Published: 13th April 2006
The Christian Medical Fellowship (CMF) is an interdenominational organisation with more than 4,500 British doctors as members. All are Christians who desire their professional and personal lives to be governed by the Christian faith as revealed in the Bible. Members practise in all branches of the profession, and through the International Christian Medical and Dental Association are linked with like-minded colleagues in over 100 other countries.
CMF regularly makes submissions on ethical and professional matters to Government committees and to other official bodies. We are very grateful for this opportunity to respond to the Law Commission's consultation document, 'A New Homicide Act for England and Wales'. Our interest in the current consultation arises primarily from our concerns about the 'Mercy Killing' proposals. Our response is therefore mainly directed at this issue. An unanswered question or unquestioned proposal represents our lack of specific qualification to comment rather than agreement with the proposals.
Other submissions we have written that are relevant to the current discussion are:
The key Christian concepts relevant to this discussion, both of which have been fundamental in laying the foundation of our current law on homicide, are the prohibition on the taking of innocent human life (the sixth commandment), and the requirement for mercy in bringing judgement on offenders. The first emphasises that every human life is precious and worthy of the utmost respect and protection and that taking innocent human life in any circumstances is a very serious crime (see appendix). The second recognises the need to lessen the sentence levied on the offender in circumstances where he or she could be judged less culpable than someone of sound mind as a result of a mental condition, provocation or duress.
We agree with the Commission that the reform of the homicide act is not an appropriate forum for a debate of legalising euthanasia. (para 8.5 of the full report)
We agree that the fundamental principle that 'it is always a serious offence to kill another person intentionally even if the killer believes that it is in the best interests of the victim and even if the victim consents' must be upheld. (para 5.89 of the overview)
We also agree with the Commission's focus on the question of 'severe depression' in carers who kill – and that deserving cases should be covered by the partial defence of diminished responsibility. (5.91 – 5.93) The Commission is right to emphasise that this defence is 'highly unlikely' to be extendable to professional carers.
We have concerns over the provisional proposals that the consent of the victim, when present with the diminished responsibility defence, could result in a 'manslaughter' rather than 'second-degree murder' offence. Please see comments below (6.13 – 6.15). We are also concerned that a victim's illness and/or suffering should not be seen as a justification for their having been killed.
- We have no specific comment in response to these questions -
'First degree murder'
With regard to statement 6.6 (3) – 'that an unlawful killing committed with an intention to kill should be “first degree murder” irrespective of the status of the victim' – we feel that this is an important point to maintain.
Any indication that the lives of certain individuals might be valued more highly than others seems disingenuous – as it automatically introduces a scale of human value. We prefer the Commission's proposal that the increased vulnerability of some (such as police officers and children) be recognised in the sentencing of the defendant rather than creating a special category of murder.
With particular reference to 'mercy killings', it is important to ensure that all victims are seen equally. There are concerns among certain communities – specifically the elderly and disabled – that their lives are valued less highly than those of others. It is imperative that we resist attitudes which de-value these members of our society and therefore the status of the person who is murdered should not alter the definition of murder in any way. In this respect we agree with proposal 6.14(2) that 'all cases of mercy and consensual killing should be “first degree murder” unless the defendant can prove diminished responsibility' (discussed below).
'Second degree murder'
- We have no specific comment in response to these questions -
- We have no specific comment in response to these questions -
6.13 – 6.15
The 'Mercy Killing' proposals are of particular interest to us. As doctors, we are closely involved with vulnerable, ill, disabled and elderly people – the very ones who might become victims of so-called mercy killings. It is very important that the respect and dignity given to these people remains as high as that extended to all members of society.
We are concerned that diminished responsibility on the part of the carer, if it is proven, should not result in the charge being reduced to manslaughter. Such cases should still recognise that a person has been murdered, and label the crime as such. The option of changing the charge to second-degree murder will allow for appropriate sentencing in cases where a carer was suffering from depression (or other conditions contributing to diminished responsibility).
Regarding the option of reducing the offence to manslaughter rather than 'Second Degree Murder' in cases where the victim consented to the killing (para 10.33 of the full report), we strongly disagree. The legally relevant issue is the depressed state of the carer, not the suicidal character of the consenting victim. To allow the victim's physical or mental state (both of which may contribute to a victims 'consent') to result in a reduction of the offence appears to go against the assurances the Commission makes that a) the status of the victim should not define the crime of murder and b) that the Commission doesn't want to discuss euthanasia.
If society wishes to make provision for euthanasia or assisted suicide then this is something that should be covered by specific legislation – following a full democratic process with wide public consultation. It would be entirely inappropriate for the present review to lead to changes to the law on euthanasia as an indirect consequence of a change to the homicide law. It is imperative that the current review upholds the principle that killing is fundamentally wrong because of the equal respect due to every human being, a respect that remains regardless of the status of the victim.
At the same time we recognise that the status of the victim may be relevant to a determination of the defendant's state of mind (and thus the level of diminished responsibility) at the time of the crime. This may be particularly true where the victim was actively asking to be killed, rather than consenting to a suggestion that they be killed. However, this is a separate issue, and one that needs to be clearly distinguished in any new law.
