This article appears in the November 1999 edition of the Catholic Medical Quarterly
Have You Seen This?
The Archdiocese of Glasgow
July 2 1999
Dr Michael Wilks, Chairman
BMA Ethics Committee, BMA House
Tavistock Square, London WC1H 9JP
Dear Dr Wilks,
I write to you to express my dismay and concern at the recent publication of BMA guidelines on withholding and withdrawing nutrition and hydration. The new guidelines are both sinister and worrying. They will cause very sincere anxiety to thousands of patients and their families who will now find themselves in a state of fear and alarm when they have to enter hospital.
My concern is quite simple. There can be no justification for starving and dehydrating people to death. That this should happen in NHS hospitals with the full approval of the BMA is almost beyond belief.
In essence, these guidelines give doctors the power of life or death over stroke victims, accident victims, the elderly and those with Alzheimers disease, many of whom are not in a terminal condition. Lest you misunderstand the Church s position, can I make it clear that we do not follow a vitalist line? We do not call for the prolongation of life at all costs, and indeed would not oppose discontinuing treatment of the dying when that treatment is burdensome and offers little hope of improvement in condition.
This, however, is very different from deliberately starving and dehydrating people to death, even when the people involved are not terminally ill and when the move goes against the wishes of their relatives. Such a course of action would ordinarily cause rather than accept a patient's death.
In addition, the best interests of the patient risk being replaced by economic criteria: as a result situations could arise where lives were deemed too costly to support. In a nation as wealthy as the United Kingdom, no-one should be starved or dehydrated to death because their life is regarded as too expensive to support.
Some of the guidelines do not even seem to reflect the current state of the law. Indeed in Scotland in recent weeks, the new Government has chosen not to legislate on these issues because there is no public consensus.
I am alarmed lest these guidelines be used to soften public opinion leading to a change in the law of the land. Issues of such magnitude are of incalculable moral and ethical importance. They should not be decided by one professional body, especially when that body makes no claim to particular expertise in issues of philosophical, ethical and moral concern.
In these circumstances, I find the BMAs decision to support the widespread withdrawal of hydration and nutrition quite unacceptable.
I will be urging all people of good will, whatever their religious or philosophical background, to seriously consider the implications of these new guide-lines.
If they are allowed to develop without challenge then everyone of us will be the losers.
I must ask you and the other members of the committee to re-consider the content of your recently-published guidelines.
+Thomas J Cardinal Winning Archbishop of Glasgow, President of the Bishops Conference of Scotland.
Rt Hon Tony Blair MP
Rt Hon Jack Straw MP
Rt Hon Frank Dobson MP
Mr Keith Vaz MP
Rt Hon William Hague MP
Rt Hon Ann Widdecombe MP
Dr Liam Fox MP
Mr Donald Dewar MSP
Mr Jim Wallace MSP
Ms Susan Deacon MSP
Lord Hardie QC
Mr Alex Salmond MSP
Ms Roseanna Cuningham MSP