Legalisation of Euthanasia and Physician-Assisted Suicide in the UK - Essay Example

Legalisation of Euthanasia and Physician Assisted Suicide in the UK Introduction Euthanasia and physician assisted suicide should not be legalised inthe UK. The following discussion supports this stance. Euthanasia and physician assisted suicide have been controversial from the times of the ancient Greeks and Romans. The intentional act of ending the life of a person by another entity constitutes the act of euthanasia. However, the objective behind this act should be to relieve the suffering of the person whose life is brought to an end. Euthanasia admits of the classifications, voluntary, non – voluntary, and involuntary (Gupta, et al., 2006). The ancient Greeks and Romans had frequently permitted their citizens to undergo euthanasia, in order to circumvent unending suffering. Such deaths were widespread, with a modicum of resistance towards them. However, some of the physicians of that era had vociferously protested against permitting euthanasia. These physicians were members of the Hippocratic School (Gupta, et al., 2006). Subsequently, Christianity became firmly entrenched in that region, and several radical changes were effected. The Church appreciated the stance of the Hippocratic School, in the context of euthanasia. This led to sustained opposition to euthanasia among the physicians. In the 19th century, breakthroughs in the area of anæsthesia were discovered. This had the effect of reviving proposals for the use of euthanasia (Gupta, et al., 2006). In the year 1870, Williams put forth the proposal of deliberately ending a patient’s life, by means of anæsthetics and morphine. This proposal generated considerable debate among the medical fraternity. Within a score of years, sociologists and members of the legal profession joined this debate (Gupta, et al., 2006). I have chosen this topic because the legalisation of euthanasia would result in a number of problems, such as causing the death of the invalids legally, without any second thought. As such, the disabled and sick may be at risk of hastened death from their relations and doctors. It is morally and ethically unacceptable to end the life of a person with the aid of the law. In addition, a major danger associated with permitting voluntary euthanasia is that it could usher in involuntary euthanasia. This would transpire, because doctors would be empowered to decide whether a particular patient’s life was worthy of being continued. Hence, there has to be awareness regarding the contemporary position of the issues related to euthanasia and assisted suicide, so as to save society from the dangers inherent in legalising these interventions. Existing Law Pertaining to Euthanasia in the UK Euthanasia is defined in the Oxford Reference Concise Medical Dictionary, as the act of depriving someone of his life, in order to relieve that person’s agony. Voluntary euthanasia is a situation, wherein the suffering individual asks for the adoption of measures that will end his life. Such killing can be achieved by active or passive measures (Cuninghame, 1993). An instance of an active measure is the administration of a lethal drug. The intentional withholding of treatment to bring about death constitutes an example of passive euthanasia. Compulsory euthanasia transpires when society or a duly authorised person issues instructions to terminate the life of an individual. An instance of this is the termination of the life of patients who are unable to express their wishes (Cuninghame, 1993). Contemporary English criminal law states that the deliberate and unlawful killing of another person is murder under most of the circumstances. The majority of the defences for murder depend upon absence of responsibility or intention with regard to the act committed. In other words, the objective of such defence is to establish the absence of the required mens rea (Cuninghame, 1993). In this context, the crucial factor is that the law does not permit a defence to murder that is based on motive. When an individual intentionally and in his right mind, kills another, then that individual is guilty of murder. The fact that this individual had been motivated by the desire to end the other person’s suffering has no relevance. Moreover, the killing of another person as per that person’s clear and honest wish renders the individual doing so, guilty of murder (Cuninghame, 1993). With the enactment and implementation of the Suicide Act of 1961, the act of suicide is not a crime in the UK. However, it is deemed a criminal offence to assist another person to die by suicide. As such, Section 2(1) of this Act states that any individual who aids, abets, counsels or procures the suicide of another individual shall be liable on conviction on indictment to a term of imprisonment