The threat of old age

What is the disease from which 30 million people suffer worldwide, and will increase to 130 million by 2050? In Britain, the number of sufferers will be around two million. No one fully understands the details of this disease, and there is no cure. It is an immensely costly disease for the state, and for the families of sufferers. In one case known to me, the out-of-pocket costs to the family were £300,000. Despite the lack of knowledge and the immense cost, research into alleviation is substantially underfunded compared with cancer and heart conditions. And, by the way, one in six of those over 80 will get it. That means you, unless you cheat by dying earlier.

I am referring to dementia, and in particular, Alzheimer’s. But it doesn’t really matter, does it? These are ancient people who have had their lives and are now reduced to gibbering idiocy through living too long. Once we have shuffled them into a care home all we need do is make an occasional visit (they probably won’t recognise us) and hope that they snuff it before their life savings run out. I am being harsh, but how long ago did you badger your MP to fight for the funding of more research, and an alleviation of crippling costs?

I am not qualified to write technically, but in elementary terms there is, in Alzheimer’s, a protein called amyloid-β which clumps together to form sticky plaques in the brain. There is also tau, a protein which causes tangles in the brain. The result is neuroinflammation and disaster. Even mild dementia can kill brain cells. They will never be restored. You will get some idea of the clinical difficulties when you learn that more than 200 clinical trials for Alzheimer’s therapies have been binned because the treatments proved ineffective. And no existing treatment addresses the underlying disease process.

Another area of research is to find ways of staving off the start of Alzheimer’s. Even pushing back its onset for a few years would be of great benefit to the individual and a substantial saving in the necessary care which both the state and the individual contribute. Studies based on drug treatment before the problems start are in action but, as I write, there are no conclusive results, either of efficacy or alleviation – and there may not be. The latest (and large) study failed in its final trials.

Although Alzheimer’s can, in exceptional cases, start as early as the 40s, many readers will see its onset only as a remote threat. But they may well have older relatives who are vulnerable. Until a cure or substantial alleviation has been found, the prospect is not inviting. But the first step is to have adequate powers of attorney: sufferers can no longer make their own decisions. Then the costs of nursing care must be considered – and they are considerable.

Anyone who has assets, including the value of their house, which exceed £23,250 must pay for their care. The average cost of care homes with nursing varies from £631 per week in the North East to £920 per week in the South East. Multiply by 52 and you’ll know how many years your relative will dare to survive. Take charitable consolation from the possibility that part of those fees may be being used to subsidise the low fees paid by local councils for the indigent patient in the next bed.

Oh wait, I must have got that wrong. The last Conservative manifesto undertook to cap care home fees to a total of £72,000. But once they had our votes they postponed its introduction until 2020. And what’s the betting on it appearing at that date, even allowing for our rocky financial future? More fool us for failing to be cynical.

There is a little light on the horizon. There is a correlation between mental activity and the likelihood of dementia. This emerged from a remarkable study in which the post-mortem brains of nuns were compared with their detailed biographies – testing the theory that brain performance is improved following demanding mental exercise. It seems that challenging the brain creates other routes for rational processes. In one dramatic example a nun preserved her mental capacity until death, even though her brain was fully invaded by the plaques and tangles of Alzheimer’s.

So one approach to delaying dementia is to undertake new activities which challenge us to develop further mental skills. It might be learning a new language, mastering a demanding craft or undertaking voluntary work which requires thought and initiative. These are worthwhile in themselves, but if they do lead to fending off Alzheimer’s, we should be grateful indeed. And there is no time to lose. The nuns who fared best were those who showed challenging and intellectual vigour from their childhood.

Posted in Catholic Herald columns, Neuroscience, Quentin queries | Tagged , | 1 Comment

Can Catholics be moral people?

A newspaper cartoon showed a stalled car being fiercely hooted by the car behind. The driver of the stalled car walks sweetly over and she says: “Why don’t you start my car while I hoot your horn?”

I hope I am not the only person who has been rattled by pressure from another driver, and even done something thoughtless or potentially dangerous as a result. Most of us fear social embarrassment and, taken unawares – unlike the driver in the cartoon, we can be hustled into an unwise action. In such situations the pressure is immediate and strong; we even have a distinct physiological reaction to it.

