Catholic Medical Quarterly Volume 68(1) February 2018
Faith in Medicine
Conscience: lessons from history, scripture and fiction
Dr Dermot Kearney FRCP.
In the movie Silence, released in the UK in January 2017, director Martin Scorsese explores the issues of religious belief, conscience, state oppression of religious practice, the personal and social consequences of defying secular authority and apostasy. The film is based on an earlier novel of the same name from 1966 by Japanese author Shusaku Endo. Like Scorsese, Endo was also a baptised Catholic.
The story is set in the area around Nagasaki in Japan in the early 17th century, a time of brutal persecution of Christians in Japan. At various stages from the 1620s onwards the Japanese people were required to renounce Christianity. They could prove that they were not followers of Christ by performing a simple act of renunciation whereby they were obliged to trample upon a carved image (the fumie) of Christ or The Blessed Virgin Mary. The act was performed in public before governing officials. In some cases, the civilian under suspicion was only required to lightly step on the image to obey the edict. The authorities had learned that the best way to stop the spread of Christianity and suppress the alien religion was to encourage apostasy. This was attempted through the widespread introduction of brutal methods of torture and execution including prolonged methods of suffocation, crucifixion, scalding and burning at the stake.
In Silence, the story focuses on the personal agony of a Jesuit priest who initially refuses to apostasise as he is prepared to suffer and die for his faith. He is forced, however, to reconsider when he learns that others are being mercilessly tortured because of his obstinacy.
While Silence is a work of fiction it is based on well-documented historical facts. Some of the original fumie images, in stone and wood, have survived. We commemorate the martyrdom of thousands of Japanese Christians on 6th February, the feast day of St Paul Miki and companions. The penalty for Christians refusing to renounce their faith was a cruel and prolonged death. The reward for apostasy, for a simple stepping-stone procedure, was a pardon and the sparing of earthly life.
The persecution of Christians, of course, did not begin in seventeenth century Japan. In the early years of Christianity there were sporadic, state-sanctioned efforts to suppress the new religious sect by the mighty Roman Empire. Christians were considered a threat to society as their loyalty to the state was in doubt and they would not conform to some traditional Roman pagan practices or uphold some traditional Roman pagan values. As a test of loyalty to the state, citizens were sometimes required to offer sacrifice to the Roman gods or declare their belief in the deity of the Emperor. In some cases, this could simply mean an offering of one or two grains of incense to the pagan gods. Christians who wished to remain faithful to Christ could not co-operate with such requirements. Conscientious objection, however, was not an option open to them. The calendar of Saints recognises the ultimate sacrifice and martyrdom suffered by many of these early Christians such as St Agnes, Saints Perpetua and Felicity and Pope St Sixtus II and companions. Their stories relate how they suffered and died rather than renounce their faith. Their lives would have been spared by obeying the law and carrying out relatively simple pagan acts ordered by the state.
In the Old Testament, God’s chosen people, in several eras, were subject to conquest and persecution by a variety of worldly powers. In the second book of Maccabees, during the period of Greek domination and suppression of Judaism, one of the great stories of faith and courage in scripture is recounted. We read that “seven brothers and their mother were arrested and were being compelled by the king [Antiochus], under torture with whips and cords, to partake of unlawful swines’ flesh”. They could have demonstrated their loyalty to the new rule of law and renounced their Judaic traditions by simply eating pork. After the first six brothers had been brutally tortured and executed the youngest brother was strongly advised to avoid the folly of his siblings. “Antiochus not only appealed to him in words, but promised with oaths that he would make him rich and enviable if he would turn from the ways of his fathers, and that he would take him for his friend and entrust him with public affairs.” The values and delights of the world can be alluring and persuasive. It is written that the young man, however, ignored the promises of the king after consulting with his mother and bravely proclaimed “What are you waiting for? I will not obey the king’s command, but I obey the commands of the law that was given to our fathers through Moses…”
After informing the king of the eternal punishment that lay ahead for him, this youngest brother was rewarded with a death even more cruel than that endured by his older brothers and “he died in his integrity, putting his whole trust in the Lord” (2 Maccabees, chapter 7).
There are many examples of attempts to persuade recusant Catholics to renounce the “Old Faith” and accept the new Anglican version of Protestantism in Elizabethan England. Catholics could avoid harsh penalties and demonstrate their allegiance to the new cult by attending Anglican services. Some, perhaps most famously St Margaret Clitherow, suffered cruel deaths for the more serious offence of harbouring Catholic priests when they could have saved their lives by publicly abandoning their Catholic faith. St Margaret was crushed to death with a large sharp stone strategically positioned under her back to ensure excruciating pain at York on Good Friday 1586. It is alleged that she was visited by several Protestant ministers in her final days with offers that she could receive a full pardon and freedom if she would only renounce the Catholic faith and embrace Protestantism. She was a convert to Catholicism while her husband had remained a member of the Established Anglican church. She declined the offers to renounce her faith and suffered a martyr’s death.
In the highly-acclaimed, modern fiction series I am Margaret, author Corinna Turner presents a futuristic society in which all religious belief is banned. To be discovered to be a believer carries a mandatory death sentence with execution by the barbaric method of dismantlement. For ministers of religion and those found guilty of spreading “superstition” to others execution by Conscious Dismantlement is particularly horrific – a futuristic version of practices already known to us from history in the cruel executions by hanging, drawing and quartering and also by the death of a thousand cuts. In Turner’s world, the condemned can save themselves and avoid such horrific treatment by the Divine Denial, simply declaring “There Is No God.”
