Electronic Telegraph
Saturday 27 September 1997
Issue 855

Where is the mercy in killing?

The Liberal Democrats want a royal commission on euthanasia. But, argues Alice Thomson, doctors should never be licensed to kill

THE "right to die" lobby has had a difficult year. First, there was the decision by the Australian parliament to overturn the Northern Territory's show-case euthanasia law. Then Andrew Devine, one of the two Hillsborough victims who suffered severe brain damage, started signalling to his family after eight years in a coma.

To make things worse, Jean-Dominique Bauby, the Editor of Elle magazine in France, made what seemed to be an emotive plea against euthanasia. Before he died of natural causes, he was alleged to have dictated a book after he suffered a stroke, using only his left eyelid. The best-selling volume made it clear that, far from wishing to die, M Bauby still revelled in life.

But recently the pendulum has swung the other way. First, Brookside took up the right-to-die cause with Gladys Charlton, who had cancer, being suffocated to death by her daughter and son-in-law. Yesterday, voluntary euthanasia campaigners also were celebrating. First there was the moving story of the mother who fought "tooth and nail" for her "adored" handicapped child, Abigail, but finally killed her. Abigail was born deaf and blind, and unable to swallow or eat. She had seven heart attacks. Her mother walked free, and the pro-euthanasia camp chalked her up as a victory.

The Royal College of Paediatrics also chose to publish guidelines telling doctors when it is right to allow a sick child to die. And yesterday, that well-known political weather-vane, the Liberal Democrats, swung towards "mercy killing". Their party conference backed a motion calling for a royal commission on euthanasia.

Of these developments, the Lib Dems' debate is the least worrying. Its activists have a distinguished record of putting fringe ideology well before common sense. Tony Blair may have initiated a new era of power-sharing, but he is unlikely to pay much heed to Paddy Ashdown's loose cannons, when he has perfected the art of ignoring his home-grown Labour variety.

Abigail's case, too, appears to set no precedent. The judge stressed that he "was not passing an indication of approval of euthanasia". The jury found her guilty of manslaughter, but the judge decided she had suffered enough. His was a humanitarian decision.

The disturbing news comes, surely, from those seemingly compassionate guidelines on sick children. The Royal College has come up with a list of five clauses under which doctors might consider withdrawing "curative medical treatment". Some seem sensible enough, but any properly trained paediatrician should be following them anyway. Most doctors instinctively know when they can do no more.

The most disturbing guidance is contained in the so-called "no purpose" clause. This advocates an aided death when "survival is possible only with such severe mental or physical disability that the child will never be capable of choice". Here, the Royal College has quietly tiptoed across the line between saying that the treatment is worthless, and saying that the patient is worthless.

Then there is a so-called "unbearable pain" clause. The pain, in this case, is being endured not only by the suffering child, but also by the parents. The family can ask a doctor to withdraw treatment in these circumstances. But surely a family's suffering, however grievous, should not determine a doctor's decision. A better course would perhaps be the provision of more hospice care, allowing nurses to share the burden with the parent.

The guidelines also suggest that food and water should be considered as a "treatment" - and be discontinued, thereby ensuring a patient's death. Those in a coma, or severely handicapped, may not be able to feed themselves or show signs of life. To withdraw a feeding tube from such a patient, however young, is tantamount to starving them. Food isn't treatment: it is a basic necessity.

The right-to-die lobby, having won these skirmishes over children, may now try to persuade the Government that the right-to-die, or even voluntary euthanasia, would be popular politics. But such a move would compromise the healing role of doctors. Pressure would be put on, say, elderly parents to choose death for the sake of their children's financial future. Controls, however rigorous, would be difficult, if not impossible, to monitor. And we would be embracing a right-to be-killed as a possible first step on the road to the compulsion-to-die.

The only way to be sure that we are acting in the patient's best interests is to have a clear-cut principle that doctors must never become state-licensed killers.

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