Hazel McHaffie

abortion

On a serious note …

You might be forgiven for suspecting I read only fiction. Not so. Alongside the reading I do to hone my skills as a novelist, I also study topics that relate to my ethical interests. And lately that’s been around discrimination on the basis of different-ness. I rarely talk about these books on my blog as they’re unlikely to appeal to most of my readers.

Ethics and religion are often intertwined and I’ve been trying to tease out why devout believers are often very judgemental and apparently blinkered. I’m thinking not so much of the extreme level of torturing and killing young women who refuse to conform to a strict dress code – the kind of ferocity that hits the headlines – or the fierce opposition to clinics helping women grappling with the consequences of an unwanted or unsafe pregnancy, we’ve seen in the USA this year. Rather I’m exploring the rationale behind closing the doors of the church against people who are coming to a different conclusion on topics like LGBTQ+ or gender equality. And I’m not looking in one specific direction; we see it across religions and denominations, amongst the rank and file members, as well as the hierarchy paid to lead their flocks.

I’m particularly perplexed where the Christian religion is concerned. Not just because ours is a nominally Christian country, and it’s the faith community I’ve been a member of all my life, but more because, after all, it’s a religion purporting to be founded on love – for God and one’s fellow-man/woman. Surely the God whom Jesus Christ came to reveal is bigger than the petty details his followers get bogged down in? Surely he can accommodate different-ness? Surely he doesn’t want his people to be uniform clones made in an image designed by a founder of any given specific denomination? The whole of nature is full of infinite variety – just watch a couple of episodes of The Frozen Planet II!

So am I coming from a prejudiced standpoint here? I’m trying not to. And to that end I’m looking at both sides of the argument, as far as it’s humanly and humbly possible, with an open mind. Right now I’m embedded in the issue of same-sex relationships. Talking with people who espouse differing views, engaging in correspondence with those who challenge my own understanding, and reading, reading, reading. Three books give a flavour of where I’ve been – each valuable in their own way.

Gay, Straight, and the Reason Why, by neuroscientist Simon LeVay, deals with the science of homosexuality from an academic standpoint; a kind of meta-analysis of the huge number of studies that have looked into a range of biological and psychological and social factors that might predispose someone to be gender-nonconformist. It’s fascinating but probably not for the faint-hearted. Suffice to say, it’s a ringing endorsement of the biological and inbuilt nature of same sex attraction on more counts than you would imagine.

By contrast, Unclobber is a much easier read. It looks at the six so-called ‘clobber passages’ in the Christian Bible that are commonly believed to say that homosexuality is a sin which God hates. Pastor Colby Martin argues that not only have these sections been misunderstood and misused, but that there is a compelling case for the church to welcome everyone regardless of their sexual orientation.

Preston Sprinkle, an academic professor, pastor and ‘ordinary dude’, challenges Christians to look at the LGBTG+ community afresh. His book, People To Be Loved: Why homosexuality is not just an issue, is a model for how to move away from the sometimes hostile confrontational kind of exchange too often seen in the past, and towards a useful balanced discussion on the subject; to see past the distant theoretical arguments and look into the faces of real people with heartbreaking stories of rejection to tell. Like Unclobber, this slim volume seeks to put common assumptions on one side and discover what the Bible actually says about homosexuality, and then to evaluate how we should treat those who make up that divergent group. Though it’s a deeper and more methodical study of the subject, it’s very accessible, and it’s challenging. The author comes to a different conclusion from Colby Martin where the Scriptural passages are concerned (he thinks the Bible tells us that same-sex sex is against God’s will), but nevertheless he advocates the same kind of unconditional grace.

If I had to sum up where these authors take me I might say being homosexual is definitely not a lifestyle choice, it’s inherent. It’s not so much an issue to be solved, it’s more about vulnerable people who need to love and be loved – loved without footnotes, without a background check, without fine print (as Sprinkle puts it). What that looks like might differ according to which side of the fence we come down on. And that’s the crunch point – how to reach out in love.

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Abortion: rights, choices and heartaches

Whatever you feel about the rights and wrongs of abortion, I suspect the news this week of the Supreme Court’s decision in the USA to overturn Roe v Wade and end the constitutional right of women to decide about reproductive matters for themselves, putting the decision into the hands of the legislature in each State, will have had an effect on you. And if my understanding is correct, some Republican States will even make it illegal to intervene in cases of ectopic pregnancy where the fetus, growing usually in the fallopian tube, cannot be viable, and the mother’s life is at risk.

Phrases like ‘going back 50 years’, ‘a dark day for women’, capture the sense of shock and outrage so many feel in the 21st Century where equality, autonomy, rights, interests, are everyday words, not esoteric ethical terms.

I guess my own circumstances influence my personal views, but I confess, I foresee dire consequences. I was in clinical practice in the days before the Abortion Act came into force here in the UK in 1967, and saw at first hand the maternal death, the terrible damage, and the family heartache caused by both self-inflicted and back-street abortions carried out by unqualified people in unhygienic conditions. It underlined for me the desperate measures women would go to to end an unwanted pregnancy. It shone a light on the grave disadvantages of those with limited resources and choices. It highlighted the anguish of losing a baby. It brought me face to face with the tragic death of young girls.

