British Section of the World Federation of Doctors Who Respect Human Life

The European Court of Human Rights refused to hear Leslie Burke’s case against the GMC guidance on withdrawing and withholding of food and fluid from patients “whose death is not imminent” on the grounds that British domestic law already protected him well enough. Leslie Burke commented on 9 August 2006 , “One of my concerns about the GMC guidance is that a disabled person can choose to die, but not choose to live.”

Disability Now of September 2006 said “The guidance gives doctors the right to remove artificial food and drink from a patient who can no longer communicate, if it is seen to be in their ‘best interests.’

“The Disability Rights Commission said it was ‘bitterly disappointed’ that ‘fundamental issues around a disabled person’s quality of life could not be tested by the highest human rights court in Europe.”

Leslie Burke’s solicitor, Muiris Lyons of Irwin Mitchell, said “Leslie wanted to have his position in law clarified now, before he loses capacity to determine his own best interests. The Court has effectively determined that his application is premature.” (The Scotsman, 9 Aug 2000.) “However, once he loses the capacity to make his own decisions he will also lose the ability to make such an application in his own right. It is a Catch 22 situation for him. Note: under the Mental Capacity Act he does not need to lose competence, but only the power to communicate decisions, to forfeit the right to live if he needs tube feeding. The European Court approvingly quoted part of paragraph 38 of the GMC’s guidance:

“Always consult a clinician with relevant experience…” in such cases. The words they replaced by dots are “who may be from another discipline such as nursing.” Have the court no confidence in nurses, or do they think the public has none?

Abundant evidence of planned death-by-dehydration in British hospitals and nursing homes was never submitted to the High Court by Leslie Burke’s then solicitors – although he had asked by telephone that it should be – and so was not mentioned in Mr. Justice Munby’s judgment. If it had been, the European Court might not have been able to ignore it.

“When you have signs of consciousness, you cannot decide to stop hydration and nutrition,’ said Steven Laureys, a neurologist at the University of Liège and co-author of the study which appears in the journal Science Today” (Guardian, 8 Sept 06).

A woman injured in an accident was studied five months later. “Neuroscientists at the Medical Research Council’s cognition and brain sciences unit at Cambridge and the University of Liège in Belgium used a brain scanning technique called functional magnetic resonance imaging (fMRI) to detect signs of awareness in the woman, the first time scientists have been able to do so in a PVS patient. The technique is now likely to become a standard way of determining how conscious vegetative patients are. ‘This is extremely important. It’s the difference between life and death,’ said Dr. Laureys.’

Wesley Smith’s blog records that Dr. Owen, co-author of this study, told the woman to “perform a mental task, to imagine herself playing tennis and walking through her house. Motor-control regions of her brain lit up like they did in the healthy people he compared with her.

“These were the kinds of tests that the Schindlers begged Judge Greer to permit to be given to Terri Schiavo, in the hope that a scan which measured function would demonstrate more activity than tests that had been done measuring brain structure.” Although Dr. Owen’s sophisticated tests would not have been possible, a PET scan could have been done. Judge Greer refused to allow it.

Mr. Geoffrey Lean, who reported the experiences he had while apparently in a coma in the Independent on Sunday ten years ago, may now be listened to with more respect. He wrote (10 Sept 06):

“It seems the stuff of nightmares. To lie in a hospital bed, unable to speak or move – not even an eyelid. To understand what people say to you, and not to be able to respond. Even to hear your fate being discussed, without being able to have your say. But it can be all too real. It happened to me. And last week research showed that it may also be reality for many patients diagnosed as in vegetative states, sometimes condemned as brain dead and beyond recovery… ”Ever since I recovered, I have had a uneasy feeling that some people were being denied food and water and allowed to die, knowing what was happening but unable to communicate…”

The New Scientist, 24th May 2006, reported an article in NeuroRehabilitation, volume 21, page 23: “A drug used to track insomnia has paradoxically helped temporarily rouse three men who were each in vegetative state following motor accidents, researchers claim. They believe that Zolpidem (marketed as Ambien) activates dormant cells in the brain.”

Clinical Ethics, published quarterly by the Royal Society of Medicine, in June 2006 printed an article by Professor Len Doyal, a member for nine years of the BMA Ethics Committee, advocating legalization of non-voluntary euthanasia.

“Proponents of voluntary euthanasia should support non-voluntary euthanasia under appropriate circumstances and with proper regulation,” he wrote.

It is interesting to speculate what “proper regulation” would consist of, but Professor Doyal claimed with justification that non-voluntary euthanasia in Britain is happening now.

“Thousands of people who desperately need an organ transplant will be given new hope by legislation that comes into force this week,” the Daily Telegraph claimed (31 Aug 06). “The Human Tissue Act, which makes consent its cornerstone, gives added weight to the wishes of the 13.4 million people on the NHS Organ Donor Register, donor cards and others who have agreed to donate.” Relatives will no longer be able to prevent removal of organs.

“Does it matter that organ donors are not dead? Ethical and policy implications” was the title of an article by M. Potts and D. W. Evans, J. Med Ethics 2005: 31; 406-409.

