The first step towards legalising euthanasia in the Isle of Man took place on Tuesday May 14th 2003 , when two politicians from the south of the Island sought leave to introduce a Bill to the House of Keys. MHKs [Members of the House of Keys] John Rimington and Quintin Gill were behind the move, which was prompted by the condition of one of their constituents, Mr Patrick Kneen, who was a cancer sufferer.
Following the discussion, an amendment from Alex Downey MHK granting leave to introduce a Bill on Euthanasia was passed by 15 votes to 7. However, before the introduction of the Bill, a Select Committee has been set up to thoroughly investigate the issue. After reading and hearing evidence from concerned members of the Manx public (and presumably also from interested friends off the Island ), the Committee Members will present their findings to the House of Keys.
The Christian response to euthanasia is to unequivocally oppose it. To put it bluntly, euthanasia is killing. In legal terms, it is ‘the intentional killing of a patient as part of his or her medical treatment.’ Although it is referred to as ‘mercy killing’, the end result of euthanasia is the deliberate ending of a person’s life. To quote a recent Briefing Paper produced by CARE, “The key factor is the intention behind the act. Euthanasia occurs when a doctor, friend, or relative intentionally ends a person’s life, to ‘put them out of their misery’, i.e. kill them.”
Bearing in mind what euthanasia is, there can be no pussyfooting around the issue when presenting our evidence to the Select Committee. In saying this, I am not suggesting that we are deliberately provocative and inflammatory. But on the other hand, we mustn’t ‘tiptoe through the tulips’, because if we do, we will fail to make an impact. This is a life and death issue that we have before us, and it must be handled not just with sensitivity, but also with firmness and forthrightness.
The Editor of the Manx Independent (Friday May 16th 2003 ) says: “What the Committee Members need is informed, reasoned and balanced input. What they don’t need is extremist reaction from sections of society, on whichever side of the argument they stand.” I would respectfully suggest that what the Editor of the Manx Independentactually means is that the Select Committee does not wish to either see or hear phrases such as ‘legalised murder,’ and ‘giving doctors a licence to kill.’ However, these phrases do have a place in the debate, because however unpleasant they may sound, they get to the very heart of the matter.
In 1994 and 1995, members and friends of Grace Baptist Church Peel rigorously opposed the legalising of abortion. Although at that time we expressed the view that it would ultimately lead to the legalising of euthanasia, we are nevertheless shocked that things have moved so quickly. However, at the risk of being castigated yet again for our ‘radical extremism,’ we are now preparing our arguments against legalised euthanasia, to present to the Select Committee. The points we will be emphasising will include the following:
1. MORE THAN AN ‘ISSUE’
Euthanasia is not just an issue for philosophical or theological discussion. It is far more than a good topic for a debating society, or an interesting theme for the letter pages of the Isle of Man newspapers. Of course the subject of ‘mercy killing’ needs to be debated, and indeed written about. However, we must remember that academic arguments and dry principles are, in and of themselves, totally inadequate. Euthanasia is literally a matter of life and death, and therefore must be approached with heart-felt compassion and deep sensitivity.
2. MEN AND WOMEN ARE MADE IN THE IMAGE OF GOD
It is argued that euthanasia provides release for those whose ‘quality of life’ has been impaired. What needs to be remembered, however, is that our significance derives not from our ‘quality of life’ but from our status as having been made in the image of God [Genesis 1:26 -27]. All human beings have been formed and fashioned in the Divine image. In this way, man is fundamentally different from the animals.
In the Bible, we are reminded that it is reprehensible to use our tongues for the purpose of cursing and slandering our fellow human beings. The reason for this caution is that these fellow human beings have been made after the similitude of God [James 3:9]. On the basis of this principle, it logically follows that if it is shameful to slander our fellow human beings, it is far worse to terminate their lives. Terminally ill patients, who are sometimes incorrectly described as having a ‘low quality of life’, are still human beings made in the image of God, and there can be no justification for either killing them, or allowing them to kill themselves.
3.THE SANCTITY OF LIFE
Since all men and women are created in the image of God, every life has an intrinsic and immeasurable value. This is the source of the sanctity of life concept. Human beings have been “fearfully and wonderfully made”, and have an inherent and God-given dignity. From conception, a human life is sacred and special, and deserves therefore, to be treated with utmost respect. Euthanasia is the exterminating of that precious life.
Euthanasia is intentional killing, and so contravenes the 6th Commandment, “Thou shalt not kill” [Exodus 20:13 ]. This applies even in the case of suicide.
4.OUR LIVES ARE NOT OUR OWN
The Bible makes it clear that human life is not our property, and we do not have the right to dispense with it when we see fit. As Job said: “The Lord gave, and the Lord has taken away, blessed be the name of the Lord [Job 1:21].” We are not the owners of our lives, but rather the stewards of them, and we do not have the right to approach a doctor and ask for our lives to be taken away from us.