Nor is the closure of these specialist clinics only the end of a single service: abortion. There are far-reaching repercussions. Because these centres – well, the good ones anyway – don’t just process patients on a conveyor belt; inbuilt into their work is listening, counselling, supporting, guiding; helping vulnerable women and girls to address the problems which make them consider termination in the first place. Decision making is a staged process. And it includes guidance for the future: dealing with the grief and guilt, avoiding further unwanted pregnancies, coping with the responsibilities they already have.

Opponents of abortion have a right to their opinions, but in my view, they do not have the right to force their opinions on others, especially on those who are at their most vulnerable and traumatised.

The reasons for seeking to terminate a pregnancy are legion. Ending the life of an innocent child is indeed a big deal, but what of the well-being of …

Sally, who has been told her 20-week fetus has a lethal abnormality.

Jacqui, whose mental health is precarious already, and who knows she can’t cope with a dependent child when she’s struggling to look after herself.

Dolly, who has learning difficulties and scarcely understands what’s happening to her body, and of her mother, already worn out looking after Dolly.

Precious who has been told her unborn child has a genetic condition that will mean he will never walk or talk or know her.

Twelve-year-old Caroline, who was sexually assaulted by her father and now has a positive pregnancy test hidden in her school bag.

Mother-of-three Hetty, who’s daily struggling to cope and simply doesn’t have the financial, emotional, or physical wherewithal to raise a fourth child.

Trixie, caught between a pregnancy which will end all contact with her family on the one hand, and the judgement of her church which forbids abortion and preaches eternal damnation on the other.

Teenager Katarina, who was assaulted by a stranger when she took a shortcut through the park so her mother wouldn’t be worried that she was late home after sports practice.

Fatima, who is in an abusive relationship and regularly raped by her partner, and now expecting his child, whom he attempts to dispose of through violent kickings every Friday night.

Elizabeth Jane, who has just got that longed-for promotion at work and for whom pregnancy right now would be the end of a promising career.

Yasmin, who has been through years of infertility treatment, ending up with five viable implanted eggs requiring selective reduction to ensure her own and the babies’ safety.

First-year university student Andrea who was taunted for still being a virgin, and in a drunken moment of madness allowed a persistent boy to remedy the situation.

It’s not for me to pick and choose which of these pregnant women/girls deserve my sympathy, which should have a choice, who qualifies for an abortion. It’s not for me to force them to give birth to these babies and live with the horror of what that means. I won’t be there.
It is for me to understand and support and stand up for the freedom to choose.

If you want to hear firsthand what a ban on all abortions can mean in real life, listen to an American lady speaking to Woman’s Hour on BBC Radio 4. Andrea Prudente was on holiday in Malta this month, when she began bleeding profusely at 15 weeks – her placenta had started to sheer off. Then her waters broke and she was told her much-wanted baby could not survive. But Malta is the one EU country that bans abortion in any circumstance, even when the fetus can’t survive, even when the mother’s life is in grave jeopardy. And this lady’s life was indeed in danger; nevertheless she had to risk a flight to another country to obtain the medical assistance she needed. It makes harrowing listening. But we can’t turn away from this reality and sanitise it. It’s happening to real women in June 2022.

America’s overturning of the constitutional rights of women doesn’t stop abortions; it stops safe abortions!

 

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Ethical challenges – did anyone press the pause button?

Well, the world may have been on pause this year, but ethical issues have still raised their heads above the parapet periodically. However, I suspect most of them were lost in the cacophony of sound relating to the pandemic, so to illustrate, I’ll share a selection from the past three months up till yesterday.

December
Sweden’s gymnastic federation has now ruled that young athletes under the age of 18 will be able to train and compete as whichever gender they choose to identify as. They will not need to provide a doctor’s endorsement or any evidence of gender dysphoria.

Following a landmark High Court ruling, in the UK, new guidelines have been introduced by the NHS that make it necessary for children with gender dysphoria to obtain a court order before they are legally allowed to take puberty blockers. It is felt that under 16-year-olds are highly unlikely to fully understand the long-term risks and consequences. However the Tavistock and Portman NHS Trust which runs the UK’s only gender identity development service has said it will appeal against this ruling.

`November
New euthanasia rules are being introduced in the Netherlands – a country already known for its liberal social attitudes. Doctors will now be permitted to spike patients’ drinks before lethal injections are administered, in cases where it’s impossible to obtain informed consent from a person with an advanced directive who has already expressed a wish for help to die when the time is right, but who might resist the final act. The change comes in the wake of a court case where a doctor in a nursing home secretly slipped sedation into coffee for a lady at an advanced stage of dementia. Opponents of euthanasia are understandably alarmed by this widening of the limits in the medical code.

The English Health and Social Care Secretary, Matt Hancock, spelled out confirmation that travelling abroad for assisted dying constituted a legitimate reason to break lockdown restrictions.

