Adapted from VES –The Voluntary Euthanasia Society of England and WalesAdapted from the Voluntary Euthanasia Society (England & Wales)
Contents:
The Case Against Voluntary Euthanasia
Only God can give and take away life
The slippery slope – voluntary euthanasia will soon lead to involuntary euthanasia
It will have a damaging effect on society
Fear of abuse of the law
Patients receive excellent palliative care, so euthanasia is unnecessary
Medical Opinion of Voluntary Euthanasia
Official opinion supports the present law
However, many doctors support a change in the law
Doctors do carry out voluntary euthanasia
What about the Hippocratic Oath?
Only God can give and take away life
Some people believe that life is sacred and that no one has the right to purposely take a life. Many religious people follow this principle, so do not agree with suicide and assisted dying. However, there are many religious people who do support voluntary euthanasia, such as our late vice-president Lord Soper, an important Methodist minister. In the Netherlands, Catholic or Dutch Reformed clergymen may be present at assisted deaths. It must also be remembered that religious arguments cannot, and should not, apply to anyone who does not share that belief.
The slippery slope – voluntary euthanasia will soon lead to involuntary euthanasia
This argument states that once we have made voluntary euthanasia legal, society will soon allow involuntary euthanasia. This is based on the idea that if we change the law to allow a person to help somebody to die, we will not be able to control it. This is misleading and inaccurate – voluntary euthanasia is based on the right to choose for yourself. It is totally different from murder. There is no evidence to suggest that strictly controlled voluntary euthanasia would inevitably lead to the killing of the sick or elderly against their will. As Ronald Dworkin, professor of Law at Oxford and New York University, said in 1994:
“Of course doctors know the moral difference between helping people who beg to die and killing those who want to live. If anything, ignoring the pain of terminally ill patients pleading for death rather than trying to help them seems more likely to chill a doctor’s human instincts.”
People who do not agree with voluntary euthanasia often refer to the 1967 Abortion Act. They argue that the numbers of abortions which now take place every year show that the safeguards set out in the Abortion Act have been ignored. They argue that this example should be taken as a warning of what could happen if helping people who are terminally ill to die is made legal. They believe that the law would not be able to control a huge amount of euthanasia cases, many of which would be involuntary. However, abortion is a very different issue to assisted dying. It is also important to remember that people choose to have abortions, they are not forced on people. There is no evidence to suggest that assisted dying will be forced on anyone either.
It will have a damaging effect on society
Some people who do not agree with voluntary euthanasia argue that if it was legalised, it would damage the moral and social foundation of society by removing the traditional principle that man should not kill, and reduce the respect for human life. However, the idea that we should not kill is not absolute, even for those with religious beliefs – killing in war or self-defence is justified by most. We already let people die because they are allowed to refuse treatment which could save their life, and this has not damaged anyone’s respect for the worth of human life.
Fear of abuse of the law
In any law which allowed a person to help someone to die, there would be safeguards to make sure that:
* the person is told everything about the process
* they are not forced into making a decision
* they are mentally able to make the decision
At the moment, no one knows how much non-voluntary euthanasia is carried out because active euthanasia is practised outside the law. In 1996 researchers from Monash University, Australia carried out a study comparing end-of-life decisions in Australia, where voluntary euthanasia is illegal, and Holland, where it is permitted. They found that non-voluntary euthanasia actually took place five times more often in Australia.
Patients receive excellent palliative care, so euthanasia is unnecessary
Hospices do a wonderful job, making terminally ill patients comfortable and relieving their pain, but even experts in palliative care agree that not all pain can be fully controlled. Even if pain could be fully controlled, for many patients it is other aspects of their condition, such as losing their dignity, that lead them to consider an assisted death. Palliative care cannot entirely replace the need for voluntary euthanasia. Some people will always want this choice.
Any change in the law must look at concerns about abuse of the law, but such fears should not prevent us from acting. As Ronald Dworkin, Professor of law at Oxford and New York University, said in 1994:
“…It would be perverse to force competent people to die in great pain or in a drugged stupor for that reason, accepting a great and known evil to avoid the risk of a speculative one.”
Medical Opinion of Voluntary Euthanasia
There is increasing medical interest and support in the United Kingdom for legalising voluntary euthanasia. In 1990, a working party from the Institute of Medical Ethics said:
“A doctor, acting in good conscience, is ethically justified in assisting death if the need to relieve intense and unceasing pain or distress caused by incurable illness greatly outweighs the benefit to the patient of further prolonging life.”
Official opinion supports the present law
At the moment, the British Medical Association (BMA) is against legalising voluntary euthanasia. At their 1997 conference they voted against any immediate change in the law on assisted dying. However, they do support living wills and a patient’s right to refuse treatment. In 1999 the BMA said:
“A valid advance refusal of treatment has the same legal authority as a contemporaneous refusal and legal action could be taken against a doctor who provides treatment in the face of a valid refusal.”
