Podcast: Challenges facing Christian healthcare workers

This article is part of the Affinity Talks Gospel Podcast series.

In this episode of Affinity Talks Gospel, we discuss with Steve Fouch from the Christian Medical Fellowship (CMF) how to empower health professionals to advocate for Jesus Christ, highlighting ethics, technology, and support.

Host Graham Nicholls is joined by Steve Fouch, Head of Communications at CMF, and they discuss the organisation’s mission to equip health professionals to live and speak for Jesus Christ. We delve into the changing landscape of faith in the medical field over the years, ethical challenges faced by medical professionals, the impact of advanced medical technologies on decision-making, and the need for support and pastoral care for healthcare workers facing high-pressure environments. We touch on the importance of community support and prayer for health professionals in churches, emphasising the significance of individuals being witnesses for Christ in their workplace. The conversation highlights the complexities of modern healthcare, the demands on medical professionals, and the importance of understanding and supporting them in their roles.

Find out more about Christian Medical Fellowship on their website: www.cmf.org.uk

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Topics addressed in this Podcast:

• History and Purpose of Christian Medical Fellowship
• Living on the Margins as Christians
• Challenges and Persecution in the Early Church
• Role of Christian Medical Fellowship vs. Local Churches
• Ethical Challenges in the Medical Profession
• Research and Resources Produced by CMF
• Pressures Facing Health Professionals
• The Medicalisation of Problems and Ethical Questions
• Litigation and Media Pressure on Medical Professionals
• Supporting Medical Professionals in Churches
• Emphasising the Mission Field in Everyday Work

Transcript

[0:00] Music.

[0:11] Hello and welcome to Affinity Talks Gospel a podcast talking to various members of Affinity about how they’re seeking to live the gospel and to spread the gospel and to serve the church in various areas of church life and public life public policy mission abroad all the different things that our various agencies are doing and today it’s my pleasure to welcome Stephen Fouch who is working for Christian Medical Fellowship.
What is your job for them, Stephen?
I go with the wonderful title of Head of Communications, which covers a multitude of sins.
All right. So you should be a really good communicator then. I do my best. I do my best.
So tell me about the Christian Medical Fellowship. What do they do?
So Christian Medical Fellowship’s a network for about 5,000 members.

[1:08] We’re a mixture of doctors, nurses, midwives and students of all three and a few others who are sort of interested in what we’re doing or from other health professions that don’t have a home to go to as it were um so we’re we’re a mixture of those those people together and our primary aim is uh, to unite and equip those health professionals to live and speak for Jesus Christ that’s what we’re here to do and we’ve been around for 75 years um so we’re you know we’ve been on the block for a little while um and that’s what we do we do everything from conferences and seminars books.

[1:49] Uh websites magazines and journals local networks local prayer groups in hospitals and other workplaces and all sorts of stuff as well yeah do you think uh is changed obviously you weren’t around um when it started do you think the role has changed since it kind of kicked off yeah it It has.
I suppose when CMF started back in 1949, it might be a bit unfair to typify this, but you could describe it as the British Medical Association of Prayer.
It was very much part of the mainstream of British life really.
I think faith was not something that was relegated to the margins even in the 1940s and 50s.
So to be Christian, to be in a senior role as a doctor, and it was just doctors in those days, not even medical students.
It was very much part of the mainstream. Now I’d say we were working much more on the margins.

[2:51] You know, Christian faith is, it’s there, and just about tolerated, but it has to be kept within very, very tight boundaries to be acceptable within the professions, to be within the NHS.
And I guess that’s the reality. reality we’re all living with as Christians that we’ve seen that shift in culture over the last 50 60 years uh to a much more secular way of thinking and a much more secular culture where we’re we’re not part of the establishment and despite the fact that we appear to be um we are actually more and more part of the a marginal community yeah yeah and it’s a real challenge isn’t it to work out how how to live in that way in a way that recognises we’re not the dominant culture.

[3:40] But that doesn’t sort of abandon that and just kind of go into the bunker and say, well, because we’re a minority culture, we just need to sort of hunker down and don’t be an influence for good and don’t speak the gospel.
So I think that’s the danger, how to navigate.
That’s one of the joys of reading the New Testament. I’ve been borrowing back into, In fact, I was just looking into yesterday in the Beatitudes in Matthew 5, where Jesus says, you know, blessed are you, you’re persecuted and vilified for speaking in my name.
And then you start following through all the parallel passages and you find pretty much the whole of the New Testament is speaking into a situation where Jesus’ followers are always going to be on the margins.

