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The Mental Capacity Bill could see euthanasia legalised 'by the back door' warns Christian Medical Fellowship general secretary PETER SAUNDERS

The UK parliament is very close to legalising euthanasia through two bills currently before Parliament. Christians need to be aware of what is happening so that they can pray and act wisely.

The Mental Capacity Bill, which has already been passed by the House of Commons and has its final reading in the House of Lords very shortly, provides the means for decisions to be made on behalf of people who are mentally incapacitated. Much of the bill is good and necessary and should improve the welfare of a very vulnerable class of people, but many are concerned that it also leaves open a door whereby some mentally incapacitated patients (especially those with stroke or dementia) could be starved, dehydrated and left to die.

The Bill gives statutory force to 'advance refusals', meaning that doctors could be legally required to withhold food and fluids in some situations where they believe such action is inappropriate on the grounds that it is in the patient's 'best interests' to do so. An advance refusal is where a patient can decide in advance whether or not he would like to have a certain treatment (including being given food and fluids), at a time when he is no longer capable of making decisions for himself.

In some circumstances it is entirely appropriate to withhold medical treatment and even food and fluids, for example when a patient is close to death and when giving them is unlikely to improve, or prevent deterioration of health. The law already recognises that patients who are capable of deciding should not be treated against their wills.

However, as a doctor, I am concerned that under this bill patients might make unwise and hasty advance decisions to refuse food and fluids without being properly informed about the expected course their illness will take, or the treatment and palliative care options available. It is too easy for people to be driven by fears of meddlesome treatment or 'being kept alive', into making advance decisions that later might be used against them.

Commonly, patients change their minds about what care they would like, as their condition changes, and for this reason advance decisions must be kept constantly under review. It is also striking that the majority of patients who make advance refusals actually prefer doctors to override those that they feel prejudice their care. The Mental Capacity Bill still leaves loopholes that could be abused by unscrupulous doctors and other health professionals or those with an interest – financial or otherwise – in a patient's death. Other doctors might feel pressure to abide by advance refusals, against their better judgement, in order to avoid the possibility of prosecution.

The passage of this bill is now inevitable, but I hope we will not look back and see this bill as the moment when euthanasia entered the UK by the back door.

The Assisted Dying for the Terminally Ill Bill is far more sinister. It seeks to legalise assisted suicide for competent adult patients who are 'terminally ill' and 'suffering unbearably'. Patients who are unable to participate in assisted suicide can receive euthanasia.

This Private Member's Bill, introduced by Lord Joffe, is currently being reviewed by a Select Committee in the House of Lords. The committee is currently poised on a knife-edge with eight in favour of euthanasia and five against. Although there is insufficient parliamentary time for it to become law before the election, if the committee reports in favour of euthanasia, it will be a huge moral victory for those who seek euthanasia to become law, and there would be huge pressure for the bill to be reintroduced in the near future.

If passed I am convinced that a bill like this would open the floodgates to euthanasia in this country, given the current climate of favourable public opinion, some willing doctors, and many patients already feeling a burden to relatives, carers and society at large.
Requests for voluntary euthanasia are rarely free and voluntary, and in fact extremely rare when patients' physical, psychological and spiritual needs are properly met. We should oppose voluntary euthanasia on the grounds that it is unnecessary (because alternative treatments exist), dangerous (because of the slippery slope) and morally wrong (it is contrary to all historically accepted codes of medical ethics and the Judeo-Christian ethic).

Another House of Lords Select Committee on Medical Ethics in 1994 opposed any change in the law to allow euthanasia after an extensive enquiry and concluded that “it was virtually impossible to ensure that all acts of euthanasia were truly voluntary and that any liberalisation of the law in the United Kingdom could not be abused”. They “were also concerned that vulnerable people – the elderly, lonely, sick or distressed – would feel pressure, whether real or imagined, to request early death”.

We need to pray that this wisdom continues to prevail.

There is much more information on both bills on the Christian Medical Fellowship website.