5.RESPONSIBILITY FOR OTHERS
It is a Christian belief that we have a moral obligation and social responsibility to care for all people with dignity and respect, especially those who are elderly, dying or disabled.
In the letter pages of the Manx Press, Christians have sometimes been castigated for their lack of compassion. We are accused of being uncaring simply because we disagree with euthanasia and assisted suicide. The anti-Christian argument is summed up by Doctor Jeff Garland is one of his many letters on this subject to the Isle of Man newspapers: “In scurrying to defend dogma … church representatives seem to be without compassion for the Kneens and to be unable to show any clear understanding of why they seek change in the law on assisted dying.”
This argument is overly simplistic. Being anti-euthanasia is not the same as being uncompassionate. Indeed true Christian people are very compassionate, because they seek to follow in the footsteps of the Lord Jesus Christ. Care of the terminally ill is one of the top priorities of the Christian Church. When our Lord Jesus Christ was here on earth, He was often moved with compassion when He focused His eyes on the blind, the lame and the lepers. The Bible speaks about reaching out to people in their need, and Christians have a responsibility to follow the example of Jesus Christ. Like Him, we must do all that we can to bring relief to those in pain, and comfort to those who are terminally ill.
It is not without significance that Christians have been responsible for building many hospitals, and for pioneering techniques to control pain and alleviate suffering. Furthermore, the Christian Church has been at the forefront of the Hospice Movement. Some members of the pro-euthanasia lobby fail to understand the practical compassion that Hospice Care makes available, including specialised palliative care and pain control. Our own St Bridget’s Hospice has a reputation for compassion, and yet it opposes the move to legalise assisted suicide. Chairman John Quinn said on Manx Radio [29 July 2003] “The ethos of the Hospice Movement generally, and specifically here on the Island at St Bridget’s of course, is that it does not support euthanasia.”
6. HOSPICE CARE
Without a doubt, euthanasia will undermine Hospice care. It is believed in some quarters that there are only two alternatives open to patients with a terminal Illness. On the one hand they die slowly in painful unrelieved suffering, on the other hand they receive euthanasia. There is, however, another way, namely that of compassionate medical care. Research has shown that 85% of patients with pain can be totally relieved with the help of drugs. A further 10% can be relieved almost completely, and the remaining 5% can have their pain relieved for much of the time.
This has been the work of the hospice movement: to control patients’ pain within the context of a caring, and homely environment. One woman said of the hospice where she found help and relief: “I came here to die of cancer. Now I have learned to live with cancer.” The hospice movement is to be applauded for its outstanding palliative care and end-of-life pain management. It is not surprising that in the Netherlands , where euthanasia is now officially condoned, there is only a very basic hospice movement. By contrast, in the United Kingdom and indeed the Isle of Man , there are well-developed facilities, which care very effectively for the terminally ill.
The British Isles are privileged in having what is generally regarded as the finest hospice service in the world (supported largely by voluntary funds) to care for terminally ill patients. In the year 2000, there were well over 3,000 beds in British Hospices. Each year 30,000 people die in hospice care.
The Lord Jesus Christ is described in Scripture as being “moved with compassion,” and the hospice movement reflects the Biblical concept of compassion.
7.HOSPICE & EUTHANASIA CANNOT BE BEDFELLOWS
It has been suggested in some quarters that there is strong support for euthanasia within the hospice movement. Correspondence in the Manx Press has referred to the hospice service rising to the ‘challenge’ of a change in the law. We would respectfully submit that those who talk in this way have a hidden agenda. They would like to see the hospices incorporating euthanasia as part of their remit. However, what must be appreciated is that the hospice movement and the concept of assisted suicide are poles apart.
Alex Schadenberg, Executive Director of the Euthanasia Prevention Coalition, said “Any attempt by the Right to Die Movement to ally itself with hospice is an attempt to take over the hospice movement.” Nancy Valko, a hospice nurse, warns that “Hemlock and other pro-euthanasia groups have been trying to change the tried and trusted hospice philosophy from providing compassionate care without either prolonging or hastening death to support personal or family ‘choice’ in cause or hastening death.”
8. INTENTION THE KEY FACTOR
In legal terms, euthanasia is the intentional killing of a patient as part of his or her medical treatment. Intention is the key factor. The distinction between euthanasia and good medical practice hinges on the intention with which the treatment is given.
In some cases, administering huge amounts of morphine is an expression of compassionate palliative care. The morphine is given to alleviate pain, and not to cause death. The ultimate outcome may actually be death, but as this is not the intention, the giving of the drug is good medical practice. Pain control treatment may have the effect of shortening a patient’s life, but if this is not the intention then it is not euthanasia. In other words, whilst death may be a consequence of the treatment, it is certainly not the reason for it.
