Page 8, 30th May 2003

30th May 2003
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Page 8, 30th May 2003 — Seizing the power of life and death
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Seizing the power of life and death

If euthanasia is legalised in this country, says David Alton, we will descend the chilling slippery slope which

in Holland has led to the killing of patients against their will; it would also destroy the hospice movement

0 ne of the most disturbing aspects of the Joffe Bill on euthanasia to be debated in the House of Lords on Friday June 6th is that in seeking to give people "the right to be killed" it risks turning euthanasia into a duty. Sick and disabled people will be made to believe that they are a burden on society or their relatives. In

constantly emphasising blocked hospital beds and waiting lists, vulnerable people many of them acutely depressed already will feel they owe it to their relatives and to society to seek a lethal injection.

That is what is happening in Holland. where turning a blind eye led to decriminalisation. That led to the legalising of voluntary euthanasia and then to involuntary euthanasia. In Britain we are about half way

down that same street.

What happens next is that doctors then stop bothering to report what they are doing. At a recent meeting organised by the Voluntary Euthanasia Society in Parliament, Professor John Griffiths of the Faculty of Law, University of Groningen, said that only 50% to 60% of cases of euthanasia in the Netherlands are reported to the proper authorities. More worryingly still, Professor Griffiths admitted that it is the "more problematic" cases that are escaping the control system. In other words, despite what Lord Joffe's supporters say, it is impossible to establish an effective regulatory framework for assisted suicide and euthanasia.

As we come to debate this Bill it should be noted that a broad coalition has been built in opposition to Lord Joffe's Patient (Assisted Dying) Bill. Along with the British Medical Association, the Chief Rabbi, the Archbishops of Canterbury and Westminster, both the Disability Rights Commission and Help the Aged have confirmed that they do not support the Bill. I recently chaired a meeting addressed by four medics who explained why they believe Dutch-style euthanasia laws would be a disaster for Britain. Dr Nigel Sykes, the Medical Director of St Christopher's Hospice in London agreed that there is sympathy for euthanasia among the general public. "However" he said, "patients themselves usually do not want euthanasia." Only 1520% of cancer patients want euthanasia and only 3,5% of patients dying of cancer want euthanasia. "Euthanasia is a minority interest amongst the terminally ill. It is only those who are healthy who warn Lord Joffe's Bill."

In a recent opinion poll the majority of UK doctors who responded opposed euthanasia and more than three quarters said that they would not be prepared to carry it out even if it were made legal. Not one single doctor working in palliative care who was polled was infavour of euthanasia.

The Patient (Assisted Dying) Bill if it became law would mean that we would already be halfway down the feared "slippery slope" from voluntary to involuntary euthanasia.

There are major difficulties with the definitions in the bill _

eg what is meant by "suilering unbearably" and what is a "serious and progressive physical illness"? Advanced or perhaps even not so advanced rheumatoid arthritis and diabetes would fall under the definition of "serious physical illness" and euthanasia would become a "symptom-control choice", one option of "treatment" among others. Having watched my own mother die of crippling arthritis I am not unaware of the loss of dignity and the suffering of serious illness. But I also know what would have been lost if I had commissioned her premature death or if she had been encouraged to believe that her life was worthless and that she would have been better off dead. As the doctors who spoke in Parliament stated, it will he well nigh impossible for a doctor to ascertain whether a patient is suffering "unbearably". In those circumstances we should not confuse care and kill they can never be used as synonyms.

Then there is the question of competency. A patient who is in pain or is confused would not be considered competent to consent to an assisted death. However, if society endorses euthanasia as an "appropriate treatment choice" for competent patients, surely it will be only a matter of time until euthanasia will be offered as appropriate "treatment" to patients that are temporarily or permanently incompetent. Not everything in life can be reduced to a matter of apparent choice. Choices always carry consequences.

How are we to ensure that consent to euthanasia is given by free and informed choice? Experience in Oregon, USA where euthanasia was legalised illustrates that the longer euthanasia has been legal, the higher the percentage of patients who think that they have become a burden to society and should be requesting euthanasia. The right becomes a duty.

The Bill in its current format does not even allow con scientious objection by doctors who refuse to take part in euthanasia. No doubt this will be stuck in as an afterthought, and that says everything you need to know about what any conscience clause will be worth. Peer pressure within medical practices and pressure in medical school even affecting student applications will ensure that anyone who tries to exercise their conscience will be




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