EUTHANASIA IN THE ISLE OF MAN A report by Grace Baptist Church Peel The first step towards legalising euthanasia in the Isle of Man took place on Tuesday May 14th 2003 , when two politicians from the south of the Island sought leave to introduce a Bill to the House of Keys. MHKs [Members of the House of Keys] John Rimington and Quintin Gill were behind the move, which was prompted by the condition of one of their constituents, Mr Patrick Kneen, who was a cancer sufferer. Following the discussion, an amendment from Alex Downey MHK granting leave to introduce a Bill on Euthanasia was passed by 15 votes to 7. However, before the introduction of the Bill, a Select Committee has been set up to thoroughly investigate the issue. After reading and hearing evidence from concerned members of the Manx public (and presumably also from interested friends off the Island ), the Committee Members will present their findings to the House of Keys. The Christian response to euthanasia is to unequivocally oppose it. To put it bluntly, euthanasia is killing. In legal terms, it is ‘the intentional killing of a patient as part of his or her medical treatment.’ Although it is referred to as ‘mercy killing’, the end result of euthanasia is the deliberate ending of a person’s life. To quote a recent Briefing Paper produced by CARE, “The key factor is the intention behind the act. Euthanasia occurs when a doctor, friend, or relative intentionally ends a person’s life, to ‘put them out of their misery’, i.e. kill them.” Bearing in mind what euthanasia is, there can be no pussyfooting around the issue when presenting our evidence to the Select Committee. In saying this, I am not suggesting that we are deliberately provocative and inflammatory. But on the other hand, we mustn’t ‘tiptoe through the tulips’, because if we do, we will fail to make an impact. This is a life and death issue that we have before us, and it must be handled not just with sensitivity, but also with firmness and forthrightness. The Editor of the Manx Independent (Friday May 16th 2003 ) says: “What the Committee Members need is informed, reasoned and balanced input. What they don’t need is extremist reaction from sections of society, on whichever side of the argument they stand.” I would respectfully suggest that what the Editor of the Manx Independent actually means is that the Select Committee does not wish to either see or hear phrases such as ‘legalised murder,’ and ‘giving doctors a licence to kill.’ However, these phrases do have a place in the debate, because however unpleasant they may sound, they get to the very heart of the matter. In 1994 and 1995, members and friends of Grace Baptist Church Peel rigorously opposed the legalising of abortion. Although at that time we expressed the view that it would ultimately lead to the legalising of euthanasia, we are nevertheless shocked that things have moved so quickly. However, at the risk of being castigated yet again for our ‘radical extremism,’ we are now preparing our arguments against legalised euthanasia, to present to the Select Committee. The points we will be emphasising will include the following: 1. MORE THAN AN ‘ISSUE’ Euthanasia is not just an issue for philosophical or theological discussion. It is far more than a good topic for a debating society, or an interesting theme for the letter pages of the Isle of Man newspapers. Of course the subject of ‘mercy killing’ needs to be debated, and indeed written about. However, we must remember that academic arguments and dry principles are, in and of themselves, totally inadequate. Euthanasia is literally a matter of life and death, and therefore must be approached with heart-felt compassion and deep sensitivity. 2. MEN AND WOMEN ARE MADE IN THE IMAGE OF GOD It is argued that euthanasia provides release for those whose ‘quality of life’ has been impaired. What needs to be remembered, however, is that our significance derives not from our ‘quality of life’ but from our status as having been made in the image of God [Genesis 1:26 -27]. All human beings have been formed and fashioned in the Divine image. In this way, man is fundamentally different from the animals. In the Bible, we are reminded that it is reprehensible to use our tongues for the purpose of cursing and slandering our fellow human beings. The reason for this caution is that these fellow human beings have been made after the similitude of God [James 3:9]. On the basis of this principle, it logically follows that if it is shameful to slander our fellow human beings, it is far worse to terminate their lives. Terminally ill patients, who are sometimes incorrectly described as having a ‘low quality of life’, are still human beings made in the image of God, and there can be no justification for either killing them, or allowing them to kill themselves. 3. THE SANCTITY OF LIFE Since all men and women are created in the image of God, every life has an intrinsic and immeasurable value. This is the source of the sanctity of life concept. Human beings have been “fearfully and wonderfully made”, and have an inherent and God-given dignity. From conception, a human life is sacred and special, and deserves therefore, to be treated with utmost respect. Euthanasia is the exterminating of that precious life. Euthanasia is intentional killing, and so contravenes the 6 th Commandment, “Thou shalt not kill” [Exodus 20:13 ]. This applies even in the case of suicide. 4. OUR LIVES ARE NOT OUR OWN The Bible makes it clear that human life is not our property, and we do not have the right to dispense with it when we see fit. As Job said: “The Lord gave, and the Lord has taken away, blessed be the name of the Lord [Job 1:21 ].” We are not the owners of our lives, but rather the stewards of them, and we do not have the right to approach a doctor and ask for our lives to be taken away from us. 5. RESPONSIBILITY FOR OTHERS It is a Christian belief that we have a moral obligation and social responsibility to care for all people with dignity and respect, especially those who are elderly, dying or disabled. In the letter pages of the Manx Press, Christians have sometimes been castigated for their lack of compassion. We are accused of being uncaring simply because we disagree with euthanasia and assisted suicide. The antiChristian argument is summed up by Doctor Jeff Garland is one of his many letters on this subject to the Isle of Man newspapers: “In scurrying to defend dogma … church representatives seem to be without compassion for the Kneens and to be unable to show any clear understanding of why they seek change in the law on assisted dying.” This argument is overly simplistic. Being anti-euthanasia is not the same as being uncompassionate. Indeed true Christian people are very compassionate, because they seek to follow in the footsteps of the Lord Jesus Christ. Care of the terminally ill is one of the top priorities of the Christian Church. When our Lord Jesus Christ was here on earth, He was often moved with compassion when He focused His eyes on the blind, the lame and the lepers. The Bible speaks about reaching out to people in their need, and Christians have a responsibility to follow the example of Jesus Christ. Like Him, we must do all that we can to bring relief to those in pain, and comfort to those who are terminally ill. It is not without significance that Christians have been responsible for building many hospitals, and for pioneering techniques to control pain and alleviate suffering. Furthermore, the Christian Church has been at the forefront of the Hospice Movement. Some members of the pro-euthanasia lobby fail to understand the practical compassion that Hospice Care makes available, including specialised palliative care and pain control. Our own St Bridget’s Hospice has a reputation for compassion, and yet it opposes the move to legalise assisted suicide. Chairman John Quinn said on Manx Radio [29 July 2003] “The ethos of the Hospice Movement generally, and specifically here on the Island at St Bridget’s of course, is that it does not support euthanasia.” 