Page 5, 11th November 1994

11th November 1994
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Page 5, 11th November 1994 — Compassion or murder?

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Locations: York


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Compassion or murder?

Should the terminally ill be allowed to die? Dominican friar Anthony Fisher OP (right) thinks not, but veteran euthanasia campaigner Sir Ludovic Kennedy (below) disagrees. In the wake of the Dutch television screening of a doctor giving his patient a fatal injection, we present both sides of the issue.

TIE VOLUNTARY EIMIANASIA movement has grown rapidly in recent years. In 1969 a Mass Observation poll showed that 51 per cent of those canvassed were in favour of it. Seven years later this figure had risen to 69 per cent and by 1985 to 72 per cent.

In 1988 a BBC television programme took a nationwide poll of those aged between 16 and 25 and asked the question: "Should those who are terminally ill be allowed to choose to die?" Just over 7,000 of the responses said Yes, just under 700 said No.

The membership of the Voluntary Euthanasia Society which for most of its existence could be numbered in hundreds is now more than 16,000, and having always survived on a shoestring, it has recently been the recipient of some very substantial legacies.

In Holland in 1980 permission, though not legislation, was granted to the country's doctors to practise voluntary euthanasia under certain guidelines, and has been practised ever since; while the Federation of World Right to Die Societies, which didn't exist 15 years ago, now has 22 branches in more than 30 countries.

Referenda to legalise euthanasia recently in the states of California and Washington were narrowly defeated largely as a result of scaremongering television adverts paid for sub rose by the Roman Catholic Church.

A boost was given to

euthanasia with the cases of Dr Nigel Cox and Tony Bland, the boy who became brain dead as a result of the

Hillsborough football ground tragedy.

Dr Cox gave his patient, Lilian Boyes, a lethal dose to bring her agonies to an end, was convicted of attempted murder and given a suspended sentence.

Had the charge been one of murder, which, but for a technicality it might have been, the judge would have had no option but to sentence this respected consultant to life imprisonment and have him taken down to the cells.

If the case had happened ten, perhaps even five years earlier, I have little doubt that the General Medical Council, who are traditionally sticklers for the rules, would have had Dr Cox's name struck from the Medical Register.

Instead, knowing that he had acted out of compassion towards a patient he had looked after for 13 years and who only a week before had begged him to end her life, the GMC gave Dr Cox a reprimand and allowed him to return to his old job at the Royal Hampshire Hospital.

The outcome of the other case, that of Tony Bland, was even more far reaching. After he had existed in a permanent vegetative state for three years, brain dead and beyond any hope of recovery, his doctor, with the approval of his parents, applied to the courts for permission to withdraw nutrition and hydration.

This was granted by the court of first instance and then confirmed by the Court of Appeal and the Law Lords. Nevertheless, starving him of sustenance and hydration meant that Tony Bland took nearly three weeks to die, which must have been an agonising time for his mother and father.

how much kinder to them it would have been to permit a lethal injection so as to ensure a swift, clean dissolution instead of a slow, drawn-out one.

The Bland judgement was not only a landmark in itself, it also opened the way to the recognition by the courts of the validity of Advance Directives or Living Wills, which I would like to see in every doctor's waiting room in the country.

This is a document in which you state that in the event of your becoming noncompetent, through accident or illness (as Tony Bland was), you do not wish to be kept artificially alive. This has heralded the demise of the old medical paternalism ("the doctor knows best") and confirms the new concept of patient autonomy whereby it is recognised that a patient is not obliged to accept any treatment that does not have his consent, even if such refusal may result in death.

Taking this a step further, the Master of the Rolls said in his judgement on the case that if Tony Bland had made an Advance Declaration that in the event of his becoming non competent, he did not wish to be kept artificially alive, his doctors would have been bound by law to follow his wishes and would have broken the law if they didn't.

It was the Cox and Bland cases, touching as sensitively as they did on profound questions about life and death, that led the House of Lords to appoint a Medical Ethics Committee to look into the whole question of euthanasia and matters allied to it; thus bringing the issue for the first time, at least in any depth, into the political arena, where in the long run it must be resolved.

The Committee, when I gave evidence to them, struck me as quite an impressive group and I had high hopes that they would come to see themselves as a sort of collective John the Baptist, preparing the way for better things to come, holding out a promise of hope for the terminally ill and suffering.

I should have known better; that a committee that included the Archbishop of York, who had already publicly expressed antivoluntary euthanasia views, and the Catholic peer Lord Rawlinson, were unlikely to move far, if at all, towards our way of thinking. It was no doubt the presence of these two that led to such an imbalance in their selection of witnesses.

Of the 68 individuals and organisations who submitted evidence to them, no less than a quarter were from Churches or Church affiliated bodies which in a pluralist and increasingly secular society may be thought unduly preponderant, especially when they were all playing variations on the same tune.

The Committee gave their reasons for rejecting voluntary euthanasia quite briefly. "We do not think it possible," they said, "to set secure limits on it.

"It would be next to impossible to ensure that all aspects of it were truly voluntary and that any liberalisation of the law was not abused."

Apart from the BMA the other great body which is opposed to voluntary euthanasia hook, line and sinker, is, of course, the Catholic Church.

In 1980, after declaring suicide to be as wrong as murder, the Pope approved this declaration: "It is necessary to state firmly once more that nothing and no-one can in any way permit the killing of an innocent human being... whether an old person or one suffering from an incurable disease or a person who is dying.

"Furthermore, no-one is permitted to ask for his act of killing, either for himself or herself... For it is a question of the violation of the divine law, a crime against

life and an attack on humanity.”

This negative pronouncement was then compounded by a statement of sheer ignorance:"The pleas of gravely people who sometimes ask for death are not to be understood as implying a true desire for euthanasia; in fact it is almost always a case of an anguished plea for help and love."

One would like to hear the Pope repeat that to someone suffering from terminal cancer, doubly incontinent and being fed through a tube in the nose.

But the Pope even has a word of cheer about suffering: "According to Christian teaching, suffering, especially suffering during the last moments of life, has a special place in God's saving plan; it is in fact a sharing in Christ's Passion and a union with the redeeming sacrifice which He offered in obedience to the Father's will."

To those of you reading this piece those words may say something. To me they express a view which I find medieval in its thinking and barbaric in its lack of compassion.

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