In other situations the pressure of the group to conform is similarly powerful. Both the words ethics and morals come from roots which means customs or habits, and a pre-Christian view might be that your first duty is to follow the customs of your community. In one sense this is true: if we live in a community we have a general duty to be a supportive member and abide by its rules. But a Christian must ultimately derive his judgements from his perception of the truth; the values of the community cannot be directly a source of truth, though they may witness to it. The psychologists who have tracked moral development in children suggest that the move from deriving moral imperatives from the community to holding imperatives derived independently and potentially at variance with the community comes at quite a late stage of maturity; and many adults never succeed in making this jump.

But when the community we have in mind is the Church we may well feel that the situation is different. This community has the authority of God behind it, and when it lays down the moral law (as, for example, in the Catechism) we are expected to obey. The Church claims authority to interpret the natural law. Natural law answers the question: how must we act in ways which are in conformity with the nature God gave us? An example would be that since man is a social animal there are rules about telling lies or keeping promises; these are necessary for society to flourish. Another class of natural law rules is derived from structure. It is from this that, say, the rules about homosexuality or artificial contraception are derived. They have an added factor. For instance, where we can suggest that there are situations in which we would be obliged not to keep a promise, homosexual acts are always wrong because they are evil in themselves: you can read it from the structure.

There are big advantages here. We do not have to investigate these, and confirm them through our reason. That’s just a waste of time. We know they are wrong because the Church says so. All we have to do is to obey.

But I have already implied that those who allow others to decide — whether it is the State, or the Church, or our boss – leads to immaturity. Only when we are able to confirm good or evil through our own reason can we claim to be moral people. But then of course our reason, mistakenly or not, may tell us that the Church is wrong in a particular instance. We cannot then obey the Church for, as Aquinas teaches, we are obliged to follow our reason whether or not it is objectively correct.

So how do we, as mature people, get the balance right between the authority of the Church and the authority of our own rational decision?

Posted in Bio-ethics, Moral judgment, Quentin queries | 25 Comments

Conflict in the Church

While our minds are full of Brexit and the arrival of President-elect Trump we should also be aware of another crisis which is of great interest to Catholics. As is so often the case, a point of conflict will remind us that the water has been coming up to the boil for a long time.

That is true for secular issues such as international trade or the gap between the rich and the poor. But the Church’s conflict in the matter of divorced Catholics receiving the Eucharist concerns the very nature of the Church. As we know, four senior cardinals have seriously challenged Pope Francis on his refusal to give a clear judgment about this in his encyclical Amoris Laetitia. Is he, they suggest, undoing a grave and established ruling of the Church derived from established moral doctrine? Here the flame has been under the kettle as far back as Vatican II.

Most of us, I imagine, were brought up in a powerful Church. The doctrines we learnt could be plainly understood, and left no room for private opinion. The moral law, neatly divided into mortal sin and venial sin, was abundantly clear. All we had to do was obey. I recall writing at that time that the moral law could be computerised: we would only need to type in the circumstances and the computer would produce its judgment along with the correct penance. It would have needed only a little extra work to calculate the mathematical probability of the sinner in question spending his eternity in Hell.

But Vatican II changed the direction. Instead of accepting the proposals drawn up by the Curia – which would have enabled the Council to be short indeed – the bishops appear simply to have ignored them, and to set about the task of reviewing the Church to enable the whole community to share in the work of the world’s redemption. They may have got some things wrong but they got the important things right, Chief amongst these was the declaration that even the whole Church, full of sound and fury, could not slip itself in between the conscience of the individual and God. Indeed within a very short time this principle was tested in the matter of artificial contraception. It was quickly admitted that this serious teaching, in line with the tradition of the Church going back to at least the fifth century, could nevertheless not bind the consciences of Catholics.

Of course any council of the Church takes time for all its teaching to be absorbed. Some say that a council takes a hundred years to come into full effect – so we have still some way to go. The current conflict is evidence of that.