6. HOSPICE CARE Without a doubt, euthanasia will undermine Hospice care. It is believed in some quarters that there are only two alternatives open to patients with a terminal Illness. On the one hand they die slowly in painful unrelieved suffering, on the other hand they receive euthanasia. There is, however, another way, namely that of compassionate medical care. Research has shown that 85% of patients with pain can be totally relieved with the help of drugs. A further 10% can be relieved almost completely, and the remaining 5% can have their pain relieved for much of the time. This has been the work of the hospice movement: to control patients’ pain within the context of a caring, and homely environment. One woman said of the hospice where she found help and relief: “I came here to die of cancer. Now I have learned to live with cancer.” The hospice movement is to be applauded for its outstanding palliative care and end-of-life pain management. It is not surprising that in the Netherlands , where euthanasia is now officially condoned, there is only a very basic hospice movement. By contrast, in the United Kingdom and indeed the Isle of Man , there are well-developed facilities, which care very effectively for the terminally ill. The British Isles are privileged in having what is generally regarded as the finest hospice service in the world (supported largely by voluntary funds) to care for terminally ill patients. In the year 2000, there were well over 3,000 beds in British Hospices. Each year 30,000 people die in hospice care. The Lord Jesus Christ is described in Scripture as being “moved with compassion,” and the hospice movement reflects the Biblical concept of compassion. 7. HOSPICE & EUTHANASIA CANNOT BE BEDFELLOWS It has been suggested in some quarters that there is strong support for euthanasia within the hospice movement. Correspondence in the Manx Press has referred to the hospice service rising to the ‘challenge’ of a change in the law. We would respectfully submit that those who talk in this way have a hidden agenda. They would like to see the hospices incorporating euthanasia as part of their remit. However, what must be appreciated is that the hospice movement and the concept of assisted suicide are poles apart. Alex Schadenberg, Executive Director of the Euthanasia Prevention Coalition, said “Any attempt by the Right to Die Movement to ally itself with hospice is an attempt to take over the hospice movement.” Nancy Valko, a hospice nurse, warns that “Hemlock and other pro-euthanasia groups have been trying to change the tried and trusted hospice philosophy from providing compassionate care without either prolonging or hastening death to support personal or family ‘choice’ in cause or hastening death.” 8. INTENTION THE KEY FACTOR In legal terms, euthanasia is the intentional killing of a patient as part of his or her medical treatment. Intention is the key factor. The distinction between euthanasia and good medical practice hinges on the intention with which the treatment is given. In some cases, administering huge amounts of morphine is an expression of compassionate palliative care. The morphine is given to alleviate pain, and not to cause death. The ultimate outcome may actually be death, but as this is not the intention, the giving of the drug is good medical practice. Pain control treatment may have the effect of shortening a patient’s life, but if this is not the intention then it is not euthanasia. In other words, whilst death may be a consequence of the treatment, it is certainly not the reason for it. A CARE briefing paper on the subject of euthanasia provides this helpful summary: “To tackle pain in dying patients, doctors sometimes administer large doses of strong drugs. Doctors do so foreseeing that the drugs may weaken the patient and (very rarely) shorten life, but the intention is the relief of pain rather than the shortening of life. This principle is known as double effect. It is medically and legally accepted that a doctor may give a patient drugs that may hasten death if the doctor’s intention is to prevent pain, rather than kill the patient.” 9. THE CONDITIONING PROCESS Many British Doctors are actively resisting moves to legalise euthanasia, because they have no desire to administer lethal injections. Professor Tim Maughan, the Director of Wales Cancer Trials Network at Cardiff University , said, “This is not what we became doctors to do.” However, the risk is that, as with abortion, doctors will be conditioned into accepting the euthanasia mentality. When a thing becomes legal, it very quickly appears to be right. It has been well-said that, “the law is a very powerful educator of the public conscience.” When an action becomes legally accepted, and widely practised in society, people stop having strong feelings about it. This has been clearly demonstrated by the legalising of homosexual activity between consenting adults. 10. THE SLIPPERY SLOPE An example of the validity of the ‘slippery slope’ argument is the practice of abortion. Permitting abortion for a few women has led to abortion on demand. The 1967 UK Abortion act was intended to allow doctors to terminate pregnancy when this was medically necessary to preserve maternal health. There is no suggestion in the Act that its intention was to allow mothers to get rid of unwanted children. However, since 1967 there have been over six million abortions in United Kingdom . Quite clearly, the majority of these are not being performed because doctors believe that an abortion is the only way to preserve maternal health. Thus what was originally intended as a change in the law for compassionate purposes has culminated in the needless killing of millions of unborn babies. Voluntary euthanasia is only a short step to involuntary euthanasia. In other words, the next step could conceivably be a legal change which will result in the elderly, the mentally retarded and the terminally ill being placed at risk of being killed — against their will and without their consent. Implicit in the concept of euthanasia is the suggestion that certain human beings are no longer of inestimable value — because their lives are apparently not worth living. What is the next step? Where do we go from here? Once a bad practice has been accepted as ‘the norm’, it only takes a short time before a worse practice becomes accepted in the same way. To quote Edgar Quine MHK, “Let in a little evil, and a bigger evil will follow.” This argument is supported by the acceptance of euthanasia in the Netherlands . There, the courts are now permitting euthanasia, not only for the competent terminally ill, but also for infants with serious handicaps, comatose patients, and even people suffering from severe depression. 