Melanie Phillips

8 December 2004

Killing the vulnerable

Published in: Daily Mail

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The suggestion that we might starve or dehydrate such people to death should be unthinkable. The idea that doctors, whose overriding ethical duty is always to act in the best interests of their patients, might be forced to carry out such death-dealing procedures should be doubly abhorrent.

Yet the Mental Capacity Bill, which reaches its report stage and third reading in Parliament next week, would turn just such unthinkable and abhorrent practices into law.

At this eleventh hour, a group of MPs has put down an Early Day Motion protesting that the bill would legalise 'euthanasia by omission' -in other words, enable doctors deliberately to bring about the death of patients by withdrawing what they need to keep them alive.

For under its provisions, doctors would be able to withhold food or fluids from mentally incompetent patients with the express intention of causing them to die.

The government justifies this on the basis that it merely enables such patients to ensure that their wish not to be treated, as laid down in 'living wills' before they lost their mental faculties, should be respected.

But there is a great difference between a patient of sound mind refusing treatment and being starved or dehydrated to death. Doctors have a duty not to prolong suffering. But they are under an equal duty not to take a life.

Alarmingly, many doctors themselves often fail to grasp that crucial moral questions revolve around their intentions. There is a huge difference between giving treatment designed to reduce suffering, which may have the unintended side-effect of shortening a life that is already ending, and withdrawing food or fluids without which even healthy people will die.

To do the latter is intentionally to kill someone. Killing can never be a therapeutic treatment. It is the ultimate harm. And killing someone by starving or dehydrating them to death, with all the suffering that causes, is simply barbaric.

Doctors' ethics bind them never to do any harm. Yet appallingly, this Bill may force them to do just that. For they will be bound by the terms of 'living wills' which may prevent them from acting in the best interests of a patient at the time.

The Bill's own definition of 'best interests' is disturbingly vague, opening the way to such interests being overriden by a patient's previous feelings and wishes, or by the highly subjective judgment of relatives or others about whether someone else's life is worth living.

Doctors might find themselves in the terrible situation where, for example, faced with a young girl who had tried to commit suicide and was in a coma, they would be legally prevented from saving her life because she had left a note to say that she was not to be resuscitated.

People who want to take their own lives often change their minds. As for 'living wills', since they are drafted when people are in command of their faculties, such individuals by definition cannot know what they would feel like if circumstances were drastically different.

How dreadful it would be if someone who declared a desire to refuse treatment in the event of a future catastrophe, and then changed his mind but was unable to say so, was starved to death because the law bound his doctor to carry out his earlier wishes. Yet this Bill might bring about precisely this hideous possibility.

If doctors objected, they would have to go to court to uphold their most fundamental ethical principles - and they might still find themselves overruled.

Worse still, the relative of a mentally incompetent patient may be able to force a doctor to starve that patient to death if the relative claimed that this was the patient's wish - even though there may be no written record whatsoever that the patient did [ital 'did'] want this to happen. The possibilities for deadly abuse by unscrupulous relatives or other individuals are therefore enormous.

The Rubicon was actually crossed back in 1993, when the Law Lords ruled that doctors could remove the feeding and hydration tubes from Tony Bland, the Hillsborough survivor left in a persistent vegetative state. With that seminal judgment, the judges simply tore up the fundamental prohibition against deliberately ending someone's life.

Since then, other PVS patients have been starved and dehydrated to death - even though there have been instances where similar patients have eventually recovered some of their faculties.

There is a crying need to change the law to protect the sanctity of human life from this assault. But instead, the Mental Capacity Bill is vastly extending the categories of people whose lives might similarly and even more horribly be ended.

In addition, it allows medical experimentation upon people who have lost their mental faculties 'if the risks are likely to be negligible'. If there was any doubt about the dehumanising philosophy behind this Bill, this provision surely gives the game away.

For whether the risks are negligible or not is beside the point. Any such experimentation without consent displays an unequivocal contempt for human life - a belief that the body of a living human being is merely a carcase to be used for the benefit of others.

Experimentation on the mentally deficient was a practice associated with the Nazis, as was the deliberate killing of those whose lives were not thought worth living. It is almost beyond belief that such an abhorrent measure should be going through Parliament. And yet so great is the moral confusion of the times that until now this Bill has been sailing through with barely a batsqueak of protest.

The traditional guardians of our civilised values have fallen silent. The morally confused medical profession has been inert. And although there have been some protests from Catholic bishops, the Church of England appears to have said virtually nothing about this bill apart from one short and feeble statement.

It is quite astonishing that despite its apparent obsession with human rights, Parliament is about to legislate to destroy the most fundamental right of all - the right to life - and to sanction the deliberate killing and the morally indefensible exploitation of those who cannot defend themselves.

The great and the good shudder at the thought of what losing their mental faculties might be like, and conclude that in such circumstances they would rather be dead. And such is their hubris, they are legislating to ensure that others will also end up dead.

Thus they ignore their overriding duty to defend the sanctity of life, to ensure that doctors remain therapists rather than metamorphose into executioners, and to protect the most vulnerable among us from being killed or experimented upon.

MPs who have only the most shallow grasp of these issues have been well and truly taken in by the sentimental appeal of the term 'living wills'. So at a stroke, the most basic protection required of a civilised society is being destroyed, and with it the value placed on human life itself.

About Melanie

Melanie Phillips is a British journalist and author. She is best known for her controversial column about political and social issues which currently appears in the Daily Mail. Awarded the Orwell Prize for journalism in 1996, she is the author of All Must Have Prizes, an acclaimed study of Britain's educational and moral crisis, which provoked the fury of educationists and the delight and relief of parents.

Read full biography


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Melanie Phillips
Daily Mail
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