wfn.org | [ACNS] Anglican and CatholicBishops oppose euthanasia Bill

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ACNS 3880     |     ENGLAND     |     7 SEPTEMBER 2004

Bishops oppose 'misguided and unnecessary' euthanasia Bill

[Church of England Communications Unit]

Church of England and Roman Catholic bishops have joined forces to urge
the UK Parliament not to change the law on euthanasia, arguing that
allowing assisted suicide would undermine the protection of vulnerable
people.

In a joint submission to the House of Lords Select Committee on the
Assisted Dying for the Terminally Ill Bill, the Church of England House
of Bishops and the Roman Catholic Bishops' Conference of England and
Wales describe the Bill as "misguided" and "unnecessary" and warn it
would damage the relationship of trust between doctors and patients. The
Select Committee was set up to consider a Private Member's Bill
introduced by Lord Joffe.

In its conclusion, the bishops' joint submission says: "It is deeply
misguided to propose a law by which it would be legal for terminally ill
people to be killed or assisted in suicide by those caring for them,
even if there are safeguards to ensure it is only the terminally ill who
would qualify.

"To take this step would fundamentally undermine the basis of law and
medicine and undermine the duty of the state to care for vulnerable
people. It would risk a gradual erosion of values in which over time the
cold calculation of costs of caring properly for the ill and the old
would loom large. As a result many who are ill or dying would feel a
burden to others. The right to die would become the duty to die."

It adds: "The Bill is unnecessary. When death is imminent or inevitable
there is at present no legal or moral obligation to give medical
treatment that is futile or burdensome. It is both moral and legal now
for necessary pain relief to be given even if it is likely that death
will be hastened as a result. But that is not murder or assisted
suicide.

"What terminally ill people need is to be cared for, not to be killed.
They need excellent palliative care including proper and effective
regimes for pain relief. They need to be treated with the compassion and
respect that this Bill would put gravely at risk."

In a covering letter to the chairman of the Select Committee Lord
Mackay, the Most Revd Rowan Williams, the Archbishop of Canterbury, and
HE Cardinal Cormac Murphy-O'Connor, Archbishop of Westminster, said: "We
believe very strongly that respect for human life at all its stages is
the foundation of a civilised society, and that the long term
consequences of any change in the law to allow euthanasia in limited
circumstances would be immensely grave.

"This is a view shared not just within our Churches, but very widely
among those of all faiths and none who share a moral outlook founded on
respect for human life and the protection of vulnerable people."

Covering letter

Dear Lord Mackay,

Select Committee on the Assisted Dying for the Terminally Ill Bill

We are writing to send your Committee a joint submission from the Church
of England House of Bishops and the Catholic Bishops' Conference of
England and Wales.

We believe very strongly that respect for human life at all its stages
is the foundation of a civilised society, and that the long term
consequences of any change in the law to allow euthanasia in limited
circumstances would be immensely grave. This is a view shared not just
within our Churches, but very widely among those of all faiths and none
who share a moral outlook founded on respect for human life and the
protection of vulnerable people.

As you know, having considered the evidence and the arguments against
legalising euthanasia in great depth, the House of Lords Committee on
Medical Ethics in 1994 firmly rejected any change in the law to allow
euthanasia. They concluded:

"The right to refuse medical treatment is far removed from the right to
request assistance in dying. We spent a long time considering the very
strongly held and sincerely expressed views of those witnesses who
advocated voluntary euthanasia... Ultimately, however, we do not believe
that these arguments are sufficient reason to weaken society's
prohibition of intentional killing. That prohibition is the cornerstone
of law and of social relationships. It protects each one of us
impartially, embodying the belief that all are equal. We do not wish
that protection to be diminished and we therefore recommend no change in
the law to permit euthanasia. We acknowledge that there are individual
cases in which euthanasia may be seen by some to be appropriate. But
individual cases cannot reasonably establish the foundation of a policy
which would have such serious and widespread repercussions." [HMSO,
London, 1994, paras 236-7].

We hope and pray that your Committee will reaffirm and endorse that
conclusion, given that the strength of the arguments against euthanasia
are undiminished, and the empirical evidence of the damaging effects of
legalising euthanasia in the Netherlands is even stronger now.

In our submission we have sought briefly to set out what seem to us the
key fundamental principles and then we make some specific points on this
particular Bill. We hope your Committee will find it helpful.