11. UNSAFE SAFEGUARDS? If voluntary euthanasia is legalised, we are assured that the most stringent safeguards will be put in place, and rigorous rules enforced to prevent any abuse of the law. This assurance may sound persuasive. But in reality is little more than a placatory sop designed to ‘soften up’ an unsuspecting public. Whatever the immediate effects, the safeguards will eventually offer little or no protection, because one by one they will disappear. Simultaneously, loopholes will ‘appear’ in the law, and its ultimate outworking will be very different from the original claimed intention. A loophole can usually be found in any law. Consider the laws on abortion. The official intention of the 1967 UK Abortion Act was to preserve the life of a mother should her pregnancy endanger her life. The ‘loophole’ found, which led to abortion on demand, was the clause that relates to the mother’s mental health. Who can possibly gainsay a woman who says she will have a nervous breakdown if her pregnancy is not terminated? The outworking of the UK Abortion Act therefore, means that any woman, however normal her pregnancy, can procure an abortion on the grounds that her ‘mental health may be impaired.’ A law that was originally intended to protect a woman’s life has resulted in the deaths of over 6 million babies in the British Isles . The safeguards were rendered ineffective by the loopholes in the law, so obviously the ‘safeguards’ were not safe! Why should it be any different with the proposed safeguards surrounding the anticipated euthanasia laws? In other words, how safe will we be in the Isle of Man ? In The Netherlands, where euthanasia has been ‘legally acceptable’ since 1984, a very sinister situation has arisen. Raanon Gillon, editor of the Journal of Medical Ethics says: “The restrictions on euthanasia that the legal controls in the Netherlands were supposed to have implemented are being extensively ignored.” He goes on to say that “…as well as voluntary euthanasia, which is explicitly legally acceptable there, involuntary and nonvoluntary euthanasia are also being carried out, despite their remaining illegal, and officially uncondoned.” [Emphasis ours] 12. VOLUNTARY EUTHANASIA EUTHANASIA LEADS TO INVOLUNTARY Legalisation of voluntary euthanasia would lead to changes in thinking with regard to the practice of involuntary euthanasia. However carefully the law was worded, it would be impossible to enforce it, since the key witness — the victim of euthanasia — would be dead. Holland has allowed voluntary euthanasia for many years, but the Dutch Government now has a serious problem with involuntary euthanasia. In 1990 a Dutch Government study found that over 1,000 people had been killed without their consent. The inevitable conclusion that one draws is that voluntary euthanasia swiftly moves on to embrace patients who cannot or do not, consent to be killed. Although this argument is dismissed as extreme, Dutch Government statistics released in 1991 showed that such a progression is to be expected. The sanctioning of voluntary euthanasia in that country has lead to involuntary euthanasia. Dr Herbert Hendin, an American physician who authored a 1997 report following a visit by doctors to research euthanasia in Holland, said that virtually every guideline had either failed to protect patients, had been modified or been violated. His report said that euthanasia in Holland , which had originally been intended for the exceptional case, had become an accepted way of dealing with serious or terminal illness. Voluntary euthanasia for some in practice, therefore, soon becomes compulsory euthanasia for others. A Dutch doctor, who expressed the opinion that his patient was “wretched”, killed an eightyfour year old lady with heart problems and osteoporosis, who had specifically stated that she did not want to be killed. The court ruled that although he may have made an error of judgement, he had acted honourably and according to his conscience! This lady needed compassionate nursing care, but instead her doctor killed her because, in his personal opinion, her life was not worth living. This is the sort of thing that a change in the Manx law would lead to in time. Once doctors decide that certain people are better off dead, the fact that they may not have volunteered for euthanasia becomes an irrelevancy. Euthanasia will then be imposed upon them, whether they want it or not. 13 EUTHANASIA FOR THE TERMINALLY ILL COULD LEAD TO EUTHANASIA FOR ANYTHING! In 1994 the Dutch Supreme Court ruled that euthanasia could be necessary for mental suffering. The ruling followed the euthanasia death of a depressed fifty-year-old woman, who had no physical illness at all. This particular case has been well documented and is referred to as ‘The 1994 Chabot Case.’ The lady concerned was suffering from depression after the death of her two sons. Although she was physically fit, she was euthanised by her doctor, who was subsequently cleared of committing any criminal act. Over the last few years there has been increasing debate about whether patients should be able to ask doctors to end their lives, if they feel they no longer want to live. A relaxing of the law could conceivably lead to requests for assisted-suicide by those who simply cannot cope with the pressures and rigours of life. In our modern society most of us live under pressure for most of the time, and it is not therefore surprising that much sick leave is described as ‘stressrelated.’ If euthanasia was available for those who are ‘unbearably ill,’ in the physical sense, one can see how it could very quickly become available for those who are suffering ‘unbearably’ in a mental sense. Significantly, one of the most common reasons given for authorising an abortion is the perceived risk to ‘the mental health of the mother.’ The consequences of legalising euthanasia are almost too frightening to contemplate. Many who would claim to be in favour of liberalising the law in this area, have not really thought the matter through. It is easy to be dismissive of the slippery slope argument, but it is a harsh reality, nevertheless. Today assisted suicide for those with terminal cancer. Tomorrow — assisted suicide for those with depression? 14. COMMON PRACTICE IS NOT A BASIS FOR LEGALISATION Recently, a total of 424 GPs and hospital consultants were asked to fill in an anonymous questionnaire about euthanasia. The response showed that almost half had been asked to take active steps to end a patient’s life, and a third of these had complied. The results of this survey were disclosed in the British Medical Journal, and have been used as an argument in favour of changing the law. It is said that in view of the fact that doctors are already doing the deed, it would be appropriate to legalise the practice. In 1996 pro-euthanasia protagonists, when presenting their evidence to the Constitutional Legislation Committee of the Australian parliament, put this argument forward. Doctor Robert Marr in pressing for the legalising of voluntary euthanasia said: “Every doctor in Australia knows that secret euthanasia is being practised. We need to bring it out in the open, and stop sticking our heads in the sand.” Patrick Kneen used exactly the same argument here in the Isle of Man when he spoke on Manx Radio’s Sunday Opinion broadcast on 17th August 2003, when he said: “ I do know that assisted suicide does take place — that between 20% and 30% of doctors have helped patients to die out of compassion. I feel that they would feel a lot more happy if the whole process could be properly controlled and regulated. And they wouldn’t be open to possible criminal proceedings.” This doubtful principle is similar to that used to support the legalisation of cannabis, the idea being that if it is going on anyway, we might as well legalise it. However, the fact that assisted suicide is taking place