that does not exceed 14 years. This is also applicable, if an individual helps, abets, counsels or procures an attempt by another to commit suicide (Curtice & Field , 2010, p. 187). In the Debbie Purdy case, Purdy had realised that she would require her husband’s assistance to end her life. However, if her husband were to assist her he would be liable to prosecution. The court referred to the ruling in the Diane Pretty case (Curtice & Field , 2010, p. 187). The appeal of Diane Pretty, a patient of motor neuron disease, to obtain a quick death without suffering was turned down by the English courts. She appealed to the European Court of Human Rights stating that the rights provided to her under Article 34 of the European Convention on Human Rights had been infringed by the UK government. This was rejected by the Strasbourg Court, which held that the European Convention on Human Rights did not provide a right to die (Curtice & Field , 2010, p. 188). Purdy had sought the permission of the court to absolve her husband of any liability, with regard to helping her to travel to the Netherlands, in order to undergo physician – assisted suicide. She sought recourse to Article 8 of the Human Rights Act 1998. This was rejected by the High Court, as well as the Court of Appeal. However, the House of Lords set aside this ruling and directed the Director of Public Prosecutions to promulgate an offence – specific policy regarding the manner, in which he would exercise the discretion provided to him under Section 2(4) of the Suicide Act (Curtice & Field , 2010, p. 188). Thus, Purdy won a major victory for those contemplating travelling to the Netherlands, in order to be put to death. Since, the year 2002, around 115 British nationals have gone abroad, in order to be put to death. Purdy’s victory has been hailed by the proponents of such death, as a recognition of the right of individuals to die in a manner of their own choosing. Moreover, this decision has rejuvenated the campaign to change the Suicide Act, so as to accommodate such killings (Hirsch, 2009). The UK is vehemently opposed to any dilution in the law relating to euthanasia and assisted suicide. These acts continue to be illegal in this country. There are a number of well – established arguments against weakening the law. One of these is the exertion of immense pressure on the vulnerable to end their life. Another argument is that the provision of competent palliative care renders such killing redundant (Coleman, 2012). In the Nichlinson case, Toulson LF opined that there was no justification for the court to change its traditional stance that voluntary euthanasia was tantamount to murder. This interpretation was to prevail, unless a contrary interpretation was required under the provisions of Article 8 of the European Convention on Human Rights (ECHR) (Coleman, 2012). Moreover, Article 8 provides a right to respect for private and family life. There have been a number of attempts at the European Court of Human Rights (ECtHR) to interpret this as providing a right to be killed. However, these attempts have proved futile. The English courts have invariably opined that it would be incorrect to contend that Article 8 of the ECHR requires voluntary euthanasia to provide a possible defence to murder (Coleman, 2012). Presuming that such a defence is provided by Article 8 of the ECHR, would clearly misinterpret the stand adopted by the ECtHR. It would also be at marked variance with the rulings of the House of Lords. On the basis of this line of reasoning, the High Court dismissed the various issues raised before it and declared that euthanasia and assisted suicide were illegal in the UK (Coleman, 2012). Section 1 of the Suicide Act 1961, classifies assisted suicide as a crime. In the Diane Pretty case, the ECtHR ruled that Article 8 of the ECHR protects the right of an individual’s autonomy in taking a decision relating to that person’s life and death. Nevertheless, this right to privacy can be set aside by other rights. In the above – cited case, the ECtHR held that public interest concerns were more important than the right to privacy. These concerns related to euthanasia and the protection of the vulnerable members of society (McHale, 2012, p. 442). Consequent to the decision in the Purdy case, the Supreme Court of the United Kingdom has conceded that the individual decision taking rights provided by Article 8 of the ECHR had been involved. This decision had compelled the Director of Public Prosecutions to disclose his prosecution policy, with regard to assisted dying (McHale, 2012, p. 442). The Bland case pertained to a young man who had been injured very seriously in an accident, while viewing a football match. This unfortunate individual was reduced to a permanently vegetative state, on account of the injuries sustained by