Joint Committee on the Draft Mental Incapacity Bill Written Evidence

95.Memorandum from the Society for the Protection of Unborn Children, Kensington and Chelsea Branch (MIB 333)

  1.  The 123 lay, and 35 clergy, SPUC members in Kensington and Chelsea are very concerned about the threat of legalised euthanasia by omission today. Thirty of us went to the House of Commons in April 2000 to ask our MP Michael Portillo to support Mrs Ann Winterton's "Medical Treatment (Prevention of euthanasia) " Bill. I submitted some four A4 pages upon the consultation paper "Making Decisions" to the Lord Chancellor's department, in July 2002. SPUC members in Kensington and Chelsea include the founder of the group "Nurses opposed to euthanasia", whose statement of aims I enclose, the Secretary of "Against Legalised Euthanasia Research and Teaching", a former borough councillor, and a member of the "Association of Lawyers for the Defence of the Unborn".

  2.  The pressure to allow patients to be killed in hospitals owes much to 6,000,000 babies killed by legal abortion since 1967. There are fewer people to pay for and undertake the care of the elderly and ill. I believe the evil of abortion should not lead to the legalising of euthanasia.

  3.  Alas, euthanasia by omission has happened by court order: several patients have died thus in England and Scotland since Tony Bland was starved to death in 1993, and every incapacitated patient is threatened. I disbelieve the Government's stated opposition to euthanasia, referring only to active euthanasia. To kill a patient by starvation and dehydration is euthanasia, and I submit this is the object of certain proposals in the Government's draft Mental Incapacity Bill. I helped care for my great-aunt who suffered mental incapacity, and for my grandmother who suffered recurring depression, and in the light of this experience I oppose legalising euthanasia, absolutely. While depressed, my grandmother was inconsolably miserable, and she told me how she sometimes thought of suicide. Notwithstanding, we cared for her until she died naturally. To have starved her to death would have been a terrible denial of a family's duty of care. It is always, everywhere and without exception wrong to kill patients, however emotionally hurtful their condition, for to do so means they are deemed to have only a qualified right to life.

  4.  Of course the draft Mental Incapacity Bill follows years of consideration. The Law Commission began six years of consultation upon mental incapacity in 1989, and the Government's Green Paper of 1997 "Who Decides", and its policy statement of 1999 "Making Decisions" are important. I suggest, the intensive pressure to legalise euthanasia from certain quarters has influenced this Bill. Lord Filkin, Minister of State for Constitutional Affairs, launched the Bill stating it would create a "framework" for the mentally incapacitated, enabIing people to "plan ahead for a possible incapacity" by creating a "Lasting Power of Attorney". I ask you to consider the serious danger that, in order to minimise the cost of incapacitated people—or even to benefit from their estate—Attorneys may order doctors to starve them. My great-aunt's incapacity was excruciating—she said the same thing up to 50 times over, was sometimes incontinent, and spoke of her dead brother and sisters as if alive. She had no such Attorney as the Government proposes, and her family and I cared for her until natural death.

  5.  The draft Mental Incapacity Bill defines patients' best interests in a seriously deficient way. In 2000, Ms Yvette Cooper, then Minister for Health, clearly implied continued life is not always beneficial to patients, in a reply to my MP Michael Portillo writing on my behalf. She considered that MrsWinterton's "Medical Treatment (Prevention of euthanasia)" Bill 2000 ". . . might require artificial nutrition and hydration to be continued even when no longer of benefit to the patient" (my emphasis). The Bill pursues this idea, by considering best interests as being defined by the ascertainable "wishes and feelings" of the incapacitated individual. The Bill omits any reference to such basic principles as sustaining life and promoting health, which are acknowledged by doctors as the objects they pursue, and endorsed in legal judgements as among best interests. I submit patients' best interests must include receiving food and drink—by tube, or fork whilst capable of digestion, and this redefinition aims to legalise killing people, on grounds like "well, he wouldn't want to go on living like this" (notably, in the case of Tony Bland: he was killed by dehydration without ever having indicated his wishes before or after he was injured). My grandmother thought of suicide while depressed, and my great-aunt suffered great distress while incapacitated, but I and my family did not starve them.

