REVIEWS

DOIhttp://doi.org/10.1111/j.1468-2230.1969.tb01246.x
Date01 November 1969
Published date01 November 1969
REVIEWS
EUTHANASIA
AND
THE
RIGHT
TO
DEATH:
THE
CASE
FOR
VOLUNTARY
EUTHANASIA. Edited
by
A.
B.
DOWNING
with
a
foreword
by
the Earl
of
Listowel. [London: Peter Owen.
1969.
206
pp.
40s.
Od. net.]
ONCE
suicide had ceased to be
a
crime in itself, the argument in favour of
allowing doctors to help those undergoing the suffering of
a
terminal illness to
an easy death was bound
to
be redoubled. That it has not yet achieved general
acceptance was shown by the defeat of the Voluntary Euthanasia Bill
1969
in
the House of Lords in March of this year. One difficulty facing reformers in
this field is that, apart from the obvious advantages of “mercy-killing”
as
a
topic for debating societies and school essayists, most people shy away from
thoughts of death and are unwilling to face the possibility of their own painful
deterioration
or
that of
a
relative unless such events have already been forced
upon them. In
a
society where sex and its aberrations are freely discussed,
death has become the forbidden topic and sociologists have shown that this
rejection of reality causes increased suffering to the dying and bereaved who
are thereby made outcasts.
This volume was published
as
part of the campaign to legalise voluntary
euthanasia and is
a
collection of essays, many already published elsewhere,
putting the case for and against from
a
number of viewpoints
:
humanitarian,
moral, sociological, philosophical, religious, medical and legal. One important
point is that the contributors who favour voluntary euthanasia continually
emphasise that their campaign only relates to the dying who freely choose
a
painless death.
No
attempt is being made to advocate mercy-killing for those
unable to make the choice for themselves; the mentally ill, the severely
deformed child, the cancer patient who has already fallen into
a
drugged
coma.
It
is suggested, however, that a man might make
a
written declaration
of his views while he is in good health which might then be put into effect once
illness had ensued,
as
is
possible under the Human Tissue Act
1961
to permit
the use of
a
corpse for medical purposes after death. Their opponents argue
that once voluntary euthanasia is authorised (the thin end of the wedge) this
will eventually lead to compulsory extermination of the sick, aged and
defective, though there is no evidence that a democratic society would be
forced into such
a
position or that it would be more likely
to
accept such
measures if it had already accepted voluntary euthanasia. Will the acceptance
of voluntary abortion necessarily lead to compulsory abortion and sterilisation
of women considered too irresponsible to be good mothers?
One of the shortest but most compelling essays
is
by
W.
R.
Matthews,
formerly Dean of
St.
Paul’s, based on an address given to the Euthanasia
Society in London in
1950.
His view is that, in the case of hopeless and
destructive suffering, Christian charity demands that we act positively to put
the sufferer out of his misery
as
we should with an animal. Life in itself is
not valuable; it is the human personality which
is
sacred. “Nothing could be
more distressing than to observe the gradual degeneration of
a
fine and firm
character into something which we hardly recognise
as
our friend, as the result
of physical causes and of the means adopted to assuage intolerable pain.’’
But is this not another example of
our
horror of death, that we demand that
the dying be removed from
our
sight
so
that we can return to
our
image
of
them
as
vital and living beings?
The most important essay in this book is by Professor Yale Kamisar of
700
Nov.
1969
REVIEWS
701
the University
of
Michigan Law School who is the only contributor who
totally rejects the principles advocated by the Euthanasia Society, not on any
religious or philosophical ground, but
as
a practical matter. Can anyone in
good health really be sure that if he were dying he would desire
a
swift death,
or
even that he would want to be told of the hopelessness of his condition?
If
a
patient asks for death when he is already in pain and taking drugs, can
we be certain that this is what he really wants? When
a
dying man asks for
euthanasia, but his closest relatives oppose it on religious
or
other grounds,
is the doctor to kill the patient against the wishes of the patient’s wife and
children? What of the dying woman who wishes to live
a
few more weeks
but seeing the strain which her condition puts on her husband and children
feels it her moral obligation to die quickly? And, most horrifying of possibili-
ties, what about those cases, which are bound to occur, where the patient has
been wrongly diagnosed and is not in fact
a
dying man? One of the main
arguments after
all
against capital punishment is the case, however rare, of
wrongful conviction and execution.
Yet
still
there remains the man
or
woman whom many of
us
have known
who is condemned to die
a
lingering and painful death. We know that
many doctors give large doses of morphine to such patients knowing that this
will shorten life, that many others fail to give antibiotics when the patient
contracts pneumonia, knowing that this will hasten death. Some doctors
have admitted that they have taken even more active steps to bring about the
death of
a
suffering patient. If we tacitly approve
or
even turn
a
blind eye
to such practices, ought we not
as
a
society openly recognise them
so
that
each doctor can know that he is safe in undertaking them, and each patient
can find
a
doctor who is willing to undertake them? This is the argument of
Professor Glanville Williams.
At the end of this book the reader
will
find set out the unsuccessful
Voiuntary Euthanasia Rill
1969,
including the Form of Declaration
to
be
executed by each individual indicating his wishes for the future (probably
when he makes his will). By clause
1,
the painless inducement of death
would be lawful if undertaken by
a
registered medical practitioner,
or
under
his direction by
a
state-registered
or
state-enrolled nurse, where the patient
being of full age, has, not less than thirty days but not more than three
years before, made
a
statutory declaration requesting euthanasia, and where
two physicians, one of whom is of consultant status, have certified that the
patient is suffering from an irremediable condition,
i.e.,
incurable and expected
to cause him severe distress
or
render him incapable of rational existence.
Under clause
2
(2),
a
declaration re-executed within the twelve months
preceding its expiry date shall remain in force (unless revoked) during the
lifetime of the declarant. The declaration must be in writing witnessed by
two persons.
It
is when one looks
at
the actual clauses of this Bill that Professor
Kamisar’s objections are most compelling.
To
begin with, there are still
several cases annually in British hospitals
of
operations performed on the
wrong patient
or
on the wrong arm
or
leg. How can we ensure that
a
similar mistake does not occur between, say,
a
patient who has requested
euthanasia and another patient of the same name who has not? The patient
who has made
a
statutory declaration is
“at
risk.” He may revoke the
declaration, but if his revocation
is
lost,
or
if he is stricken by an illness which
paralyses him
so
that he cannot communicate his revocation he may be
subjected to involuntary euthanasia.
Is
there to be
a
central register of
declarations, or will these be kept by the declarants
so
that they may
or
may
not be discovered when the issue arises?
Clause
3
provides that
a
declaration may be revoked
at
any time by
destruction
or
by notice
of
cancellation shown on its face. What if +he
patient taken
to
hospital writes to
a
relative asking him
to
cancel the
declaration but the relative fails to do
so?
On
a
Wills Act interpretation

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