him. The attending doctors and his parents finally came to the conclusion that his suffering was to be terminated and that this was to be effected by discontinuing nutrition and hydration to him. Accordingly, the court was informed of the patient’s hapless state and its permission was sought to discontinue the assisted feeding (McLean, 2005, p. 241). Furthermore, in the Scottish case of Law Hospital v Lord Advocate, Johnstone had undergone a permanent vegetative state for three years. This was the result of permanent damage to the cerebral cortex. She had no awareness of her environs and was insensate all the time. The only reaction from her was due to reflex movements, such as those that enabled breathing and cardiac function. There was absolutely no possibility of recovery. Consequently, her family and attending physicians applied to the court for discontinuance of artificial nutrition and hydration (McLean, 2005, p. 241). Similarly, in Frenchay Healthcare NHS Trust v S, the court ruled that it was not against the law to abstain from reinserting a feeding tube that had dislodged. In Swindon and Marlborough NHS Trust v S, the court considered whether it was justified to reinsert a feeding tube surgically, with respect to a patient being cared for at home. In all these cases, the attending medical team had concluded that it was in the patient’s best interests to withdraw hydration and nutrition. However, it was clearly stressed that the permission of the competent court had to be obtained, prior to the exercise of this option (Negri, 2012, p. 227). Literature Review The provision of a person with the assistance and the means to commit suicide by others constitutes assisted suicide. It essentially differs from suicide due to the element of assistance that it involves. The individual has the desire to die and includes the intervention of some other person to achieve this end. On the other hand, the prescription of a lethal drug by a doctor and its administration by a third party or the patient is termed physician – assisted suicide (Haigh, 2012, p. 34). The acceptance of euthanasia, results in involuntary euthanasia and the killing of individuals deemed to be undesirable. Moreover, it would be incorrect to presume that euthanasia promotes the best interests of a person. As such, it affects the rights of the patient and other people (BBC, 2013). However, from a pragmatic point of view, it has to be realised that euthanasia is not necessary if there is proper palliative care. It is no possible to regulate euthanasia to the extent desired. On being permitted, it will result in inferior care for the terminally ill. Another major drawback with euthanasia is that permitting it will seriously undermine the commitment of doctors and nurses, with respect to the saving of lives (BBC, 2013). Moreover, it may emerge as a relatively inexpensive intervention in the treatment of the terminally ill. Furthermore, there will be a substantial reduction in the search for new treatment relating to the terminally ill. In addition, euthanasia seriously affects motivation to provide proper care and relief from pain to the dying (BBC, 2013). Some countries permit assisted suicide under specific circumstances. For instance, induced death is permitted in the Netherlands, when the physical or mental suffering of a patient is excruciating. Thus, this nation had never conceded that euthanasia and physician assisted suicide were to be practiced solely with regard to the terminally ill patients. Even the requirement for unbearable suffering is likely to be diluted, there are strong indications that the Netherlands will permit physician assisted suicide or euthanasia, with respect to the elderly who despite being healthy are no longer interested in living (Marker & Hamlon, 2012). As such, in the year 1990, Netherlands permitted the killing of approximately a thousand patients. The frightening feature of these deaths was that none of these patients had requested to be put to death. There can be no proper control over who is to be put to death, if such killing is permitted. There are several reports from the Netherlands, which disclose that doctors tend to avoid reporting about the people they put to death, in quite a few instances (CARE, 2010). Moreover, when patients are provided with a right to die; simultaneously, a duty to kill is imposed upon the physician. This has the undesirable effect of limiting the doctor’s autonomy. Furthermore, a right to die for some individuals has the danger of transforming into a duty to die by others (CARE, 2010). This would be especially true of the dependant and vulnerable members of society. Europe, Belgium, Luxembourg, and the Netherlands permit euthanasia. Assisted suicide, in general, pertains to individuals who possess some capacity to kill themselves. This could