Thursday, November 13, 2008

Hannah Jones

The sad case of Hannah Jones (BBC Story) aptly demonstrates the contradictory nature of current English Law. For Hannah, the decision to drop legal proceedings is clearly the right decision and for her sake I am very glad that her wishes are to be respected. It does seem to me though that had her case come to court it would have been a perfect opportunity to correct the current state of the law on consent for medical treatment of minors.

For adults, the law is very clear. Any adult who has capacity (which means they have sufficient understanding of the issues to make their own decision) has an absolute right to refuse medical treatment regardless of the consequences to their health. The only exceptions to this are in cases where there are public health or public safety implications.

Necessarily the law is somewhat different for individuals under the age of
18. Parents (or those with parental responsibility) have the right and
responsibility to consent to or refuse medical treatment. If doctors feel
that parents are not acting in the best interests of the child then they
may appeal to the High Court for a child to be made a ward of court and
then have the court decide on appropriate treatment. By statute,
individuals aged 16 to 18 years can give consent for their own treatment.

In the case of Gillick v W Norfolk and Wisbech AHA the principal of what
was termed Gillick competence (now correctly referred to as Fraser competence) was established. This principal states that once a child has obtained sufficient maturity and understanding to appreciate the significance and implication of a decision they may consent to their own medical treatment. The problem comes with the refusal of medical treatment. Lord Donaldson in the cases Re R and Re W set the precedent that whilst a Fraser-competent child may consent to treatment, if they refuse treatment then this refusal may be overridden by the parents or if the parents refuse, then it may be overridden by the court. In Re R Donaldson used the analogy of three ‘key-holders’ to unlock treatment, the child, the parents and the court each holding a key. In the case Re W, Lord Donaldson wrote: "… I now prefer the analogy of the legal ‘flak jacket’, which protects from claims by the litigious whether [the doctor] acquires it from his patient who may be a minor over the age of sixteen, or a ‘Gillick Competent’ child under that age or from another person having parental responsibilities which include a right to consent to treatment of the minor. Anyone who gives him a flak jacket (i.e. consent) may take it back, but the doctor only needs one and so long as he continues to have one he has the legal right to proceed.” As a doctor, I find the phraseology of a ‘legal flak-jacket’ both worrying and offensive.

As the law stands, the hospital looking after Hannah were acting completely within the law and the court could have ordered that Hannah undergo a heart transplant. The implications of such a decision would clearly be massive for both her and her family, not to mention the practical problem of administering an anaesthetic to an unwilling 13 year old.

It seems to me that a child who is competent to consent to treatment must also be sufficiently competent to know that for her, a transplant is not what she wants even if that means her life is shortened. Whilst the doctors have and must have a duty to establish that a child is both competent and protected from coercion and abuse, the idea that a mature teenager who clearly understands the decision and does not want such a massive operation, can have her wishes overridden by her parents or the courts is somewhat troubling. If she were 18, no one would dispute her decision. I
believe that the law in this area is not only contradictory but also wrong.

For Hannah Jones, I am very pleased that her wishes will be respected and my prayers are with her and her family. However I think that the law does badly need changing and without the will of parliament to legislate is will require a case like this one to correct this dangerous contradiction.

I think Lord Donaldson was very unwise and plain wrong in his rulings

Saturday, November 08, 2008

Not so much bad poetry and bad rhyme...

Lord, I want your will to do,
To serve you all my life through.
But I only seem to know,
Where I want to go.
O Lord please show me,
What my future ought to be.

Lord, I want your will to do,
To serve you all my life through.
My hopes and dreams are clear,
But God's voice I long to hear.
You I want to trust,
For you are kind and just.

Often the choices that I make
Are for my own sake.
Lord shape my will to be
In line with what you want for me.
In the years from now to my end,
I want you proud to call me friend.


Tuesday, September 23, 2008

Things I don't understand...

There are many many things in this world that I don't understand and here is an example;

I mean, why?
Just why?


Tuesday, September 09, 2008

Rambling thoughts about company loyalty, the NHS, governments and politics...

Today's blog may well end up as a bit of a window on my mind. I suspect that is not a good idea and may disturb. You have been warned. Something that fascinates me is how trains of thought form and develop. It happened to me, just yesterday. On a bus.

