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Submission from CMF (Scotland) to Margo MacDonald MSP's Consultation Document: The Proposed End of Life Choices (Scotland) Bill

Published: 9th March 2009

Introduction

The Christian Medical Fellowship (CMF) is an interdenominational organisation in the UK with some 4,500 doctor members and around 1,000 medical student members. Of these, 450 doctors and 96 students are members in Scotland. All members 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 matters to Government committees and CMF Scotland submitted evidence [1] to the Scottish Parliament in 2005 concerning Jeremy Purvis MSP's Dying with Dignity consultation paper. In terms of the whole UK, prior to the devolution of health matters to Scotland, CMF made a major submission[2] to the 1993-1994 House of Lords Select Committee on Medical Ethics which considered euthanasia and related matters.

We have also published widely on the subjects of euthanasia and assisted suicide – see our website at www.cmf.org.uk and in particular CMF Files on [3]Euthanasia and [4]Assisted Suicide.

CMF's membership of the Care Not Killing Alliance

CMF is a member organisation of the Care Not Killing Alliance which is a UK-based alliance of individuals and organisations bringing together disability and human rights organisations, healthcare and palliative care groups, and faith-based organisations, with the aims of 'promoting more and better palliative care; ensuring that existing laws against euthanasia and assisted suicide are not weakened or repealed…; and influencing the balance of public opinion further against any weakening of the law'.

Care Not Killing has already made a substantial submission[5] to Margo MacDonald's consultation, commenting critically on its lack of clarity (does it advocate euthanasia or physician assisted suicide or both?) and on its lack of detail (particularly about 'safeguards'). We do not intend to repeat all these valid points, nor to answer the consultation questions which are predicated on a claimed 'need' (never argued and certainly never proved) for some patients to be killed by their doctors.

Rather, we intend here to restate here the fundamental Christian case against euthanasia and physician assisted suicide, to reject the claim that killing by doctors is needed for compassionate reasons, to summarise public policy objections, and to advocate comprehensive, compassionate and competent palliative care at the end of life.

The Christian case: killing patients is wrong

Most religious faiths regard intentionally ending life as morally wrong. In Christianity, a fundamental principle is that unlike all the animals, human beings alone are made in the image of [6] God and are therefore worthy of the utmost respect, protection, wonder and empathy.

The Sixth Commandment 'You shall not murder'[7] prohibits the intentional killing of the legally innocent and this forms the basis for part of Christian medical ethics. It also forms the basis for law and legal practice on homicide, including that in Scotland.

'Bearing one another's burdens'[8] is at the very heart of Christian morality, and Christians are called to love others in the same way that Jesus Christ loved, which for him meant making sacrifices and willingly laying down his life for others. So, rather than contemplating the taking of innocent human life, Christians are often at the forefront of providing the best quality care for patients who are terminally ill. Recognising the inevitability and often the rightness of natural death, Christians work against unnatural deaths and seek to practise a deep commitment to relieving human suffering legitimately.

Objections are not just faith based

The consultation document is of course right to acknowledge that 'our society embraces many people who do not share this belief'. However, the Alliance's submission [5] counters the claim that opposition to legalising euthanasia is only faith based: 'It is not religion that is the main driving force of the opposition; it is concern over public safety'.

Lord Walton of Detchant, Chairman of the 1993-1994 House of Lords Select Committee on Medical Ethics, explained their rejection of changing the law to legalise euthanasia as follows: 'We concluded that it would be virtually impossible to ensure that all acts of euthanasia were truly voluntary and that any liberalisation of the law in the United Kingdom could not be abused. We were also concerned that vulnerable people – the elderly, lonely, sick, or distressed – would feel pressure, whether real or imagined, to request early death.' [9] As we enter a global economic recession, these words are even more timely.

The medical case: killing patients is unnecessary

If Scotland is to continue to reject euthanasia and PAS, then compassion requires that everything legitimately possible should be done to reduce suffering, and to transmit meaning and purpose into the lives of the terminally ill, thus restoring their sense of dignity.

The hospice movement and its derived specialty, palliative care, have proved that it is not necessary to kill the patient in order to kill the symptoms. We therefore object, for example, to the language used in the consultation document of motor neurone disease patient Diane Pretty that she was 'waiting only for a slow and painful death by choking and suffocation'. This was never going to happen, and did not happen. These sorts of scare tactics are irresponsible and simply add to the (misplaced) fears of the public which the House of Lords' Committee rightly noted.

The public policy case: killing patients cannot be controlled

Care Not Killing is right to point out that 'the so-called safeguards which appear in her proposals consist of little more than form-filling and box-ticking. They seem to assume that all applicants for euthanasia would be clear-headed, self-reliant and determined individuals – an idealised picture that is far removed from the real world of most seriously ill people.'

'Safeguards' are much vaunted by euthanasia advocates, but there is clear evidence that where voluntary euthanasia has been legalised and accepted, it has led to involuntary euthanasia. This was demonstrated in the Netherlands as early as 1990, where over 1,000 patients were killed without their consent in a single year [10].

A report commissioned by the Dutch government showed that for 2001, in around 900 of the estimated 3,500 cases of euthanasia, the doctor had ended a person's life without there being any evidence that the person had made an explicit request [11]. In addition, when it came to the reporting safeguard there was a huge gulf between the expectation of Dutch law and actual practice. For example, only 54% of doctors fulfilled their legal responsibility to report their actions concerning euthanasia.

Conclusion: leave the law as it is and promote palliative care

CMF Scotland has fundamental objections to euthanasia which are unapologetically faith based. They are also concordant with historic ethical teaching and with the stance of our colleagues in the British Medical Association and all the medical Royal Colleges which have expressed a position.

Euthanasia and physician assisted suicide are unnecessary and the law should not be changed.

Compassion never requires us to kill the patient to kill the symptoms. Rather, the emphasis should be on palliative care research and provision so that we can continue to lead the world in developing the best palliative care possible, and to deliver that with increasing equity. There is a real need for resources to be expanded to include those with diagnoses other than cancer, and to promote palliative care in the community, where most people wish to end their lives.

Should it reach debate, we therefore call on the Scottish Parliament to reject The Proposed End of Life Choices (Scotland) Bill, and instead to invest in researching and resourcing palliative care.

References

1. Submission from CMF Scotland to the Scottish Parliament on Jeremy Purvis' 'Dying with Dignity' Consultation Paper.
2. Submission from CMF to the Select Committee of the House of Lords on Medical Ethics , 1993.
3. Maughan T. Euthanasia. CMF File 22, 2003.
4. Myers K. Physician-assisted suicide. CMF File 9, 2000.
5. The Proposed End of Life Choices (Scotland) Bill. Response by Care Not Killing to Consultation Document, 2009.
6. Genesis 1: 26-27
7. Exodus 20: 13
8. Galatians 6: 2
9. Walton. Hansard. 1994; May 9: 1345
10. Remmelink Report. 1991. Partial translation and comment are published in the Lancet 1991; 338:669-74
11. Sheldon T. Only half of Dutch doctors report euthanasia, study says. BMJ 2003; 326:1164

For further information:

Steven Fouch (CMF Head of Communications) 020 7234 9668

Media Enquiries:

Alistair Thompson on 07970 162 225

About CMF:

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.

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