warns that doctors who opt for voluntary euthanasia are playing at God and that they should not be able to choose when to kill those they cannot cure.
HE central risk of legalised euthanasia is that vulnerable people will be killed against their will (this is universally recognised as murder).
Far from introducing a formula for death with dignity, the result will be chaos.
As Dr Christolph Hufeland recognised in 1806, the doctor would become the most dangerous person in the state. We have reached a critical stage in the battle to protect the most vulnerable.
Following the Dr Cox case pressure for a change in the law is being orchestrated by the Voluntary Euthanasia Society (VES). The VES have great hopes for the Medical Treatment (Advance Directive) Bill to be introduced into the House of Lords in the next Parliamentary session.
Having moved from previous failed attempts to decriminalise assisted suicide this bill will be a euthanasia enabling bill.
. It. is a clever tactic which may confuse politicians and .public alike.
The advance directive is a patient .statement which declares that in the event of ,future incompetence or serious ,injury or illness (not .necessarily terminal) they do riot wish to have medical treatment.
The VES claim that advance directives do not ask for anything unlawful but, given statutory force rather than being advisory (as the BMA wish), they could confuse the law and introduce the idea (as in America) that food and fluid is part of medical treatment.
Thus withdrawal of basic nutrition "allowing" the patient to die of starvation and thirst would be legalised and the euthanasia people would have achieved one of their central aims.
As Helga Kuhse argued at the fifth biennial conference of Right to Die Societies, "if we can get people to accept the removal of all treatment and care... they will see what a painful way this is to die, and then in the patient's best interest, they will accept the lethal injection."
Christopher Grant Docker of the Voluntary Euthanasia Society of Scotland states "Whether... advance directives become legally binding on doctors may be decided by the new bill...
"Once acceptable guidelines and safeguards have been established for passive euthanasia, similar studies can be done to enable physician
aid-in-dying or active euthanasia." (New Scientist, July 25, 1992).
Statutory advance directives have a central flaw. They could enable killing of incompetent patients rather than reflecting patient autonomy, for once the patient's circumstances change they may not be able to communicate a revocation of their previously expressed wishes.
Currently in the Tony Bland case, his parents and doctor wish to withdraw his nutrition.
owever, patients in a Persistent Vegetative State (PVS), like Tony Bland, are not terminally ill and acceeding to the demands of relatives to "allow" death would require that the doctor strives officiously to kill by starvation and dehydration.
Barbara Smoker, of the VES, states "...to establish the principle that withholding food... is allowable passive euthanasia. This is, of course, nothing but convenient casuistry since it is obvious that to withhold food from a patient in non-euthanasia conditions would be murder." (VES Newsletter, September 1991).
Anti-euthanasia campaigners do not wish to see death aggressively prolonged and the Hippocratic code does not require such action yet there is a duty not to neglect those we cannot cure.
The doctor must do everything to make the patient as comfortable as possible; to treat distressing symptoms, relieve pain, thirst, breathing difficulties, vomiting etc...
This is known as palliative care and expertise is exemplified by the Hospice movement.
Progress is such that palliative care is recognised as a medical speciality in its own right. (1) Indeed, experts have advised that had they been asked for help they could have served Dr Cox's patient and eased her pain.
Objections to killing are reasonable and just. The current law and the BMA 2988 statement against euthanasia is rational.
The fact that voluntary euthanasia leads to involuntary and non voluntary euthanasia is evidenced by the Dutch experience.
The VES claim that doctors kill patients now (without any evidence for the claim) if so, what more would such doctors be prepared to do if the law protected them as killers?
It is claimed that families can make death decisions on behalf of vulnerable and incompetent relatives.
But do families always protect their vulnerable members? What of those with families? What of the homeless and the abandoned elderly?
We cannot allow eugenic and economic arguments to prevail. We have the knowledge to extend palliative care.
We have the ability to protect the dying. We must inform the public that euthanasia is a greater threat to them than pain.
Pain is treatable. Killing is irreversible.
The Washington state campaign resulted in a public vote against euthanasia.
People reject medical killing once they are informed of the true dangers that there are no safeguards for the elderly, disabled, chronically sick, people with AIDS no safeguards for the vulnerable.
In the face of the euthanasia threat from the proposed legislation our objective must be to kill the bill, not the ill.
(1) See Medical Ethics booklet (forthcoming), available by writing to The Christian Theology Trust ISBN, 93 Bedford Road, Birkdale, Southport PR8 4HT.