It was an accidental error that led to the Oxford/Astro-Zeneca vaccine against Covid-19 reaching 90% efficacy. About 3000 of the more than 20,000 volunteer trial participants had been given just half the dose they should have received according to the research protocol. The ‘correct’ dose achieved just 62% efficacy. A serendipitous result. And a lucky break for whoever was responsible for the mistake!

October
The Dutch government approved plans to allow euthanasia for terminally ill children under the age of 12 who are suffering hopelessly and unbearably. Objectors see the thin end of the wedge visibly widening.

Legislation to allow medically assisted death was passed by the New Zealand parliament last year, but lawmakers delayed implementing it until the public had had their say in a referendum.  Under this law, the End of Life Choice Act, a mentally sound adult who has a terminal illness with a life expectancy of less than six months, and who is experiencing unbearable suffering, can request a fatal dose of medication. New Zealanders have voted overwhelmingly to legalise this, which means the measure will now pass.

An angry backlash developed when the Women’s Prize for Fiction opened up its eligibility criteria to include transgender women.

Six consecutive days of protest followed a near-total ban on abortions in Poland by the constitutional court. A country of 38 million people, Poland already has some of the most restrictive abortion laws in Europe, and an estimated 80,000 – 120,000 Polish women travel abroad for terminations or seek illegal abortions each year.

The English government has been keen to make the process of applying for a Gender Recognition Certificate kinder, cheaper and less complicated. As part of a drive for greater equality, the Women and Equalities committee are in the process of examining whether the currently mandatory diagnosis of gender dysphoria should be dropped from the legal process of transitioning, whether transgender people should be required to live in their preferred gender for at least two years before formally transitioning, and how their rights can be better supported.

As it stands, parents in this country are allowed to terminate a pregnancy where the fetus has Down’s syndrome, at any point up to full term. Three adults with Down’s Syndrome are now launching a landmark legal challenge to the Government’s abortion legislation on the grounds that it makes them feel they shouldn’t exist and would be better off dead.

A former Public Health England medical director, Professor Paul Cosford, had never wanted to be a supporter of assisted dying, but after developing incurable lung cancer himself, changed his view and bravely declared his hand in the BMJ.

A poll of 29,000 BMA members found – for the first time – that a majority were in favour of medical professionals being able to prescribe life-ending drugs. The BMA’s position currently is that they are opposed to assisted dying.

A Dutch fertility doctor has been found to have fathered 17 children during the 1980s and 90s, with women who thought they were receiving sperm from anonymous donors.

September
After President Macron turned down his personal appeal for euthanasia, a Frenchman in his fifties, Alain Cocq, suffering from an incurable condition where the walls of his arteries stick together, announced he would refuse drink, food and medicine, and live stream his death. However Facebook said it would block this being broadcast on its forum. M Cocq subsequently said he had lost capacity for the fight, it was too difficult, and he accepted palliative care.

Last year staff at the Gender Identity Development Service raised serious concerns about safeguarding issues relating to the use of inhibitors and the speed or referral for treatment for young people. It transpired that England’s only NHS gender clinic for children knew about recommendations for puberty blockers from an internal review carried out 15 years previously, but failed to implement them. An independent review into these services is underway now to improve access to and delivery of support for these young people.

Who knew there were so many, huh? I shall never be short of material for my novels!

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By the way

The old brain is somewhat discombobulated by rather too many competing demands at the moment. Not a time for deep analytical reading or serious long distance writing, but  even in the busiest times, my obsessions won’t allow me to abandon writing and reading altogether. And it’s curious what life throws in your path when you’re not looking, or when you’re tramping through the autumn leaves.

Who’d have thought to find the ethics of stem cell research buried in a Kathy Reich‘s murder mystery?! Grave Secrets is billed as a chilling murder in the searing heat of Guatemala. Forensic anthropologist, Dr Temperance Brennan, is searching for the remains of twenty-three women and children, victims of a brutal massacre. She’s then somewhat distracted by the disappearance of four teenagers who go missing, not to mention being physically involved in the retrieval of a skeleton of a young woman from a septic tank. I confess I got rather bogged down in the complexity of the plot at times, but interest was reignited by the excursion into my field of ethics.

And the newspapers yielded their usual challenging real-life sensations.

In the central German state of Hesse, for example, police are investigating a woman who forged documents to pass herself off as medically qualified, to see if she’s responsible for multiple deaths. She worked as an anaesthetist/anaesthetic assistant – different papers, different claims – either way, the mind boggles! How could she not be detected in that high-risk arena over two years? It’s reported that evidence links her with repeated medical failures and botched procedures, and many more are likely. If I’d put that in a novel, the critics would deem it ‘too far fetched to be credible’!

A birth coach has resigned from an association called Doula UK, claiming she’s been driven out because transgender activists took offence at one of her Facebook posts. Reacting to the trend towards gender-neutral descriptions she wrote: ‘I am not a cervix owner … I am a woman; an adult human female … Women birth all the people.’ Up flew the activists objecting to ‘trans exclusionary comments’. Out went the mother-of-four birth coach. Hello?