So, sat on a bus yesterday morning, unsurprisingly various people were getting on it. I think that's normal. One of this morning's passengers got on without clearly showing her ticket (weekly bus pass or whatever) to the driver. Whether this was her fault or whether the driver wasn't paying full attention (long line of passengers) I'm not really sure, but he was quite diligent and got up from his seat and called the lady back to check her ticket and ensure she was entitled to ride said bus. Someone made a comment about the driver being very diligent. And that really got me thinking.

I have done various part-time jobs for various corporations and I have always tried to do my job properly but I've often found a general apathy about my employer as an entity. Not deliberately and not consciously but definitely real. Let me explain. When I worked for a major supermarket, I remember people who worked on the customer service desk being genuinely annoyed by customers who would try and get refunds that they felt weren't justified. They seemed to feel a certain anger on behalf of the company that someone was trying to take advantage of them. To me, that seemed entirely reasonable and morally right - in essence to make a spurious claim for a refund is theft. But I found that I didn't really care. I couldn't bring myself to care. The actual loss to the company was small and the small saving that you could make by deterring and preventing spurious refund claims would be so much smaller than the loss you would make by losing the good-will of customers with genuine claims. However, even so, I just can't bring myself to really care if the company was losing out in this way. Partly that's because it was only ever a part-time job and I think that changes one's perspective but also because the company was and is extremely profitable and simply making money doesn't really matter to me.

I do not think that making a profit is in any way immoral and companies have to make a profit in order to exist in the first place and the economy has to work in order for it to work. However it's just not inspiring to me.

These days, of course I work for the NHS. That changes how I feel quite strongly. I really does bother me if people take advantage of my current employer and 'play the system as it were.' On one level, I simply work for the government, the NHS is a state organisation but on another the NHS is entirely different and so much more.

I don't think there's any doubt that the NHS is a unique institution with a very special place in the public's mind. This isn't all good. The NHS is also a national joke in some ways - the health service is often jokingly referred to as doing things on the cheap. In the Western world we are increasingly cynical about our governments and I suspect this is where the cynicism about the NHS comes from. The fact the the only positive comments tend to be from politicians about what they have done or will do is probably the reason for this. That and the media obsession with pulling down the NHS. I wrote to a national newspaper recently, challenging them to publish only positive stories for a month. They didn't rise to the challenge. Given that over 95% of patients are happy with the care they receive and given how much the NHS does it would not be difficult but because the media don't do this there is a subtle but very real and pernicious bias in the reporting we see. Good news remains no news.

My final destination on this thought pathway was how spoilt we are in the western world to be able to be cynical about governments.

I am not for one second, suggesting that everything the government does is good. I am not for one moment proposing that governments are infallible or that we should be uncritical. What I am saying is that Cynicism is equally simple-minded and deluded as naive optimism.

A very famous and entertaining celebrity in the UK who is known to be out-spoken made the comment the other day that the UK is a third-world country. Now, I know he was saying this for effect but it still really annoyed me. It is so blind to the realities of our world. Britain is a country where there are laws and (in general) they are applied to all fairly. Britain has a massive infrastructure, roads, railways etc. Britain has free education, universal healthcare and a welfare safety-net that means no-one need starve. None of these things are a given; they don't exist in all countries and they have not always existing in this country. They came about by many processes but including governments making the right decisions - such as the introduction of the welfare state after the second world war. My grandmother was born before the NHS and before the welfare state. Governments serve us. How well they serve us is the key question but the cynicism that says they don't serve us at all is breathtakingly arrogant and denies the privileges we have that so much of humanity don't enjoy.

The end-point of such cynicism is the failure of democracy because then people stop bothering to vote and governments loose their accountability. Now, when it comes to democracy, I'm with Churchill Democracy is the worst form of government... ...except for every other form of government. People think that democracy works because people get what they want. This is not true. Our elected representatives serve us best by representing us not necessarily by doing what we want. The genius of democracy is that governments are accountable. It is accountability that makes democracy work. In a messy and complicated way, sure but ultimately work.

I guess for my poor readers, it is lucky that it was only a 10 minute bus ride - wow that was a lot of rambling...


Wednesday, August 27, 2008

The problem of atheism...

Fundamentalist Atheism seems to be fashionable these days - or at least noisy.

It's interesting that in a philosophical sense I have met very few atheists. Well-thought-out philosophical atheist are rare in my experience. The vast majority of people in the western world are agnostic. And most agnosticism is not honest, open minded agnosticism but really I can't be bothered agnosticism.