With every good wish

Yours sincerely,

The Most Revd Rowan Williams
The Archbishop of Canterbury

HE Cormac Murphy-O'Connor
Cardinal Archbishop of Westminster

There follows the complete text of the submission:

The House of Lords Select Committee on the Assisted Dying for the
Terminally Ill Bill

Joint submission from the Church of England House of Bishops and the
Roman Catholic Bishops' Conference of England and Wales

2 September 2004

Foundations

1. The arguments presented in this submission grow out of our belief
that God himself has given to humankind the gift of life. As such, it is
to be revered and cherished.

2. Christian beliefs about the special nature and value of human life
lie at the root of the Western Christian humanist tradition, which
remains greatly influential in shaping the values held by many in our
society. These beliefs are also shared in whole or in part by many
people of all faiths and none.

3. All human beings are to be valued, irrespective of age, sex, race,
religion, social status or their potential for achievement.

4. Those who become vulnerable through illness or disability deserve
special care and protection. Adherence to this principle provides a
fundamental test as to what constitutes a civilised society.

5. The whole of humankind is the recipient of God's gift of life. Life
is to be received with gratitude and used responsibly. Human beings each
have their own distinct identities but these are formed by and take
their place within complex networks of relationships. All decisions
about individual lives bear upon others with whom we live in community.

6. For this reason, the law relating to euthanasia is not simply
concerned either with private morality or with utilitarian approaches.
This is one of the issues - relatively few in number but fundamental in
importance - on which justice calls for a limit to moral or ethical
pluralism. A positive choice has to be made by society in favour of
protecting the interests of its vulnerable members even if this means
limiting the freedom of others to determine their end.

Two arguments for legalising euthanasia

7. There are two considerations which are often appealed to in defence
of euthanasia - individual autonomy (the so-called 'right' to die at a
time of one's choosing) and welfare (the view that at beyond a certain
point some lives are not worth living).

8. In recent years there has been an increasing emphasis on individual
rights and self-determination. In the world of medicine, this has had
its impact with patient autonomy being accorded an ever higher priority
in medical ethics. In the Assisted Dying for the Terminally Ill Bill,
the emphasis on autonomy is evident in the way that "unbearable
suffering" is given a purely subjective definition: it is suffering
"...which the patient finds so severe as to be unacceptable..". The Bill
requires the patient to be informed of alternative responses including
palliative care, but the patient must then be helped to die if this is
his or her settled wish. The Bill does however restrict its scope to
those who are terminally ill, where death is likely to result "within a
few months at most.". But if the principle of autonomy is being invoked
to justify the Bill it is difficult to see how this restriction could be
defended. The suffering caused by a non-terminal chronic illness,
whether mental or physical, may equally be "so severe as to be
unacceptable" to those affected. Why should euthanasia not be made
available to them too?

9. At this point the second consideration - welfare - comes in. If it is
not enough simply for the patient to want euthanasia, then the
justification often given is that it is in his or her best interests to
die. It is argued that in some situations life has no value, especially
if the patient cannot look forward to any improvement and faces a slow
and lingering death. But if this is the justification, there is once
again no basis for restricting the scope of euthanasia to the terminally
ill, or indeed to those making a voluntary request.

10. Both autonomy and welfare considerations can lead in practice to
much more widespread euthanasia than was originally envisaged. The
submission to this Committee from the Linacre Centre for Healthcare
Ethics contains ample evidence of this in the case of the Netherlands
where, as they point out " we see both an extension of euthanasia to
those who are mentally ill or 'tired of life' and its extension to those
who are unable to consent such as infants and young children".

The limits of autonomy

11. Neither of our Churches insists that a dying or seriously ill person
should be kept alive by all possible means for as long as possible. On
the other hand we do not believe that the right to personal autonomy is
absolute. Patients should not be overtreated, and may reasonably refuse
particular treatments as too burdensome. Having said this, life should
be respected, whether in oneself or in another; the aim of giving or
refusing treatment should never be to make the patient die.

12. The exercise of personal autonomy necessarily has to be limited in
order that human beings may live together in reasonable harmony. While
at present people may exercise their legal right to refuse treatment
(although this may be overridden in special but strictly limited
circumstances), the law denies that there is a legal right to die at a
time of one's own choosing. The consequences which could flow from a
change in the law on voluntary euthanasia would outweigh the benefits to
be gained from more rigid adherence to the notion of personal autonomy.
But in any case we believe (para 6) that respect for the life of a
vulnerable person is the overriding principle.