be by imbibing a fatal dose of drugs or a lethal beverage. Such death has been permitted in Switzerland. This is the only European nation that permits foreigners to visit it to die (Cheng, 2013). In addition, there are several arguments that do not favour euthanasia. Some of the more important groups of such arguments are those of religion and the requirement of consent. Most of the religions decry suicide and do not recognise a right to end life. Suicide is usually regarded as a grave sin, as life is deemed to be a divine gift (Politics, 2013). The other major group of arguments against euthanasia is that of the requirement of consent. There are serious misgivings regarding the capacity of a terminally ill patient providing informed consent for his own killing. It has also been insinuated that relatives and doctors could persuade patients to undergo euthanasia against their will and for reasons that have no bearing upon their welfare (Politics, 2013). In the year 1993, The House of Lords established a Select Committee on Medical Ethics. This was in response to the increasing public interest in euthanasia, and the ruling in the cases of Tony Bland and Nigel Cox. The submissions of various individuals and parties were considered by this committee, during its deliberations (Saunders, 2013). However, change to the law was opposed by the Department of Health, the Home Office, The British Medical Association and the Royal College of Nursing. The final report of this committee was published in February 1994, and this report was unanimous in its conclusion that the law was to remain unchanged (Saunders, 2013). The medical profession has traditionally been regarded as one that heals. Hence, the medical participation in active euthanasia has been viewed by some as violating these objectives. The acceptance of euthanasia is lower among the members of the medical profession, in comparison to that of the general public. However, the level of medical acceptance is significant (Parker, 2000, p. 320). There have been instances, wherein the presiding physician had been of the opinion that ideals had made it difficult for the physician to address the real needs of the patient undergoing agony. Some of the empirical studies have shown that official ethics and the law are violated by quite a few doctors (Parker, 2000, p. 320). This had been done, in order to assist the death of patients, actively. In addition, a sustained campaign was launched by Debbie Purdy to bring about clarification regarding the law relating to assisted suicide. Her campaign actuated the Director of Public Prosecutions in the UK to provide guidelines on the circumstance, wherein an individual who assisted others to end their life would be prosecuted. Moreover, in Scotland, legislation to allow such killing had been presented to the Parliament by Margot MacDonald; however, this attempt was unsuccessful. (Haigh, 2012, p. 34). With the exception of some nations in Europe, the US is the only nation that permits assisted dying. However, just two of the 50 states in the US allow it. In the state of Oregon, assisted dying has been legal for more than 11 years. With regard to the state of Washington, it has been legally permitted, since the year 2009. In Scotland, legislation to allow such killing had been presented to the Parliament by Margot MacDonald; however, this attempt was unsuccessful (Haigh, 2012, p. 34). The controversy regarding the advantages and disadvantages of assisted suicide have always captured the headlines. For instance, in January 2012, the contemporary legal status of assisted death in the UK attracted considerable criticism in the report Commission on Assisted Dying, on the grounds that it was inadequate and incoherent (Holmes, 2012, p. 392). This report had been commissioned by Demos, a prominent intellectual institution of the UK. It had been proposed to bring up these critiqués during the hearing of the case of Tony Nicklinson in the High Court of England and Wales. Nicklinson had been rendered paralysed from the neck downwards, subsequent to a stroke. This unfortunate individual had been clamouring for euthanasia (Holmes, 2012, p. 392). There is a marked disparity between the views of the public and that of the physicians in the UK. After perusing the pertinent literature of some 20 odd years, McCormack and his colleagues discovered several interesting facts. One of these was that the English doctors had in the main, been opposed to assisted voluntary euthanasia or physician assisted suicide (Science Daily, 2011). In addition, religion, with regard to the physician, also had a major role in such convictions. For instance, the more religious minded the physician the greater would be that physician’s opposition to assisted voluntary euthanasia or physician assisted suicide. It was also made very clear