In July 1995, The Lancet, one of the main medical journals in the world, dealt positively with voluntary euthanasia. The article was called The Final Autonomy, and the final sentence read:
“All we ask is that Medicine moves towards non-medical opinion by admitting euthanasia openly (and more honestly) into all its future discussions of end-of-life decisions affecting competent adults.”
However, many doctors support a change in the law
In the September 1996 issue of the BMA News Review, the results of a survey of over 750 GPs and hospital doctors showed that doctors were divided over legalising voluntary euthanasia. The results were as follows:
* 46% of doctors supported a change in the law to allow them to carry out the request of a terminally ill patient for voluntary euthanasia.
* 44% were against euthanasia and supported the present law
* 37% said they would be willing to actively help end the life of a terminally ill patient who had asked for euthanasia, if the law allowed it.
Twenty-two doctors actually confessed to having broken the law and helped someone to die. Following this survey, Dr Stuart Horner, who was then the chairman of the BMA’s medical ethics committee, said:
“…if we genuinely believe that all the efforts of medicine have been exhausted it may well be that in a particular case euthanasia has to be considered. That is a matter for the doctor concerned and I would be the last person to say they had done the wrong thing.”
Nurses would also like to see a change in the law. In 1995, a survey carried out by the Nursing Times found that 68% of nurses believed that if people ask for help to end their life, it should be given in some circumstances. 69% of nurses had personal experience of a patient asking for voluntary euthanasia.
Doctors DO carry out voluntary euthanasia
In 1994, a report published in the British Medical Journal showed that British doctors do practice voluntary euthanasia, despite the law. The study by Ward and Tate, from Cambridge University, found that 32% of doctors surveyed had agreed to a patient’s request to be given treatment to help them die more quickly. A larger proportion – 46% – said they would consider giving treatment to help someone die if it were legal to do so. In November 1997, 200 GPs responded to a survey carried out by Pulse magazine. The survey revealed that 93 GPs (47%) had given treatment to ease a patient’s death. 49% said that they had been in a position where they felt that easing a patient’s death, other than with the intention of relieving symptoms only, was the right thing to do.
The most recent investigation was carried out by The Sunday Times, in November 1998. A confidential questionnaire, answered by 300 doctors, revealed that one in seven had broken the law and helped a patient to die at their request. The full results were:
Question Yes No
Have you ever been asked by a patient to help them die?
Yes 44% No 56%
Have you ever assisted a patient’s death at their request?
Yes 15% No 83%
Do you think doctors should have the power to assist death without fear of prosecution:
by withholding treatment
Yes 68% No 31%
by withdrawing treatment
Yes 67% No `32%
c) by administering pain killers in the knowledge that they are likely to shorten life?
Yes 60% No 37%
d) by prescribing lethal drugs for patients to take themselves?
Yes 18% No 75%
Do you believe in a patient’s right to die?
Yes 63% No 33%
Do you think it is a good idea for patients to make living wills?
Yes 69% No 27%
Whilst most of the doctors who admit to having helped a patient to die seem to escape prosecution, some of them do, however, fall foul of the law. You can find a summary of all these cases in our law pages.
What about the Hippocratic Oath?
The Hippocratic Oath was established around 2,500 years ago in Greece. Some doctors use it as a guide to carrying out their work. Part of the Hippocratic Oath states:
“I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect.”
A doctor who follows this oath also promises “not to give a woman a pessary to produce abortion.” However, an abortion is now legal in some circumstances, and many doctors perform this operation. The Oath has been changed and updated to fit in with new attitudes and medical practices – it is not a code which cannot be altered. At the moment, the British Medical Association (BMA) is campaigning to update the oath. They argue that it does not reflect the reality of medical practice today. They want the code to recognise that keeping people alive is not the only aim of health care. As R Weir wrote in 1992:
“The achievement of…appropriate medical goals is more important than a literal adherence to an ancient oath whose religious and moral framework is of such limited relevance to contemporary medicine that the oath is frequently altered when used in medical school convocations and increasingly replaced entirely by other kinds of oaths, including those written by medical students themselves.”
It is important to remember that the Voluntary Euthanasia Society was set up by a group of doctors and clergy in 1935. Today, the growing support of the medical profession for assisted dying will eventually help to change the law.
NOTE: For those of you who are researching the subject of euthanasia in some detail, the Voluntary Euthansia Society site also carries an in-depth listing of opinion surveys from the UK and around the world. Full academic references are given, together with a brief summary of the findings. Where possible, we’ve also included links to the research, if it can be found on the internet.