  6.  I submit that the draft Mental Incapacity Bill will undermine the foundations of medical morals, by giving statutory force to advance decisions to refuse treatment, and treating food and drink as medical treatment. It is ludicrous that I, or any human being, should need a doctor's order to eat and drink, yet the bill could deliver me to starvation if incapacitated, by considering tube feeding as medical treatment. I draw to your attention aim no. 4 of the group "Nurses opposed to euthanasia": "To challenge the increasingly accepted belief that nutrition and hydration constitute medical treatment, considering assisted nutrition, in almost every case as a basic necessity of care, when required, appropriate and possible". I believe medicine should follow the precept "thou shalt not kill, but needs not strive officiously to keep alive", and the Bill represents an appalling attack on this principle. It breaks the Government's undertaking not to legislate on advance decisions (Lord Hunt of Kings Heath, House of Lords website, 3 February 2000), and will make it impossible for anyone, once incapable, to revoke a living will they made in the past. In this context, we should remember that individuals have recovered from so-called Persistent Vegetative State—and resumed active life!—and incorrect diagnoses have been made, such as the case of Marian Sallery. I recall neither my grandmother nor my great-aunt made an advance directive—and a very worrying point in leaflet 6 of the Government's consultation paper "Making Decisions" was its emphasis on patient autonomy to the exclusion of health and life, leaving no room to continue food and drink and implying that a patient without a living will should be starved to death.

  7.  Finally, the draft Mental Incapacity Bill transfers the High Court's inherent power over "serious healthcare cases" to the Court of Protection. Its proposed authority over all areas of decision-making would include power to cut off food and drink from incapacitated people, denying the name "Protection". By the way, my incapacitated great-aunt was married to a High Court judge, Sir Roualeyn Cumming-Bruce, and he cared for her unstintingly.

  8.  I submit: the Government's conduct is extremely unhelpful and only likely to bring it into disrepute, in setting a deadline of Monday 1 September for responses to the draft Mental Incapacity Bill. The Government has shown its disregard for public debate and for human life before. In December 2000, a statutory instrument allowing so-called therapeutic cloning that is, creating human beings to cannibalise them for research—was rushed through Parliament. The then Leader of the House of Commons, Margaret Beckett had promised long-term debate upon human cloning, in November 2000, just as Lord Hunt undertook not to legislate on advance decisions in February 2000. The Government now proposes to Parliament a bill allowing people to be killed in hospitals, setting a deadline for submissions far too short to allow many individuals and groups deeply concerned by this issue, to respond. This conduct by Tony Blair's Government, so contemptuous of due Parliamentary procedure, is reminiscent of Margaret Thatcher's hubris after her third election victory.

  9.  Therefore, I ask you to safeguard the elderly and ill by resisting the proposals in the draft Mental Incapacity Bill.

  I copy this letter to my MP Mr Portillo, who wrote in a letter to me in May 2001, concerning his voting intentions in the present Parliament: "I am not in favour of euthanasia. People who are old or ill have the right to live free from fear, and confident that they will be treated ethically."

August 2003


Nurses opposed to Euthanasia



  1.  To be prepared to protect patients from people/practices which are aimed at killing them.

  2.  To maintain the historical nursing duty of care and respect for people, who may or may not be able to speak for themselves.

  3.  To offer a network of support and encouragement to nurses concerned about the threat to life of patients in their care/work environments.

  4.  To challenge the increasingly accepted belief that nutrition and hydration constitute medical treatment, considering assisted nutrition, in almost every case as a basic necessity of care, when required, appropriate and possible.

  5.  To continue the tradition and maintain the right of nurses to act as the patient's advocate with support from the profession.

  6.  To achieve an addition to the Nursing Code of Professional Conduct[10] to protect nurses from being forced or required to carry out any clinical orders/decisions which compromise the nurse's duty of care, patient safety and physical and/or mental well-being.

  7.  To work against the threat of legalised euthanasia and promote humane, compassionate care alternatives.

  8.  To raise awareness of the UKCC Nursing Code of Professional Conduct in relation to respect for people's rights in relation to ethical/religious beliefs.

9   Florence Nightingale: Notes on Nursing (Hospitals) (1863), cf The Hippocratic Oath. Back

10   United Kingdom Central Council for Nursing, Midwifery and Health Visiting, Code of professional Conduct. Back

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