A 29-year-old Christian man who uses a wheelchair after breaking his back in a climbing accident, has become the first person to be arrested and prosecuted for praying in public outside an abortion clinic in Ealing, west London. A Public Spaces Protection Order is in place creating a buffer zone around that particular clinic, forbidding anyone to show either approval or disapproval with respect to issues relating to abortion. However, the case has collapsed because there is insufficient evidence to provide a realistic prospect of conviction. Cue another outcry re injustice!

Never a shortage of challenges to keep the grey cells buzzing whatever else my hands and feet are busy with in this gloriously autumnal month. In those situations, what would I do? What do I think? Could I defend my position?

What would YOU say?

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Rights and wrongs

What a week! And still the debate about the rights and wrongs of Brexit agreements and arrangements grinds on … and on … and on. Conflict. Tension. Lies. Threats. Who do we believe? Who can we trust? Whose interests and rights should take precedence? Who/what are these politicians really acting for – themselves, their constituents, their party, their consciences, or what? How much is Joe Public entitled to know? What will history make of these unprecedented shenanigans?

I sigh for the simple philosophies of a McCall Smith character … Todd the surveyor in 44 Scotland Street, perhaps, reprimanding his dishonest employee caught out in a lie: ‘All of our life is based on acts of trust. We trust other people to do what they say they’re going to do.’ Hmmmmm. If only.

No one is immune to doubt and uncertainty. Those much feted and privileged royals, the Duke and Duchess of Sussex, revealed in an interview this week that they’re both struggling with the conflict between their privacy and media coverage in their lives. Taxpayers contribute towards the upkeep of the monarchy, but does that entitle us to put them under the microscope? What should be considered legitimately in the public interest? Where do the limits lie? What if their mental health is less than robust? Is the loss of a parent in childhood an ‘excuse’ for the rest of one’s life? Should they have broken with royal tradition and confessed to human frailty? Is it different when a child is involved? And so on … and on.

Then there’s the Northern Ireland abortion laws, decriminalised this week, although implementation of the change is still hedged about with caveats and fraught with peril. Was it ever fair that a woman was legally prevented from having an abortion, even for a lethal fetal abnormality or when her pregnancy was the result of rape or incest? Is it right for Westminster to legislate for Northern Ireland coming into line with the United Nations rules on human rights? Should religious belief influence laws? Should someone else’s scruples limit my choices? If you’re pro-choice, this is a momentous victory for women’s human and reproductive rights; if you’re pro-life in all circumstances, it’s a sad day for Northern Ireland … Where do you stand?

Speaking of women’s rights … the jolly old debate around gender continues to blow my mind. Not only must provision be made for gender-neutral toilets and changing rooms; not only must transgender women be permitted to win the awards in female sport; but now a rapist must be recorded as female if that’s how they self-identify. What about the rights and feelings of the victims in all this? A quintessential female symbol has even been removed from sanitary towels – yes, you heard right, sanitary towels – by Proctor & Gamble, apparently because not everyone who has periods identifies as a woman. Hello?!! As a leading feminist campaigner put it: ‘We’re now moving towards the total elimination of women’s biology’ . The rights and wrongs, the questions arising, are too numerous to enumerate on this blog.

Welcome to my world – constantly asking what’s permissible, what’s morally right, what’s fair, what’s expedient? And nowhere do I probe more deeply than in my fictional characters’ lives. I have to be totally immersed in their emotions and thoughts and beliefs and experiences in order to make them authentic and believable. Their dilemmas haunt me day and night. Especially when the novel is at an early stage and I have no idea how, or ever whether, they’re going to survive or resolve or surrender to the pressures. Their pain and anguish swallow me whole.

Ideas for my twelfth novel are at an embryonic stage at the moment, so tender and fragile indeed that they might even miscarry altogether. I have several characters lurking around disturbing my peace, and eventually one group of them will send down roots and cling on with more persistence than the rest. Once they’ve claimed my full attention, and I know they’re here to stay, that’s when I’ll start to sink below the horizon of their stresses. All those what-ifs and rights and wrongs scrambling for answers. I might be gone some time!

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Future possibilities

There will never be a shortage of subjects for me to write about! I lose tracks of scientific breakthroughs and medical marvels. And today, given the breadth and range of material available, I’m not going to even attempt to link everything I mention to scientific papers – Google the key words and you’ll get the information if you’re interested.

When HIV/AIDS first came to our attention in the 80s there were doomsday predictions of biblical plague proportions and real-life devastating statistics. I was a researcher at the time and saw it, wrote about it, first hand. Then came huge public awareness campaigns … followed by the development of anti-retroviral wonder drugs … then combination therapies, that could hold the disease at bay. Now here we are, with stories of stem cell donations from people with ‘natural immunity’ rendering patients free from the virus. You could weave a pretty complex plot with that one! And in 2019 my file marked HIV/AIDS looks completely different from the slim wallet of 30 years ago.

Inside of Me coverThen there’s the transgender issue. Wow! So many dimensions. About young children wanting to transition. About people wanting to reverse the process; the irreversibility of some therapies. About misleading statistics. Eebie jeebie – how crazily tortuous a plot could you construct in that area. The imagination goes into overdrive. Makes my little sally into that world in Inside of Me, pale into banality.