Whilst I have met very few well-thought-out philosophical atheists, I have met many many functional atheists. Most people live, whether they believe in God or not live as though there is no God. And functional atheism is really the original sin in a slightly different form.


Monday, July 14, 2008

It's a Wonderful Life

I've recently watched the classic film It's a Wonderful Life. I've been meaning to watch it for ages because I've heard so much about it but until yesterday I had never seen it.

For those of you fellow Philistines out there I won't ruin the plot (well not too much). It's an unapologetically sentimental film but I don't see that as a bad thing personally. The under-pinning philosophy of the film is actually really serious and incredibly real - that each of us has an impact on many many lives. Every time we interact with another human being, we potentially have an impact on that person.

All of us, I'm sure can remember dozens of key moments in our lives when we've been affected by another person - for good and for ill.

All people - certainly all adults - are responsible for there own actions (to a greater or lesser extend but that's for another time perhaps). All of us need to take responsibility for ourselves and what we do. However we cannot take responsibility for the consequences of our actions - not entirely - because it is impossible to know what the knock-on effects will be. That's in many ways the message of the film.

Some encounters we have with people are very minor - some very major but it's not always possible to tell the difference.

I think all, each of us can hope for - and indeed should aim for - is that in each and every situation we find ourselves, we seek to have a positive impact and not a negative one on the lives of the people around us. The English actor Paul Eddington wanted his epitaph to read "He did very little harm" and he made the very astute observation that this is not a small ambition and it is in fact difficult to do little harm. I do, however think we should aim higher. You never know how big an impact a small thing can have.

The kind people who carried me through the dark times, the teachers who challenged and inspired me, the true friends who have shared the highs and lows. All of these and countless more make me what I am. Do something positive for someone you meet and you never know how big the consequences may be.

A wonderful life may indeed be one that we wouldn't necessarily expect.

Wednesday, June 04, 2008

Opinion and fact

"Everyone is entitled to their own opinion, but not their own facts."

Sen. Daniel Patrick Moynihan

Wise words indeed - in my opinion that is.

Some more bad poetry....

My only defence is that someone out there asked for it!

This is a little piece I wrote six years ago when life was a bit tough. It has several themes, the main one is that I can honestly look back at the hardest times in my life - and some of them have been really rough - and not want to change any of them at all. This is an important perspective when facing up to current trials.

There are also some important sub-themes - particularly about facing up to the truth and not giving in to the temptation of denial: "...make true what is not, So that the lies that so appeal Were not the poisons that they are..."

Anyways, make of it what you will. Agree, disagree, post comments.


Oh to have the power to change the way things are,
I'd reshape my life, make true what is not,
So that the lies that so appeal
Were not the poisons that they are;
That I could let my heart believe what it longs to,
To take away these hurts that cripple me.
If only I could change the world,
And make these painful truths untrue.

I remember the times that have been, and will be,
When I would change my life, to make easy
That which had broken me within,
Mental illness, cancer, failure,
All that I had to know, to walk through, I so longed
To take away these hurts that cripple me.
If only I could change the world,
And make these painful truths untrue.

So now I live with all these hurts I've had to know.
The now fading scars and new challenges.
And I see my God's hand at work,
That in me much work he has done.
I am coming to know that it is better not,
To take away these hurts that cripple me.
If only I could change the world,
And make these painful truths untrue.

Oh to have the power to change the way things are,
I'd live my life, with what is true; and not
Dwell on the lies that so appeal.
I'd trust that you are in control,
That you Lord do know what you are doing in not
Taking away these hurts that cripple me.
If only I could change the world,
I'd embrace these painful truths.


Saturday, May 03, 2008


So, by popular demand - ok, so ONE person asked for it... here's some thoughts on the word 'should.'

Whenever we use the word 'should' we are making a moral or ethical statement.

Let us suppose that my friend Justin has cancer. Now he's a young man with a lot to live for. Now suppose that in my pocket, I have the cure for cancer, should I give it to him?

I don't think many of us will have any hesitation in giving an answer to this question (whether you know Justin or not). Of course I should. But why? Well, because the notion that to save life is good is embedded into our thinking. (It is for this reason that healthcare is primarily a moral pursuit and only secondarily a scientific one.)