And that’s what makes it important. Yes, we hold that sacramental marriage can only be ended by death. Yes, a second marriage expressed sexually may technically be a sequence of adulterous acts. Yes we must accept that a Catholic in such a case is living in an irregular relationship. But if he (or she), taking notice of guidance and prayerfully considering conscience, wishes to receive the Eucharist to bring him closer to God and to reinforce a virtuous family life, we must consider whether he should be allowed to do so. In our consciences we do not see God through the hazy spyglass of the Church, we hear him directly. No one can answer for us but ourselves.

This issue is important enough in itself but it also signifies our overall attitudes concerning the relationship between law and conscience. If we permit Catholics to contraceive despite the Church’s grave prohibition, why may we not apply this mercy in the matter of second marriage?

If you have a little time to review what Pope Francis has to say about the law and pastoral care, set aside a few minutes (or perhaps the rest of your life) to read the Catholic News Service story of Pope Francis’s response at http://tinyurl.com/j73e5oj

Posted in Bio-ethics, Moral judgment, Pope Francis, Quentin queries | 84 Comments

?GOD?

Does God exist? It’s a fair question. I am not a betting man but I can do the arithmetic of chance versus reward. And this is quite straightforward. I can decide that God exists and, if I’m right, I have the prospect of eternal happiness. If he does not exist then I will return to the same nothingness that I had before my conception.

You will of course have recognised my version of Pascal’s Wager. Philosophers have argued its validity but there was an occasion, 20 years ago, when it was useful to me. I was lying in my bed, somewhat sedated, waiting for open heart surgery. Although the risk of mortality was small I had made my general Confession and written a farewell letter to my wife, with messages for the children. Would I still exist by the end of the morning? Then Pascal came to my aid. If he was wrong, it didn’t matter for I would never know. If he was right, then I was prepared. My mind was now at ease, and I dozed off.

Of course there are specific ways of demonstrating the existence of God; we are in debt to Aquinas for the most traditional. The concept of the first cause seems the simplest to me: everything comes about as a result of causes. It follows that nothing would exist if there were not an uncaused first cause. That first cause is what we call God. Neat, but few are convinced. A different approach is the argument from design. Were we to find a pocket watch we would not suppose that its precise mechanism has come about by chance; it has obviously been designed by some intelligence. But the whole of our world, from the overall to the detail, is a mechanism. We must surely accept a designer, whom we call God. Again, there are sceptics; they suggest evolution as the impersonal agent of design – and perhaps point out natural disasters as evidence of, at least, a poor job.

I am attracted by the ‘ontological argument’ which seems to have first been formulated by St Anselm in the 11th century. He said that our concept of God was that of the greatest being. But since existing was greater than not existing, God must therefore exist. This is a tricky one: Bertrand Russell said, in his History of Western Philosophy, that although it seems to us to be fallacious it is hard to detect where the fallacy lies. It implies that the human mind, by its nature, has a grasp of the existence of God. Ontology was further developed but in the 19th century the Holy Office demurred. Fallacious or not it does point to our recognition that there is something over and above our material experience, and toward which we are drawn.

We are concerned to find meaning. But a world limited to the material can display no overall meaning. We have a concept of infinity but we have no way of grasping or even visualising it. We explore the spiritual in many manifestations, and we experience it as both other and higher than the material world. We recognise the unique qualities of love and we have an imperative sense of right and wrong which transcends the utilitarian. While none of these can be described as concepts of God we are left wondering why human beings should be drawn to elevate such internal phenomena unless they point in God’s direction.

Our own answer may be that proofs of God are not significant: after all we have faith. But even that requires investigation. The word itself is a general one. To say that we believe such and such a thing to be true is not to say that we know it to be true, but rather that, despite the gap between the evidence and the conclusion, we have chosen to accept the conclusion. Even to use a word like perception does not, on analysis, get us any further. We simply trust the conclusion to be true.

As a born Catholic the evidence for my religious faith came from my faith in my parents, although I had to re-work it as an adult to give it a rational basis. Others will have come to this through experience, reflection or the influence of a respected person. But the gap remains and, in the end, a choice has to be made. But here we consider the effect of grace, because our decision to relate to God requires it. But grace is not of course an extra push towards our belief. We know, though we cannot understand, that our engraced personalities remain wholly us, while wholly the work of God. I rely on Paul’s dictum: “I live, now not I, Christ lives in me.”