A CARE briefing paper on the subject of euthanasia provides this helpful summary: “To tackle pain in dying patients, doctors sometimes administer large doses of strong drugs. Doctors do so foreseeing that the drugs may weaken the patient and (very rarely) shorten life, but the intention is the relief of pain rather than the shortening of life. This principle is known as double effect. It is medically and legally accepted that a doctor may give a patient drugs that may hasten death if the doctor’s intention is to prevent pain, rather than kill the patient.”
9. THE CONDITIONING PROCESS
Many British Doctors are actively resisting moves to legalise euthanasia, because they have no desire to administer lethal injections. Professor Tim Maughan, the Director of Wales Cancer Trials Network at Cardiff University , said, “This is not what we became doctors to do.” However, the risk is that, as with abortion, doctors will be conditioned into accepting the euthanasia mentality. When a thing becomes legal, it very quickly appears to be right. It has been well-said that, “the law is a very powerful educator of the public conscience.” When an action becomes legally accepted, and widely practised in society, people stop having strong feelings about it. This has been clearly demonstrated by the legalising of homosexual activity between consenting adults.
10.THE SLIPPERY SLOPE
An example of the validity of the ‘slippery slope’ argument is the practice of abortion. Permitting abortion for a few women has led to abortion on demand. The 1967 UK Abortion act was intended to allow doctors to terminate pregnancy when this was medically necessary to preserve maternal health. There is no suggestion in the Act that its intention was to allow mothers to get rid of unwanted children. However, since 1967 there have been over six million abortions in United Kingdom . Quite clearly, the majority of these are not being performed because doctors believe that an abortion is the only way to preserve maternal health. Thus what was originally intended as a change in the law for compassionate purposes has culminated in the needless killing of millions of unborn babies.
Voluntary euthanasia is only a short step to involuntary euthanasia. In other words, the next step could conceivably be a legal change which will result in the elderly, the mentally retarded and the terminally ill being placed at risk of being killed — against their will and without their consent.
Implicit in the concept of euthanasia is the suggestion that certain human beings are no longer of inestimable value — because their lives are apparently not worth living. What is the next step? Where do we go from here? Once a bad practice has been accepted as ‘the norm’, it only takes a short time before a worse practice becomes accepted in the same way. To quote Edgar Quine MHK, “Let in a little evil, and a bigger evil will follow.” This argument is supported by the acceptance of euthanasia in the Netherlands . There, the courts are now permitting euthanasia, not only for the competent terminally ill, but also for infants with serious handicaps, comatose patients, and even people suffering from severe depression.
11. UNSAFE SAFEGUARDS?
If voluntary euthanasia is legalised, we are assured that the most stringent safeguards will be put in place, and rigorous rules enforced to prevent any abuse of the law. This assurance may sound persuasive. But in reality is little more than a placatory sop designed to ‘soften up’ an unsuspecting public. Whatever the immediate effects, the safeguards will eventually offer little or no protection, because one by one they will disappear. Simultaneously, loopholes will ‘appear’ in the law, and its ultimate outworking will be very different from the original claimed intention.
A loophole can usually be found in any law. Consider the laws on abortion. The official intention of the 1967 UK Abortion Act was to preserve the life of a mother should her pregnancy endanger her life. The ‘loophole’ found, which led to abortion on demand, was the clause that relates to the mother’s mental health. Who can possibly gainsay a woman who says she will have a nervous breakdown if her pregnancy is not terminated? The outworking of the UK Abortion Act therefore, means that any woman, however normal her pregnancy, can procure an abortion on the grounds that her ‘mental health may be impaired.’ A law that was originally intended to protect a woman’s life has resulted in the deaths of over 6 million babies in the British Isles . The safeguards were rendered ineffective by the loopholes in the law, so obviously the ‘safeguards’ were not safe!
Why should it be any different with the proposed safeguards surrounding the anticipated euthanasia laws? In other words, how safe will we be in the Isle of Man ? In The Netherlands, where euthanasia has been ‘legally acceptable’ since 1984, a very sinister situation has arisen. Raanon Gillon, editor of the Journal of Medical Ethics says: “The restrictions on euthanasia that the legal controls in the Netherlandswere supposed to have implemented are being extensively ignored.” He goes on to say that “…as well as voluntary euthanasia, which is explicitly legally acceptable there, involuntary and non-voluntary euthanasia are also being carried out, despite their remaining illegal, and officially uncondoned.” [Emphasis ours]
12.VOLUNTARY EUTHANASIA LEADS TO INVOLUNTARY EUTHANASIA
Legalisation of voluntary euthanasia would lead to changes in thinking with regard to the practice of involuntary euthanasia. However carefully the law was worded, it would be impossible to enforce it, since the key witness — the victim of euthanasia — would be dead.