It order for the word 'should' to have any meaning at all there has to be moral absolutes. That is things that are right and things that are wrong. . That does not mean necessarily that any one of us necessarily knows what's right or wrong in any or every particular situation but that such things do exist. A lot of people argue that morality is a matter of opinion or even about majority views. I have serious issues with this.

To take two extreme examples, the Nazis thought that exterminating the Jews and homosexuals and Gypsies and the mentally ill was right. Similarly, if you were to take a poll of the Maassi tribe in Kenya and Tanzania they would say that female circumcision (or female genital mutilation) is acceptable and a traditional ritual. In both cases I think they are clearly wrong. These are things that should not be done.

The philosophical arguement is one about atheism vs theism. The reason for this is that in order for there to be any such thing as more absolutes there must be an absolute bench-mark of morality which we call God. If God does not exist then there are no moral absolutes. Many people will argue that there aren't moral absolutes. If this is true then the word should is meaningless, there is no morality and we should (sic) do whatever makes us happy.

Monday, April 07, 2008


It was the 40th anniversary of the assassination of Martin Luther King last Friday. I am a huge fan of Dr King, I think he was an amazing man for lots of reasons. If you read Dawkins' The God Delusion you will find a completely ridiculous argument that King's pacifism and dramatic impact on history particular in terms of race relations had nothing to do with his religion. Not only is this ridiculous but it takes about 10 seconds of examining the facts to discover that it is plainly wrong. King was a modern prophet, he was first and foremost a Christian minister. I would strongly encourage everyone to read or listen to his sermons - they are amazing. But none of that is the actual point of today's blog.

Today's blog is about my idle wondering.

I was wondering whether what we think of Dr Martin Luther King Jnr is affected by the fact that he was murdered. Do we think more of him because he was assassinated for what he stood for. And if we do, is this a good thing or not? For that matter, if we don't, should we?

Martin Luther King's murder was a personal tragedy for all who knew and loved him. In terms of the major cause that he is associated with - equal rights for black Americans - it may well have been a positive thing.

I think that anyone who is willing to lay down his life for his friends is worthy of respect and honour. But if he hadn't actually been murdered, would we still laud him as we do?

As I said, Idle wondering....

Wednesday, March 12, 2008


Ultimately power extends out the barrel of a gun. Well, sort of.

In the UK, we live in a society that has a strong legal system that to a great extend protects every member of our society. People are not able to take away your home without due legal process even if you don't pay your mortgage. I could steal your car but you'd probably call the police. The police force would detain me and the courts could order me to be imprisoned. If I try to escape the prison guards will use force to detain me.

We often forget how privileged we are in a democracy. Despotic dictatorships often steal property and land from their citizens because they hold all the guns. In a society that has a respect for the law itself, all the people who hold the guns do what the courts and the properly appointed government tell them to do. But a Coup d'etat is simply what happens when the ones with the guns stop following those orders.

So Power extends from the barrel of a gun.

Except for one thing. It really, really doesn't. If you want to talk about real power, power to change people's hearts and minds and not simply force them to act our of fear, well then you need to talk to Gandhi or King or Romero.

Tuesday, February 26, 2008


Reflection is powerful stuff. It certainly can be self-indulgent but I think far more often than not it can be very constructive. For reasons that I cannot easily explain I have been rediscovering my deep loneliness tonight. I am deeply blessed with many great friends and yet sometimes I feel alone and fragile. I have a very soft centre.This is, in reality of no great significance, life has taught me much and there is so much joy in the world does remain a winding road.

The hardest things in my life have genuinely been the most valuable and I would not want to go back and change anything (if such a thing were possible) because to do so would mean giving up part of me. However the scars remain and sometimes they bother me.

When they bother me I write bad poetry. Sometime I might share on this blog a couple of works that I think are actually quite good. (For the record they are called My Father and If Only I could Change the World) but for now, I want to post the few lines I constructed tonight to try and describe my current thoughts and feelings. They will probably be impenetrable to all but me. For that I apologise.

Wonder Why

In the centre of a cloud,
I see glimpses of the clear sky.
In searching for the truth,
I just continue to wonder why;

Why am I alone in the centre of a crowd?
Why am I insecure and yet somehow proud?

A contradiction, I remain,
Each low must accompany a high,
Sometimes in joy, sometimes in pain,
I just wonder, just wonder why;

Why, so fragile is my identity?
Why am I wise to all but me?

My tired frustration burns,
I know the truth in my mind's eye,
Yet I feel not its power,
I just continue to wonder why.