[4:26] And actually, that’s where the New Testament is written from.
On. So actually we’ve got a template there that shows us already, this is normal territory for Christians.
Being part of the mainstream in the establishment is a bit of a…

[4:39] Um what’s the word it was a bit of an odd situation whereas for most Christians around the world for most of history it’s been the other way around and it’s and we’re kind of back into the Christian mainstream as it were yeah yeah no definitely uh yeah it just happens just sharing stories of yesterday but we uh in our church preaching through acts and we happen to have got acts uh seven uh or is it six can’t remember anyway it’s the one where Stephen is.

[5:07] Martyred chapter six i think and then chapter seven basically the church persecuted and spreads out to Samaria so basically you get the first martyr you get the appearance of saul who’s going to do lots of bad stuff before he becomes paul and gets converted you get a persecution which means that the loads of Christians spread out from Jerusalem um but the consequence is uh lots of people hear the gospel and uh there’s great joy in Samaria you know and so on but it all it it all is birthed out of persecution.
It wasn’t probably quite the way the apostles expected the gospel to go out or the early church.

[5:43] You know, they were scattered by partly in fear of their lives and so on.
So yeah, persecution is definitely the norm. Going back to CMF, Christian Medical Fellowship, what, why, you said sort of what it does, but why does it exist compared to just local churches doing stuff? Why is it even needed?
Absolutely. I mean, I think, First and foremost, the church is the real focus for all fellowship and all teaching and ministry, but there’s a dimension.

[6:15] That particularly if you’re in a profession medicine nursing with two examples but there are others where you’re up against some particular challenges day to day that are going to be outside of the scope of the teaching and the pastoral ministry of your local church yeah i mean it’s not fair that you know your average minister has to be an expert in bioethics and professional ethics, and all of these other questions, and being able to think critically about them as a Christian.
That’s something we have the luxury of being able to do. We’ve got the people with the time, the skills, the knowledge, the training to start doing that work and actually helping our members to do that.
So it’s that living out your faith in your place of work and actually thinking through those issues.
And of course, when you’re dealing with life and death stuff as you do in the health professions and when you’re dealing with stuff at the extremes of human experience not just life and death but also you know dealing with grief and bereavement dealing with severe disability we’re dealing with mental health crises um you need to be able to with what well how do i how do i deal with this as a christian because they throw up for you yeah um And I think it’s something that ministers will all want to support and care for their parishioners with, but there are dimensions of it that are just…

[7:45] Way outside of the lived experience of your average pastoral person in your average church.
And that’s just something that we can bring an extra dimension to help support

[7:56] that day-to-day pastoral ministry and teaching ministry.
Yeah, that’s really helpful. What do you think are the ethical challenges that are sort of not unique but particular to medical professionals?
We’re going to talk about the personal challenges in a minute, but kind of the ethical ones where expertise is helpful.
Well, yeah, I mean, I think the range of them has extended massively.
I mean, the classical ones that most people will think of will be abortion and euthanasia.
These are the ones that crop up quite regularly in discussions and people would assume that to be the top headline ones.
And they’re certainly ones that we grapple with and have grappled with for many, many years.
But medical technology galloping away and doing things that we didn’t even think of a generation ago, even five, 10 years ago.
We are now at the bleeding edge of some technologies that are way outside of anybody’s experience.

[9:03] I mean, a very simple ethical dilemma that’s cropped up quite a bit for quite a lot of members, there are now a variety of supported respiration technologies for people who have had severe injuries that are designed to take the place of the heart and lungs on a short-term basis whilst the body recovers from a serious injury.
But the problem is sometimes with severe brain damage.

[9:31] The normal functions are just not going to come back. But then you’ve got someone being sustained on an artificial life support system that’s not really designed to do long-term artificial life support.
You turn it off and end that person’s life.
Is that person really dead already and all you’re doing is artificially extending their life? Those are real questions.