Peter Saunders is General Secretary of Christian Medical Fellowship

© Christian Family Network
is run by CPO, supported by
Care for the Family, Marriage Resource, Positive Parenting,
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		CAMPAIGNS Life and death decisions The Mental Capacity Bill could see euthanasia legalised 'by the back door' warns Christian Medical Fellowship general secretary PETER SAUNDERS The UK parliament is very close to legalising euthanasia through two bills currently before Parliament. Christians need to be aware of what is happening so that they can pray and act wisely. The Mental Capacity Bill, which has already been passed by the House of Commons and has its final reading in the House of Lords very shortly, provides the means for decisions to be made on behalf of people who are mentally incapacitated. Much of the bill is good and necessary and should improve the welfare of a very vulnerable class of people, but many are concerned that it also leaves open a door whereby some mentally incapacitated patients (especially those with stroke or dementia) could be starved, dehydrated and left to die. The Bill gives statutory force to 'advance refusals', meaning that doctors could be legally required to withhold food and fluids in some situations where they believe such action is inappropriate on the grounds that it is in the patient's 'best interests' to do so. An advance refusal is where a patient can decide in advance whether or not he would like to have a certain treatment (including being given food and fluids), at a time when he is no longer capable of making decisions for himself. In some circumstances it is entirely appropriate to withhold medical treatment and even food and fluids, for example when a patient is close to death and when giving them is unlikely to improve, or prevent deterioration of health. The law already recognises that patients who are capable of deciding should not be treated against their wills. However, as a doctor, I am concerned that under this bill patients might make unwise and hasty advance decisions to refuse food and fluids without being properly informed about the expected course their illness will take, or the treatment and palliative care options available. It is too easy for people to be driven by fears of meddlesome treatment or 'being kept alive', into making advance decisions that later might be used against them. Commonly, patients change their minds about what care they would like, as their condition changes, and for this reason advance decisions must be kept constantly under review. It is also striking that the majority of patients who make advance refusals actually prefer doctors to override those that they feel prejudice their care. The Mental Capacity Bill still leaves loopholes that could be abused by unscrupulous doctors and other health professionals or those with an interest – financial or otherwise – in a patient's death. Other doctors might feel pressure to abide by advance refusals, against their better judgement, in order to avoid the possibility of prosecution. The passage of this bill is now inevitable, but I hope we will not look back and see this bill as the moment when euthanasia entered the UK by the back door. The Assisted Dying for the Terminally Ill Bill is far more sinister. It seeks to legalise assisted suicide for competent adult patients who are 'terminally ill' and 'suffering unbearably'. Patients who are unable to participate in assisted suicide can receive euthanasia. This Private Member's Bill, introduced by Lord Joffe, is currently being reviewed by a Select Committee in the House of Lords. The committee is currently poised on a knife-edge with eight in favour of euthanasia and five against. Although there is insufficient parliamentary time for it to become law before the election, if the committee reports in favour of euthanasia, it will be a huge moral victory for those who seek euthanasia to become law, and there would be huge pressure for the bill to be reintroduced in the near future. If passed I am convinced that a bill like this would open the floodgates to euthanasia in this country, given the current climate of favourable public opinion, some willing doctors, and many patients already feeling a burden to relatives, carers and society at large. Requests for voluntary euthanasia are rarely free and voluntary, and in fact extremely rare when patients' physical, psychological and spiritual needs are properly met. We should oppose voluntary euthanasia on the grounds that it is unnecessary (because alternative treatments exist), dangerous (because of the slippery slope) and morally wrong (it is contrary to all historically accepted codes of medical ethics and the Judeo-Christian ethic). Another House of Lords Select Committee on Medical Ethics in 1994 opposed any change in the law to allow euthanasia after an extensive enquiry and concluded that “it was virtually impossible to ensure that all acts of euthanasia were truly voluntary and that any liberalisation of the law in the United Kingdom could not be abused”. They “were also concerned that vulnerable people – the elderly, lonely, sick or distressed – would feel pressure, whether real or imagined, to request early death”. We need to pray that this wisdom continues to prevail. There is much more information on both bills on the Christian Medical Fellowship website. Peter Saunders is General Secretary of Christian Medical Fellowship © Christian Family Network is run by CPO, supported by Care for the Family, Marriage Resource, Positive Parenting, Care, Women Alive, Christian Herald and many others.