in the British Isles doesn’t make it right, and it is certainly not a justification for legalising it. Those who argue that euthanasia should be legalised because it is already being practised, are treading on very dangerous ground. All manner of sinful things are being practised in our society. How many of them do we legalise? And what are our canons of judgement? The Christian’s assessment of right and wrong is not based on the dubious practices of society, but on the Word of God, which says ‘Thou shalt not kill.” 15. HARD CASES MAKE BAD LAWS More often than not, those who have a loved one who is terminally ill and suffering agonising pain present the most powerful argument in favour of voluntary euthanasia. Unless one is extremely callous, one cannot help but feel genuine sympathy for those who watch a loved one suffer; and one can understand therefore, the rationale behind their demand for a change in the law. Indeed, the more severe a case is, the more plausible the argument appears. However, allowing difficult cases to create a precedent for legalised killing is most certainly not the right way forward. Apart from anything else, it will open the floodgates and allow in dangerous laws that will have the effect of devaluing human life. Over the years, difficult cases have invariably been the ones used to erode moral barriers. In a document produced by the Christian Medical Fellowship in 1997, it was emphasised very strongly that hard cases make bad laws: “Legalisation of euthanasia is usually championed by those who have witnessed a loved one die in unpleasant circumstances, often without the benefits of optimal palliative care. This leads to demands for a ‘right to die’. In reality the slogan is misleading. What we are considering is not the right to die at all, but rather the right to be killed by a doctor; more specifically, we are talking of giving doctors a legal right to kill.” The writer then goes on to say that legalised killing is not the answer, but rather ‘the best possible quality of life for patients and their families.’ Heart-rending though the extreme cases may be, it would still be wrong ethical methodology to use their plight to introduce legalised killing. What is required is not the introduction of a bad law, but the improvement and development of our standards of medical care. 16. EUTHANASIA UNDERMINES MEDICAL RESEARCH Modern medicine is making advances all the time, and can alleviate pain and suffering to a very great degree. This is not at all surprising, because it represents the accumulated wisdom of several generations. Today we have doctors who are skilfully trained in pain management. Indeed, Doctor Twycross, an internationally known expert on pain-relief quotes the World Health Organisation as saying that “a practical alternative to death and pain exists, so that there is now no need for anyone to die in pain.” Medical research is essential if medicine is to advance further. Until now, one of the driving forces behind modern medical progress has been the desire to develop treatments for the terminally ill. This has been coupled with a desire to alleviate hitherto unmanageable symptoms. If the emphasis moves from curing to killing, palliative medical research will be seriously jeopardised. Rather than being used for research into pain relief, funds will be diverted to develop more efficient ways of assisting suicide. To quote the Christian Medical Fellowship once again: “If euthanasia is legalised we can expect advances in Ktenology (the science of killing) at the expense of treatment and symptom control. This will, in turn, encourage further calls for euthanasia.” 17. DOCTORS LICENSED TO KILL? Euthanasia is contrary to traditional medical ethics. The work of a doctor has always been to cure not to kill. Historically, doctors have always said ‘No!’ to euthanasia. For thousands of years, the medical profession has refused to aid suicide or participate in euthanasia. In 1988 a report on euthanasia was published by the BMA, in which it reaffirmed its opposition to any attempts to change the law: “We do not, at present, see that any general policy condoning medical interventions to terminate life can be reconciled with commitments to good medical practice.” [P 19] Reading between the lines, the BMA was saying that good doctors kill pain not patients. They did not want to be given the power to end their patients’ lives. Furthermore, the medical profession appreciated that it would be detrimental to society if the traditional role of a doctor as healer of the sick were altered — and they were right. We do not need doctors who are ‘licensed to kill’. We need good medical practitioners, whose perceived role is to alleviate suffering, not to end the sufferer’s lives. One of the consequences of legalised voluntary euthanasia will be a drastic change in the doctor-patient relationship. The elderly, the handicapped and the terminally ill will no longer feel comforted and reassured by their doctor. Instead they will feel threatened by him. 18. AN OBLIGATION TO DIE! Terminally ill patients may not genuinely wish to ‘take control of their fate’ by choosing the time of their deaths. However, in certain circumstances they could be made to feel under an obligation to die, so as not to be a burden to their sorrowing relatives. In short, the vulnerable and elderly could conceivably be under pressure to request euthanasia to save their loved ones from what they think is unnecessary anguish. When considerate people are dying, the last thing they want is to be a burden to anybody. Moreover, they have no desire to be selfish, or even appear to be selfish. If euthanasia is legalised, therefore, vulnerable people will very quickly begin to feel that assisted suicide is something they ought to request, for the sake of their families. Mr Patrick Kneen, whose condition prompted the euthanasia debate in the House of Keys, said himself that he would rather die by assisted suicide than “waste away in front of my family.” As has already been observed, terminally ill people may have no desire to die at all, yet may express a wish for assisted suicide solely for the benefit of their loved ones. They wish to protect their families from what they think will be a harrowing death. They may in fact wish very much to live as long as possible. However, such unselfish people would never acknowledge this, because it would defeat their object, which is to attempt to protect their relatives, and loved ones from distress. In short, loving family members may unconsciously and unintentionally, place a great deal of pressure upon each other. 19. indeed SELFISHNESS MUST NOT PREVAIL We live in a society that is constantly clamouring for ‘rights,’ one of which is the so-called ‘right to die.’ Many of the letters that have recently appeared in the Isle of Man newspapers have been from correspondents who have been pressing for the sick and disabled to have a legal ‘right’ to assisted suicide. Their argument goes something like this: “If a person is suffering unbearably as a result of a serious illness, he should have a right to be helped to die, if that is what he wants.” Initially, this argument sounds quite plausible and even compassionate. However, when it is weighed in the balances, it is found wanting. If it is analysed carefully it will be seen that the argument is fatally flawed, because it does not take the third-party involvement into proper consideration. The expression ‘assisted suicide’ presupposes the aid of a member of the medical profession; but is it not selfish to burden a caring doctor with this responsibility? How do you ask a man or woman who is dedicated to healing the sick, and saving life, to become involved in an assisted suicide? Because make no mistake about it — all doctors will be involved, one way or another, whether they are for euthanasia or against it. It is argued that a doctor who does not wish to take part in an assisted suicide, will be allowed to ‘opt out’ for reasons of conscience. At first sight this seems to be a protection for a doctor who is a conscientious objector. In reality however, it is no such thing, because that doctor will be legally obligated to hand his patient over to another GP who is prepared to assist in the suicide. It is almost certain that the Isle of Man euthanasia bill will be based on ‘The Patient (Assisted Dying) Bill’ currently going through the House of Lords. This particular Bill contains the following clause: “If an attending physician, whose patient makes a request to be assisted to die… has a conscientious objection … he shall refer the patient without delay to an attending physician who does not have such a conscientious objection.” By handing his patient over to another GP, the conscientious objector becomes involved by implication. He will understandably feel guilty of aiding and abetting the killing of one of his patients, and he will have to live with that for the rest of his life. When people fight for what they describe as their personal rights, they sometimes do so at the expense of the rights of others, and indeed it is not unusual for the rights of others to be trampled under foot. Doctors who are conscientious objectors have rights too — but the pro-euthanasia lobby doesn’t seem to recognise those rights. Their unspoken reaction is that prolife doctors should not have such sensitive consciences. They should just do what their patients want, and pay attention to their rights. This is the very point we are seeking to make about the selfishness of many who claim the ‘right to die.’ They manifest a distinct lack of concern for those members of the medical profession who feel that it is their responsibility to save life rather than to destroy it. Whilst there are many medics who do not want to assist a suicide, there are also many families who do not want to have their loved ones ‘euthanased.’ In a recent edition of Tonight With Trevor MacDonald [First shown 24 Jan 2003 . Repeated 18 Aug 2003 ], viewers witnessed the harrowing scene of Reg Crew’s daughter weeping profusely as her father drank a dose of lethal barbiturates through a straw. Poor Jan did not want her father to die, but because it was what he wanted, the deed was done. Reg’s wife Win described her daughter’s feelings in a recent issue of a popular women’s magazine: “She thought it was too distressing, that I might get prosecuted. And although Reg was ill, she wanted him around for as long as possible. Everything I’d already thought of. It always came back to the same thing, though — it was what he wanted. We couldn’t refuse the last wishes of a dying man.” [Chat; Issue 36; 11 September 2003 ] No man is an island, so it is not just what he wants that matters. A person’s decision to take his own life can have a profound and often lifelong effect upon the lives of others. There may be guilt, remorse and even anger and bitterness felt by those who are left behind. It has been well said that personal autonomy is never absolute. The effect, which personal decisions will have on others, must always be taken into consideration. 20. AUTONOMY IS NOT ABSOLUTE Supporters of voluntary euthanasia and assisted-suicide frequently argue on the basis of what they describe as ‘individual autonomy.’ According to them, a competent individual should have the right to determine how and when to die. It is not unusual to hear the following sentiment expressed: ‘It’s my life, and I should be able to end it when I want to. The law as it stands undermines my autonomy and therefore needs to be changed.’ What needs to be appreciated is that autonomy is not absolute, because as human beings we are interdependent. We all belong to the family of man, and to a great or lesser extent are dependent upon each other. Furthermore, what we do affects other people, so if we decide to take our lives, others will be affected. The famous quotation from English poet and preacher John Donne illustrates this truth most effectively: “No man is an island, entire of itself: every man is a piece of the continent, a part of the main…Any man’s death diminishes me, because I am involved in mankind.” To be quite honest, the idea of absolute autonomy is absolute nonsense. George Bernard Shaw, in his well-known work ‘Pygmalion’ described the notion of total individual independence as “middle class blasphemy.” He went on to say: “We are all dependent on one another, every soul of us on earth.” There is no escaping from the fact that what we do as individuals has a profound effect on our fellow human beings. Thus, when a patient makes a request for assisted-suicide, he instantly involves other people. A person’s decision to end his life can have far-reaching effects, and indeed repercussions. Those who have been involved in the deliberate ending of a life will never be the same again. Doctors will have to live with the fact that they have become ‘angels of death,’ and family members, who approved the assisted suicide, will have to wrestle with the pangs of troubled consciences. 21. NO ONE HAS A ‘RIGHT TO DIE’ Despite all the talk about ‘rights’ no one has a right to be killed on request. Some see the right to life and the right to die as equally valid expressions of personal liberty. However, as Alison Davies of No Less Human rightly observes: “There is a fundamental difference in the assumptions behind the two concepts. The ‘right to life’ is a well-established term, recognised in international law, reflecting a basic of justice, upheld in ancient and modern religious and ethical codes, that no innocent human being may be deliberately killed. The ‘right to die’, by contract, is merely a play on words which does not reflect a right at all. Death itself is not a ‘right’ but a natural event which comes to everyone eventually. Those who say there is a ‘right to die’ really mean a ‘right to be killed’”. The fact that people are talking about a ‘right to die’ is a reflection on our society, and perhaps the churches in particular. In this materialistic society people see nothing of any lasting value in life, and become despairing, with feelings of hopelessness and uselessness. People should be shown the value of their lives, and encouraged to appreciate that whatever their circumstances, they can live with dignity and die a natural death. 