Posted in Catholic Herald columns, Philosophy, Quentin queries | 56 Comments

God’s truth

This week I am returning to a subject which we looked at some years ago. I do so because we have had some interesting recent discussions on the behaviour of God on aspects of grace, faith, judgment and redemption. It is all too easy to assume that because we can describe these matters, often in terms of Scripture’s account, we are able to express the truth.

We can, to take the obvious example, describe God as infinite, omniscient and omnipotent. You agree, of course. But we have no knowledge and can have no knowledge of what these qualities mean. Fundamental theology will tell us firstly that these are not qualities which God has but qualities which God is. They will go further and tell us that even relating God to such human concepts is to derogate from his nature. “Be still and know that I am God” would be the watch word.

Similarly we speak about eternity as if it were human time. We wonder how many days we may spend in Purgatory, or visualise our dead relations, reduced to mere souls, waiting patiently for the end of the world (only a billion years and 33 days, and counting.). But Purgatory is not even instantaneous – that word has no meaning in the hereafter.

When we think of more day to day concepts such as faith, grace or repentance we find similar difficulties. How do we understand grace, for instance: we believe it to be wholly from God yet if we respond, in itself through grace, has the capacity to make us holy as individuals. Or would anyone be prepared to tell us what faith really means when we apply it to our recognition of God?

And, by definition, Scripture is no better. Since it is written for human understanding there is no way for it to display the real truths which lie behind its words. When for instance we read Paul’s words “I live, now not I, Christ lives in me.” what the heck does that really mean? Have we actually changed our personal identity? Perhaps the best we can say is that Scripture is an impressionistic description of God’s ways with man. We are told stories, some of which are historical and some not, which inspire us to meditate and pray, and from which we can explore the truth and so can take us towards the ultimate truth which is too big for the human mind to grasp. The mysteries of faith as expressed are not the last word but the first word – from which we start our puny exploration.

I have no easy answers, but I must remind myself that in my discussions, for example in this Blog, I must be humble. I must hesitate at expressing my opinions as if they necessarily record the truth. I must respect those who disagree with me for they may have another shard of the truth, and their understanding – even if I disagree – may well enlighten me. Perhaps, when I comment, I should always include a little prayer to the Holy Spirit. It is hard to dodge humility when he’s around and he does not let us down.

And there you have a final example. I have called the Holy Spirit ‘he’. Why?

Posted in Philosophy, Quentin queries, Scripture | 53 Comments

The truth is not in us

There will be few readers who have not heard the story of the Jesuit and the Benedictine who agreed to ask their superiors if they could smoke while praying their Office. The Benedictine asked if he could smoke while he prayed, and got a flea in the ear. The Jesuit asked if he could pray while he smoked, and got congratulations for his piety. But do we often think about the significance of the story?

What it reminds us is that we do not think in a vacuum because our answers are influenced by what is already in our mind – or in the case of this story what someone has put into our mind. We do not make our decisions from scratch but by comparison. A recent Horizon programme on illusions illustrated how our five senses convey what we expect to happen rather than what actually happens. It’s an essential shortcut in our brains.

J Pierpont Morgan, the great financier, once said “A man generally has two reasons for doing a thing. One that sounds good, and a real one.” It seemed cynical until, in a few dangerous moments of honesty, I realised how often it happened to me. It runs from the trivial “I’m sorry but I just can’t make it that day” instead of “I don’t want to come because your conversation bores me.” to the more serious: “I’m a bit short this month so I can’t lend it to you” instead of “I don’t trust you to pay me back.”

When did you learn to smile? Perhaps it was originally instinctive, or imitated from an adult, but you quickly learnt that a smiling baby got more approval and attention. Today you will often smile, not because you’re happy, but because your brain knows it will create a better atmosphere, and make your requests more acceptable. No doubt you learnt ‘please’ and ‘thank you’ at your mother’s knee, but how often does your ‘please’ consciously mean ‘if you please’?