Monday, February 25, 2008

Cynicism and some other -isms...

I've been wondering recently if there's far too much cynicism floating around. It seems to me that there is a lot but that it is both very subtle and very persuasive. Everyone has an angle, everyone is only in it for themselves, all politicians are corrupt etc.

The problem, I think, with cynicism is that ultimately it values nothing. I went to a Christening the other week and it was a very nice occasion. It made me consider the true value of family and how great love and friendship actually are. It seems rather passe to say any of these things, of course.

So what is the answer? Well, I don't think that naive optimism is particularly useful either. So what I would recommend is a kind of optimistic pragmatism (or perhaps pragmatic optimism).

Pragmatic optimism is about a realistic approach to the world but one that finds true value in things. It is about dealing with the tension between how things are and how they should be. ('Should' is a very dangerous word, but that's for another time.) I think a kind of realistic perfectionism has it's place here too. If we set our sites low, we tend to achieve our aims. If on the other hand, you aim for perfection, you probably won't get there, but the place you get to will be well worth it. Can you imagine willingly consultantig a doctor who was content with not trying to provide the best possible care?

Pragmatic optimism: Aim for the best, never be satisfied with setting your sights lower but be prepared to willingly accept your own and other people's failings.

Just a thought.

Sunday, February 17, 2008


Tears do not flow from the pitiful and the weak – they also spring from the love and tenderness of the strong. We should never be ashamed of our tears, whether crying in private or grieving in public.
The heart would have known no rainbow if the eyes had never known tears.

Friday, January 25, 2008

The difference between perception and reality

Received wisdom is a dangerous thing. It's amazing how many things people 'know' that are simply wrong. A good example of this is crime rates.

At various times I have been the victim of crime. I've had bikes stolen years ago and about 4 years ago my car was broken into and the stereo stolen. How people perceive crime is to some extent a function their direct experience. If your home is burgled then the crime rate is too high and terrible. Alternatively, if you have never been a victim then your perception may be very different. Strangely though, that isn't necessarily true.

Below are two graphs, answers on a postcard as to which is the actual trend in crime rates:

One of these graphs I just made up, the other was produced by the British Crime Survey. The BCS is a massive survey done to gain a picture of actual crime rates compared with reported crime rates. There are lots of different reasons why people don't always report crime to the police. Therefore a rise is reported crime can be a bad thing - obviously crime going up is bad. Alternatively it could reflect an increased confidence in the police force which is a very good thing. Hence the British Crime survey.

So, any offers? Is crime is this country rising or falling?

For the record, crime levels overall (and violent crime which is the area that there is most concern over) are approximately half their peak level of 1995. Let me just say that again, half of the peak level of 1995. So why is there such a massive difference between the actual crime rate and the perceived one? Now I don't want to minimise what it means to be a victim of crime, in a very real way, 1 crime is 1 too many.

However, for lots of reasons many people in this country 'know' that crime is out of control, when it's actually falling.

Received wisdom is a dangerous thing.

Saturday, January 19, 2008

NHScine Creed

An unusual bit of blogging today. In general this vanity exercise it about writing my thoughts. For today, I am going to quote someone else's, but these are words that I completely agree with. For the record I am an unrependent apologist for the NHS for lots of reasons that I won't go into just now. This is one of the best expressions that I have come across of why the NHS is not just important but vital. It was written by someone I only know as DoubleThink - who I believe is a Quaker, but also is wise and insightful and believes like I do that access to quality healthcare is the right of all of God's people. Many thanks Doublethink.

For anyone who doesn't quite get the reference, check out the Nicene Creed here.


I believe in one National Health Service
Provider of treatment and care,
And of all things
Therapeutic and necessary

And in one point of access,
The General Practitioner’s surgery
Visited first before all referrals.
Source of advice, place of screening,
Foundation of healthcare.
Given not sold,
Being of one body with the State,
To whom all taxes are paid;
Who for our people and for our welfare
Created and funded the NHS,
As was envisioned by Beverage, of suffering & want,
and was made real,
and was sore mutilated under Thatcher,
was starved and denied,
and in the second millennium rose again,
according to the promises,
and grew strong in ideas,
and sitteth on the list of priorities of the State,
And shall come again to national pride,
to care for both the quick and the dying,
whose provision shall have no end.

