed and attempts made to drive it out.
Stridency is the least you should muster . . . It's the shame of your colleagues that they don't form ranks and say, "Listen, we're going to defend our colleagues from these appalling and obfuscating elements."

Fascism and the Catholic Church

RD The people who did Hitler's dirty work were almost all religious.
CH I'm afraid the SS's relationship with the Catholic Church is something the Church still has to deal with and does not deny.
RD Can you talk a bit about that - the relationship of Nazism with the Catholic Church?
CH The way I put it is this: if you're writing about the history of the 1930s and the rise of totalitarianism, you can take out the word "fascist", if you want, for Italy, Portugal, Spain, Czechoslovakia and Austria and replace it with "extreme-right Catholic party".
Almost all of those regimes were in place with the help of the Vatican and with understandings from the Holy See. It's not denied. These understandings quite often persisted after the Second World War was over and extended to comparable regimes in Argentina and elsewhere.

Hitchens on the left-right spectrum

RD I've always been very suspicious of the left-right dimension in politics.
CH Yes; it's broken down with me.
RD It's astonishing how much traction the left-right continuum [has] . . . If you know what someone thinks about the death penalty or abortion, then you generally know what they think about everything else. But you clearly break that rule.
CH I have one consistency, which is [being] against the totalitarian - on the left and on the right. The totalitarian, to me, is the enemy - the one that's absolute, the one that wants control over the inside of your head, not just your actions and your taxes. And the origins of that are theocratic, obviously. The beginning of that is the idea that there is a supreme leader, or infallible pope, or a chief rabbi, or whatever, who can ventriloquise the divine and tell us what to do.

A

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George Eaton is political editor of the New Statesman.

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All doctors kill people – and the threat of prosecution is bad for everyone

We must recognise the reality of medical practice: just because a doctor makes a mistake, that doesn’t mean they’ve all broken the law. 

On 15 November the Court of Appeal quashed the 2013 conviction for gross negligence manslaughter (GNM) of a senior consultant surgeon in London, David Sellu. Sellu, who had completed his prison term by the time the appeal was heard, will never get back the 15 months of his life that he spent in jail. Nor will the personal and family trauma, or the damage to his reputation and livelihood, ever properly heal. After decades of exemplary practice – in the course of the investigation numerous colleagues testified to his unflappable expertise – Sellu has said that he has lost the heart ever to operate again.

All doctors kill people. Say we make 40 important decisions about patients in a working day: that’s roughly 10,000 per annum. No one is perfect, and medical dilemmas are frequently complex, but even if we are proved right 99 per cent of the time, that still leaves 100 choices every year where, with the benefit of hindsight, we were wrong.

Suppose 99 per cent of those have no negative consequences. That’s still one disaster every 12 months. And even if most of those don’t result in a fatal outcome, over the course of a career a few patients are – very regrettably – going to die as a result of our practice. Almost invariably, these fatalities occur under the care of highly skilled and experienced professionals, working in good faith to the very best of their abilities.

If one of these cases should come before a crown court, the jury needs meticulous direction from the trial judge on the legal threshold for a criminal act: in essence, if a doctor was clearly aware of, and recklessly indifferent to, the risk of death. Sellu’s conviction was quashed because the appeal court found that the judge in his trial had singularly failed to give the jury these directions. The judiciary make mistakes, too.

Prosecutions of health-care professionals for alleged GNM are increasing markedly. The Royal College of Surgeons of England identified ten cases in 2015 alone. This must reflect social trends – the so-called “blame culture”, in which we have come to believe that when a tragedy occurs, someone must be held responsible. In every one of these cases, of course, an individual’s life has been lost and a family left distraught; but there is a deepening sense in which society at large, and the police and Crown Prosecution Service (CPS), in particular, appear to be disconnected from the realities of medical practice.

Malpractice investigation and prosecution are horrendous ordeals for any individual. The cumulative impact on the wider health-care environment is equally serious. In a recent survey of doctors, 85 per cent of respondents admitted that they were less likely to be candid about mistakes, given the increasing involvement of the criminal law.

This is worrying, because the best way to avoid errors in future is by open discussion with the aim of learning from what has gone wrong. And all too often, severely adverse events point less to deficiencies on the part of individuals, and more to problems with systems. At Sellu’s hospital, emergency anaesthetic cover had to be arranged ad hoc, and this contributed to delays in potentially life-saving surgery. The tragic death of his patient highlighted this; management reacted by putting a formal rota system in place.

Doctors have long accepted the burden of civil litigation, and so insure themselves to cover claims for compensation. We are regulated by the General Medical Council, which has powers to protect patients from substandard practice, including striking off poorly performing doctors. The criminal law should remain an exceptional recourse.

We urgently need a thorough review of the legal grounds for a charge of GNM, with unambiguous directions to the police, CPS and judges, before the spectre of imprisonment becomes entrenched for those whose only concern is to provide good care for their patients. As Ken Woodburn, a consultant vascular surgeon in Cornwall who was accused and acquitted of GNM in 2001, has said: “You’re only ever one error away from a manslaughter prosecution.”

This article first appeared in the 01 December 2016 issue of the New Statesman, Age of outrage