“Much of the information given to the public regarding organ donation and the declaration of death comes though literature in support of people signing organ donor cards. Currently, the statement on organ donor cards asserts that organs may be taken ‘after my death.’ We believe that such wording should be changed to reflect the fact that ‘brain dead’ individuals are not dead on the usual understanding of what death is. Explanatory literature should be frank that a ‘brain dead’ donor’s heart is beating during part of the organ removal surgery.”

Nancy Valko in the USA, commenting on a conference held in Utah in April reported in the Deseret Morning News, said: “Note the new way of using donations after cardiac death involves PUTTING THE PERSON BACK ON LIFE SUPPORT TO LESSEN THE HASTE NECESSARY TO HARVEST THE ORGANS. In older protocols , ethicists emphasised that the ‘irreversibility’ of cardiac death as defined by state laws was met by the decision not to resuscitate the person/donor rather than physical impossibility. Now, it seems that putting a person back on life support doesn’t really count.”

“A Chinese company has begun marketing kidneys, livers and other organs from executed prisoners to sick Britons in need of transplants,” the Daily Telegraph reported on 20 Dec 05.

“…Dr. Na said military hospitals have access to the Public Security Service – the police. This means transplants that are a good match for potential donors are more readily available from the execution grounds. Foreigners, after an initial check-up, are guaranteed an organ will arrive within two weeks.”

The St. Louis Post Dispatch reported on 22 Aug 06 that some Americans visit China, where “for the right price – $130,000 for a liver and $160,000 for a heart – organs are available for transplantation. Many are obtained from people whose only crime was to practise a form of meditation and exercise called Falun Gong.

“This week, Post-Dispatch reporter Deborah Shelton documents the case of Huangui Li, 62, who was arrested for distributing banned literature in 2001. She was taken to a medical facility, for tests to judge her suitability for organ donation. She believes her high blood pressure saved her life.”

Roger Highfield, in the Daily Telegraph of 4 April 2006, reported that “A milestone has been passed in the field of tissue engineering; the first group of patients has received organs that were grown from their own cells in a laboratory.

“Dr. Anthony Atala will announce a long-term success today relating to seven children and teenagers who had implanted bladders grown from their own muscle and bladder cells.” (The Lancet, Vol 367, Issue 9518, 15 April 2006).

The long, seemingly unstoppable, progress of Lord Joffe’s “Assisted Dying for the Terminally Ill” Bill, into and out of a Select Committee, etc., was due to the Government’s tacit support. It was assisted by the claim that it was “not done” to divide the House of Lords on a Private Member’s Bill.

On 12th May Lord Carlile of Berriew, summing up against it, said “… the threat that the provision will be brought back if it is defeated today intimidates neither me nor anyone of my view not one jot. I urge the House to ignore it.” He then quoted the Clerk of the Parliaments: “ ‘It is unusual, but not improper, to vote against the Second Reading provided notice has been given on the order paper.’ The Bill was defeated by 148 votes to 100.

The stiffening of opposition was due to the CARE NOT KILLING Alliance, formed on January 31st 2006 by Hospice doctors and pro-life groups, with support from Church leaders. Peers were thoroughly well briefed, as well as receiving numerous letters from the public. (CNK is now chaired by Brian Iddon MP, whose speech in a debate on the Mental Incapacity Bill was one of the most notable.)

Not Dead Yet UK, for disability activists, was launched on the day of the Second Reading, and members joined a Rally against the Bill opposite Parliament, led by Jane Campbell (just awarded a DBE). The demonstration was described by Baroness Jay, a Joffe supporter, as “deeply unpleasant”. The Bill will be presented again, perhaps not by Lord Joffe.

From Wesley Smith’s blog, 10-17 August 2006:

”BBC host Jenni Murray has created a suicide pact with friends in case she becomes incapacitated. But here is the real deal. She doesn’t want to be burdened with caring for her ageing parents. From the publicity materials about a coming documentary in which Murray ’rants’ about the so-called right to die, Jenni is angry that, having fought so hard to become liberated and independent, women are now being trapped into caring for ageing parents.’

“Poor baby. But it is good that she is being candid.”

“Doctors at the British Medical Association conference today voted that doctor-assisted suicide should not be made legal in the UK, the Daily Mail reported on 29 June 2006.

“They voted by 65 per cent against 35 per cent in favour of overturning the BMA’s neutral position on assisted suicide, decided at the BMA conference last year.”

The jiggery-pokery needed to get this decision in 2005 had provoked a rebellion. Dr. Phil McCarthy, writing in the Catholic Medical Quarterly of August 2006, reported:

“The National Secular Society claimed that doctors had ‘ditched’ their neutral stance under ‘Christian pressure’, and Dignity in Dying (formerly the Voluntary Euthanasia Society) blamed the ‘religious lobby’… These responses seem odd since none of the arguments supporting the motion had been made from any religious text, teaching or tradition. Although the Christian Medical Fellowship was accused of ‘packing’ the meeting, in fact out of the 520 delegates to the ARM only 13 were members of the CMF and none of them spoke in the debate.” However Dr. McCarthy does not deny that a certain world-view influences some people to set a high value on human life.

Dr. Michael Wilks, chairman of the BMA Ethics Committee and a supporter of euthanasia, has now retired.