VOLUNTARY EUTHANASIA (Hansard, 7 April 1970)

§ Dr. Hugh Gray (Yarmouth)

I beg to move, That leave be given to bring in a Bill to make lawful the administration of euthanasia at the request of the recipient. This matter has already been discussed on three occasions in another place. The last was in 1969, when the noble Lord, Lord Raglan's Bill was defeated on Second Reading by 61 votes to 40. It seems to me that at this point in history it is appropriate that the subject should now be discussed here and that legislation should be introduced changing the present statutory situation. My argument rests on the contention that the choice of life or death should always be with the individual concerned, and that the things that happen to him should be in accordance with his values and not the values of others.

At the moment, of course, the choice is with the doctors who always deal with their patients in the very best way possible, but always in accordance with their own values. It became clear, in the debate in another place, that doctors fall broadly into three groups. The first was described by the noble Lord, Lord Platt, when he said that a certain amount of euthanasia was already practised. He gave as an example a man who was suffering from terrible cancer and who contracted pneumonia, but to whom antibiotics were not administered because it was thought better he should die rather than continue to live.

The second group of doctors are those, broadly speaking, who do not strive Officiously to keep alive the patient, and who act in terms of what they consider to be their own humane values. The third group are those who think that life has an absolute value and that in no circumstances must the flame be extinguished, even in circumstances in which there is no consciousness, no personality, just a living organic shell and nothing else. It seems to me entirely wrong that an individual, whether he favours euthanasia or is opposed to it, should not have his choice prevail over the doctors who are going to care for him. In terms of individual liberty, the choice 253 should always be with the individual. It should be his choice and if he cannot act for himself he should be able to say how he wishes to be treated.

Since 1961, in this country a man has had a right to take his own life when he is able to do so. This is clearly recognised. Given the developments that have taken place in medical science and the possibility of keeping people alive in circumstances that would not have been possible in the past, it seems to me that one should be able to speak with one's own voice, on the basis of one's own values, to say how one wishes to be treated in certain circumstances.

For example, if I am motoring to this House, and am involved in a motor accident and I suffer irreparable brain damage, I do not wish to be kept alive. I wish to be eased gently and comfortably out of life; and I would hope to be cared for by a doctor who shared these values. But at the moment I run the chance of being cared for by one who has absolute values. Similarly, anybody who has this absolute value runs the chance of being cared for by one of these doctors who takes a different view.

I suggest to the House that we have arrived at a moment in time when statutory legislation is necessary to ensure that the individual can exercise his own effective choice. How can this be done? I suggest that it can be done by an individual declaration which can be in favour of voluntary euthanasia, or can be against it; and that such a statement should accompany a man's or woman's medical record.

I take as a definition of euthanasia that given by the noble Lord, Lord Chorley, who defined it as the termination of life at the request of the individual for the purpose of avoiding unnecessary suffering in the last extremity. I believe that the kind of form that such a declaration should take, although I am not suggesting that this wording is final, is that proposed in the noble Lord, Lord Raglan's Bill, namely: I declare that I subscribe to the code set out under the following articles:— If I should at any time suffer from a serious physical illness or impairment reasonably thought in my case to be incurable and expected to cause me severe distress or render me incapable of rational existence, I request the administration of euthanasia at 254 a time or in circumstances to be indicated or specified by me or, if it is apparent that I have become incapable of giving directions, at the discretion of the physician in charge of my case. In the event of my suffering from any of the conditions specified above, I request that no active steps should be taken, and in particular that no resuscitatory techniques should be used, to prolong my life or restore me to consciousness. This declaration is to remain in force unless I revoke it… Of course, nobody should sign such a declaration unless he wants to and unless it is in accord with his own values; and such a declaration, if it accompanied his medical records, would have to be renewed periodically; or similarly, there might be a central registry. But the important point is that one should be treated in accordance with one's own values. One should act as an adult in a civilised society.

In a leading article, The Times this morning suggested that it was better to leave it to the humane values of the doctors. I suggest that this is a paternalistic argument. It means that if one is lucky one has someone who shares one's values and if one is unlucky one has somebody who is opposed to them. The choice must be with the individual. Legislation is needed at this particular time for this to be achieved.

I hope that the House will give me the opportunity of bringing in my Bill so that the subject can be discussed at much greater length. I regret the brevity of my argument, but, of course, this is the nature of a Ten-Minute Rule Bill. I have simply discussed the principle, the issue of choice, and whether it should be with you, with me, or with others. We should be treated, when we can no longer consciously choose suicide for ourselves, in accordance with our values; one may call it suicide by proxy if one likes.

It seems to me that this is a choice as an adult that I should be able to make and I hope that sufficient of my fellow hon. Members will share my view and give me leave to introduce the Bill.

§ Mr. Norman St. John-Stevas (Chelmsford)

The subject of this Bill is the question involving life and death. It is, therefore. a very grave and important issue. I would like, first of all, to congratulate the hon. Gentleman the Member for 255 Yarmouth (Dr. H. Gray) on the manner in which he has presented his case. I would like to congratulate him, too, on his courage, which always commends itself to the House. I believe that many hon. Members with majorities less exiguous than his might shrink from espousing such a controversial question in what is likely to be an election year. But it is doubtless because, like myself, he is a doctor of philosophy and so is able to adopt a disinterested attitude.