And I believe in the public good,
Ethical work, the supervision of practice,
Which proceeds from competence and care.
Which, with the team and the individual together,
Is effective and needed,
Guided by research.
And I believe in one integrated & multidisciplinary approach.
I acknowledge one profession for the teaching of skills.
And I look for the support of government,
And the future of the service to come.


With apologies to scribes at Nicea

Saturday, January 05, 2008

An Essay on Love

I wrote this a few years ago. I would probably write something slightly different now. It is still a work-in-progress and I think there is room for improvement. I do not think it is as well expressed as it might be. However it is what I think and it is, I hope, helpful, interesting and insightful. I hope.

Well done to anyone who manages to read all of it!

Towards a Definition of Love

For some time I have trying to construct a working definition of love. An important question that was posed recently to me is why? – why bother? Surely how one acts is actually all that matters and any kind of definition is simply irrelevant. I almost agree with this. Academic argument and discussion that does not result in any real difference is clearly, well, academic. However, understanding is very important. We all talk about love and use the word so much, but to actually explain what it is, is more difficult. My aim with this essay is that to understand the nature and character of love, as to understand love is to become a more loving person.

Some would perhaps begin with the age-old question of whether love is a feeling or an action. I do not intent to do this because I believe the answer to that question is implicit. It seems to be clearly the case that love is both a feeling and an action, and that this does not require much discussion. One can feel love, and one can be loving when one does not feel like it. Often love is at its most powerful when we continue to love without feeling it. We feel love for someone and we show love by our actions. Love is both a feeling and an action. The importance of this is that any definition of love must encompass this duality.

1 Corinthians 13 contains a description of love, this is helpful but not actually a definition; Love is patient, love is kind, it does not envy, it does not boast, it is not proud. It is not rude, it is not self-seeking, it is not easily angered. It keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always protects, always trusts, always hopes, always perseveres. [NIV] If this description is true, then any valid definition of love must correspond with this description.

So what is love, this feeling and action that we all want and aspire to? This definition is about relationships and does not allow for concepts such as I love chips as I feel that is an entirely different use of the word.

My contention is that love is a balance of three aspects and that love must always be proactive in each of these. I will refer to these three aspects as acceptance, growth promotion and the desire for intimacy. I do not claim to have the answer to any great mysteries here, and do not think there is anything special about having three aspects, I simply believe that these three aspects, as I understand them, constitute a definition that works. The terminology is somewhat limited and I feel it is difficult to express these concepts. However I hope you will bear with me whilst I expand of these three and explain precisely how I understand love.


I do not like the term 'unconditional love.' I believe this is tautology, but that it is not constructive because it implies that there is such a thing as conditional love. The first aspect of love is unconditional acceptance. To not accept unconditionally is to not love. We must begin we acceptance; what each of us needs before all other things is to be accepted as we are. To be accepted with all our strengths and weaknesses. Love must therefore not be blind, as one cannot accept unless one knows what one is accepting. To see someone as faultless or perfect is not to love but to be stupid. Love sees and yet accepts the person. That is not to find all behaviours acceptable, as I will expand later, but to say that my love for the person is not dependent. It does not depend on what someone can do for me. However acceptance on its own is not love. Acceptance alone is indulgence.

Growth Promotion
This is the terminology that I have wrestled with most. I do not think that growth promotion really explains what I mean but is the best I have thus far manage to devise. Hopefully this section will explain all that I mean by this term. It must encompass a wanting of the very best for the object of one's love.

Perhaps to most difficult concept to express is the paradox between acceptance and growth promotion. Acceptance without growth promotion is indulgence; growth promotion without acceptance is judgmentalism and counterproductive. We humans are able to grow when we know we are accepted and have the opportunity to grow. Without that acceptance growth is retarded. It must be in that order; acceptance and then the encouragement to grow. It has been argued to me that growth promotion denies acceptance. I do not believe this because to wish someone to grow and to aid that growth is not to un-accept them, if one will love just as much if that despite the desire and promotion, growth does not occur. Put simply, love says 'I want you to grow and I will do all I can to help you to grow. But if not, I will still accept you as you are.' So what is growth? I believe that real love encourages and nurtures growth emotionally, spiritually, physically - in every way. Love wants the very best for the object of that love, and nothing less will do. That is why love can be helping a sick relative to wash and dress and love can be the extravagant gift that makes someone feel special and valuable and happy. Love can be the soldier diving on a grenade to save his comrades as that is the very best for them.

