LONDON, SEPT. 25, 2004 (Zenit.org).- The British Parliament is considering a proposal which, opponents argue, will dangerously liberalize the laws on assisted suicide. The Mental Capacity Bill, introduced June 18, would enable patients to decline life-saving treatment, the Times reported the following day.
The measure would impact on people who foresee the day when a disease might affect their capability to make a decision regarding medical treatment. Such people would be able to name, in writing, someone to take decisions regarding their health, including when doctors should cease medical care.
Such documents, or “living wills,” are already possible, but their legal status is uncertain, the Times said. On introducing the proposal Lord Filkin, the constitutional affairs minister, affirmed: “This bill expressly provides that it does not affect the law on murder, manslaughter or assisted suicide.”
A briefing note, made up of detailed legal arguments, issued July 19 by the Catholic Bishops’ Conference of England and Wales, pointed out a number of defects in the bill. The briefing was prepared by Archbishop Peter Smith, head of the bishops’ Department for Christian Responsibility and Citizenship, and John Finnis, professor of law and legal philosophy at the University of Oxford.
The bishops are not alone in their worries over the bill. On July 16 the Catholic Herald published a letter from, among others, the head of the Guild of Catholic Doctors, Chris Harrison.
The bill, explained the letter, is being promoted as enabling patient autonomy. “In reality,” it warned, “the Mental Capacity Bill permits ‘slow euthanasia,’ a form of homicide by omission, and sets up a pathway by which routine lethal injection will inevitably become desirable.”
“The proposals turn medical practice upside down,” the letter contended. Faced with a “living will,” a doctor could even be guilty of a criminal offense for refusing to bring about the patient’s death. This could even apply to merely administering fluids to a patient, explained the letter.
“To say that the Mental Capacity Bill will empower patients is a cruel deception,” argued Harrison. The letter also explained that additional provisions of the proposed law threaten to allow compulsory sterilization and forced abortion of the mentally handicapped.
The bill, Harrison added, “compromises the principle that all people have an intrinsic dignity irrespective of their mental impairment or physical condition, one of the cornerstones of Christian civilization, enshrined not only in the ancient common law of England, but also in the Hippocratic tradition of medicine and in international law properly understood.”
In a letter published Aug. 31 by the Times, 750 Catholic priests wrote to protest the bill. The priests, headed by Father Timothy Finigan, of the Association of Priests for the Gospel of Life, affirmed that “the bill in its present form will endanger those under our care by enshrining in law euthanasia by omission.”
“We share the grave concern of those Catholic medico-legal experts who have warned that provisions such as legally binding ‘living wills’ will force doctors to remove life-sustaining nursing care (including food and water) and medical treatment,” stated the letter.
Their worries were echoed by experts in bioethics, expressed in a letter published Sept. 7 in the Guardian newspaper. The letter was written by Helen Watt, director of the Linacre Center for Healthcare Ethics; Nigel Cameron, executive chairman of the Center for Bioethics and Public Policy; and David Jones, senior lecturer in bioethics at St. Mary’s College.
“The bill may not formally permit euthanasia by omission, but certainly invites it,” the three wrote. “It should be read in the light of court decisions which permit withdrawal of treatment, food and fluids from patients even where the purpose of so doing is to bring about their deaths.”
The bioethicists observed that the definition of a patient’s “best interests” is described in the bill only in subjective terms. They also noted that the bill permits invasive research on those unable to consent — “with not even the pretense that it is in the patient’s interests.”
A coalition of disabled people is also opposing the bill. In a Sept. 10 letter to the Guardian, Simone Aspis, a member of the group Changing Perspectives that forms part of the coalition “I Decide,” pointed out that the bill “creates an imbalance of power between decision-maker and person without capacity.”
People lacking the capacity to make their own decisions will not have any legal redress if the decision-maker in charge of them decides they should not receive medical treatment. This would affect those disabled people who suffer from intellectual impairments, explained Aspis.
Assisted suicide proposal
Along with the Mental Capacity Bill, the British Parliament also has before it a private member’s bill, introduced by Lord Joffe, a former chairman of Oxfam, which seeks to allow assisted suicide for the terminally ill. Press reports judge that it has little chance of being approved, as it is only a private initiative. Nevertheless, the proposal has led to a joint declaration by the Catholic and Anglican churches who have united in their opposition to the bill.
The submission, dated Sept. 2, to Lord Mackay, head of the Select Committee on the Assisted Dying for the Terminally Ill Bill, noted that “Those who become vulnerable through illness or disability deserve special care and protection. Adherence to this principle provides a fundamental test as to what constitutes a civilized society.”
The submission observed that in recent years an increasing emphasis on individual rights has led to patient autonomy “being accorded an ever higher priority in medical ethics.” Another argument used to justify assisted suicide or euthanasia is that of welfare, particularly in cases where the patient faces a slow death.
However, the Catholic and Anglican bishops in their declaration pointed out that both of these justifications “can lead in practice to much more widespread euthanasia than was originally envisaged.” Such has been the case in the Netherlands, where euthanasia was recently extended to infants.
"Neither of our Churches insists that a dying or seriously ill person should be kept alive by all possible means for as long as possible,” they explained. “On the other hand we do not believe that the right to personal autonomy is absolute.” What is important to keep in mind is that: “life should be respected, whether in oneself or in another; the aim of giving or refusing treatment should never be to make the patient die.”
Giving absolute priority to personal autonomy should not override the respect for the life of a vulnerable person, argued the submission. Moreover, the bishops warned that “A serious consequence of introducing euthanasia would be to undermine the relationship of trust between doctors and patients.”
As an alternative to enabling suicide, the submission called for greater attention to the hospice movement, which provides patients with adequate treatment for pain, along with emotional and spiritual support. “Helping people to die well in this way is not the preserve of any particular faith,” the submission said. “It is a profoundly compassionate and humane response to the reality of death which we all eventually face.”
In conclusion the bishops warned that a law permitting assisted suicide “could risk a gradual erosion of values in which over time the cold calculation of costs of caring properly for the ill and the old would loom large. As a result many who are ill or dying would feel a burden to others. The right to die would become the duty to die.”