LONDON (Reuters Health) Nov 08 - The case of a British woman who wants her husband to be allowed to help her commit suicide highlights the need for Britain to legalize euthanasia and physician-assisted suicide, two academics report in the November 10th issue of the British Medical Journal.
Diane Pretty, 42, is incapacitated by advanced motor neurone disease and wants her husband to be immune from prosecution if he helps her end her life. The High Court last month dismissed her case and the House of Lords, Britain's highest legal authority, is due to hear an appeal on November 14.
In a BMJ editorial, Professors Len and Lesley Doyal write that the High Court decision was "morally wrong" and argue that the law needs to change.
The two editorialists note that doctors can legally withdraw medical support from incompetent patients if the treatment is deemed to be of no medical benefit or if it is "too burdensome."
They write that at the heart of this decision is a belief on the part of the doctor that the life of the patient in question "is not worth living and therefore not worth prolonging."
"That is why withdrawal of treatment is deemed to be in the best interest of the patient and consistent with the duty of care to protect this interest," they write.
There is little if any practical difference between "passive" and "active" withdrawal of medical treatment, the academics argue. "So if we accept that passive euthanasia is OK...then why can't we do it actively if it will reduce the suffering of the patient," Len Doyal, professor of medical ethics at St. Bartholomew's and Royal London School of Medicine and Dentistry, asked in an interview with Reuters Health.
And if "involuntary" active euthanasia in the case of some incompetent patients is acceptable, then so should the "voluntary" euthanasia sought by Mrs. Pretty, the editorialists suggest.
"Some doctors would probably be only too glad to help Mrs. Pretty to end her life," they write. "This support should be regarded as a moral good instigated in her interests and at her request. It should be legally condoned — either by the interpretation of existing law by a more courageous judiciary or by new legislation."
Finally, they argue, it can also be morally right to give patients in certain circumstances the means necessary to kill themselves.
Professor Vivienne Nathanson, the BMA's head of science, healthy policy and ethics, said that while doctors have widely differing views on the ethics of these issues, most rejected any change to the law.
"I've never met a doctor who doesn't feel great sympathy in the case of Diane Pretty," Prof. Nathanson told Reuters Health. "But the majority of doctors are against changing the law. They believe it would put at risk...the trust that patients feel when they are at their most vulnerable."
In response, Prof. Doyal said the recent legalization of physician-assisted suicide in the US state of Oregon and of euthanasia in The Netherlands shows how laws can be successfully implemented. These two examples are "the gold standard" of what could be achieved with new legislation, he said.
"What we mustn't get confused is the regulatory process and whether the law itself should be changed. Public policies are important but they're not moral arguments against euthanasia," he said.
Copyright © 2001 Reuters Ltd
Copyright © 2001 Reuters Ltd