You are in: Coloured Supplements » Euthanasia (June 1999)

Euthanasia by David Holloway

Printer Friendly Version

Dr David Moor

On the 11 May 1999, Dr David Moor, a local Newcastle doctor, was acquitted at Newcastle Crown Court, after facing charges of murdering a terminally ill patient by a lethal drug overdose. The case had national significance. In court he argued, contrary to what he had said earlier to the press and TV, that all he tried to do "in treating Mr Liddell [the patient] was to relieve his agony." So the jury did not convict him of murder - which would require an intention to kill. According to The Guardian, the turning point in the case came when the judge, Mr Justice Hooper, excluded key toxicological evidence leaving the prosecution with no proof that the drug injection had caused the death. The Judge decided that Dr Moor should pay a third of the defence costs, saying Dr Moor had partly brought the prosecution on himself by "very silly remarks to the press" and lying to the NHS and police.

This case highlighted two things: one, the vigorous campaigning by the Voluntary Euthanasia Society (Dr Moor's supporters in the 30,000 strong petition came from 19 countries of the world); and, two, the confusion over euthanasia. This case has not changed the law one wit. The case maintained a critical distinction. Doctors may administer drugs to relieve the pain and distress of dying patients, even if such a dose might, as a side effect, hasten death. That is known as the "double effect". What is prohibited is for doctors to give patients lethal doses intending to kill them.


Christian and anti-Christian views

The bible is clear that God is our creator. Human life is not our "property" - it is held in trust or on loan. We may not just "dispense" with it. As Job said: "The Lord gave and the Lord has taken away" (Job 1.21). Our lives are meant for the service of God. It is not for us to "take" life. We should think of our lives in the spirit of Jesus Parable of the talents (Mat 25.14-15). And you have the fundamental prohibition on killing, and the basis for it, set out in Genesis 9.6:

Whoever sheds the blood of man, by man shall his blood be shed; for in the image of God has God made man.

Our significance, and so the claim to protection, derives not from our "quality of life" or gifts and abilities, but on our status as being made in God's image. We have the worth that he put on us when he "so loved the world, that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life" (John 3.16).

But the world is drifting from that understanding.

Dr Jim Howe was Tony Bland's consultant neurologist. Tony Bland had been injured during the Hillsborough disaster in 1989 and it resulted in his being in a "persistent vegetative state". The Law Lords made a controversial ruling to allow the withdrawal of food and water on the basis that this was "medical treatment" and not a normal right - in this case. Tony Bland was then allowed to die. Jim Howe has now gone public for the first time in an interview. One question was, "Did he see Tony Bland as a person?"

"No, his personhood had gone when his chest was crushed; he was not a person in the sense that I understand it, in an ethical sense. A person is someone who has the capacity to value their life: that's the definition given by Professor Harris from Manchester, and I think it's the best one I have seen. A person is that creature, that sentient creature, which has the capacity to value its own life, so by that definition chimpanzees and gorillas are persons; we should not kill them, any more than we should kill other human beings who don't want to be killed."

The next question was: "Does a young baby have value as a person?"

"A new-born baby probably doesn't ... One of the things that irritates me about people who believe in the sanctity of life is that they don't extend that sanctity of life to higher primates and dolphins and so on - or maybe they do - because I think they should. They think that we have a God-given sanctity of life. Well, I don't believe in God so I don't see any divine imprint."

That is the problem. And there are hidden agendas. There is an assault on Christian values. In Australia, the Northern Territory - with a tiny population - voted for euthanasia in 1995. That vote has subsequently been overturned, but not before Dr Nitschke, one of the Bill's proponents had help eliminate four people, with his laptop "deliverance" machine that administered the poison. He admits, however, "I had little contact with terminally ill patients until I became involved in the political struggle to try and get the legislation through up here." It is all part of his support for "libertarian-type issues" as he calls them. And who is stopping and overturning his efforts? He says, "the Church ... I think we can win against the [medical] profession but we didn't win against the Church. The Church is the force making the politicians crumble."


The solution

There is no real conceptual problem about euthanasia - "thou shalt not kill nor strive officiously to keep alive" is an excellent rule of thumb for doctors. What is wrong is intentional killing. There is a clear distinction between, on the one hand, taking action with the specific intention of shortening life; and, on the other hand, withdrawing medical treatment that is of no further benefit or that is so burdensome to the patient that it far outweighs any benefits it might produce. Yes, sometimes there are difficult decisions. But, no, this is not "killing" or euthanasia. Given a Christian framework, policies and practices can be worked out for new types of problem when they occur. But lacking such a framework there will be (and is) chaos. In Holland where euthanasia is tolerated, this already is the case. The elderly now carry "passports for life" in their wallets to avoid euthanasia if they should happen to end up in hospital.

A main problem is inadequate palliative (pain reducing) care. The solution, therefore, is wider knowledge and the wider use of the available resources of good palliative care - or so argues George Chalmers, a consultant geriatrician. If palliative care is not well taught in medical schools or researched there will be pressures for euthanasia. A report to the Health Council on Palliative Care in Holland concluded that 54% of cancer patients who were in pain, suffered unnecessarily because doctors and nurses had insufficient understanding of the nature of the pain and the possibilities for its alleviation (the culture of euthanasia in Holland may also explain the lack of provision of hospices for children). Kathryn Mannix, consultant in Palliative Medicine at the Marie Curie centre in Newcastle claims:

I have seen about 6000 patients in the last 13 years but in all that time I can only remember three occasions, when a patient has begged me to take their life.

And we must beware of myths - especially the myth that drug relief invariably means a shortening of life. It does not. Sadly this myth means some patients refuse help. But drugs often extend the patient's life by relief of debilitating pain and other symptoms.

There are other problems that generate support for euthanasia. Demographic changes mean that people are living longer, but with the break down of marriage and the family there are fewer potential carers for older and disabled people. This means higher expectations from the State. All this inevitably leads to a resource question - "who will pay and provide?" But this question of "who should care?" which is a legitimate one, should never turn into "why care?" or "should we care?" Also there are now higher expectations of cures generally in medicine and the non-acceptability of illness. This means people are less able to cope with illness, and indeed the approach of death.

But the most important practical problem is that people are less and less aware of the claims of God. Less believe that life is his gift; they think it is a human right, to be disposed of as any one will.


Conclusion

It is urgent we fight these pressures for euthanasia. If it ever became legal, it would be used as an easy option for doctors, for patients and for relatives; it would inhibit the development of palliative care; it would entail a slide from voluntary to involuntary euthanasia as is happening in Holland, where according to Dr Anthony Daniels, "many doctors admit that they have killed their patients because they thought their patients would be better off dead;" it would, therefore, breakdown trust between doctors and patients and especially elderly patients.

Some words written 200 years ago are still relevant:

The physician should and may do nothing else but preserve life. Whether it is valuable or not, that is none of his business. If he once permits such considerations to influence his actions, the doctor will become the most dangerous person in the State (Christoph Hufeland).

Printer Friendly Version