Assisted suicide: The Meacher Bill is Not Assisted Dying but Euthanasia!
Dr. Tony Cole and Dr. John Duddington
Once again euthanasia is on the Parliamentary agenda with the introduction into the House of Lords in May 2021 by Baroness Meacher of the Assisted Dying Bill with the euphemistic short title of: ‘A Bill to enable adults who are terminally ill to be provided at their request with specified assistance to end their own life.’ How reasonable those words look at first sight!
Assisted dying has a comforting ring to it but behind it lies the legalisation of euthanasia. G. K. Chesterton in his poem ‘O God of Earth and Altar’ spoke of the ‘easy speeches that comfort cruel men’ and nowhere is this truer than in the ‘easy speech’ description of euthanasia as ‘assisted dying.’ As Bishop Mark Davies of Shrewsbury said in a recent Pastoral Letter: [1]
The language employed in seeking this seismic change in the law is one of compassion, knowing that no one is opposed to the relief of human suffering. However, the fact this legislation is being proposed in Parliament by the Chair of what was the Voluntary Euthanasia Society should leave us in no doubt as to the goal.
As Bishop Mark pointed out, the Bill comes at a singularly inappropriate time because, as he says:
“The Bill comes at the end of a public health crisis where all our efforts have been directed towards safeguarding the vulnerable. During this past year we have been reminded how the true measure of a society is seen in how we safeguard and care for the sick, the aged and those nearing the end of their lives.”
What should our response be?
First we need to examine the details of the Bill. Section 1 provides that, subject to the consent of the High Court (Family Division), a person who is terminally ill may request and lawfully be provided with assistance to end his or her own life. This consent can only be given if the High Court is satisfied that the person:
(a) has a voluntary, clear, settled and informed wish to end his or her own life;
(b) has made a declaration to that effect in accordance with section 3; and
(c) on the day the declaration is made (i) is aged 18 or over; (ii) has capacity to make the decision to end his or her own life..
Terminal illness for the purposes of this Act is defined by section 2 as where a person:
(a) has been diagnosed by a registered medical practitioner as having an inevitably progressive condition which cannot be reversed by treatment (“a terminal illness”); and
(b) as a consequence of that terminal illness, is reasonably expected to die within six months.
One might make the following comments on this;
(i) What does ‘expected to die within six months’ mean? How will it be evidenced? We all know of cases where a person has either lived much longer or much less than the prognosis indicated. One example is that of a friend of ours who was told by the surgeon who had just examined his wife that she could die within three months and at most would have three years to live. In fact she lived for twenty more years.
(ii) The apparent safeguard that a High Court judge must agree to euthanasia provided the conditions are met is likely to be removed in future. Withdrawal of food and fluid from patients in a long-term permanent vegetative state originally needed court approval after the Bland case. But in 2018 the UK Supreme Court [2] decided that as long as the families and doctors agree, medical staff can now remove feeding tubes to allow such patients to die without applying to the court. The same creeping relaxation of safeguards will happen here as euthanasia becomes common.
However, even if by some means this Bill were changed to meet these objections, the principle behind it is still fundamentally wrong.
The true assisting of patients at the end of life is already there. It is the prime purpose of palliative care which brings symptom relief and holistic, psychological and spiritual care to the dying.
Effect on the Disabled
The issue is not purely one of the sanctity of life in Roman Catholic terms where in the words of Samaritanus Bonus [3] our belief is that ‘Euthanasia, therefore, is an intrinsically evil act, in every situation or circumstance’. It is also the wider one of protecting some of the most vulnerable members of society against being killed. Craig Wallace, writing in the Guardian [4] said:
Like the rest of the community, people with disability debate euthanasia with many views, but a number of us are genuinely concerned that legalised suicide will encroach on our rights and see the vulnerable among us subjected to financial, social, emotional and other pressures to take our own lives.
