Catholic Medical Quarterly Volume 74(4) Nov 2024
Assisted Dying Bill
Dr Philip Howard
Background
Ms Kim Leadbetter is shortly to submit a Private Members Bill to Parliament on assisted suicide. The Prime Minister has agreed that there should be an open discussion and that MPs will have a free vote. The Bill is likely to follow the framework introduced by previous bills including those put forward by Baroness Meacher and Lord Falconer in the House of Lords and the private members Bill of Mr Liam McArthur in the Scottish Parliament. However, on 1 October, the Scottish Health Minister, Mr Neil Gray was reported as saying that legislation concerning the use of lethal drugs was beyond the powers of the Scottish Parliament.
Ms Leadbetter’s Bill is due to be debated in Parliament on 29 November ahead of a free vote on the issue. The latest opinion poll on 11 October 2024 from the Policy Institute and the Complex Life and Death Decisions group at King’s College stated that 63% of 2,063 adults wanted assisted dying to be legalised, 20% were against is and 17% were undecided.
Terminology
The term assisted dying is ambiguous. It covers a range of issues from established palliative care practice, to assisted suicide and even active euthanasia. Palliative care services are widely appreciated and largely funded by the public. The issue is assisted suicide which is a form of deliberate killing of another person. Suicide itself was decriminalised in 1961 by the Suicide Act after it was recognised that those who attempt suicide suffer from serious mental health issues and depression and should not be penalised if their attempt at suicide fails. Nevertheless, assisted suicide remains a crime which can be penalised by imprisonment for up to 14 years.
Proposed legislation
The purpose of the current proposed legislation, which is yet to be published and presented to Parliament is to decriminalise assisted suicide for adults who have mental capacity and have a terminal condition.
Assisted suicide is a form of homicide and both endorses and facilitates the suicide of the most vulnerable patients at the most difficult time of their lives. No-one has actual, personal experience of death which is a fundamental essential issue for us all. Yet, those advocating assisted suicide maintain that they will be reassured by knowing that they may choose death if their circumstances deteriorate.
Fundamental right to life
Assisted suicide destroys the fundamental right to life which is the
ethical foundation of Medi- cine. Without the right to life there can be
no logical duty to respect any other right.
The right to life is
inherent, can neither be conveyed or withdrawn, is universal, equal and
non-discriminatory.
It is inherent by virtue of our creation and
membership of the human family.
It is universal and applies to all
human beings across the World and throughout time.
It is not conferred
by Society, nor can it be denied in law.
It is equal for all human
beings and does not change with age, disability or illness.
It is
inalienable and the foundation for the enjoy- ment of all other rights.
Denial of the right to life means that no other rights can be recognised.
If there is no right to life there can be no other rights.
Safeguards
Those advocating assisted suicide are quick to reassure others that there will be adequate safeguards. There can be no safeguards.
- The acceptance of assisted suicide means the denial of the right to life and all other rights.
- The decriminalisation of assisted suicide defies the common law maxim that the consent of the victim cannot be used in mitigation. The victim cannot lawfully agree to their own deliberate killing.
- The Bill would decriminalise assisted suicide which would no longer be a crime.
- Any offence therefore would be in relation to civil, not criminal
issues and would revolve around procedural matters such as:
- Was the victim over 18, have mental capacity, a terminal condition and express a clear desire to have their life ended with the assistance of another and was there due diligence in following the procedures prescribed by law?
- Since, the death would be overseen by two medical practitioners who would make their own independent assessments, there would be a subjective component to the assessments. This applies particularly as to whether the person had a clear knowledge and understanding of their condition and a fixed desire to end their life. How can this be proven, especially when the person has died?
- What if friends, family or the patient’s normal medical practitioner disagree with the independent assessment?
- Since the primary victim is dead, how can there be any compensation and who would be compensated?
- What, if any, would be the repercussions on the medical practitioners?
- Who would bring a case and on what grounds?
- What compensation, if any could there be for others such as other family members or carers.
- Would there be monetary compensation for bereavement or mental health issues for those who knew the patient?
- What would be the claim against the medical practitioners and how would it be substantiated, if at all?
- Who would pay the considerable legal fees and what if any would be the monetary compensation for those involved?
Effects of assisted suicide on the medical and nursing professions.
The fundamental position as stated in the Hippocratic Oath is contained
within one sentence:
“I will give no deadly drug to any, nor will I
counsel such.”
The person who can cure can also kill.
Assisted suicide would enable doctors to deliberately be involved in the killing of patients. The issue is not assisted dying but deliberate killing. The Bill would cross the Rubicon and destroy the ethical basis of all medical practice. Parliament will have destroyed the very core of justice through a denial of the fundamental right to life which is the basis for all other human rights and our legislative and judicial systems. The concept of justice itself will be destroyed if doctors are allowed to directly and deliberately kill patients. How can those who are lonley, isolated, elderly, vulnerable, disabled or facing terminal illness be properly protected except by a complete ban on direct and deliberate killing by those who are entrusted to care for them?
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