Holland has allowed voluntary euthanasia for many years, but the Dutch Government now has a serious problem with involuntary euthanasia. In 1990 a Dutch Government study found that over 1,000 people had been killed without their consent. The inevitable conclusion that one draws is that voluntary euthanasia swiftly moves on to embrace patients who cannot or do not, consent to be killed.
Although this argument is dismissed as extreme, Dutch Government statistics released in 1991 showed that such a progression is to be expected. The sanctioning of voluntary euthanasia in that country has lead to involuntary euthanasia. Dr Herbert Hendin, an American physician who authored a 1997 report following a visit by doctors to research euthanasia in Holland, said that virtually every guideline had either failed to protect patients, had been modified or been violated. His report said that euthanasia in Holland , which had originally been intended for the exceptional case, had become an accepted way of dealing with serious or terminal illness. Voluntary euthanasia for some in practice, therefore, soon becomes compulsory euthanasia for others.
A Dutch doctor, who expressed the opinion that his patient was “wretched”, killed an eightyfour year old lady with heart problems and osteoporosis, who had specifically stated that she did not want to be killed. The court ruled that although he may have made an error of judgement, he had acted honourably and according to his conscience! This lady needed compassionate nursing care, but instead her doctor killed her because, in his personal opinion, her life was not worth living. This is the sort of thing that a change in the Manx law would lead to in time.
Once doctors decide that certain people are better off dead, the fact that they may not have volunteered for euthanasia becomes an irrelevancy. Euthanasia will then be imposed upon them, whether they want it or not.
13 EUTHANASIA FOR THE TERMINALLY ILL COULD LEAD TO EUTHANASIA FOR ANYTHING!
In 1994 the Dutch Supreme Court ruled that euthanasia could be necessary for mental suffering. The ruling followed the euthanasia death of a depressed fifty-year-old woman, who had no physical illness at all. This particular case has been well documented and is referred to as ‘The 1994 Chabot Case.’ The lady concerned was suffering from depression after the death of her two sons. Although she was physically fit, she was euthanised by her doctor, who was subsequently cleared of committing any criminal act.
Over the last few years there has been increasing debate about whether patients should be able to ask doctors to end their lives, if they feel they no longer want to live. A relaxing of the law could conceivably lead to requests for assisted-suicide by those who simply cannot cope with the pressures and rigours of life.
In our modern society most of us live under pressure for most of the time, and it is not therefore surprising that much sick leave is described as ‘stress-related.’ If euthanasia was available for those who are ‘unbearably ill,’ in the physical sense, one can see how it could very quickly become available for those who are suffering ‘unbearably’ in a mental sense. Significantly, one of the most common reasons given for authorising an abortion is the perceived risk to ‘the mental health of the mother.’
The consequences of legalising euthanasia are almost too frightening to contemplate. Many who would claim to be in favour of liberalising the law in this area, have not really thought the matter through. It is easy to be dismissive of the slippery slope argument, but it is a harsh reality, nevertheless. Today assisted suicide for those with terminal cancer. Tomorrow — assisted suicide for those with depression?
14. COMMON PRACTICE IS NOT A BASIS FOR LEGALISATION
Recently, a total of 424 GPs and hospital consultants were asked to fill in an anonymous questionnaire about euthanasia. The response showed that almost half had been asked to take active steps to end a patient’s life, and a third of these had complied. The results of this survey were disclosed in the British Medical Journal, and have been used as an argument in favour of changing the law. It is said that in view of the fact that doctors are already doing the deed, it would be appropriate to legalise the practice.
In 1996 pro-euthanasia protagonists, when presenting their evidence to the Constitutional Legislation Committee of the Australian parliament, put this argument forward. Doctor Robert Marr in pressing for the legalising of voluntary euthanasia said: “Every doctor in Australiaknows that secret euthanasia is being practised. We need to bring it out in the open, and stop sticking our heads in the sand.” Patrick Kneen used exactly the same argument here in the Isle of Man when he spoke on Manx Radio’s Sunday Opinion broadcast on 17th August 2003, when he said: “ I do know that assisted suicide does take place — that between 20% and 30% of doctors have helped patients to die out of compassion. I feel that they would feel a lot more happy if the whole process could be properly controlled and regulated. And they wouldn’t be open to possible criminal proceedings.”
This doubtful principle is similar to that used to support the legalisation of cannabis, the idea being that if it is going on anyway, we might as well legalise it. However, the fact that assisted suicide is taking place in the British Isles doesn’t make it right, and it is certainly not a justification for legalising it. Those who argue that euthanasia should be legalised because it is already being practised, are treading on very dangerous ground. All manner of sinful things are being practised in our society. How many of them do we legalise? And what are our canons of judgement? The Christian’s assessment of right and wrong is not based on the dubious practices of society, but on the Word of God, which says ‘Thou shalt not kill.”