[9:58] And the more sort of cutting edge technology and that’s that’s not cutting edge technology and that’s been around for a while but that raises regular questions then you go on to something like um the crisper cast 9 technology that can edit genes yes now that’s life-saving i have my wife has a cousin who has um um cystic fibrosis yes and she wasn’t expected to live past her 20s or she made it into were early 40s but she had like 16 function she could barely do anything there’s a new gene technology that replaces the faulty gene it’s just an in her in an infusion that comes comes in and actually replaces that faulty gene in the cells in her lungs she now has 100 lung function back and is living her life the life that she never expected she would have yeah um it’s transformative Now, that’s fantastic, but that technology could also be used not just to save life and restore quality of life to people who’ve had it taken away, but what about if we then use it to enhance intelligence or athletic ability?
When does the line between treatment and care and enhancement…

[11:17] Get crossed? And when do we start saying, hang on, is that really what this technology should be used for?
Now, those are wider ethical questions, but they’re ones that as Christians, we’re going to ask, well, what are we designed to be as human beings?
And how do we deal with the question about disability and chronic illness that are inherited or that are acquired through the environment that we live in?
And treatments that can stop that and treat that, that’s fantastic but then perhaps can enhance us and make us more you know is that right is that wrong is that good is that bad is it neutral and we’ve got to grapple with those sorts of questions and those technologies are appearing more and more rapidly yeah now i’m feeling kind of i’m getting tense actually even thinking about all the complexity of it all thinking i want to know the answer to all of those questions um and so yeah i mean at a trivial level but not trivial for the people involved but uh someone asked a question last night at a seminar that’s going on at our church.

[12:18] To do with the morning after pill and uh i don’t think anyone in the room had the expertise to figure out is this a contraceptive or is this an abortion uh uh drug and that’s um yeah that’s a good example of where you need someone in the room who’s got that kind of expertise who can at least give you the information and then you can make the moral judgment about it exactly i mean that’s an example of something that sits in ethically grey territory because it stops implantation of a fertilised egg.
So therefore, you’ve got to get your theology right from the start. Is.

[12:55] The moment that life begins, the moment of fertilisation, is at the moment of when that blastocyst, that ball of cells, implants on the wall of the womb and starts to grow.

[13:10] And that may sound like a straightforward question and people will easily go, oh well, it’s obvious. The answer is obvious. Well, it’s not.
What do you do with the fact that the vast majority of those fertilised blastocysts never implant at all?
Are they you know so naturally the wastage is actually very very high yeah so how do you does that only some of them actually where life begins and others don’t you know so those all those questions you’ve got to wrestle with it is not it’s not a straightforward answer and there will be different opinions about uh about that and about how you handle that yes well i can see that that um i suppose my instinct is to think you’ve got to start somewhere so i suppose the fertilized egg is where you where you start with the beginning of life and um and and a pill is an intervention which sure loads of them may die anyway but this is one that you’ve intervened to stop it getting there um in that kind of theoretical case that there’s one there’s one on its journey and yeah he’ll kind of zaps it and sends it off it’s our and i think the question you really have to ask in the end.
Is our intervention stopping that would in the normal order of things happen, and therefore are we also then contravening God’s purposes in the process?

[14:27] And your process with grappling with all these issues, presumably you have conferences and produce papers and blogs and videos and stuff on it? Yeah.

[14:39] We have a group that’s been going pretty much for 75 years called the Medical study group, which is a mixture of doctors, ethicists, bioethicists, some of whom are doctors, some of whom are not, theologians, some church pastors, some of whom also happen to be two or three of the other types of thing as well.

[15:05] At least one Christian lawyer with a medico-legal background and others.
And we meet three times a year.
And grapple with these issues. What are the big that are out there?

[15:20] What’s the things on the horizon that we need to deal with? We have people who come to us and say, well, I’ve been working in this area.
I want to write a paper on this particular issue.
And then we actually go through pretty rough and ready. No, rough and ready is not the right word.
Robust peer review process process of, right, are the bioethics of this sound, is the theology of this, are the medico-legal aspects of it sound?
And then we produce a paper or we sometimes do podcasts or some other resource and sometimes books as well out of discussing all of those issues.
So we’ve got a number in progress at the moment from a revamped one looking at the origins origins of bioethics to another one organ transplantation to um we’ve done one recently on.