It’s 41 years since the first test-tube baby, Louise Brown, was created, and infertility was very much top of my pile when it came to choosing subjects for my set of novels. Now despite widespread opposition, criticism, vilification, stigma, as many as 8 million babies have been born by IVF. And the endless thirst for knowledge and understanding, coupled with a bottomless pit of compassion, drives researchers and clinicians in this area to seek more and more solutions to the problems couples have in conceiving, or avoiding perpetuating deadly genetic diseases. There’s mileage for several more books to follow on from Paternity, Double Trouble and Saving Sebastian. Did you know, for example, that the success rate for assisted fertility is way way higher (50%) than for natural conception (25%) … plenty of scope to work up a story-line there, huh? Imagine a gang of 35-year-old career girls going to the freezer to select artificially-created sperm … or genetically screened/modified embryos … ticking selection boxes along the way for green eyes, athletic ability, fiery temperament …? Endless possibilities!

The statistics on abortion reflect changes in society’s mores and values; programmes like Call the Midwife have increased public awareness of how things have developed in a generation. Add in dating apps, modern career paths, cohabitation, social expectation, fertility statistics … I feel an historical reflective story coming on! I well remember, in the 70s/80s soon after the 1967 Abortion Act was introduced, women coming in for a second, perhaps even third, abortion were looked upon askance. Recent Government figures have highlighted that of almost 68000 abortions carried out in 2017, 1049 were undergoing their fifth abortion and 72 their ninth! And there’s a story behind every one.

Then there’s the horrific topic of female genital mutation … don’t get me started! The recent story of the first person to be convicted in Britain briefly reported in the national press was shocking enough – the little girl was three years old; the mother cut the child herself in her London home; indecent images and animal pornography were involved. I absolutely couldn’t go there with fiction. But … should our collective conscience be prodded?

Resources, caps on the cost of medical and social care … I’m somewhat allergic to numbers, but reading about the human consequences of budgetary restrictions brings out the indignant in me. And might just compel me to write about it if I’m around long enough to get to that file.

Even the topic of assisted dying – a recurring hot potato – has subtly changed since I published my novel on the subject, Right to Die, eleven years ago. The issue’s been described by lawyers for the Royal College of Physicians as ‘one of the most controversial and morally contentious issues in medicine’, but ongoing polls of both medical and public opinion show a definite move towards accepting the need for some change. This might be simply taking a neutral professional stand as against opposing it; or a swing towards legalising some form of assisted suicide in the UK. A novel today could look very different.

Yep, I’m endlessly adding to the possibilities in my files as medicine and science reveal more and more, and society’s tolerances and expectations change. This is just a superficial skim. Anyone out there keen to pick up the gauntlet?

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Splinter the Silence

In Splinter the Silence, Val McDermid explores the issue of internet trolling/hate mail/harassment/villification/abuse of women who put their heads above the parapet to speak about discrimination and injustice. In this fictional case, the public figures are apparently hounded to the point of suicide, although the reader knows from the outset that they are actually being murdered, each killing disguised to mimic the suicides of famous feminists. The murderer has his own reasons for objecting to women who step outside their domestic role and tell men what’s right or wrong.

Well, sadly, I know people in real life who would still tether women to the kitchen sink if they could. I have myself come in for criticism for being a woman and daring to voice and defend an opinion; for having ideas above my subservient station. Fortunately, positive responses have far, far outweighed the negative, so it hasn’t been that difficult to maintain perspective, but then, I’m not an A-list celebrity, so such pernicious or malicious activities don’t hit the headlines, the number of critics doesn’t reach stratospheric levels. Nevertheless, I can vouch for the discomfort of being on the receiving end of such unjust vitriol. It’s not as far fetched as you might imagine.

This week I’ve been thinking a lot about the matter of standing up and being accountable, and about all the cases coming to public attention right now that lend themselves to strong column inches. I’ll itemise a few, but please note, I have no privileged access to information on any of them, so the facts I include are as subject to distortion and prejudice as any other media-generated stories.

OK, serious time, folks. And in every case multiply the questions many times over.

Ten days after legally completing his transition from female to male, a transgender man, TT, underwent intrauterine insemination, resulting in a pregnancy. He has now taken his case to the High Court in an effort to be the first to have no ‘mother’ registered on the birth certificate. Hello? ‘Cake’ and ‘eat’ instantly spring to mind. Expensive legal and parliamentary resources are to be deployed to look into the ramifications of the current laws governing fertility treatment.
One British doctor is reported as saying, now that it is medically possible to transplant a womb into biological males, it would be illegal to deny them access to this opportunity to carry a child to birth. What do you think? Would it?
What about the rights of the unborn child?
One author of a letter to the Telegraph outlined the scenario and concluded, ‘The lunatics truly have taken over the asylum.‘ Do you agree? Or is this a case of establishing the deep-seated needs of people who have struggled all their lives with their dysphoria?

