Let's call a bigot a bigot

Some people need offending.

Things have reached a slightly ludicrous situation when a gay rights group can be patronised for labelling as "bigots" those individuals who have gone most out of their way not only to prevent gay rights becoming a reality but also to viciously insult and ostracise the entire homosexual community.

Nelson Jones tells Stonewall to “grow up” and calls its Bigot Of The Year award “offensive and out of date”. To whom could the award be construed as offensive? The bigots it describes? That is unfortunate but something with which they will have to live. They will continue having to live with it if they insist on calling gay marriage “a grotesque subversion of a universally accepted human right” or, in pathetic attempts to attract sympathy, comparing their objection to gay marriage to the persecution of the Jews in Nazi Germany. If they cease to make such crass and ignorant statements they may find themselves not being described as bigots. Nick Griffin is probably offended when people call him a racist; he's still a racist.

Nelson Jones is also mistaken when he describes as “abuse” what Stonewall are doing through their Bigot Of The Year award. It seems immediately apparent that – much like the New Humanist's Bad Faith awards – Stonewall are with an ironic smile and a sense of humour highlighting the people who have done most to retard the gay rights situation. If you want a glimpse into what abuse is, read Martin Robbins' Guardian article "Gay marriage "Nazis" and the disgrace of Lord Carey". In staging its award Stonewall are fighting against a society that has been intolerant of homosexuals for thousands of years, and they are doing so with great dignity and wit. They are also, I'm happy to see, yet to apologise for the award despite hysterical outcries from clerical spokespeople.

Let's look at the word 'bigot' and see whether or not it can be accurately applied in this instance. A bigot is someone who “regards or treats the members of a group … with hatred and intolerance”. He has attempted to raise £100,000 in order to oppose same-sex marriage and compared it to slavery: if 'bigot' doesn't accurately encapsulate Stonewall's victor, Cardinal Keith O'Brien, I don't know who else it could. Nelson Jones seems perfectly happy to describe as a bigot a Chief Constable from over 25 years ago – and rightly so – but why is he afraid of being consistent in this case? A large reason is of course the religious element of the condemnation. If we were to take religion out of the equation, thereby confining to the closet the kid gloves with which it is handled, O'Brien would not be receiving the same level of support and excuse-making. Given that he is in a position of religious authority, many – including, it seems, Nelson Jones – wish to turn down the volume on criticism of O'Brien and interpret his statements in a peculiarly neutral light. This does not advance the gay rights position and encases O'Brien in the cushions in which he has been cocooned for 74 years.

A spokesman for the Catholic Church said that Stonewall “promoted terms like "bigot" and "homophobe" relentlessly in order to intimidate and vilify anyone who dares oppose their agenda”. Given that Stonewall's agenda is the battle to secure equal rights for gay people, I don't think that they can be criticised for responding passionately and with wonderful irony towards the very people keenest to see gay rights suppressed and gay behaviour demonised. If you want a discussion on language, note here its slithery usage – anyone who "dares" oppose the laudable agenda of a group representing a persecuted minority. A homophobe is someone who fears or hates homosexuals; if the word cannot be used in instances like these, when can it possibly be used? Try being told for thousands of years that loving a member of the same sex means that you are an "abomination" and should be killed, and see if "bigot" or "homophobe" are the strongest terms that spring to your lips.

Religious figures like Keith O'Brien cannot expect to be ignored for expressing hateful and outdated opinions. He is perfectly entitled to speak his mind concerning the legal recognition of the love shared between two members of the same sex; and he is perfectly entitled to be called a bigot if what emanates from his mind is extremely bigoted.

Stonewall's award may be offensive but it offends all of the people who most urgently need offending.

A flag at a gay pride festival. Photograph: Getty Images
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When it comes to the "Statin Wars", it's the patients I pity

Underlying the Statin Wars are two different world-views: the technological and holistic.

September saw the latest salvos in what has become known in medical circles as the Statin Wars. The struggle is being waged most publicly in the pages of Britain’s two leading medical journals. In the red corner is the British Medical Journal, which in 2014 published two papers highly critical of statins, arguing that they cause far more side effects than supposed and pointing out that, although they do produce a modest reduction in risk of cardiovascular disease, they don’t make much difference to overall mortality (you may avoid a heart attack, only to succumb to something else).

In the blue corner is the Lancet, which has long been the publishing platform for the Cholesterol Treatment Trialists’ (CTT) Collaboration, a group of academics whose careers have been spent defining and expounding the benefits of statins. The CTT was infuriated by the BMJ papers, and attempted to force the journal to retract them. When that failed, they set about a systematic review of the entire statin literature. Their 30-page paper appeared in the Lancet last month, and was widely press-released as being the final word on the subject.

A summary would be: statins do lots of good and virtually no harm, and there really is no need for anyone to fuss about prescribing or taking them. In addition, the Lancet couldn’t resist a pop at the BMJ, which it asserts acted irresponsibly in publishing the sceptical papers two years ago.

Where does all this leave the average patient, trying to weigh up the usefulness or otherwise of these drugs? And what about the jobbing doctor, trying to give advice? The view from no-man’s-land goes something like this. If you’ve had a heart attack or stroke, or if you suffer from angina or other conditions arising from furred-up arteries, then you should consider taking a statin. They’re not the miracle pill their proponents crack them up to be, but they do tip the odds a little in your favour. Equally, if you try them and suffer debilitating side effects (many people do), don’t stress about stopping them. There are lots more effective things you could be doing – a brisk daily walk effects a greater risk reduction than any cholesterol-lowering pill.

What of the millions of healthy people currently prescribed statins because they have been deemed to be “at risk” of future heart disease? This is where it gets decidedly murky. The published evidence, with its focus on cardiovascular outcomes alone, overstates the case. In healthy people, statins don’t make any appreciable difference to overall survival and they cause substantially more ill-effects than the literature suggests. No one should be prescribed them without a frank discussion of these drawbacks, and they should never be taken in lieu of making lifestyle changes. Smoking cessation, a healthy diet, regular modest exercise, and keeping trim, are all far more important determinants of long-term health.

Underlying the Statin Wars are two different world-views. One is technological: we can rely on drugs to prevent future health problems. This perspective suffers substantial bias from vested interests – there’s a heck of a lot of money to be made if millions of people are put on to medication, and those who stand to profit make huge sums available to pay for research that happens to advance their cause.

The other world-view is holistic: we can take care of ourselves better simply by living well, and the fetishising of pharmaceutical solutions negates this message. I have great sympathy with this perspective. It certainly chimes with the beliefs of many patients, very few of whom welcome the prospect of taking drugs indefinitely.

Yet the sad truth is that, irrespective of our lifestyles, we will all of us one day run into some kind of trouble, and having medical treatments to help – however imperfectly – is one of mankind’s greatest achievements. In arguing for a greater emphasis on lifestyle medicine, we must be careful not to swing the pendulum too far the other way.

Phil Whitaker’s latest novel is “Sister Sebastian’s Library” (Salt)

This article first appeared in the 20 October 2016 issue of the New Statesman, Brothers in blood