From Dr Dewi Rees
Sir, - The lack of public interest in the Assisted Dying Bill
would be remarkable if we had not gone through similar processes
already. In Nazi Germany, there was no resistance to the kindly
killing of the mentally ill which preceded the Holocaust and set
the stage for euthanasia as it is practised today.
This was followed in the UK by the legalisation of suicide in
1961 - which had been a crime for many centuries - and, in the
Netherlands, since the 1970s, by the practice of euthanasia and
assisted suicide by Dutch doctors, a development that was not
sanctioned by legislation but by decisions taken by the Dutch
Because the incidence of such deaths was never properly
determined, the Minister of Justice established the Remmelinck
Commission, which published its findings in 1991. It reported that
2300 cases of active voluntary euthanasia and 400 cases of assisted
suicide occurred each year in the Netherlands. It also found that
about 1000 cases of active euthanasia, mainly involving disabled
babies, took place annually without the patients' consent.
A further 22,500 deaths occurred each year from doctors'
withholding or withdrawing treatment, mainly from elderly patients
in nursing homes. Later, in 1994, the Supreme Court ruled that
mental suffering per se was a sufficient reason for providing
euthanasia. This meant that a physical or psychiatric illness was
not a requirement, though the doctor who received the request to
end this life should have the patient examined by at least two
other doctors, of whom one must be a psychiatrist.
The 1967 Abortion Act was the next stage towards the acceptance
of legislation for assisted suicide. The passage of this Act
encountered little public opposition, and I supported it, expecting
that few babies would be aborted; but I was totally wrong. I
expected 1000 deaths in England and Wales, but the actual figure
was 189,100 by 2009, established safeguards having been
circumvented as abortion on demand became the norm.
I did refer one woman with rubella for termination before the
Act was passed, and with my consultant's help and under his
supervision performed a hysterotomy on another woman referred to us
by a cardiologist for abortion. Once I realised the serious social
implications of the Act, however, I refused to refer any other
pregnant woman for termination.
Many years later, when I was a retired GP on a temporary
assignment in a practice, I was surprised to be told by the senior
partner that it was my duty to refer pregnant women for termination
when they wished to have their babies aborted. I did not comply,
but his attitude indicates the pressures put on people.
People who wish to end their own lives have the legal right to
do so, but that is different from expecting someone else to do it
for you. As a hospice doctor, I admitted the occasional patient who
asked to be put down. The answer was always: "No, but we will look
after you and keep you comfortable." Not one repeated the request,
and they all seemed content with the care that they received. That
was 30 years ago, and patterns of care have changed, but I remember
taking about 20 Dutch doctors around the hospice, and was surprised
by their apparent lack of interest in what we did; maybe they
thought they had something better to offer patients.
Finally, I remember a colleague who, while working in the
Netherlands, had agreed to end a patient's life. He went to the
person's house and gave the patient a lethal injection.
"Unfortunately," he said, "I botched the job and had to go back the
next day to do it properly."
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