Then there’s the issue of rights and dignity and bodily integrity and mental welfare of female athletes with naturally high testosterone levels? Renewed calls have been made for such women to be given drugs to lower their levels before they compete, or for them to be channelled into other categories such as intersex competition.
What about the effect on these sportswomen of the abuse and accusations levelled at them?
Is it a fair playing field?
Other scientists have cast serious doubt on the integrity of the research behind this latest demand; how many people either know of this or have the scientific or mental wherewithal to judge the issue fairly?

Exactly four years ago, on their half-term break, Shamima Begum and two school friends fled this country, aged only 15, to join Isil and become jihadi brides. In those years, Begum has borne three children, two of whom died of illness and malnourishment. She has told the world she doesn’t regret her actions, that she was unfazed by the sight of severed heads, that’s she’s into retaliation, but wants to bring baby number three back to her home country.
We have no way of knowing just how much coercion lies behind her public pronouncements, but her responses to interviewers chill the blood. The government have refused to jeopardise more lives by sending anyone to rescue her, but at first the lawyers told us, she’s a British citizen, she cannot be rendered stateless, so legally speaking, there is no choice; we must have her back. Then a couple of days later we hear that no, the government are not obliged to repatriate her … and indeed the Home Secretary has revoked her British citizenship … she has dual Bangladeshi nationality … the baby has a Dutch father  …
What consequences should this girl’s actions have?
Whose rights take precedence?
What kind of a future lies in front of her or her baby son?
Who should assume responsibility?
Is it a measure of our own more civilised behaviour that we rise above the terrorists’ creed and show compassion now towards this girl?
What of all the other people who’ve dabbled in terrorism but who now want to return?And a zillion other questions.
No wonder opinion is divided.

Retired accountant, 80-year-old Geoff Whaley, diagnosed with MND two years ago, decided that an agonising and undignified death was not for him; he would go to Dignitas in Switzerland for a controlled end to his life. But his careful planning was threatened days before his proposed departure by the appearance of police at his door, interviewing his wife of 52 years under caution, in response to an anonymous tip-off. It was this unwelcome intrusion, coupled with the laws of this country opposing assisted suicide, not his impending suicide, that engendered fear and anguish in this man, provoking him to protest to the BBC and MPs:
‘The law in this country robbed me of control over my death. It forced me to seek solace in Switzerland. Then it sought to punish those attempting to help me get there. The hypocrisy and cruelty of this is astounding.’
Put aside for a moment your personal views on assisted dying, and ask, what could possibly have motivated someone to blow the whistle in this way at the Whaley’s eleventh hour? Genuine concern, self-righteousness, extreme religious views, a sense of public duty, malice? Or what?
Should other people’s private scruples be allowed to control the rights of families in such tragic circumstances?

Imagine being born in war-ravaged Yemen, stranded in a hospital in a country where social, political, economic and health care systems have all collapsed, where about half of the 28 million inhabitants are living on the brink of famine. Now add to that the babies being conjoined twins. Their picture appeared in the British press; the Yemeni doctors appealing for help from the UN to get them to Saudi Arabia.
What should our response be?
What is our responsibility in such cases?
What chance did they realistically have?
At least 6,800 civilians have been killed and 10,700 injured in the war, according to UN statistics. Did these two extremely vulnerable boys warrant such an exceptional rescue mission?
In the event they died in their homeland, but the questions remain.

I could go on … and on …

All the youngsters who become victims of disturbing material on line … the BBC being criticised for not offering abortion advice after an episode of Call the Midwife featuring a backstreet abortion … impecunious students being paid to contract dangerous tropical diseases like typhoid and malaria in the search for new effective vaccines … the matter of a 97-year-old Duke of Edinburgh flouting the country’s law on the wearing of seatbelts …

I have opinions on all these issues. You don’t have to listen to me. You are perfectly entitled to disagree with me – fundamentally and even vociferously. But you ought not to shut me up! Especially not in a threatening or damaging way.

 

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A Spark of Light: Jodi Picoult

Among the stacks of files for possible novels-I-might-write-some-day is one labelled ABORTION – a hot potato and one with evolving ethical and legal and philosophical issues.

I’ve personally lived through major change as a clinician in this area of practice. When I was in my early twenties, deliberately terminating pregnancy was illegal, and we midwives saw at first hand the damage done by so-called backstreet procedures carried out by unskilled hands. Then in 1967 the law changed to allow abortions to be carried out by trained professionals in certain circumstances. And gradually, over the years, those strict criteria have been relaxed. Nowadays, social circumstances and personal preference can be used as reasons to proceed; the mother’s mental well-being is invoked. But somehow a novel on the subject has slipped farther and farther down my priority list.

It remains a much more controversial issue in the States. Girls/women procuring an abortion have been incarcerated in prison for murder/homicide; professionals have been killed by ardent pro-lifers; centers offering the procedure have been attacked. (Jodi Picoult lists some of the sobering statistics in an appendix to her book on the subject.)

So perhaps it’s better that an American author has picked up the gauntlet and run with it. And I’d have said, Jodi Picoult was a natural choice to do so. She’s one of the four authors closest to my own genre of writing, and I’ve read (and own) pretty much all her books.