22. DANGER FOR THE VULNERABLE If euthanasia were to be legalised, many vulnerable people would live in fear. A poll carried out among residents of homes for old people in Holland , where voluntary euthanasia is widely accepted, showed that 68% were afraid that they might be killed without their consent. Over 10,000 Dutch people now carry ‘Anti-euthanasia passports’ because they are so afraid of being killed by euthanasia if they are hospitalised. If euthanasia in any form became an accepted part of our society, vulnerable people would be afraid to express any unhappiness or discontent for fear that they would be regarded as “better off dead” and killed because they fell within the ‘strict criteria’ drawn up for acceptable killing. This is an especial concern for the elderly. If assisted suicide is legalised, the elderly could very quickly become prey to the unscrupulous. There are many elderly folk today living in Care Homes, who have no family, and thus no one to protect them. They are at the mercy of health-care professionals. By legalising assisted suicide they will be in an even more vulnerable position. When you are old, physically weak and alone, who will protect you against unscrupulous people? How can you deal with someone who wants to ‘persuade’ you towards assisted suicide, for his or her own ends? If the law is relaxed it, will become possible for unscrupulous people to manipulate the vulnerable into ‘assisted death’ for their own ends. There are already vast numbers of con artists who exploit the vulnerable for personal gain, and to legalise ‘assisted suicide’ would create another means for them to pursue their devious objectives. If you are old, weak and alone, and your life is in the hands of others, you will do as they say because you have no option. Statistics show that the birth rate is falling and that there are more elderly people than ever before. As the number of old people grows, and there are increasing demands on NHS funds, there will be more pressure to ‘help’ the old and seriously ill to an early death. An estimated two-thirds of NHS beds are occupied by patients over 65 years of age, and the number of people over 85 has doubled in the past fifteen years. There are now over a million men and women between 85 and 89, and 330,000 over 90. In the next 50 years, these numbers are expected to triple. It is not entirely beyond the realms of possibility therefore, that doctors may one day be issued with a form entitled ‘Qualifications for Involuntary Euthanasia,’ citing the criteria: ‘Over 75…visited the doctor so-many times during the past year…cost to the NHS so-much…No useful contribution to the State = Euthanasia Recommended.’ We live in a society that has lost its respect for the elderly. Not so many years ago the young would have gone to them for advice and benefited from their wisdom and knowledge of the past. Today many young people possibly considering themselves to be technologically superior either ignore the elderly or treat them with utter contempt. Legalising euthanasia would spawn even more of this attitude because it would encourage the idea that the elderly, infirm and vulnerable are disposable and dispensable. 23. ASSISTING SUICIDE CAN LEAD TO SUICIDE On 12th September 2003 , the Manx Independent carried an article entitled “30% of Mercy Killers Commit Suicide.” It contained an extract from a report published by the Voluntary Euthanasia Society (VES) on 9 th September 2003 , in which it was stated “30% of suspects in reported mercy killing cases end up committing suicide.” The chief executive of VES, Deborah Annetts is quoted as saying, “Behind the statistic of 30% of mercy killers going on to commit suicide, there lies a huge amount of suffering.” Ms Annetts’ interpretation of the statistic is that mercy killers commit suicide because they are fearful of prosecution. However, this is not necessarily the correct interpretation. The person who has assisted a loved one to die may have begun to suffer guilt, remorse and despair, and this is the most likely reason they take their own lives. The fear of prosecution is unlikely to be uppermost in their minds, because it is a known fact that the ‘Powers that Be,’ more often than not turn a blind eye to what they call ‘mercy killing.’ Take the case of Reg Crew, for example — possibly the most publicised assisted-suicide case so far. Win Crew was well aware of her situation, and was actually waiting for the police to contact her, which they did. She said: “I knew it was a criminal offence to help someone to die in this country, so I wasn’t surprised when the police came round to Jan’s to interview us both. I had to tell them why I did it. That it was an act of love. They were sympathetic. But the matter was still hanging in the air. But a few weeks later, the police said they’d drawn a line under it.” In the light of the police response to Reg Crew’s assisted-suicide, Win will certainly not be living in constant fear of prosecution. However, only time will tell how she will feel within herself in days to come with regard to her own emotions. People who have killed loved ones out of ‘mercy’, or have assisted in their suicides, are quite likely to defend their actions to the bitter end. Nonetheless, inside they may suffer deep regret and even remorse. For a number of reasons they may never publicly acknowledge these feelings, nor even admit them to themselves. They may become deeply depressed, without understanding the reasons for their despair. If they do ultimately come to regret their actions, they may feel unable to tell anyone because they know it will cause further distress, particularly within the family unit. One can well imagine that feelings like this can lead to suicidal thoughts. 24. THE MOOD SWINGS OF THE DYING Terminally ill patients are susceptible to drastic mood swings. This in itself highlights the danger of legalising euthanasia. Canadian researchers from the University of Manitoba , Queens University Kingston and the St Boniface Research Foundation have found that terminally ill cancer patients can long for death one day but cling to life the next. They fear such patients could opt for euthanasia when at an extremely low ebb. The study, published in The Lancet (Vol. 354 p816), looked at 168 cancer patients who were receiving palliative care following a terminal diagnosis. It found that patients who said they wanted to die might say the opposite 12 hours later. In the recent debate on euthanasia in the House of Lords (06.06.2003), Baroness Finlay of Llandaff, Honorary Professor in Palliative Medicine at The School of Medicine, gave a poignant illustration of the mood-swings of the seriously ill. She described a cancer patient of hers who once pleaded for death, yet now lives a very fulfilled life. “A wish to die is a feature of untreated clinical depression,” Lady Finlay said. 25. DISABILITY IS NOT INDIGNITY Being disabled is not the same as being without dignity. Many of those who are pushing for voluntary euthanasia argue that they want to ‘die with dignity.’ When pressed, they say that if they became doubly incontinent and extremely dependent, they would consider that to be undignified. The truth is, however, that many people are incontinent and dependent, although they are not terminally ill. Indeed, there are some who have been in this position all their lives, and it would be nothing short of iniquitous to describe these people as undignified. People’s individual conception of dignity differs. A person who has been fit and well most of his or her life, and then becomes disabled and dependent, may feel a loss of dignity. This does not mean that their perception of dignity is accurate. Others have been disabled all their lives; but without a doubt they are very dignified people. The pro-euthanasia supporters imply that only their concept of dignity is correct. In other words, according to them, anyone who becomes dependent on others and loses control of their bodily functions is undignified. By definition, to be undignified is to be ‘low in value and lacking in quality.’ This is a most inappropriate description of any human being, not least the disabled. One thinks of the actor Christopher Reeve, who until a few years ago was a fit and powerful man, as is seen from his casting as ‘Superman’ in the films of that name. However, a fall from a horse left him almost totally paralysed, and he is now completely dependent upon others in most aspects of his physical life. Nevertheless, no one who reads his autobiography, or sees him on the television speaking about his life as a paraplegic, would describe him as degraded or undignified. It is reasonable to assume that many of the pro-euthanasia submissions that are being sent to the Select Committee of the House of Keys, will be drawing attention to “sufferers who have lost their dignity.” These sufferers, in becoming ill, have taken on disabilities, which have allegedly rendered them undignified. A disturbing equation has thus been drawn between having a disability and being undignified. Apparently, a person in good health is dignified, whereas the person who lives with a disability is not. This is the logic of the pro-euthanasia argument, and it is very disturbing to say the least. It is an insult to the disabled and a slur upon those who are not terminally ill, but suffer a chronic and debilitating illness. 26. ASSISTED SUICIDE IS NOT ‘DIGNITY IN DEATH’ In February 2000, an enquiry by the Erasmus University in Rotterdam into 649 cases of assisted suicides in Holland published the following details: — One in 8 patients had ‘problems with completion’ — either because of an undesirably long time to reach death, or by waking up. One in 10 patients suffered unpleasant side effects such as vomiting. As a result, one fifth of the doctors who had initially intended only to assist a suicide ended up having to kill the patients themselves. In Salem , Oregon , a doctors’ group have issued guidelines for doctors relating to the practice of physician-assisted suicide. Under the heading ‘On The Day Of The Suicide’ there is the following advice: “ If the patient develops distressing symptoms during or after taking the drugs, the physician may, and should, use good medical judgment to relieve those symptoms. This might include administration of antiemetics, anti-anxiety agents, oxygen and/or anti- seizure medications. These drugs may be given by injection as appropriate.” It seems reasonable to suppose that past experiences have made this guideline necessary; otherwise it would be inappropriate. Bouts of vomiting, panic attacks, difficulty breathing and convulsions can hardly be described as an “easy exit.” In other words, physician-assisted death is not necessarily the gentle, distress-free experience anticipated by the patient. Many people, who support euthanasia, do so because they are genuinely concerned by the prospect that either they, or a loved one, may die in pain or in deeply distressing conditions. They see euthanasia as a means of avoiding a harrowing end, and this is why they find the euphemism ‘death with dignity’ so appealing. The above-mentioned statistics indicate that some who opt for euthanasia will not have a dignified death at all. We will never hear about these deaths, however, because no one who is involved in euthanasia will ever release such disturbing details. 27. THE ‘ECONOMIC’ ARGUMENT Legalised euthanasia is seen in some quarters as a convenient solution to a lack of resources. In May 2002, a law was passed in Belgium ‘permitting the killing of sick people using medical techniques under certain conditions.’ During the publicity campaign in the run-up to the passing of the law, a number of studies were carried out relating to the final year of people’s lives. The studies apparently proved that the final year of a person’s life was usually the most expensive for the State. It would seem that this morbid financial statistic was being used to justify a change in the law. In other words, it was being suggested to the electorate that euthanasia makes good economic sense. Suggesting a link between legalised voluntary euthanasia and saving money for the Health Service is not sensational scare mongering. There is a link, and Miss Barbara Smoker, a former chairman of the Voluntary Euthanasia Society and a leading figure in the pro-euthanasia movement, confirms this. In an article in the VES Newsletter in September 1991 she said: “…The drain of scarce hospital beds, nursing and other medical resources under the NHS is beginning to convince some of our politicians of the need to amend the law.” If the government sees there may be an easy way out of the economic problems in the Health Service, and doctors perceive an ‘easy’ way round the unpleasantness of telling somebody that they have to die, then why shouldn’t they work to make euthanasia mandatory? This scenario is not as extreme as it might seem. In a recent poll taken amongst economic students in America , it was found that 90% of the students supported compulsory euthanasia for unspecified groups of people, to ‘streamline the economy.’ Of course, it may be said that America is quite different from the British Isles , and that no one would think this way here. This smacks of the ‘ostrich mentality’ because it is not beyond the realms of possibility that in the not too distant future, our own economic students may also advocate compulsory euthanasia to ‘streamline’ the NHS. To advocate euthanasia on the basis of an economic argument is despicable and morally indefensible. You cannot put a price on a human life, even though it may be elderly and infirm. Each person is unique and every life is of inestimable worth. A human being cannot be compared to a ‘clapped out’ car, which the garage proprietor condemns as being “an old banger, not worth fixing.” 28. A POSSIBLE MANX ‘HAVEN’ FOR ASSISTED SUICIDES If euthanasia is legalised in the Isle of Man , it could conceivably lead to residents of the United Kingdom using our Island home as a means of procuring medical help to die. Although Members of the House of Keys are adamant that this will not happen, we would respectfully ask ‘Why not?’ What will prevent people from taking up residence in the Island (for whatever period might be stipulated as a ‘safeguard’), with the ultimate purpose of committing medically assisted suicide? It would seem that we are not the only ones who see this as a possible future for the Isle of Man. On the day following the debate in the House of Keys, one of the national broadsheets carried an article concerning the Isle of Man ’s move towards euthanasia. The content of the said article is quite revealing: “The Isle of Man could soon become a haven for those wanting to end their own lives, with Members of the Manx parliament voting overwhelmingly in favour of introducing a bill to legalise voluntary euthanasia yesterday. If the law was changed on the island it could end the trip abroad for those wanting to partake in assisted suicide.” [Daily Telegraph, Wednesday 14th May 2003 , page 7]. At present, our Island home has a reputation for being a ‘tax haven.’ If voluntary euthanasia is legalised, it could become a ‘haven’ of an entirely different kind — a safe place to die! In a public meeting convened under the auspices of CARE [ 25 June 2003 ] this chilling prospect was actually vocalised, when the speaker said that the Isle of Man was in danger of becoming “a venue for death tourism.” 