Desire for Intimacy
It is entirely deliberate that I suggest the third aspect of love is a desire for intimacy rather than intimacy itself. If love is, as I believe it must be, proactive in each aspect, then clearly wherever intimacy is possible, the desire for intimacy will result is intimacy consequentially. However I believe that love is still love when intimacy is not possible for some reason. Intimacy is a two-way-street. True intimacy is only possible as a result of mutual love, but when we love someone who does not return that love (such as a parent to a wayward teenager) the desire for intimacy remains. And is the cause of much pain. The desire for intimacy is why we miss people. True friends are those whom I talk to till 3 am with only breaks to refill the wine glasses. For in those times I share more than at any other, the real me with any true depth and meet with the real them.

Intimacy is a broad term. If we are talking about sexual love (eros) then the intimacy will be sexual, but if we are talking about parental love the intimacy will be the special bond that a parent and child share but that changes as we grow up. With friends it is another kind of intimacy again. I do not think that one kind of intimacy is better than another but they are clearly different.

Desire for intimacy without acceptance and promotion of growth is selfish and not love. It leads merely to manipulation or lust or to a lack of fulfilment and eventually a denial of this desire and cold-heartedness. True intimacy is only possible with acceptance and a desire for growth.

Implicitly love must be proactive in each of these aspects. Love is not lazy. Love says I accept this person and I want them to know they are accepted. Especially love deals with minor annoyances. Love decides that this person is more important to me than my being annoyed so that I will still accept them. Love decides that with true wrong, acceptance demands forgiveness. Forgiveness is an act of the will which love demands.

Proactive growth promotion says I want the very best for this person, I will do whatever I can do to help that person grow. Love says I will do everything possible for the very best for this person. Hence the generosity of love.

And love desires intimacy and will move mountains to make it possible. The proactiveness of love inspires us to drive all night or to cross continents or to make long phone calls in order to be close to someone.

Clearly to have some vague concept of accepting someone because you do not really care what they are like, to wish them well but not do anything about it and do desire closeness and not strife to achieve this is not love.

Different kinds of Love: Love of self
It is generally assumed that people have no difficulty with loving themselves. I do not believe this is true. However that is a subject for another time. My definition of love does not, at first glance, easily fit with the concept of loving oneself. The need for unconditional acceptance is clearly relevant to love of oneself. I firmly believe this is where many people who struggle to love themselves have difficulty, because they find it very difficult to accept their failings and weaknesses. But acceptance is the first thing we all need, even from ourselves. If people feel unacceptable then they feel unlovable. The other extreme is people who totally accept themselves uncritically, without any desire to grow in anyway. Without any need to look for what is best for them.

The problem with applying this definition of love to love of oneself is, of course with the issue of intimacy. How can one be intimate with oneself. This may require some poetic license but I am not the first to suggest that being comfortable with oneself, for time spent alone and for self-awareness to be the equivalent of intimacy with another person. If one can accept this equivalence then this three-aspect definition does describe love of oneself.

Different Kinds of Love: Parental Love
Those displaying parental love are not always parents. There seems to me to be two main ways is which parental love goes wrong. Firstly parents can be totally accepting without promoting growth. These are the spoilt children who never really develop as the parent is always reinforcing that whatever they do is acceptable. To reiterate I contend that unconditional acceptance of a person does not require unconditional acceptance of their behaviour. Simply that one's love should not depend upon that person's actions.

The other extreme is the promotion of growth without acceptance; the pushy parent for whom nothing is ever good enough. Of course these children do not really grow and never feel good enough no matter what they do. With either of these extremes true intimacy is an early casualty.

What we all need as children and, for that matter as adults, is to be accepted, to have our growth aided and supported and to have a depth of intimacy with other human beings. That is love.

Different Kinds of Love: Love for God
Another difficulty is to explain love for God within this definition. Christians and people of other religions will contend that they love God, so any useful definition of love should encompass this.

There are two obvious problems; firstly acceptance and secondly growth promotion. How can God need our acceptance is he is God and perfect and how can we promote the growth of God.