In A Spark of Light – just published – she’s tackled many of the issues I planned to include. The scene is The Center – formerly The Centre for Women’s Reproductive Health – the last standing abortion clinic – in Mississipi. The building is a hideous orange scar on the cityscape, everything inside it is run down, shabby, used. It’s protected by a perimeter fence, a border patrolled by zealous vigilantes /activists demonstrating outside it and against it.

Into this centre of controversy strides a very angry man with a gun and a personal agenda. He cold-bloodedly shoots some of the women and a male doctor before taking others hostage. His murderous rampage is fuelled by rage, because it’s in this place that the life of his own potential grandchild was taken; all he can think of is exacting revenge on those who were responsible.

Police negotiator Hugh McElroy is drafted in, initially unaware that his own teenage daughter and his sister are inside The Center. The two men establish contact. When he discovers that Bex (his sister) has been shot and seriously wounded, and that his girl Wren is being held hostage, it all becomes horribly personal.

The story unravels backwards in hourly increments. Hmmmm.

Picoult explores profound questions. Just where does the right to life end and the right to choose take over? When does killing for a cause (war, unwanted pregnancy) become murder? How can black and white legislation deal with the multiplicity of greyness that is people’s lives and experiences and beliefs? So far, so appropriate.

But sad to say this book did little for me. Sorry, Jodi.
Stylistically it simply doesn’t work. It starts with the shooting and unravels back to the reason each person is in that building at that time. Had I cared about any of the characters I’d have been interested in their backstory; but they were either too unbelievable or two-dimensional. As it was, with each chapter giving snippets about each one, I struggled to hold their identities in my head.
I was more concerned with how far the shooter would go, but then, blow me, after all that effort to follow the threads, the ending falls very flat. Promising story lines are left in limbo.
The agenda glares through the narrative, both visible and contrived.
The cod psychology is both intrusive and pervasive.
Everyone philosophizes and juggles competing ideals and thoughts and wise reflections, makes profound statements, encapsulates deep existential ideas in succinct phrases – completely unbelievable … especially in a crisis like this!
So disappointing.

So why do I offer such a negative review? Because the experience reminds me of the burden on authors – myself included. My own next book has the potential to disappoint my readership. I’ve strayed outside my comfort zone with this story and just this week one of my critics has pointed out many flaws – even questioned the appropriateness of the genre!  It’s on hold at the moment, but in the new year I’m going to have to forensically dissect it and try to up my game.

Oh, and I dare to criticise Picoult on two counts. I’ve given her plenty of positive publicity in the past. And she’s rich and famous and confident enough not to be derailed by my humble opinion!!

 

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Living the dream

What a week I’ve had! OK, I may be confined to barracks post-surgery, strictly forbidden (by authoritative medical personnel no less) from all housework or exertion of any kind, having to keep my leg elevated day and night … but, bored? Not a bit! Frustrated? Nope. Secretly sorry for myself? Certainly not! I’m capitalising on the situation and achieving far more than I ever anticipated. And buzzing! Has to be good for the soul.

OK, I knew it was coming. Before surgery I accumulated the usual materials for sedentary occupations like knitting, reading, writing, DVDs, etc etc. What I hadn’t bargained on was a complete takeover bid!

It started as soon as I began to actually write the annual Christmas story/play I compose and direct for my grandchildren. As part of my research I began dipping in and out of my all-time favourite books … soon lost in memories and other lives, somewhere in my head my own quite distinctive characters from different strata of society and various times in history who form the core of the play.

Then it was time to start actually committing ideas to the computer.

I began tentatively, feeling my way gently, setting the scene, getting to know the principals, but suddenly one after another they assumed accents and speech patterns and habits of their own. And away we went! Enormous fun. All without the constraints of my other kind of writing (this story is for a very select and exclusive readership indeed; not a single literary critic or publisher’s delicate sensibilities to be factored in).

On the day of the play itself, the youngsters will bring their own personalities to the characters as they assume their roles, but afterwards, once it’s in book form, I want these people to live on the page. Their mannerisms, their language, their reactions, must convey so much. It’s proved both a welcome challenge and a runaway delight!

Then there’s the side effect of recuperation. Lots more thinking-time. Without all the usual time-consuming domestic responsibilities there’s more leisure to watch TV and read papers, and it’s astonishing how many programmes and articles impinge on my own fields of interest. Factual as well as fiction, they make me reflect, which has to be good for my mental state.

So, for example, there’s the news this week of a patient who’s been in a persistent vegetative state for 15 years, who has now had his vagus nerve stimulated to some effect, putting him into a minimally conscious state. Progress, you might think. Clever stuff. Could this be the start of new hope for many? But hey! Is it really better to be aware you can’t move or do anything spontaneously? Would I want such a thing for my husband/son/brother in his thirties? Does this influence my thinking on assisted dying?

Then there are the up-coming court cases. Victims of the contaminated blood scandal from the 1970s/80s have finally won a ruling allowing them to launch a High Court action. Imagine! Forty years of waiting! And they’re a long way from a resolution or compensation even now. Something in the region of two and a half thousand2,5000! – have already died. Whose fault is/was it? What are the pros and cons of a legal system that grinds so slowly? How could we deal more effectively with such a catastrophe in the future?

