I often get the feeling that the Christian church thinks that being 20 years behind the times is a virtue. It was therefore a pleasant surprise to find that this book by a Church of England working party was not a new publication, but rather an updated edition originally published in 1975.

There are many contributors to this book and its scope is wide, covering moral, theological, medical and legal considerations in the euthanasia debate. It includes the submission from the Church of England to the 1993 House of Lords' Select Committee and an updated bibliography. The material sensitively engages with the complexity of the issues, and is accessible to both the layperson and health professional.

I found that the sections on moral and theological considerations gave me the most food for thought. The working party wanted to shy away from 'simple or absolute moral conclusions', yet they also stated that, 'To declare it is not always wrong to kill the innocent...would be to deprive the principle of the sanctity which we feel it possesses'. I enjoyed the discussion and found it thought provoking and refreshing, although some might find it to be a typical example of the Church of England taking the middle ground. Proof texts were avoided and a comprehensive biblical framework attempted. While the discussion of the principle of responsibility-based rather than rights-based ethics could have been expanded, the conclusion of the working party was never in doubt: 'The good and simple principle that innocent human life is sacred has influenced profoundly our conviction that the old and the dying should be cared for and consoled, no matter what their condition.'

Is a book published 25 years ago still relevant today? The chapter on medical considerations needs some updating, but, as the introduction rightly observes, it is not the issues that have changed but rather, 'society has moved further down the road of individual autonomy and choice'. What the authors had to say 25 years ago is therefore still vital in today's debate. The saddest thing is that it still needs to be said.

Reviewed by
Jim Paul
SpR in Palliative Care in London