A 'Right' That Turns Doctors into Killers

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Byline: WILLIAM REES-MOGG

There was a great debate in the House of Lords last Monday which showed a breadth of knowledge and experience that could not be matched in the House of Commons.

The subject of the debate was the Report of the Select Committee on the Bill For Assisted Dying For The Terminally Ill. The report was published in April; there are two volumes of evidence.

Anyone who wants to understand the arguments for and against assisted suicide will need to study the report, the evidence and the debate.

These will, I think, become classic documents. Their high quality owes much to the chairman of the committee, Lord Mackay of Clashfern, the distinguished former Lord Chancellor.

There are two stages in this argument. People first have to decide whether the principle of medical euthanasia can ever be justified.

When our domestic pets are in pain, or terminally ill, or sometimes for lesser reasons, we have them killed, 'to put them out of their misery'.

Would it be a social good to do the same for humans, subject to their consent, or is there something about human life that is sacred? Is killing humans for medical reasons always wrong?

There are many aspects to this debate, which obviously raises issues such as pacifism, religious belief, the autonomy of the human, the quality of medical care for the dying and so on.

I think all one can do is state one's own conviction. Like most Roman Catholics, I think medical killing is always wrong, but that there is no obligation, on doctors or patients, to push extreme treatments beyond the point at which they can only prolong suffering.

What I did not fully realise was the complexity of the purely medical arguments that arise if euthanasia is allowed in principle, whether as direct killing or as assisted suicide.

These problems were brought out best in the evidence, particularly that of doctors and nurses.

Fortunately, most of us do not have to deal with many deaths in our lifetimes, and we have little idea whether a death we have been close to is relatively typical or quite unusual.

Doctors and nurses see a large number of deaths, sometimes 1,000 or more in their careers, and they are in a position to take a general view.

That is not to say that all medical people are in agreement about euthanasia. They are not. There is, however, a widespread reluctance among doctors to take the responsibility for causing death. All opinion polls suggest that more doctors are opposed to euthanasia than members of the public, perhaps because the doctors would have to carry it out.

If society does decide to allow euthanasia, it will undoubtedly be putting a new strain on doctors and nurses. Professor Richard Glynn Owens, who has spent the past 20 years working on the care of dying people, observed in his evidence, 'our own research into the provision of euthanasia by doctors in Holland (the only research of its kind, to date) has highlighted the extent to which doctors find the procedures distressing.

There is a very real risk that the provision of euthanasia will have a stressful impact on practitioners.' Only a minority of advocates of euthanasia, or of assisted suicide, would be willing to inject the syringe themselves. Is it fair to put that moral burden on to doctors?

There are other points that arise if we look at euthanasia from the doctors' or the nurses' point of view.

The National Group of Palliative Care Nurse Consultants put one pithy point: 'The Bill makes the assumption that end-of-life care is physician-led. …