And what about the families devastated by the consequences of giving Sodium Vaproate to pregnant women. That too goes back decades and it’s left to the families to fight on for justice. My brain is throwing up questions and doubts right left and centre. Not necessarily for a book; just challenges about the morality of what’s done in the name of medicine.

Ahhh, back again comes that old chestnut, abortion. Irish girls have been coming to England and Scotland to have pregnancies terminated for decades. (I remember being troubled by the questions way back in 1960s when I was in clinical practice and saw it first hand.) This week it was announced that Ireland is to hold a referendum next year on whether to repeal its ban on abortion in almost all circumstances. Are the issues any different today? Could this have been resolved more appropriately? Should religion influence laws? Is a referendum the best way forward? And what about all the other forms of medical tourism …?

Inside of Me coverThe BBC2 programme aired a couple of days ago, Being Transgender, was billed as dealing with ‘one of the hot topics of the moment’. Well, that was my thinking when I published Inside of Me last year. But even though I’d immersed myself in the topic of gender and identity for a couple of years, I was still fascinated by these personal experiences, still wondering about the issues, but be warned, the footage of reassignment surgery in this case is pretty shocking.

So all in all the days are flying by faster than I feared they would. My mind is in overdrive. And I’m hoping to be ahead of the game when I return to normal functioning … God willing.

 

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A Place Called Winter

All except one of my trusted readers/critics have now given me their feedback on my latest book, Listen. Exciting times. But before I sit down for a serious edit, I’m immersing myself in some exquisite writing, beautiful language from the pen of a master, that will be a incentive to me to raise my own game – I hope!

The author? Patrick Gale. The book? A Place Called Winter. A sad, tender, compelling tale of Harry Cane’s battle with his own demons, the taboos of his day, and the wild wastelands of a new country. It’s an intensely personal novel inspired by a true story from Gale’s own family history: one gay man reaching out with sympathy and deep feeling to another (his mother’s grandfather) across a century of social change.

Harry Cane is born into privilege, raised to ‘believe that what mattered was to be unmistakably a gentleman’. He rides horses; others muck out their stables. His soft hands remain idle while callouses build up on the palms of his social inferiors. But his childhood is emotionally impoverished, with his mother dead and his father absent, schooldays punctuated by all the trials upper class boys can inflict on those they see as weaker prettier mortals. Consequently his life is centred on his younger brother Jack. It’s Jack who drags his shy insecure brother into society after their father’s death and introduces him to Winifred Wells, his future wife. Theirs is a gentle undemanding relationship which reluctantly produces one daughter before it settles into platonic coexistence.

The time is the early 1900s; apartheid is unchallenged; class distinctions rule; abortion and homosexuality are unlawful, the latter punishable by hard labour and utter disgrace; ‘treatment’ for psychiatric illness and ‘deviance’ is draconian. When his brother-in-law discovers Harry’s guilty secret, Harry – now an exiled ‘unmentionable‘ – signs up for a new start in a new country, Canada, one of 511 passengers on a ship sailing to the unknown.

The vast impossible prairies are simply waiting to be tamed, and after serving his year-and-a-day apprenticeship to a Danish farmer, Harry commits himself to converting 160 acres of wild wasteland into a self-sufficient thriving homestead within three years. Setting out with simply the map coordinates SW 23-43-25-W3, and directions to a place called Winter scribbled on the brown paper the cheese was wrapped in. An English innocent in a harsh unbroken landscape where there is ‘not much call for cash‘, and ‘neighbour is a relative term‘.

His closest neighbours are a brother and sister, Paul and Petra Slaymaker, whose lives become intimately entwined with his own. Beautiful relationships are established which are tested in the cauldron of  gossip, violence, war and illness. But their peace is threatened much more by the reappearance of a common enemy whose actions and knowledge cast a long shadow over their lives.

Gale’s writing is superb. His characters are beautifully realised, their emotions are captured with tenderness and palpable truth, and the abiding fear of loss, disgrace and exile haunts every hour of reading. Much as I revelled in the writing, though, I had a powerful feeling of desolation at times. Harry’s apologetic personality, his sad acceptance of the degrading things that happen to him, his gentle resilience, his innate decency even in the face of extreme provocation, stand in sharp contrast to the militance and ferocity of modern day campaigners for individual and collective rights. I wanted to reach out to him with compassion, understanding and reassurance.

But it’s a novel. I must instead give you a flavour of the lyrical prose:

… hot breakfast rolls as soft and pale as infancy.

… torn rags of sentences.

… they gave the impression of having emerged, fully formed, from eggs, as brittle as the waxy shells they had discarded.

There’s the heir and the spare and the heiress-beware.

A horse is ‘like a sofa with hooves‘.

‘Vaccinated by this cruel loss of his first daughter, he approached fatherhood the second time round with a certain reserve. He did not consciously harden his heart, but he loved with hands metaphorically behind his back.’

… war was declared in August, when harvest preparations were at their height. The news was sown swiftly, shaken from pulpits and scattered by posters and threshing gangs.’

I rarely give a book 5*s – this novel reminds me why. It wholeheartedly merits them. Highly recommended.

*****

 

 

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