It is not only Christians who have suffered and died for their faith through the ages. To our shame, we must accept that Christians, including Catholics, have been responsible for the torture and death of Jews, Moors and others who haven’t shared our beliefs. Forced conversion has occurred. As in the Maccabees story this “conversion” to Christianity could be demonstrated by simple acts such as the eating of pork or by simple attendance at religious services.
Fortunately such abuse of power by Catholics does not seem to occur today. Christians, on the other hand, continue to be persecuted for their beliefs in many parts of the world, perhaps most notably in recent times by Islamist forces in northern Iraq and Syria. There have been many substantiated reports of torture and execution of Christians and other minorities for refusing to convert to Islam. In some cases, where death has been avoided, survivors have had all possessions confiscated while others have been subjected to the re-introduction of the unjust Jizya tax. This is a payment by non-muslims to muslim rulers allowing them to remain alive, allegedly under protection, in a muslim-controlled society.
The lesson to be learned from these examples from history, scripture and fiction is that people, in all ages, have been cruelly treated for trying to practice their deeply-held and legitimate religious beliefs. Attempts are made to force others, sometimes by extreme cruelty and bullying, sometimes by more subtle, even seemingly benign and gentle gestures, into renouncing their faith and into acting in ways contrary to conscience.
There are situations facing healthcare workers today where they are pressurised to participate in practices that are contrary to their religious beliefs and where failure to do so can result in various penalties and punishments. Sometimes the pressure exerted on personnel to be complicit in morally illicit activities can be overwhelming. Sometimes this pressure is of a psychological nature; sometimes it takes the form of outright bullying with threats of grave punitive sanctions. Junior doctors expected to prescribe contraception or pharmacological agents used in the induction of abortions are told “you only have to write the prescription, you don’t actually have to give the drug…” Pharmacists are pressurised into making direct arrangements for clients requesting “emergency oral contraception” to ensure that the drug is administered to them in a timely and convenient fashion. In some cases they are bullied to actually personally dispense the drugs. Failure to comply can result in dismissal. Medical secretaries are bullied into typing referral letters for abortion under a similar threat that they will lose their job if they refuse to do so. Nurses are pressurised into assisting at sterilisation and abortion procedures even though they request to be excused from such participation by a process of “reasonable accommodation”. Doctors who wish to pursue careers in reproductive and maternal care are told that they cannot continue in this profession “in this country” if they will not participate in abortion, contraception and IVF provision.
There can be little doubt that people of faith, especially Catholics, are still being asked to renounce their faith or else suffer the consequences in the UK in the 21st century. There is a very close analogy between Catholics capitulating to the demands of secular authority and participating in activities contrary to Church teaching and Catholics who agreed to reject Christ and step on the fumie in seventeenth century Japan. Complicity with abortion, contraception provision, euthanasia and assisted suicide, for example, can be regarded as the fumie of today. If Catholics are seen to be willing, for whatever reason, to participate in practices that are contrary to the teachings of Christ and His Church it sends out a very powerful signal to others. Many may be influenced adversely by such scandal. Many souls are at risk of being lost. A courageous and stubborn refusal to be complicit with evil is vital for the salvation of many souls, not least our own.
In Matthew’s Gospel (chapter 10) Jesus addressed the twelve apostles with the following words: “Do not be afraid of those who kill the body but cannot kill the soul; fear him rather who can destroy both body and soul in hell.” He goes on to give encouragement but also a warning. “So if anyone declares himself for me in the presence of men, I will declare myself for him in the presence of my Father in heaven. But the one who disowns me in the presence of men, I will disown in the presence of my Father in Heaven.”
Those who try to enforce compliance with regulations contradicting the teachings of Christ are at risk of placing themselves in a very precarious position comparable to the position held by Roman emperors and seventeenth century Japanese magistrates, King Antiochus and many other despots throughout the ages. How about those who, for whatever reason, feel they must comply with unjust and immoral laws for the sake of retaining a job or some other social standing and, in doing so, collaborate with injustice? The warning from Our Lord seems very clear for those who would deny Him “in the presence of men”.
The question arises as to whether or not Catholics or other conscientious objectors should be allowed to deny services that are legal and sanctioned by the state to others. On the other hand, should Catholics be forced to act against their conscience and run the risk of losing their souls to satisfy the wishes of those who don’t share their faith? Do practising Catholics now represent a danger to modern society as had been formerly perceived in ancient Rome or seventeenth century Japan? If the answers to these questions falls on the side of denying healthcare workers the right to practice their profession in full conformity with their conscience and with the established teachings of their religion it implies that there is no role for Catholics and others with conscientious concerns in many aspects of medicine, nursing and pharmacy. There are many who would welcome the removal of Catholicism from all aspects of public life and service. Would this be fair to members of the public who specifically wish to be served and attended by personnel who share their own values and beliefs? The exclusion of Catholics or other Faith groups from some areas of public service would be a blatant attack on the whole notion of Equality and Diversity, one of the sacred cows of modern secular society. There are no simple answers that will satisfy everyone but these are questions that will need to addressed by our society for many years to come.