The Poignant Cases of Diane Pretty and Miss B

2 End-of-Life Decisions in Line with Catholic Thinking

LONDON, MAY 4, 2002 ( Recent legal decisions in end-of-life cases make clear the need to identify well the factors involved in each situation. In the case of Diane Pretty, the European Court of Human Rights ruled unanimously April 29 that the British courts´ decision not to allow her husband to help her die does not violate the European Convention on Human Rights.

The same day, it was announced that a woman in Scotland, known only as Miss B, had died after discontinuing her medical support, with court approval. In both cases, Catholic bishops supported the legal decisions. But there is no contradiction in these positions, as an examination of each case shows.

BBC reported that the seven-member European Court of Human Rights expressed sympathy for Mrs. Pretty but added, “No right to die, whether at the hands of a third person or with the assistance of a public authority, could be derived.”

Doctors and anti-euthanasia groups, as well as the Catholic Church, supported the decision. Dr. Michael Wilks, of the British Medical Association, said: “The European Court of Human Rights has made the right decision.”

But Mrs. Pretty, who is in the advanced stages of motor neuron disease and is paralyzed from the neck down, commented: “The law has taken all my rights away.”

Some activist groups also criticized the decision. Reacting to the judgment, the Voluntary Euthanasia Society and civil rights organization Liberty said the British Director for Public Prosecution should draw up a policy document outlining when individuals could help others to die without fear of prosecution.

As the Times explained March 20, the British Parliament has abolished the law against suicide, but owing to her disabilities Mrs. Pretty would need assistance in ending her life. British law treats assisted suicide like a crime, punishable by up to 14 years in prison.

A right to refuse treatment

The situation of Miss B is quite different. While Diane Pretty was seeking active intervention to directly cause her death, Miss B asked that her treatment (the ventilator keeping her alive) be stopped.

Five weeks before Miss B´s death, Dame Elizabeth Butler-Sloss, president of the High Court Family Division, ruled that Miss B had the “necessary mental capacity to give consent or to refuse consent to life-sustaining medical treatment,” the Times noted April 30. As a result, her life-support equipment was switched off. Miss B, a former senior social worker, was paralyzed a year ago when a blood vessel ruptured in her neck.

At the time of the court decision on Miss B, Catholic Archbishop Peter Smith of Cardiff observed: “The right of a patient to refuse such treatment has long been recognized as legally and morally acceptable. It is important to be clear, however, that this case did not involve questions about euthanasia or assisted suicide and has set no precedents in respect of either.”<br>
Archbishop Mario Conti of Glasgow agreed. “The request in this case is not for assisted suicide,” he noted. “Rather, it is for the discontinuation of a medical procedure which has become burdensome to the patient.”

He added: “The Catholic Church has always upheld that discontinuing medical procedures that are burdensome, dangerous, extraordinary or disproportionate to the expected outcome can be legitimate. … In such cases the patient does not will her own death, rather she simply accepts the reality of her condition.”

No “right to die”

Commenting further on Mrs. Pretty´s case, Archbishop Smith declared: “The right to life cannot, without a distortion of language, be interpreted as conferring the diametrically opposite right, namely a right to die. Nor can it create a right to self-determination in the sense of conferring on an individual the entitlement to choose death rather than life.”

Archbishop Smith was given leave to make a written submission in the case, and he outlined a number of moral principles for the European Court of Human Rights.

Life is a gift of God “to be revered and cherished,” he wrote. “To direct one´s actions towards the extinction of the suffering person, oneself or another, is a false mercy.” Suicide and euthanasia are inconsistent “both with love of God and with the love of self,” the archbishop continued.

The submission does note that suffering may greatly diminish the responsibility of individuals, and it stresses the need for compassion and adequate palliative care. But the archbishop warned about the false argument that life is not worth living or “lacks all dignity.”

“Such thoughts, and choices and actions based upon them — however understandable in those confronted by the reality of suffering, disability, and dying and however worthy of compassion — are all incompatible with the equality of every human person in dignity,” stated Archbishop Smith.

The submission refers to a number of studies that point up the dangers of allowing assisted suicide. Among these is the 1994 study by the New York State Task Force on Life and the Law: “When Death is Sought: Assisted Suicide and Euthanasia in the Medical Context.”

The report observes that those who attempt suicide often suffer from depression or other disorders. Moreover, among the terminally ill, uncontrolled pain may contribute to depression. Archbishop Smith noted that the report concluded that the legalizing of any form of assisted suicide or euthanasia “would be a mistake and disaster of historic proportions, with catastrophic consequences for the vulnerable and an intolerable corruption of the medical profession.”

The submission also pointed to “compelling evidence to suggest that, once some ´limited´ form of euthanasia or assisted suicide is permitted under law … it is virtually impossible to confine its practice within the necessary limits to protect the vulnerable.”

The Dutch experience bears out this fear, noted Archbishop Smith. The Netherlands´ own study of deaths in 1990 shows that alongside 2,300 cases of voluntary euthanasia and 400 of assisted suicide, there were more than 1,000 cases of euthanasia without an explicit request and a further 4,941 of administration of a lethal overdose of morphine without the patient´s explicit consent.

In his March 23 speech to the World Organization of Gastroenterology, Pope John Paul II called upon doctors to show respect for sick people, especially those suffering from terminal illnesses. He also warned against considering the concept of health merely as psycho-physical balance. “Such a vision of health disregards the spiritual dimensions of the human person and would end by harming his true good,” observed the Pope.

Doctors must try to provide people an adequate treatment, forgetting neither spiritual values nor the limits of medicine, he said. As for steps taken to prolong a patient´s life, John Paul II stated that “an exasperated and overzealous treatment, even if done with the best of intentions, would definitely be shown to be, not just useless, but lacking in respect for the sick person who is already in a terminal condition.” In other words, respect for God´s gift of life doesn´t mean imposing useless suffering on the sick and dying.

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