Of course you never tell a lie – unless it comes into your private list of white lies. These are naturally well motivated, and often necessary to avoid giving information to the wrong person. Unfortunately the Catechism disagrees: you may never tell a lie of any kind since it breaches God’s purpose for communication. However, you can use ‘discreet language’ in certain cases. I think this simply means that you may deceive – providing you avoid an actual lie. The result would appear to be much the same. Deriving natural law from human structures and so creating absolutes is a dangerous game.

We all have an armoury of deceit which we use almost unconsciously in order to influence the understanding of others. But how about the attitudes we import from others? Perhaps the broadest source is the effect of culture on our conclusions. We don’t have to be very old to recall how much our culture has changed. This is summed up for me by the chief prosecutor’s question at the “Lady Chatterley” trial (1960) He asked the jury if it were the kind of book “you would wish your wife or servants to read”. The question was a generation out of date even then, and the broad changes of attitude towards sexual practices over 50 years are manifest. I talk with my adult grandchildren about this, and they do not appear to understand my drift.

Economic attitudes have changed a great deal during my life. Until recently international trade was all the fashion, but it is beginning to be realised that the effect of high international debt, and the dangers to the lower swathes of society who cannot compete in modern methods, need to be questioned. And this influences our political attitudes, as we are only too aware today. Among Catholics, I speak of Western countries, there are those who claim faithful orthodoxy and those who claim to be progressive. We may protect ourselves from questioning our position by picking our friends from those of a like mind.
The whole advertising industry is centred on ensuring that people make the desired choice. While there are regulations to give protection they cannot neutralise the skills which persuade. So go the supermarkets. So go the politicians. The truth is not in them. Nor indeed in us, as we continue to be influenced in ways we do not suspect.

Unfortunately we are born with poor defences. Our brains have developed to speed our thinking through referring to existing patterns of experience, whether recent or remote – and making their comparisons. Evolution has taught us that survival is secured by conformity with our immediate groups and cultures. We are programmed to react speedily and instinctively to perceived danger or loss. Finding the truth is an uphill battle, but we must be ready to slog it out.

Posted in Catholic Herald columns, Church and Society, Moral judgment, Neuroscience | 59 Comments

Good judgment

One day we will all stand before the judgment seat of God. How would we like him to judge us? Our answer may be personal but I will describe what I hope for. I accept that the picture will be patchy. I have done some good things and some bad things – but mostly things in between. So I hope that God will start by looking on such good things as I may have done. I would rather that he left the bad things for later. I would prefer that he saw me as a good person on the whole; I simply slipped a bit from time to time.

When he comes to my bad things I want him to be understanding. Then he will look for all the pressures and the instincts which have driven me in the wrong direction. He will search for every reason, compatible with the truth, to excuse or at least reduce my fault. I would hope that he was prepared to go to extremes in order to get me into Heaven. He will only refuse me if I maintain my obstinate determination towards evil. Then reluctantly he will accept my free will to depart from him.

If I make the grade I will become very aware that I need a good clean up. I now know how far I fall short of his goodness. So I will go cheerfully to the washing machine called Purgatory because I am now determined to be clean and shining for the Beatific Vision.

Your own wishes for your judgement day will not be identical to mine, but I suspect they will be similar. Perhaps one day, when the angels pause their music, we will all get together and compare notes.

Having thought about that, it comes to my mind that we may spend a good deal of time judging others – from our parents, to our siblings, to our teachers and our school fellows, to our spouses, to our colleagues and to all our friends. I dare even to suggest to our fellow contributors on this Blog. Do we judge them in the same way as we hope God will judge us? Are we mainly focusing on their good qualities, and attempting to understand and forgive their faults? Do we look first at what they do right and secondly, even reluctantly, note their failures? Are we determined to see them as good people, as far as we possibly can?

Why am I asking these questions? In fact it is not me who is asking, it is God who is asking. When God taught us how to pray he was specific: “Forgive us our trespasses as we forgive those who trespass against us.” We cannot expect God to judge us more mercifully than we judge others.

Posted in Moral judgment, Spirituality | Tagged | 169 Comments