that palliative care had the capacity to reduce suffering (Science Daily, 2011). As a result, palliative care had a restricting effect upon the necessity to engage in assisted dying. Moreover, there have been deep concerns regarding the absence of adequate safeguards if assisted voluntary suicide or physician assisted suicide were to be introduced. Conclusion In the UK, it is against the law to end a person’s life prematurely. It is also illegal in this nation to assist individuals in ending their life. Several attempts had been made to change the laws, so as to make assisted or physician – assisted suicide legal. All these endeavours have met with failure. The legalisation of euthanasia and assisted suicide will result in discrimination against people with disabilities, who will be exposed to a greater risk of being killed. In addition, there would be a diversion of effort from positive measures to encourage the disabled to live independently, and there would be diminution in the efforts to cure diseases (Right to LIfe Charitable Trust, 2009). Any member of society is entitled to expect doctors to treat disease, disabling conditions, and illness. Doctors should cure people and not kill them. As such, from the perspective of ethics, there are several disquieting features of euthanasia. Euthanasia reduces the respect that society has towards the sanctity of life. Upon accepting it, one automatically declares that the lives of the sick or disabled are not as valuable as those of the others are. From the above discussion, it can be surmised that euthanasia and assisted suicide should not be legalised, since it encourages killing rather than curing of the vulnerable people of society. References Airedale NHS Trust v Bland (1993) AC 789. BBC, 2013. Overview of anti – euthanasia arguments. [online] Available at: [Accessed 12 August 2013]. CARE, 2010. Euthanasia: The Arguments For and Against. [online] Available at: [Accessed 12 August 2013]. Case of Pretty v The United Kingdom (2002) Application no. 2346/02. Cheng, M., 2013. UK court rules against euthanasia. [online] Available at: [Accessed 12 August 2013]. Coleman, P., 2012. UK Rejects Changes to Law on Euthanasia, Again. [online] Available at: [Accessed 16 August 2013]. Cuninghame, K., 1993. Euthanasia. [online] Available at: [Accessed 15 August 2013]. Curtice, M. & Field , C., 2010. Assisted suicide and human rights in the UK. The Psychiatrist, 34(5), pp. 187 – 190. Frenchay Healthcare NHS Trust v S (1994) 2 All ER 403. Gupta, D., Bhatnagar, S. & Mishra, S., 2006. Euthanasia: Issues Implied Within. [online] Available at: [Accessed 19 August 2013]. Haigh, C., 2012. Exploring the case for assisted dying in the UK. Nursing Standard, 26(18), pp. 33 – 39. Hirsch, A., 2009. Debbie Purdy wins significant legal victory on assisted suicide. [online] Available at: [Accessed 13 August 2013]. Holmes, D., 2012. UK High Court case to reignite debate over assisted death. The Lancet Neurology, 11(5), pp. 392 – 393. Human Rights Act (c. 42), 1998. London, United Kingdom: Her Majestys Stationery Office. Law Hospital NHS Trust v Lord Advocate (1996) SCLR 566. Marker, R. L. & Hamlon, K., 2012. Euthanasia and Assisted Suicide Should Not Be Legal. [online] Available at: [Accessed 12 August 2013]. McHale, J. V., 2012. Can doctors lawfully kill competent patients who want to die?. British Journal Of Nursing, 21(7), pp. 442 – 443. McLean, S. A. M., 2005. Permanent vegetative state: The legal position. Neuropsychological Rehabilitation, 15(3/4), pp. 237 – 250. Negri, S., 2012. Self – Determination, Dignity and End – of – Life Care: Regulating Advance Directives in International and Comparative Perspective. Leiden, The Netherlands: Martinus Nijhoff Publishers. Parker, M., 2000. Medicine, psychiatry and euthanasia: an argument against mandatory psychiatric review. Australian & New Zealand Journal of Psychiatry, 34(2), pp. 318 – 324. Politics, 2013. Euthanasia. [online] Available at: [Accessed 12 August 2013]. Pretty v The United Kingdom (2002) ECHR 427. R on the application of Purdy v DPP and others (2009) EWCA Civ 92. Right to LIfe Charitable Trust, 2009. Euthanasia – A Controversial Contemporary Issue. [online] Available at: [Accessed 12 August 2013]. Saunders, P., 2013. Christian Medical Fellowship. [online] Available at: [Accessed 12 August 2013]. Science Daily, 2011. UK Doctors Consistently Oppose Euthanasia and Assisted Suicide. [online] Available at: [Accessed 13 August 2013]. Suicide Act (c.60), 1961. London, United Kingdom: Her Majestys Stationery Office. Swindon and Marlborough NHS Trust v S (1995) Med L Rev 84. The Convention for the Protection of Human Rights and Fundamental Freedoms. 1950. Rome: Secretary General of the Council of Europe. The Queen (on the application of Tony Nicklinson) v Ministry of Justice (2012) EWHC 2381. Read More