Anglican responses to the Mental Capacity Bill

From Dr Gillian Craig
Sir, — I note with regret that the Bishop of St Albans and the Bishop of Worcester have spoken in support of the Mental Capacity Bill (MCB) in the House of Lords (News, 14 January).

The Government will assure them that the Bill does not permit euthanasia. It will do so, because it ignores euthanasia by omission as an entity. Yet the fact remains that to deny a person tube-feeding is just as lethal as to give a drug overdose or lethal injection. The crucial point in law is the intent of those who authorise lethal acts and omissions. The Bill will permit euthanasia by omission.

The promise extracted from the Lord Chancellor by Archbishop Peter Smith, when the Bill was debated in the House of Commons recently, is very dangerous. Clearly it is essential to outlaw any decision where the motive is to kill, but the wording appears to permit “acts or omissions intended to relieve or prevent suffering, or the ending of treatment where the patient is in an irreversible coma”. This leaves the Bland judgement intact, but opens the door wide for a dangerous escalation of killing the vulnerable.

To permit decisions (acts or omissions) to be taken in order to prevent suffering (at some stage in the future) could permit euthanasia. At the very least, the wording should be amended to make it clear that such decisions are permissible only if the intention is to prevent further intolerable suffering that cannot be controlled in any other way. This amended wording would link up with the doctrine of double effect that has worked reasonably well over the years, albeit at some risk of being abused.

Professor Downie, a philosopher on the BMA Medical Ethics Committee that created its notorious 1999 guidelines on withholding and withdrawing life-prolonging medical treatment, insists that financial considerations and the equitable distribution of taxpayers’ money should take precedence over “complex judgements” about the value or quality of life in medicine. That is the hidden agenda for the profession and the Government. The guidance under which the profession now operates has been ruled to contravene the European Convention on Human Rights.

The Mental Capacity Bill will enable lay people with no duty of care to be appointed as proxy healthcare decision-makers, with the power to prevent doctors’ treating their patients or providing tube-feeding. The Bill would make advance directives legally binding rather than advisory. Doctors who ignore advance directives and continue to treat their patients, for reasons of conscience, will risk being charged as criminals. Once mentally incapacitated, a person cannot revoke his or her advance directive or change his or her mind; yet many patients do change their minds when calamity strikes. Many people discover that life is worthwhile despite a stroke; that pain can be endured with skilled treatment; that to be the recipient of loving care can be a blessing. Sadly, many who sign advance directives will be condemned to death unnecessarily early.

Compassion that kills is not compassion. Our Lord did not break the bruised reed.
GILLIAN CRAIG
Retired consultant geriatrician
118 Cedar Road East
Abington, Northampton NN3 2JF

From Mr J. Alan Smith
Sir, — Professor Robin Gill’s article (Comment, 21 January) “What I believe about euthanasia”, fails to live up to its title. On the one hand, he does not wish to change the law on euthanasia: “I am not a supporter of changing the law in this area. Our opposition to legalising euthanasia is itself based on compassionate grounds.” On the other, he does not wish violations of the law on euthanasia to be punished appropriately: “In my view (I cannot speak for the Bishops), the current judicial situation in which so-called mercy-killers are treated leniently, is both compassionate and justified.”

If, in all cases of “mercy killing”, the perpetrators are treated leniently, then we have a de facto change of the law without the due parliamentary process. It seems that the great and good have adopted the view that the law on euthanasia is wrong, but, doubting their ability to get the changes they desire through Parliament, they seek their objectives by influencing members of the judiciary.

The rule of law requires that crimes are punished appropriately: if all particular violations of the law against euthanasia are treated leniently, then the general case against it is undermined. As George Savile, the 17th-century Marquis of Halifax, remarked: “Men are not hanged for stealing horses, but that horses may not be stolen.”
J. ALAN SMITH
40 Albany Court, Epping
Essex, CM16 5ED