From Sister Francis North CJ SIR — You were wise to head the article by Alice Thomas Ellis (Feature, July 2) as you did, referring to “a lifelong battle with the liberal demons”. One might otherwise have taken the comments as coming from one who “had wak’d after long sleep”, missing out the decades that have elapsed since the sharp fall in responses to religious vocations which began in the later 1950’s, well before the changes brought about by the directives of Vatican II.
Among these was, of course, the loss of the full habit, and since then of the so-called mitigated habit. While we may regret these changes, they are not the cause of From the Master of the Guild of Catholic Doctors, the Chairman of the Catholic Union and nine others SIR — The dangers inherent in the government’s new Mental Capacity Bill ought not to be underestimated. The Bill is being introduced under the auspices of “promoting patient autonomy”. In reality, the Mental Capacity Bill permits “slow euthanasia”, a form of homicide by omission, and sets up a pathway by which routine lethal injection will inevitably become desirable. What the Bill does is to make living wills (both written and verbal) legally binding and to authorise to a raft of new actors power to refuse “treatment” which, after the highly criticised case of Airedale and NHS Trust v Bland, can include food and fluids. A former president of the World Federation of Right to Die Societies once said that “[i]f we can get people to accept the removal of all treatment and care — especially the removal of food and fluids — they will see what a painful way this is to die, and then, in the patient’s best interests, they will accept the lethal injection.” The proposals turn medical practice upside down. At present, if a doctor denies a patient assisted food and fluids or ordinary treatment such as insulin negligently, recklessly or with the intention of bringing about a patient’s death he would be guilty of wilful neglect, manslaughter or murder, respectively. However, in the face of a legally binding advance directive, or refusal by an attorney, requiring such, he could be guilty of a crimi today’s shortage of nuns. The habit, as we know, does not make the nun. What has hindered a wholehearted response to religious vocations today is the reluctance of young people to commit themselves — in particular, to undertake a lifelong commitment. They are not ungenerous, but all is regarded now as temporary.
Humanity, and therefore the Church, is undergoing constant change; change involves trauma, and this often painful renascence inevitably brings with it features not attractive to the eye or ear. Alice Thomas Ellis employs various metaphors to colour her protests against these aspects of our dynamic existence. I am not nal offence, the crime of assault, for not bringing about the death of a patient.
How could this come about? The Mental Capacity Bill creates legally binding advance directives or decisions and powers of attorney. It also introduces courtappointed deputies and independent consultees authorised to make these and other questionable decisions. Contrary to popular opinion, advance directives will only apply to refusals of treatment. Positive advance statements will not be legally binding. Attorneys will be able to prevent doctors from treating incapacitated patients under pain of criminal sanctions against the doctors. This will include life-sustaining treatment (which includes giving fluids) if such are the powers granted by the donor to the attorney.
Incapacitated patients unable to swallow, eg after a stroke, will present a particular dilemma if assisted fluids have been refused by an attorney or advance directive. Doctors and nurses could be forced to stand back and let a nondying patient die of dehydration. Thirst is a powerful drive, and sane, competent patients do not refuse fluids. Patients who are dehydrated but unable to communicate are likely to suffer greatly.
Clause 58, which states that nothing in the Bill will affect the law relating to manslaughter, murder or assisted suicide, would provide little or no protection. The Bill is clear that a valid and applicable advance refusal or a refusal of life-sustaining treatment by an attorney, if such is the power sure that they help the cause in question. The photographs too depict a dolorous approach.
How can we cheer her? Patient perseverance in irreligious times strengthened our forefathers. Or, as Diego Valeri succinctly puts it: “Sol dal confuso si può uscire al chiaro.” Yours faithfully, FRANCIS NORTH Norwich, Norfolk