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Published online by Cambridge University Press: 20 August 2013
The latest attempt by a determined, well-resourced lobby to introduce a law to permit assisted suicide/euthanasia in the UK was announced 15 May 2013 in the House of Lords. There are many dangerous facets to their arguments, not least of which is the rôle they cast for doctors in this debate.
Rush Rhees' remarks on the topic display a depth that is lacking in the current debate in the public square, which needs to be lifted from its current low level.
I try to show inter alia why the question of who is ‘qualified to speak’ in this deep moral dilemma is important (doctors are not special moral agents); why resistance is vital against a law, which must be general, permitting assisted suicide/euthanasia (‘hard cases’ make notoriously bad law which can have catastrophic consequences); how one group of (non-disabled) people judging another group of (disabled) people as candidates for elimination, is based on the false notion that a disabled life is ‘not worth living’; that so many of the deep moral questions raised by assisted suicide/euthanasia are not even considered in the contemporary impoverished public debate.
1 Rush Rhees in a letter to M C O'Drury reprinted in Moral Questions (ed.) Phillips, D.Z.(Macmillan Press, 1999), chapter 11CrossRefGoogle Scholar.
2 Cf. for example, the report of the Commission (sic) on Assisted Dying (Demos 2012, ISBN 978-1-906993-92-3) led by Lord Falconer, populated largely with already declared supporters of legalising assisted suicide/euthanasia, funded by the pro-euthanasia lobby Dying in Dignity (DiD is the re-branded Voluntary Euthanasia Society), and celebrity supporters.
3 Rhees, op. cit., 109.
4 Between 2003 and 2006 Lord Joffe made three attempts to introduce bills that would have legalized assisted suicide and voluntary euthanasia – all were rejected by Parliament. Lord Falconer has taken up the mantle and his latest attempt, backed by DiD was presented for its first reading in the House of Lords in London 15 May 2013.
5 Perhaps especially since Elisabeth Kübler-Ross published On Death and Dying in 1969.
6 No doubt Harold Shipman and Beverley Allitt stand outside the usual expectations of medical practitioners but one killed more than 250 older vulnerable people, the other four children, and attacked several others.
7 For example, the British Medical Association re-iterated its opposition to ‘all forms of assisted dying’ in 2013. The Royal College of Surgeons holds the same position.
8 Cf. for example Fitzpatrick, Kevin ‘Should the law on assisted dying be changed? No’ British Medical Journal 2011CrossRefGoogle Scholar;342:d1883 against Professor Raymond Tallis, a well-known advocate in this debate, who presented his arguments for a change in the law. The BMJ poll which accompanied the ‘head-to-head’ article was roughly 75% against. But that still means 25% of practitioners voted for a change to allow physician assisted suicide/euthanasia.
9 Professor Clive Seale's report, cited in the Falconer report, puts the figure at 1 in 3 doctors already terminally sedating patients. Some of those confidentially admitted doing so intentionally; obviating the ‘double-effect’ defence.
10 Dame Jane Campbell DBE ‘What disabled patients want from the NHS in the 21st century’ speech delivered in St Thomas Hospital London November 3, 2006.
11 ‘They asked me why I would want to live’ Irish Times 4 April 2011.
12 David and Carol Glass v United Kingdom Applicants response to the Government of the UK's observations on admissibility and merits. In the European Court of Human Rights. App. No. 61827/00.
13 Tony Bland's case was resolved in court four years after he was injured in the Hillsborough Disaster. The court ‘granted leave’ for food and water to be withdrawn on the application of the NHS Trust, with support from his family, to ‘let him die with dignity’. Airedale NHS Trust v. Bland (1993) AC 789 HL. He was the first person in English legal history for whom the court judged he should be allowed to die.
14 Cf. The Mid Staffordshire NHS Foundation Trust Public Inquiry chaired by Robert Francis QC (HC 947 London: The Stationery Office) ISBN: 9780102981476.
15 Cf. Pullicino, P. ‘The dangers of abandonment of evidence-based medicine in the use of the Liverpool Care Pathway’, Catholic Medical Quarterly Volume 62(4) November 2012Google Scholar.
16 Rhees, Rush: Wittgenstein and the possibility of discourse (Blackwell, 2006), xvi.Google Scholar
17 Rhees, op. cit., (1) 114.
18 Withdrawal or with-holding treatments is more correctly orthothanasia, which means ‘passive death' as opposed to euthanasia, generally translated as a ‘good death’.
19 Tony Nicklinson's campaign was to change the law on murder, permitting a doctor to kill him, since he could not take the final act himself. Nicklinson was (mis)described as ‘locked-in’ after a stroke left him able to move his head a little and to communicate by blinking at his computer to generate synthesised speech. His view of his life, though understandable, was different from Jean-Dominique Bauby editor of Elle magazine in France, who was only able to move one eyelid but wrote the book which became the film The Diving Bell and the Butterfly, or Bram Harrison, who is a DJ with locked-in syndrome after a head injury and has no wish to die.
20 As in Thomas More's satirical discussion of state-sponsored euthanasia in Utopia (1516).
21 Rhees, op. cit., 111.
22 Gaita, Raimond, Good and Evil: an absolute conception (MacMillan, 1991), 4.CrossRefGoogle Scholar
23 Ibid., 9–10.
24 Ibid., 9–10.
25 Ibid., 326.
26 As reported by Lord McColl. House of Lords Official Report (Hansard) 12 May 2006: col 1285.
27 I first heard Dr Peter Saunders using this phrase, to replace the hackneyed use of ‘slippery slope’. ‘Incremental extension’ more accurately reflects what has happened in jurisdictions that have legalised euthanasia.
28 Pereira, J., MBChB MSc ‘Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls’ in Current Oncology vol. 18, no. 2, 2011.CrossRefGoogle ScholarPubMed
29 Alex Schadenberg Exposing vulnerable people to euthanasia and assisted suicide (Ross Lattner Educational Consultants, Canada, 2013 ISBN 978-1-897007-27-3).
30 Press release by the Euthanasia Prevention Coalition (Canada), 25 September 2012.
31 I have not pressed the specifically religious position taken by doctors like Peter Saunders (Cf. his blog http://pjsaunders.blogspot.fr/) who work extremely hard to oppose assisted suicide/euthanasia from their Christian and their medical perspective.
32 Rhees, op. cit., 118 for this and the preceding quote.
33 Ibid., 110.
34 See for example: http://www.dailymail.co.uk/news/article-1214180/Fiona-Pilkington-suffered-years-abuse-gang-killing-disabled-daughter-car-fire.html; http://www.guardian.co.uk/uk/2010/jan/20/mother-guilty-murder-disabled-son; http://www.cbc.ca/news/canada/story/2010/12/06/f-robert-latimer-compassionate-homicide.html For the avoidance of doubt, I do not personally go along with the idea of ‘compassionate homicide’.
