The Select Committee reviewing Lord Joffe's Assisted Dying for the Terminally ill Bill reported on 4 April. The committee was divided on whether such a law was needed. The House of Lords will debate the report on 10 October and we anticipate that an amended bill will be introduced shortly afterwards in an attempt to legalise physicianassisted suicide (but not euthanasia) along the lines of the Oregon model.
The Mental Capacity Bill was finally passed on 6 April and is now the Mental Capacity Act. It comes into force in 2006. The bill gives statutory force to legally binding advance directives and there are still concerns that it may have opened the door to inappropriate withdrawal of food and fluids in some mentally incapacitated cases in response to advance directives or rulings made by people granted power of attorney. The accompanying Code of Practice is still to be written; and we have to wait and see how the profession and the courts interpret the law. As always the price of freedom will be constant vigilance.
A number of high profile court cases keep beginning and end of life issues in the news especially those of Joanna Jepson Qate abortion for cleft palate), Leslie Burke (withdrawal of food and fluids), Zain Hashmi (saviour siblings), Charlotte Wyatt (braindamaged baby) and Sue Axon (parental consent for abortion). Cases like these arouse considerable media interest and shape both public opinion and the law not just here but around the world. In particular the reaction to the case of Terri Schiavo (withdrawal of food and fluids) in Florida shows that ethical issues are now global Whilst it is true that the media often wants to create polarisation and confrontation and paint in black in white where there are shades of grey, it is also true that hard cases create bad law. It is therefore essential that we don't shrink from addressing the underlying issues involved.
In the last few months we have made submissions on the following, all of which can be found on the CMF Website at www.cmf.org. uk/ethics/submissions:
- The ethics of prolonging life in fetuses and the newborn (Nuffield Council on Bioethics - 09/06/2005)
- Tomorrow's children - a consultation on guidance to licensed fertility clinics on taking into account the welfare of children to be born from assisted conception (HFEA - 07/04120OS)
- Dying with Dignity Consultation .Alper (Scottish Parliament 04104/2005)
- Social Value Judgements (NICE - 30/06/2005)
The BMA Annual Representative meeting in late June saw the BMA adopt a neutral stand on euthanasia by a slim majority and also oppose a move to lower the upper limit for social abortion from 24 weeks, an age where the latest research is showing that babies have an 80% rate of survival.
We live in dark times and CMF will have to play an increasingly prophetic role in the coming months and years as the medical establishment continues to turn its back on its Hippocratic and Judaeo-Christian roots.