Having already stated that acceptance is vital to the object of love, I need to add that in order to love acceptance is obviously vital. We cannot feel love and we cannot act lovingly if we do not accept someone. But why should acceptance of God be an issue if He is perfect and thus faultless. I do not consider this a major issue as experientially all find God difficult to accept. Not because God is not perfect, but because He is not what we would always wish him to be. In order to love God we must accept Him as He is and on His terms. He is not a sugar-daddy and He is not remotely easy-going on issues of holiness. Life, it seems, would be much easier if he was. He is a perfect father and he is love, but He is also holy and sovereign and to love God is to accept that He does not fit in a box and will not do what we want.

Perhaps more difficult to reconcile is to concept of growth promotion and love of God. Clearly if God is God then he does not need to grow, nor can he grow, and there is nothing we can give him anyway. I would argue that each human being can give something to God that He does not need, but He would not have is we did not give it to Him. And it gives Him Joy. You see each of us can give ourselves to God, can respond to His Love by loving Him back and by giving out lives to His glory. Obviously He does not need anything from us, but one of the most awesome things about God is that in giving us freewill He has given us a genuine choice to love Him or Not. The awesome part is that He will not remove that choice from us, and thus our love, which He wishes to have can only be His if we give it to Him. This I believe fits with what Jesus said; "If you love me, you will obey my commands." Love for God is expressed in a desire to please Him, and hence give him yourself. To give him yourself is to give to God the only thing we have to give.

Problems with Love
Love is not a digital concept but an analogue one. It is not all or nothing. Only God can claim to have perfect love. Perfect love is totally accepting even when we are completely intolerable. Perfect love is ruthless in its pursuit of the very best for the object of that love. And perfect love leads to genuine and lasting intimacy.

However human experience of loving someone is not quite like that. We find accepting people very difficult and growth promotion requires effort and sacrifice. As for intimacy there are some people whom we would rather not get close to. Real love goes beyond the easy and accepts and nurtures and desires closeness even with those who are very difficult to like. That is the act of will to love one's enemy.

Fundamentally I think that the problems with love are two-fold. Firstly we tend to get unbalanced in our efforts to love. If maturity is defined in terms of balance, then mature love is a balance of these three aspects. The second problem is that we do not allow love to deepen. Over time, we should accept more, be more and more prepared to do things for a true good of another and intimacy should become greater.

As I have mentioned above often we tend to accept without growth promotion or to want the best for someone without accepting them first. I believe both of these errors constitute not-love. Acceptance on its own is indulgence and does not result in the true good for the object of love and thus is not love. With simple acceptance we do not grow or change or benefit, we simply regress and potentially become increasingly selfish which makes true intimacy impossible. To love is to accept and then to aid the moving-on of the object of love. This paradox is fundamental. It works because real love is able to promote growth without depending on it.

To want the very best for someone without accepting them is perhaps even more dangerous. It is so damaging to try to change someone before accepting all that they are. All that has gone into making them what they are. The successes and failures, the joys and the deep hurts. Any attempt to promote growth without accepting all that makes up a person is doomed to both hurt them deeply and fail in terms of true growth. I am confident of this analysis because I believe this is how God deals with each of us. True Christianity is salvation by faith is Jesus. What that means is that God meets us where we are, he totally accepts us as we are and then begins a process of changing us (only by consent). The fact that God's acceptance of us depends upon Jesus' death merely affirms how powerful God's love is and how ruthless it is that he would go that far to accept us and enable us to grow and have true intimacy with Him.

Intimacy is slightly strange. It is often suggested that there is a selfish aspect to love, of wanting to be close to someone. I do not believe real love is selfish. The desire for intimacy is fundamental to love and is obviously something that rewards the lover but it is a two-way process and a major aspect of promoting growth in someone and it is to their benefit. The most difficult experiences of my life have been when I have loved someone and known that the best thing for me is for them to leave me. For to love is to desire intimacy, but love is not selfish because real love is prepared to give up intimacy if that is what is best for the object of that love. Of course, this hurts. But real love is sacrificial and desiring the very best for the object of that love can sometimes mean giving up intimacy. The simple example of this is the parent saying goodbye to the child-now-grown leaving for university and the conflict of emotions this produces. A desire for intimacy alone - because of loneliness or whatever - is of course selfish and doomed to fail, as true intimacy is dependent upon acceptance and the desire for growth.

In this essay I have attempted to construct and explain a working-definition of love. A definition that is useful and explains how love does work, as well as how love should work. To understand the inter-relationship between acceptance, the desire to see growth and our need and desire for intimacy, is I hope, to be able to begin to love more and to love better.