29. DOCTORS ARE NOT OMNISCIENT It is not uncommon for doctors to give a mistaken diagnosis. Even the British Medical Journal carried an article entitled “Patients with ‘terminal cancer,’ who have neither terminal illness nor cancer. ( 1 August 1987 ).” The article may have been written 16 years ago, but we have all read in the newspapers about someone who had been given only months to live, and is then told that he did not have a terminal illness after all. Legalised assisted suicide would therefore send to an early grave, both those who were terminally ill and those who are not! What happens after death is a matter of faith and cannot be rationally or scientifically evaluated. The person who has had medical assistance to take his own life would, of course, be the chief witness— but he is dead. A doctor’s opinion might be that his patient is ‘better off dead’ but he does not know that he is. Indeed, his claim that the patient’s suffering is over cannot be rationally or scientifically evaluated. No doctor can say categorically, therefore, that knows he is acting in his patient’s best interests when assisting in a suicide, or performing euthanasia. Our convictions as Christians are not based on scientific evaluation. They are based on the Bible, which is the Word of God, and the Bible makes it clear that there is a Heaven to be won and a Hell to be shunned. The humanist doctor, who rejects the concept of an after-life, will no doubt argue that Christians cannot know that there is a Heaven and a Hell. By the same token, the doctor cannot know that there is not, and the burden of proof must surely lie with him because he is the one taking a life. Doctors are not omniscient. Their knowledge, even in medical matters, is limited. Therefore, if something worse than his present suffering might possibly await an unbearably ill patient, a doctor should err on the side of caution. 30. DEATH IS NOT THE END Those who plead for ‘dignity in death’, ease from suffering and release from pain do not begin to comprehend the certainty of Judgement. The Bible makes it very clear that “It is appointed unto men once to die, and after that the Judgement (Hebrews 9:27 ).” The Atheists and Humanists of this world are of the opinion that physical death is total extinction. This was borne out in the editorial of The Times Newspaper dated 7th June 2003 . Patients seeking to end their lives were described as “being quietly assisted towards oblivion.” The Biblical truth however, is that eternal suffering awaits all who meet their Creator in an unfit condition. There is no dignity in death. On the contrary, it is an enemy that brings a fearful retribution for sin against all who enter God’s presence without the righteousness of Christ. Death is the wages of sin, and sin’s testimony against man. We trust that the information contained on this web page will be helpful for those wishing to write to the Select Committee, and the Isle of Man newspapers. It is vitally important that pro-lifers do write, because the proeuthanasia lobby will be very active. There is reason to believe that groups like the Voluntary Euthanasia Society and EXIT are already mustering their forces and co-ordinating a massive ‘correspondence campaign,’ and we anticipate that the Select Committee will be bombarded by submissions from those who are advocating Voluntary Euthanasia and Assisted Suicide. It is imperative that we redress the balance and put pen to paper. The correspondence columns in the Manx Press have contained a number of varied contributions relating to the ‘Euthanasia Debate.’ Unfortunately, an impartial observer could be forgiven for thinking that the majority of Manx Residents are in favour of a change in the law. Perhaps this is true. Surely, however, there should be a clearer and louder voice raised by those who genuinely appreciate the sanctity- of life, and recognise that all life is a gift from God. There have been some scathing, vitriolic and decidedly irreligious letters in both the Isle of Man Examiner and the Manx Independent. The reading of same causes one to take a sharp intake of breath, particularly as we are often accused of being unloving and lacking in compassion! Obviously it would not be appropriate to respond to these letters with the same venom. It is needful nevertheless, that we state our case. The correspondence columns are widely read, not just by the populous, but also by the politicians. A Manx resident who buys the Examiner or the Independent will most definitely read the letter page. Writing to the paper therefore is an extremely efficient way of getting an important message across. Pressure for legalised euthanasia does seem to be mounting, but it is no good just grumbling and worrying about it. The late Mary Whitehouse used to say: “Don’t moan — ‘phone!” The point that she was making was that we should be prepared to do something. The urgency of this cannot be overemphasised. It was Edmund Burke, the great eighteenth century Scottish philosopher and British parliamentarian who said: “Evil triumphs when good men do nothing.” If we do nothing, and euthanasia is legalised, there is a very real sense in which we will have the law we deserve. For the benefit of friends contemplating writing to the letter pages of the Manx Press, the address of both the Isle of Man Examiner and the Manx Independent is as follows: Isle of Man Newspapers Publishing House Peel Road Douglas Isle of Man IM1 5PZ Fax No: (01624) 611149 E-mail: newsdesk@newsiom.co.im In addition to writing to the newspapers we should also write to the Select Committee. The Manx politicians do pay attention; not only to the content, but also to the number of submissions and letters they receive. Without doubt, pro life organisations such as CARE, LIFE and SPUC will be presenting written evidence. However, what they do does not absolve us from our responsibilities. The politicians want to hear from the public in general — not just from some sections of society, but from all sections. Not just from one age group, but from all age groups. Let us therefore take up the challenge, ever remembering that the pen is mightier than the sword! Details concerning the Select Committee’s requirements and also the address to which submissions should be sent are set out in the Government Notice reproduced below: Government Notice * SELECT COMMITTEE OF THE HOUSE OF KEYS ON VOLUNTARY EUTHANASIA On 13th May 2003 the House of Keys gave leave to Mr John Rimington MHK to introduce a Bill to enable a competent adult who is suffering as a result of a terminal or a serious and progressive physical illness to receive medical assistance to die at his own considered and persistent request, to make a provision for a person suffering from such a condition to receive pain relief medication, and for connected purposes. Leave to introduce the Bill was qualified by the requirement that, before it should be introduced, a Select Committee of five Members should take written and oral evidence on the subject matter of the proposed Bill and report to the House. The Members elected to the Select Committee are: Mr Q. Gill MHK (Chairman), Mr D.M. Anderson MHK, Hon A.F. Downie MHK, Mrs H. Hannan MHK and Hon J. Rimington MHK. The Committee invites written evidence with regard to the proposed Bill to be submitted to the undersigned no later than 30th September 2003 . In view of the likelihood that many witnesses may seek to give oral evidence to the Committee in addition, it would be helpful if submissions would indicate whether the persons making them wish to give oral evidence and why they wish to do so. The Committee will subsequently decide which witnesses to call for further evidence. Malachy Cornwell-Kelly Secretary to the House of Keys Legislative Building Douglas , IM1 3PW Suggestions and contributions relating to our Euthanasia Web page have been gratefully received. Especially appreciated is the continuing input from Susan Richardson and Peter Hedditch. Thanks also to Leslie Kaighin for his a regular supply of literature relating to the subject. [Matthew F Else. 26-09-2003]