[16:13] Assisted um conception technology so you know in vitro fertilization and the whole industry around assisted conception um we’ve got uh stuff we’ve done perhaps quite still quite topically uh one on COVID vaccines, or vaccines in general, and how Christians have responded to vaccines, COVID vaccines being the most recent example of that, but sort of looking back over 150, 200 years worth of debate about how we should respond to these sorts of things. So we have all of that.
And so we have a review process, a writing process, and a production of other resources as we go along.
And are those available for ordinary people? Or do they seem to be- All on our website, yeah. Brilliant. Okay.

[17:03] I was going to ask you at the end, but I’ll ask you now. What is your website?
Cmf.org.uk. Brilliant. Got the same ending as ours. Must be a good thing.

[17:13] So, yeah, brilliant. What are the pressures at more of a sort of emotional, practical level that are facing health professionals? Yeah.
And I think this is something that’s been growing for a while, but I think COVID and the aftermath of COVID have really sharpened it.
The challenge is that the demand.

[17:37] Is outstripping supply. I suppose that’s in a very basic economics language.
In other words, there’s more need than we have the resources to meet.
And by resources, I don’t just mean money or hospital beds, although those are definitely in short supply, but I also mean trained and experienced staff who are also increasingly in short supply. July.
We’re running at between 10% and 15% vacancies on key posts across the NHS and have been for many, many years.
It’s not a new phenomenon. It’s got somewhat worse in the last four years or so, and it’s not just because of the natural turnover.
We’ve got a lot of staff leaving and going into early retirement or leaving the professions altogether together because of stress and burnout.
And of course, that then exacerbates the problem for the people who are left behind who are then also likely to leave. But we’re also losing a lot of very experienced people.
That’s particularly true in nursing and midwifery, but it is true in medicine too.
So again, the handover, those skills that are acquired by years and years and years of working with patients with the same problems and really, really knowing what we’re doing.

[18:55] And being able to deal with all sorts of unusual circumstances because you would have seen it before because you have dealt with it so many, many times.
Those people with those skill sets are leaving more rapidly than…

[19:10] You would normally expect. And that means that you’re not just losing people, you’re losing knowledge, you’re losing skills, you can’t replace overnight.
Yeah. So that puts a pressure on. Are there other sort of factors that are feeding into that as well?

[19:27] More complicated technologies or more distressed people, maybe poor attitudes? I don’t know.
It’s a complex picture. One side of it is, I think we all kind of expect more from our health service now than we might have done back in the 1940s and 50s.
We’re living longer, which is one of the benefits of the health service, although it’s not all just down to the health service.
But we’re longer with more complex and chronic health problems.
So you may be living into your late 70s to mid 80s more readily than people a generation ago would have done.
But you will probably spend those last 10, 20 years of your life with more chronic, and accelerating health problems that requires drugs, surgery, special adaptations around your house, social support, social care, all of those sorts of things.
That demand is going up and up and up and up.
But also our expectation that somehow or other there’s a pill to solve every problem has got stronger and stronger because we have cures for more and more conditions.

[20:42] The question is, is a medicalised response to all of our problems, including mental health issues, but also physical health issues, the best way to deal with it?

[20:53] We medicalise everything from.

[20:58] Male pattern baldness is now seen as a medical condition. So somebody with as shiny a pate as me could go and get medical treatments that will restore hair or replace hair and everything else.
Do I need that on the NHS? We talked about assisted conception.
It’s a very real need for people who want to have a family, but actually it doesn’t work for everybody.
In fact, for the vast majority of people it’s pretty ineffective but it’s very expensive yeah is that where all of our resource should go there are new treatments that can extend the life of people with serious health problems certain types of cancers and everything else but extend them by weeks or months, not years or decades yeah do is that the best way of using a resource and that’s a very tricky tricky question to answer because if you’re the person who might say, but if I can have this treatment that’s going to cost, but it will give me an extra six months and I can see my daughter’s wedding.
Yeah, actually that is well worth spending for you, but for the NHS and they say, but yes, but that could go to be treating hundreds of other people with other problems that will be less expensive and have longer term benefits.
So those are all the big economic social questions that you’re struggling with all the time.

