quarta-feira, 4 de julho de 2012

A leading medical journal in the UK is backing a movement for the legalisation of assisted dying. Is it possible to have safe, legal and rare euthanasia?. - by Pravin Thevathasan


A recent press release from the British Medical Journal states: "The BMJ supports a call from leading UK medical bodies to stop opposing assisted dying for terminally ill, mentally competent adults. Healthcare Professionals for Assisted Dying (HPAD) wants the British Medical Association and royal colleges to move their position from opposition to neutrality." 

It was an extraordinary failure of judgement on the part of what is probably the world's most prestigious medical journal. 

The royal colleges for medical specialists are opposed to assisted suicide -- as is the BMA. The BMA came under enormous pressure to adopt a position of neutrality at its annual delegates conference, but fortunately rejected it. It was arguments like that put forward by the BMA's outgoing chairman of council Hamish Meldrum which prevailed. He told the conference: "I don't come to this from any strong religious view but I do come to these views from having worked as a doctors for 40 years - mostly in general practice - where I have always felt I have been able, in almost every occasion, to support my patients when they were dying without having to actively end their lives."

HPAD, an organization affiliated with the celebrity-endorsed pro-euthanasia group Dignity in Dying, represents less than 0.25 percent of Britain's doctors. But you have to hand it to them - they are well organized and are determined to impose their beliefs on the rest of us.

So Tony Delamotte, the deputy editor of the BMJ, has written in favour of assisted suicide and is a supporter of HPAD. Fiona Godlee, the journal's editor-in-chief, has written that the BMJ now supports HPAD's call. She appears to suggest that even if the majority of doctors now oppose euthanasia, they will eventually come around to accepting it once there is a change in the law, as they have done with abortion.

This is troubling given the high rates of abortion. Is there an implicit support here for assisted suicide as a normal and frequent practice in future?

This certainly seems to be the view of some of the patrons of Dignity in Dying as seen on their website. The philosopher and best-selling author A.C. Grayling writes: "I believe that decisions about the timing and manner of death belong to the individual as a human right. This is essentially relevant in cases of terminal illness, painful or undignified unrelievable illness, exhausting old age and other circumstances where an individual might make the autonomous decision to end his or her life."

There are an awful lot of circumstances here!

Very different indeed from "assisted dying for terminally ill, mentally competent patients who are suffering intolerably" - the public argument normally put forward by Dignity in Dying. When I asked a well-known member of Dignity in Dying who is a professor in a medical speciality about Grayling's remark, he admitted that Grayling "might be in favour of assisted suicide as well as assisted dying."

Assisted suicide is death for the those who are not terminally ill -- even for people who have nothing whatsoever wrong with them but are simply tired of life. My colleague went on: "You may have seen the recent programme by Terry Pratchett. The two men who were assisted to die are examples of assisted suicide as they had at least a year to go."
These admissions appear to suggest that high-profile members of Dignity in Dying are campaigning for assisted suicide for a variety of reasons. In the words of Howard De Voto, another patron: "Nobody asks to be born. Life is thrust upon us. Who are you to try and force me to stay if I'm suffering at the end of my life?"

Or as Jasper Conran writes: "If our pets are hopelessly ill we have them put down... If our nearest and dearest are terminally ill and writhing in an agony that drugs cannot help any more, we allow the law to insist that we do nothing." A straightforward reading of this would suggest that there is little moral difference between voluntary and non-voluntary euthanasia as seemingly what matters is the perceived degree of pain. In some cases that would mean that we could put our loved ones out of our misery, rather than theirs. 

So it seems that Dignity in Dying is an organization that campaigns for euthanasia for a variety of different reasons. Abortion has never been safe, legal and rare. Nor will euthanasia. The BMA has voted to continue opposition to assisted suicide, but its supporters will certainly be back.

Dr Pravin Thevathasan is a consultant psychiatrist in the UK. He is also the editor of the Catholic Medical Quarterly.