Should society allow the terminally ill to ask that they be assisted to die by doctors and nurses? On October 10 the House of Lords will debate the fundamental issue of euthanasia following the Select Committee report on this issue. It is a debate of fundamental importance. It may well be followed by an attempt to introduce legislation in Parliament to make euthanasia legal.
The deceptive words of the dictionary definition of euthanasia tell us that it means “the bringing about of a gentle and easy death in the case of incurable and painful disease”. This does not mean just suicide. It does not mean the death that occurs when extraordinary means of supporting life are not necessary. But it does mean another person deliberately killing a human being even though the human being may wish that to happen. There have been several previous attempts in Parliament to legalise euthanasia. The definitive 1994 House of Lords Report on Euthanasia appeared to have marked an end to the debate by firmly rejecting voluntary euthanasia. So why has it returned to Parliament?
The Christian view is that human life is a gift from God and is sacred. We believe that any action which deliberately ends a life is wrong. This approach prohibits any intentional killing although this principle does not require the preservation of life at all costs. But now with the modern secular concept of personal autonomy the sanctity of life is equated to the quality of life. Life it is said only has value “if it is worth living”.
This is a dangerously vague basis for bringing a human life to an end. Is the permanently disabled and partly braindamaged person living a life that is not worth living? Is somebody suffering from Alzheimer’s who is not terminally ill leading a worthless existence? Is the worth of life in this approach simply a matter of “quality” or will it quickly pass on to that which is “economic” so that expensive treatment of the old becomes an economic justification for euthanasia in time to come. Why waste money on palliative care for the terminally ill? Christians and right-thinking people should reject this thinking. All of us as individuals live in a society in which the protection of life works for the common good. Valuing human life by what is “worthwhile” is hopelessly unreliable both for the patient and for society. To use such a nebulous concept is fundamentally to undermine the moral strength of the concept of sanctity of life.
And not to be forgotten is that it falls upon the medical profession to kill the person who wants to die. For us the idea of doctors, families, friends or counsellors playing their part in assisting a suicide is morally repugnant. It often involves a real confusion between whether treatment is worthwhile or whether the life involved is worthwhile. The latter always will be, the former may not – “Thou shalt not kill, but needst not strive officiously to keep alive”. So the advocates of euthanasia speak of “the morality of compassion” and in fact asserting the absolute right of each person to end their own life, as against the Christian view that each person has the right to decide whether or not to ask for further or burdensome treatment when death is near at hand.
Quite apart from the pressure on the vulnerable or old and terminally ill the involvement of doctors and nurses in this process is a fundamental change in a profession which has always been dedicated to caring for the living. From a time before Christ the doctors’ Hippocratic Oath included “to please no one will I prescribe a deadly drug, nor give advice which may cause his death”. The Royal College of General Practitioners is against euthanasia. So is the Royal College of Nursing, which believes that euthanasia is “contrary to the public interest, to nursing and medical ethical principles as well as patients’ civil rights” and it rejects any legislation that would place the responsibility on nurses and doctors to terminate life for any patient suffering from intractable, incurable or terminal illness.
The British Medical Association is the largest organisation of family doctors. In the spring of 2004 it repeated its opposition to euthanasia in a convincing sevenpoint declaration. It concluded that legalising doctor assisted suicide would “fundamentally alter the ethos of medicine”. Further, there was the risk of undermining the trust that vulnerable elderly disabled or very ill patients have in their doctors. Patients might choose euthanasia for the wrong reasons. But, above all, it would weaken society’s prohibition on intentional killing and could weaken safe guards against non-voluntary euthanasia of people who are both seriously ill and mentally impaired.
However, at its recent summer meeting – by a bare majority of fewer than 200 people – it adopted a neutral position about euthanasia. This volte-face occurred following the most tawdry procedural strategems. It is astonishing that on such a grave question the views of the entire membership were not sought after full debate and consultation. Are we really to look forward to classes at medical schools and nursing colleges describing how patients can be killed at their own request?
The slippery slope in euthanasia is obvious. In the few counties where voluntary euthanasia is legal there is serious debate about the way it is being implemented. Its proponents use the language of personal choice to make their course the more acceptable.
But an article by Mick Hume in the Times in 2003 rightly argued that “nobody who truly values liberty should want to reduce life itself to just another ‘lifestyle choice’. It is telling that public support for legalisation is out of all proportion to any actual demand for voluntary euthanasia. In practice few terminally ill people go through with it...” Hume points out the dangers revealed by the claim of the Swiss group Dignitas, who assist people in their own deaths, and have said that they would accept “a diagnosed schizophrenic for assisted suicide”. The Dutch Supreme Court recently ruled against a doctor who had helped a physically well man to commit suicide simply because the man claimed that he was “tired of life”.
Hume concludes: “Are we at such a low point that the law sees an unhappy existence as a good enough reason for a premature death? As disabled campaigners point out making ‘quality of life’ a measure of whether euthanasia is justified is a dangerous business. No law should be allowed to declare that a life that will end in pain is worthless, never mind worthless.” The Christian conclusion is clear – assisting the terminally ill to die is intentionally killing and morally unacceptable. The danger to the trust relationship between patient and medical profession is obvious should euthanasia be introduced. There will be an early and clear division between those who would kill and those who would not.
But what of human life itself? Is the body simply raw material to be disposed of when a person concludes that he no longer wishes to exist?
If we so regard ourselves, raw material we will become, and the sanctity of life will eventually be measured by utility and economy. The principle of the sanctity of life is not open to legalistic or moral qualification. We must be vigilant to resist any move to introduce the assisted dying of human beings, whether they are terminally ill or not.
Lord Brennan QC is a Labour peer and president of the Catholic Union of Great Britain