One great achievement of our age is that we have been enabled to conquer disease and illness and increase life expectancy in a way no other age has seen. I believe this to be a substantial blessing. Life is an uncovenanted gift, and if one can extend its scone and span the possibilities for achievement and happiness are proportionately increased. But as one welcomes the advance of medical science one would be shallow indeed if one did not see the very real and complex problems with which we are faced by this prolonging of life. It is true that more people are exposed today to the chance of terminal illness than in the past. While more will survive, they may well find themselves surviving in a state where their powers and faculties have waned or wasted away.

The response of the supporters of euthanasia to this very real problem is to allow such people as painlessly as possible to be put, at their request, out of their misery. This is a response which I recognise is inspired by compassionate concern and by humanitarian motives. I do not doubt that, but equally I do not doubt that it is neither truly compassionate nor humane to facilitate euthanasia as proposed in the Bill.

My approach to the problem, first of all, as it must be, given my beliefs, is religious. In common with the majority, though not all, who find themselves heirs to the Judao-Christian tradition, I believe that it is ultimately God, not man, who has the disposal of human life. In the last analysis we are the created, not the Creator, and we are bound by the given of our condition.

Having said that, it is necessary to recognise that the hallmark of our humanity is freedom and that the glory of being human is precisely that we can transend the limits of our nature. 256 Between the two poles of our freedom and creaturehood there is inevitably a tension, never sharper than today when an advancing technology is putting greater and greater powers into the hands of man. It is on our resolution of that tension that the future of our humanity depends.

In helping us to resolve the particular tension which the Bill presents, there is one reasonably sure guide, namely, the moral values that are shared in our society that constitute both its inherited and its developing wisdom. It is now proposed to do away with part of that wisdom, namely, the fact that we deny to any individual the right to dispose of the life of another and that life can only be taken in extreme cases at the hands of the State. Many who do not share my theological presuppositions will, I think, subscribe to that view, because to do away with it would deprive our society of an essential protection and expose us to a whole variety of dangers.

The burden of proof that this is not so must lie upon those advocating this fundamental change. They must show that it will not undermine respect for the value of life. They must show that the safeguards they propose are adequate. I do not believe that this burden of proof has been discharged by the proposer today.

The central point of the case put forward by the hon. Member for Yarmouth was that the Bill presented a transfer of choice, that the Bill would take away a right from the doctor and confer it upon the patient. I think that that is a profoundly inadequate analysis of the situation. I believe that the Bill would not transfer a right, but would create an entirely new right of allowing one person to kill another, albeit at that person's request.

It is not true to imply that a doctor at present has a discretion to dispose of life. A doctor, whatever his views, is under a duty to preserve life. The knowledge that that is so is the basis of the patient-doctor relationship. That does not mean that there is a duty to prolong life at any cost. That would be neither good morality nor good medicine. Lord Horder, a very great doctor, once said that the good doctor will know how to distinguish between prolonging life and prolonging the act of dying.

257 There is surely a clear moral distinction between administering a pain-killing drug in the knowledge that it may or will shorten life and administering a drug with the direct intention to kill. The safeguard of that distinction is contained in the standards of the medical profession, supported by the law. Take away either of those safeguards and the patient and the doctor are exposed to equal danger.

Let us consider the case of old people in particular, whom the Bill sincerely intends to help. What kind of agonising moral pressure could open up to a sick old person if the Bill were to pass into law? It is not only unscrupulous relatives who might create pressure—they would be a minority—but the mental processes of the old person that would do so. He would be asking himself, "Should I cease to be a burden to those who are looking after me? Are they thinking that I am a burden? Should I take this step or should I not?" What then has become of the peaceful, easy death which is held out by the supporters of the Bill?

I believe these to be powerful arguments, but, strong as they are, my most rooted objection to the Bill is that it is a short-cut: it offers a simple solution to problems of the highest complexity. The problems that arise today in our society from the need and desire of those suffering from incurable disease to die in peace and in dignity are much 258 complicated than mere relief from physical pain.

There is an inner misery and loneliness which afflicts such people which needs to be assuaged. What causes more agony to dying people in these conditions than anything else is the sense of being written off when they are, in fact, alive; being treated as dead when they are still living. It is precisely this mentality that I fear the Bill will induce not only in the dying person, but also in relatives and medical attendants.

The final stage of an incurable illness can be a wasteland, but it need not be. It can be a vital period in a person's life reconciling him to life and to death and giving him an interior peace. [Interruption.]This is the experience of people who have looked after the dying. To achieve that needs intense loving and tactful care and co-operation between relations and medical attendants. This painstaking, conscientious, constructive approach to the dying is, I believe, more human and compassionate than the snuffing out pro posed by those who are well-intentioned, but who seem to understand little of the complexities of the needs of those they a are attempting to help.