In the UK Baroness Campbell, a leading campaigner for disabled people’s rights who herself has the degenerative condition spinal muscular atrophy, spoke strongly in the House of Lords in a debate in 2009 saying that if euthanasia were to be legalised:
… despair would be endorsed as a reasonable expectation for which early state-sanctioned death is an effective remedy. Is this really the message that we wish to give disabled and terminally ill people? Is this really the future that we wish to offer those who become terminally ill? [5]
Meanwhile Baroness Grey-Thompson, has noted the dangers of mission creep, pointing out that a Group called ‘The Commission on Assisted Dying’ [6] said in a report that ‘lethal drugs should not be offered to disabled people at this point in time.’ [7] She says: ‘I found those five words chilling. They told me that I would not be a candidate for legalised assisted suicide at first but should consider myself in the waiting room.’ [8]
We know that mission creep happens where euthanasia is legalised. In Oregon 38.6% of patients committing suicide had expressed concern about being a ‘burden’ on others and in 2020 the Dutch government approved plans to allow euthanasia for terminally ill children aged between one and 12 saying that this ‘would prevent some children from ‘suffering hopelessly and unbearably.’ There are many other instances of this ‘mission creep’ especially in Holland and Belgium.
Effect on Health Care Professionals
Doctors, nurses and other health care professionals who look to their faith for inspiration, together with others, perhaps without a religious belief but with clear ethical standards, would all in time feel that they had to leave the profession. There is indeed a ‘conscience clause’ in the Bill providing by clause 5 that :
A person is not under any duty (whether by contract or arising from any statutory or other legal requirement) to participate in anything authorised by this Act to which that person has a conscientious objection.
This supposed guarantee will almost certainly be worthless in practice. Subtle pressures will be brought on health care professionals opposed to euthanasia to refer the patient to someone who will provide assistance in committing euthanasia and ultimately the result will be identical to what has happened with abortion: those opposed to euthanasia will be driven out of this whole area of practice.
Moreover the World Health Association has launched a Public Consultation on a Draft Revised version of the International Code of Medical Ethics proposing a change to Principle 27. [9] At present it reads: ‘Conscientious objection must only be considered if the individual patient is not discriminated against or disadvantaged, the patient’s health is not endangered, and undelayed continuity of care is ensured’. What is now proposed is the addition of the words: ‘through timely and effective referral to another qualified physician’. The effect would be to mean that any conscientious objection would be reduced to: ‘I won’t do it, but I’ll find someone else who will.’
Palliative Care
Palliative care is described by Samaritanus Bonus [10] as ‘an authentic expression of the human and Christian activity of providing care, the tangible symbol of the compassionate “remaining” at the side of the suffering person’. Moreover, the Catholic principle of respecting all life in this way is actually a popular one with patients .However, palliative care has recently become, in some cases, a vehicle for euthanasia as Samaritanus Bonus points out:
.. the definition of palliative care has in recent years taken on a sometimes equivocal connotation. In addition, palliative interventions to reduce the suffering of gravely or terminally ill patients in these regulatory contexts can involve the administration of medications that intend to hasten death, as well as the suspension or interruption of hydration and nutrition even when death is not imminent. In fact, such practices are equivalent to a direct action or omission to bring about death and are therefore unlawful.
If euthanasia is legalised then the danger is that the emphasis in palliative care will switch from being driven by sensitive, evidenced based medicine underpinned by a respect for life into one where the practice of euthanasia is embedded.
Conclusion
As Baroness Grey-Thompson said in her letter quoted above, the present law rests ‘on a natural frontier’ and applies ‘equally to everyone, irrespective of their state of physical health or physical ability.’ Mission creep is inevitable when the present law ‘is replaced by a law with an arbitrary boundary like terminal illness. Such laws contain within themselves the seeds of their own expansion. To ignore this is to court danger.’ One might only add that in an age when so much stress is placed on the concept of equality, it is odd that this very principle is denied when it comes to the legalisation of euthanasia. As Samaritanus Bonus puts it: ‘Each life has the same value and dignity for everyone.’ [11]
Dr. Anthony Cole JP F R C P Edin. F R C P C H is a retired consultant paediatrician and Chairman of the Medical Ethics Alliance.
Dr. John Duddington is editor of Law and Justice, the Christian Law Review
References
[1] May 30th, 2021, See www.dioceseofshrewsbury.org
[2] Re Y UKSC 46
[3] CDF (CTS, 2020) at V. I
[4] 27th September 2017
[5] 53 HL Deb 7 July 2009
[6] In reality largely made up of pro-euthanasia supporters.
[7] Our italics
[8] Letter to the Daily Telegraph 2 June 2021
[9] Available at www.wma.net/what-we-do/medical-ethics/declaration-of-geneva/public . Comments on the draft version had to be submitted by 28 May 2021.
[10] At V. 4
[11] At V 1
Assisted suicide: The Meacher Bill is Not Assisted Dying but Euthanasia