[22:22] I can see that, yeah, definitely. So that’s one aspect of it.
I think the other aspect is, how should I put this? NHS workplace culture. It’s not…
You would think…

[22:40] That where everybody who’s working is working for the welfare and the wellbeing of others, that the culture that you work in, the way you’re looked after by your colleagues, your superiors, the way you’re trained and treated, the people management, human resources would be very much more caring and supportive.
The reality is it’s not. It’s quite brutal. The workplaces arm and teams tend to function more in a blame focused and sometimes quite bullying way of managing and and it comes from the top down it you know you you you kick the people below you and they kick the people below them and they kick them you know it just tends to to work its way down that way um it and it’s kind of the culture that everybody comes into and the consequences is that you get very demoralised staff, you get very stressed and broken people doing care and trying to go the extra mile and trying to be caring towards their patients, but not getting the care and support from their superiors.
Now, I say that as a generalisation.

[23:53] There are exceptions. There are units that function very well.
I’ve got friends and family who work within certain parts of the NHS where the pastoral care and support has been fantastic, but the workplace pressures are huge and you need good care and support to do that.
But in other places where they’re just as huge, it’s not there and those people are burning out and just quitting left, right and centre.
So that is another aspect of it. We started a pastoral care ministry a while back because we felt perhaps there was a need, particularly because some of the issues that people come up against are really quite complex and difficult.
There might be times when someone else who’s a health professional would be the best person to talk with you and pray with you about a question.

[24:44] To begin with, when we first started setting this up in 2018-2019, we were getting loads of people volunteering.
People wanted to be pastoral carers. That was fantastic. We’ve got a really strong team and good patterns and protocols and everything else to work with.
What we didn’t quite expect, first of all, was COVID.
The pressures that put everyone under.
But actually how it’s grown over time, the pastoral ministry is huge now.
And we run pastoral care drop-ins and book-in sessions at all of our conferences, and they are booked solid. solid.
And we, our teams are constant, our pastoral care team is in constant demand because.

[25:32] People are facing these sorts of issues in the workplace i said the local church can deal with a lot of this but there’s a lot of it that they that people just need someone who understands, their context better yeah to pray through with them as well and where the demand has just gone through the roof yeah now i can understand that i can understand all those pressures um i can understand probably it’s not just as the public we have expectations that that medical people should solve all our problems i think we’re just a bit more of a litigant kind of culture so i think if you’re if you’re giving out care you’ve always got in the back of your mind maybe i’ll i’ll be on some radio 5 phone in in a few days time because i’ve made a mistake and people are complaining i’m i’m the top news item and everybody’s talking about me um you know stories do just explode.

[26:25] Absolutely and that is true so it is um you know because there was a and i’ve still probably got out of an age where i’ve got it sometimes and i have to kind of overcome whether it was a silly kind of deference to doctors which silly in the sense that it kind of um it it puts too much weight on their shoulders to solve all your problems or to understand everything and i i think we’ve in a good way we’ve moved to a more um collaborative approach with with a doctor well where say well let me try and help you we’re trying to explain my symptoms i’ve got these thoughts about it and you know let’s listen to but i think that can then roll over to a you should serve me you didn’t give me the right advice um yeah i remember my my father this is an old story my father’s passed away now quite a while ago but he a doctor didn’t notice something in his eye to do with his diabetes he lost his sight the doctor had kind of made a brief note note of it, but didn’t kind of go forward with it.

[27:20] I just think today probably make much more of a fuss, and maybe that’s right, but maybe it went a bit too you know, eager to sort of try and blame somebody and not accept people that make mistakes they can be um really negligent and and needs dealt with but sometimes they’re just genuine mistakes where they don’t quite value something correctly and and doctors are all the time trying to work out you know that that lump is that is that serious is it not um i send them for a scan shall i not and they’re all value judgments um and we don’t want to be blaming everybody every time they They make a value judgment, which turns out to be not right.
Well, absolutely. And, you know, doctors are human and they make mistakes.
I think also one of the big issues is when you are short-staffed and you’re having to sort of deal with twice the turnover of patients.
If you’re a GP and you’ve literally got five minutes per patient, you know and all of these other things these things do get missed these things will get dropped and um yes the fear of litigation does affect a lot of people i have to admit uh and we are we’re not as bad as the states but we’re moving in that direction and.

[28:42] Yeah it’s very consumerist culture and health care has become very consumerist i mean we know that’s true that that’s a thing that churches struggle with yeah you know people shop around for churches now instead of seeing it as a part of yeah it’s the same you know this is one of the big.