We furthermore believe that reducing the offence to manslaughter for someone with diminished responsibility killing a consenting victim would be profoundly unwise due to the difficulty of proving a victim's valid consent. 'Informed consent' is a very important issue in medicine and should be obtained before treatment of any patient commences. The Assisted Dying for the Terminally Ill Bill currently before the House of Lords illustrates the difficulties of determining whether the consent of people who are suffering, depressed, mentally incapacitated, or for some reason feeling themselves to be a burden on carers, relatives or society, can in fact be freely given. It is virtually impossible to determine whether or not subtle forms of coercion were brought to bear or whether the victim simply felt pressure, whether real or imagined, to request early death. The key difficulty is that the principal witness, the victim, would be dead and therefore unable to give evidence one way or the other. Murderers could otherwise plead that the victim asked them to be killed when in fact this was not the case at all.
The picture in people's minds when they think of 'Mercy Killing' is the severely ill, elderly or disabled person with a carer that is under constant pressure and feeling burdened with the care of their relative / spouse. This picture, which is certainly correct in some cases, is a reason to fight for better social structures and assistance for home-carers, not to remove protection for vulnerable people. We are opposed to any law that might encourage people to end the life of another on grounds that the sentence for the crime is easier than continuing to care. Changing the offence to manslaughter because of the victim's consent would seem, to us, just such an acceptance. This is consistent with the biblical definition of manslaughter, that it was reserved only for situations in which homicide was completely unintentional (see appendix).
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The creation narrative tells us that human beings are unique in being made in the image of God (Gn 1:26) and it is on this basis that God introduces to all humankind the death penalty for murder (Gn 9:6,7). Human beings, being made in the image of God, are not to be unjustly killed.
This is later formalised in the sixth of the ten commandments, 'You shall not murder' (Ex 20:13; Dt 5:17). But what does this mean? The English language has created for us a confusion that is not present in the original text. There are in fact ten Hebrew words translated 'kill' in the authorised version of the Bible, all with different shades of meaning, but only one of them is implicated in the sixth commandment, the word ratsach. Its Greek equivalent is phoneuo and its most accurate translation is murder (NIV). The meaning of the word is further defined in four main passages in the Pentateuch (Ex 21:12-14; Lv 24:17-21; Nu 35:16-31; Dt 19:4-13).
These passages resolve any ambiguity for us and leave us with a precise definition of what is prohibited, namely the 'intentional killing of an innocent human being'. Let us consider this in more detail.
First, the sixth commandment forbids intentional killing. Anyone killing another human being unintentionally was able to flee to a city of refuge where he would gain some protection from the 'avenger of blood'. The natural death of the high priest would later atone for the killing and the guilty party would be freed (Nu 35:28). However this 'manslaughter' provision applied only in very limited circumstances:
'For instance, a man may go into the forest with his neighbour to cut wood, and as he swings his axe to fell a tree, the head may fly off and hit his neighbour and kill him' (Dt 19:5).
Killing resulting from negligence was not excused as unintentional (Ex 21:29). Neither was killing 'in hostility' even if not necessarily premeditated (Nu 35:21).
Second, the commandment forbids the killing of an innocent human being. Under the Old Covenant God authorised or permitted killing in three situations: in the context of holy war, for capital offences and in self defence (Ex 22:2). The holy war conditions are clearly spelt out by Moses (Dt 20:10-18). In cities within the promised land everybody was to be killed, in cities at a distance the men only were to be killed and only if a preliminary offer of peace was not accepted.
There were over twenty capital offences ranging from murder to contempt of court. In these situations the Israelites had the obligation of carrying out the judicial killing as God's representatives. The self-defence provision only operated if someone who had broken into a house after dark intending to commit a crime was killed by the owner while protecting his family and property.
God only authorised the killing of the guilty. 'Innocent' blood could not be shed intentionally under any circumstances and is in fact uniformly condemned throughout Scripture (Ex 23:7; 2 Ki 21:16; Ps 106:37,38; Je 19:4).
We must not become confused here with legal, psychological or social definitions of murder. The Bible does not support the conclusions of others that murder is 'the killing of a human being unlawfully with malice aforethought' or killing with 'a feeling of ill-will' or 'illegal killing inimical to the community'. It is rather the intentional killing of an innocent human being.
Euthanasia clearly falls within this biblical definition. There is no provision for killing on grounds of diminished responsibility (on the basis age or illness) and there is no provision for compassionate killing, even at the person's request. Similarly there is no recognition of a 'right to die' as human life belongs to God (Ps 24:1) and is not any human being's personal possession. Suicide is equally a breach of the sixth commandment. Only God has the authority to take human life. Human beings may only do so under God's delegated authority.
Steven Fouch (CMF Head of Communications) 020 7234 9668
Alistair Thompson on 07970 162 225
Christian Medical Fellowship (CMF) was founded in 1949 and is an interdenominational organisation with over 5,000 doctors, 900medical and nursing students and 300 nurses and midwives as members in all branches of medicine, nursing and midwifery. A registered charity, it is linked to over 100 similar bodies in other countries throughout the world.
CMF exists to unite Christian healthcare professionals to pursue the highest ethical standards in Christian and professional life and to increase faith in Christ and acceptance of his ethical teaching.