CluRING THE Commons debate last week on Mrs Ann Winterton's Medical Treatment (Prevention of Euthanasia) Bill, designed to strengthen the law against killing the sick, Dr Peter Brand, MP for the Isle of Wight, told the House that people had "a right to death" and confessed that under the terms of the Bill he would be a "multiple murderer". He described how he once withdrew "tubes" from a twoyear-old boy with leukaemia who "might have responded to treatment" but who died within 48 hours.
The Scottish Catholic MP George Gallowaydescribed his speech as "disturbing, alarming and chilling-, and said that he was glad that Dr Brand was not his GP. And yet, Dr Brand would certainly claim some kind of ethical rationale for his behaviour. Above all, he would insist that Dr Harold Shipman, the family doctor found guilty only four days later of being incontestably a "multiple murderer", lives in a different moral universe.
But would he be right? Of course Dr Brand is not an evil monster. But is there a sense in which his actions and those of Dr Shipman must indeed be be seen as part of the same ethical culture? We have to say, surely, that it is not enough to conclude merely that Dr Shipman was able to murder around 150 women because society was not vigilant enough to stop him. We have to insist, too, that society's lack of vigilance was the direct result of farreaching changes over recent decades in our common attitude to the sacredness of human life. These changes have been mirrored and to some extent caused by a decline in medical ethics — a decline by no means without precedent in this terrible century.
IN JUNE 1947, the British Medical Association in their document "War Crimes and Medicine" (produced for the World Medical Association) stated that the Nazi doctors "departed from the traditional medical ethic which maintains the value and sanctity of every human being". Their crimes included the "deliberate killing of infirm or feeble-minded patients and of children in hospitals and asylums". Back then, the BMA spelled out the "principles for inclusion in a Charter of Medicine — the greatest crime being co-operation in the destruction of life by murder, suicide and abortion".
It was inevitable that the killing of human beings before birth allowed by the Abortion Act 1967 would lead to pressure for euthanasia, as giving more "choice". The first step was to decriminalise suicide. The right to assisted death for those too ill or incapacitated to kill themselves was next asserted. In 1988, the BMA in response to this said that "the law should not be changed, and the deliberate taking of a human life should remain a crime. This rejection of a change in the law to permit doctors to intervene to end a person's life is not just a subordination of individual well-being to social policy. It is, instead, an affirmation of the supreme value of the individual, no matter how
worthless and hopeless that individual may feel."
Much has changed since then. This year, the BMA will hold a conference on PhysicianAssisted Suicide. The BMA opposes the Winterton Bill, given a second Reading last week. Dr Peter Singer, now teaching ethics at Princeton University, equates newborn babies with the higher animals and recommends weeding out any imperfect ones, as the Nazis worked so hard to do. During the debate on the Winterton Bill, Dr Evan Harris MP defended the BMA doctors' claim to know best when their patients should die.
What is not generally recognised is that behind the campaign to permit doctors to kill those they cannot cure is an attack on our belief in the "dignity and worth of the human person" (as the United Nations once described it) as a religious superstition. Christians are not alone in upholding the value of human life. We are grateful to Muslim doctors, who have informed Parliament of their total rejection of euthanasia, whether "backdoor" or otherwise.
But we have to recognise that those who today determine the ethical responses of the profession as a whole have now abandoned not only traditional religious morality, but what was for centuries their own universally accepted ethical guide. Hippocrates, who wrote his code for doctors in 400 BC, appears to have had greater understanding of our human nature, with what the old penny catechism called its "strong inclination to evil", than the General Medical Council, which failed to strike Dr Shipman off the register when his addiction to Pethidine became known. But Hippocrates is no longer seen as relevant: most doctors, for generations (contrary to popular belief) have not sworn the Hippocratic Oath, or indeed, entered into any kind of ethical undertaking.
SOCIETY NEEDS itself to impose ethical standards on medical practice: that is the logical outcome of this retreat from medical ethics. It is, therefore, profoundly worrying that like the BMA, the Government, also opposes the•"Prevention of Euthanasia" Bill. Nevertheless, whatever Parliamentary means are found to obstruct its progress, public opinion has now been aroused.
One after another, MPs supporting the Bill spoke of letters from their constituents. The BMA believe that "a body of practice" can make it legal for doctors to cause the death of their patients, following the Bland judgement in 1993. Complaints from bereaved relatives hit the headlines last year. There has been a real awakening of public awareness on this issue. The Shipman case will certainly lead to demands that greater vigilance be exercised when unexplained deaths take place. It may well be that, even if the Winterton Bill does not become law, doctors like Peter Brand MP will feel less secure when they decide to take it into their own hands to decide whether a patient shall live or die.