[29:02] That we’ve in the west now yeah yeah and we’ve got trial by media as well by all the media which is is a form of litigation it’s a yes it’s a crueler even less it’s more of it’s more like the wild west really um yeah there’s no sort of there’s no sort of legal process of litigation it’s just it’s just a kind of um demoralizing um uh slanderous kind of process at times it’s kind of a mob rule type of yeah things more brutal yeah um just as a as a last question which yeah a big question but maybe we can do it briefly uh as much i can understand how we could pray CMF but how could um anyone listening to this pray and support medical professionals in their churches.

[29:46] Well i think the first thing to do is just ask the health professionals themselves what can we do because it’ll be different for everybody.
Some people will be facing one set of challenges and one group will be…
Another individual will be something else. Somebody might be, actually, you know what?
I love my work and it’s going great. Just pray that it continues that way.
And somebody else may be struggling just to keep their head above water and seriously wondering whether they should be leaving the profession altogether and doing something else. And there’ll be everything in between.
So I think that’s one thing, is just stop and ask and listen.
And that’s something you don’t have to be a pastor, you don’t have to be a church leader to do, anybody can do if they’re in your home group.
One of the biggest problems, and this particularly affects junior doctors and nurses and midwives, is shift patterns.

[30:40] They’re not often there in church on a Sunday morning or at home group midweek um so don’t be afraid to pick up the phone to people and say hi i know you’ve been working hard i haven’t seen you for a little while is everything all right anything we can pray for you um it’s just remembering just because you haven’t seen them around doesn’t mean that they’ve they’re wavering in their faith or they’ve gone off to another church or something like that that you know 90 of the time it will just be because work has kept them away way.
And they actually need that pastoral connection.
They need that sense of community and being part of a praying community more than anything.
So do pick up the phone if you haven’t seen someone for a little while.
Keep your eyes and ears open.
But that would be the first thing I’d say.
And yeah, I mean, I think, And I guess this is something that goes, it’s not just for health professionals, it’s for everybody.
It’s just remembering that people’s primary area of ministry outside of Sunday mornings, for most people, is their place of work, or their place of study. And.

[31:50] Let’s see how we commission and encourage people to do that.
I think that should be one of the great things that we can do as churches is say, I remember my church used to have a banner over the door on the way out, not coming in, but on the way out saying, you are now entering a mission field.
You walk outside the doors of this church and into your everyday life, that’s your mission field. That’s the mission field that God has given you.
You may not be a great evangelist, that’s fine but you are a witness wherever you are you are the presence and the aroma of Christ wherever you are so let’s see how we can encourage people and i mean that about teachers and dustbin collect you know dustman and whatever you are you are the aroma of Christ wherever you go so how do we as churches just say guys we’re with you we’re commissioning you to go out and do that the only you can do day to day because that’s where, Christ meets the world in you and you are.

[33:01] Being his body and his hands his feet his mouth to that world where he has put you, that is your mission field how do we support you to do that and i think that’s so that’s not just for health professionals as i said that’s for everybody but i think that’s something that as a church we can really really do um that’s where the kingdom of god starts breaking in that’s where we see people being saved.
That’s where we see workplaces being transformed because Christians are being salt and light.
That’s what we want to see. We want to see God breaking in in those sorts of ways. Yeah, man, brilliant.

[33:43] There’s a great series from London Institute of Contemporary Christianity called

[33:48] Fruitfulness on the Frontline, which emphasises that.
There are previous courses he’s done along similar lines but they’ve been really helpful to this i think in in in saying what what we would say and say we believe but sometimes as leaders uh particularly we need reminding of that because we’re into church as an organization um and for good reasons but we know in principle people are going to work and we know in principle that they’re there to be witnesses there but sometimes we we we just forget uh in practice and speak as though the is all that matters and it’s not it’s not just the gathering and the church related outreach activities it’s all those individual um as you say sort of like so yeah brilliant absolutely um we’ll have to bring things to a close but thank you so much uh for being a guest for us today and it’s christian medical fellowship cmf cmf.org.uk for more information and do uh do pray for these guys the great work that they’re doing. Thank you. Thank you, Graeme.

[34:48] Music.

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[35:29] Music.