13. The right of personal autonomy cannot demand action on the part of
another. Patients cannot and should not be able to demand that doctors
collaborate in bringing about their deaths, which is intrinsically
illegal and morally wrong.

14. A serious consequence of introducing euthanasia would be to
undermine the relationship of trust between doctors and patients. The
value attaching to human life implies that the primary duties of doctors
caring for those with terminal illness are to ensure their patients are
as free from pain as possible, given the information they and their
carers request or require to make informed choices about their future
lives, and are supported through the personal challenges which face
them. But if doctors were allowed in some circumstances to kill their
patients rather than care for them, this would inexorably lead to an
undermining of trust. Medical treatment would come to be regarded by the
vulnerable person as potentially life threatening rather than as
conferring benefit.

15. A change in the law to permit assisted dying would also change the
cultural air we all breathe, and affect attitudes to older people and
those with chronic illness. For example, the law permitting abortion has
profoundly changed society's attitude towards the status of the foetus.

Protection of the vulnerable

16. Doctors are rightly concerned to do the best they possibly can for
the actual patients in front of them, and so are the families and
friends of those who are ill. It is hard to stand back from the trauma
of the individual suffering and look at the wider picture; to think
about the long-term implications of decisions made under the pressure of
individual need. This is why the law has to play its part in providing a
framework within which the medical profession can operate. A
foundational guiding principle of the current legal framework is that we
should not deliberately kill each other.

Palliative care and burdensome treatment

17. Behind many of the arguments in favour of euthanasia lie powerful
fears, and in particular the fear that the alternative to euthanasia
might be a lingering and painful death, exacerbated by futile and
burdensome medical treatment.

18. When death is imminent or inevitable, the withholding or withdrawing
of medical treatment that is judged futile or burdensome is both moral
and legal today as in the past. Doctors do not have an overriding
obligation to prolong life by all available means. Treatment for a dying
patient should be 'proportionate' to the therapeutic effect to be
expected, and should not be disproportionately painful, intrusive,
risky, or costly, in the circumstances. Treatment may therefore be
withheld or withdrawn, though such decisions should be guided by the
principle that a pattern of care should never be adopted with the
intention, purpose or aim of terminating the life or bringing about the
death of a patient. Death, if it ensues, will have resulted from the
underlying condition which required medical intervention, not as a
direct consequence of the decision to withhold or withdraw treatment.

19. The hospice movement developed from a concern that people should be
helped to die with dignity (that is, to live with dignity until they
die). This work has enriched not only the lives of terminally ill people
but also their carers, volunteers, and health professionals, who have
found that caring for those who are dying can be a great source of
blessing. Friendship, companionship and above all love are the key
characteristics of a good death. Helping people to die well in this way
is not the preserve of any particular faith. It is a profoundly
compassionate and humane response to the reality of death which we all
eventually face.

20. We are concerned that the lessons learned in hospices about pain
control, and emotional and spiritual support should be applied
throughout the health service to all dying people. This requires that
medical personnel remain aware of how advice on pain control may be
obtained, seek specialist help where necessary, and that adequate
resources are made available for the care of sick and elderly people.

21. We believe that deliberately to kill a dying person would be to
reject them. Our duty is to be with them, to offer appropriate physical,
emotional and spiritual help in their anxiety and depression, and to
communicate through our presence and care that they are supported by
their fellow human beings and the divine presence.

Conclusion

22. It is deeply misguided to propose a law by which it would be legal
for terminally ill people to be killed or assisted in suicide by those
caring for them, even if there are safeguards to ensure it is only the
terminally ill who would qualify. To take this step would fundamentally
undermine the basis of law and medicine and undermine the duty of the
state to care for vulnerable people. It would risk a gradual erosion of
values in which over time the cold calculation of costs of caring
properly for the ill and the old would loom large. As a result many who
are ill or dying would feel a burden to others. The right to die would
become the duty to die.

23. The Bill is unnecessary. When death is imminent or inevitable there
is at present no legal or moral obligation to give medical treatment
that is futile or burdensome. It is both moral and legal now for
necessary pain relief to be given even if it is likely that death will
be hastened as a result. But that is not murder or assisted suicide.
What terminally ill people need is to be cared for, not to be killed.
They need excellent palliative care including proper and effective
regimes for pain relief. They need to be treated with the compassion and
respect that this bill would put gravely at risk.

2 September 2004

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