Memorandum by the British Humanist Association
ABOUT THE
BRITISH HUMANIST
ASSOCIATION (BHA)
1. The BHA is the principal organisation
representing the interests of the large and growing population
of ethically concerned but non-religious people living in the
UK. It exists to support and represent people who seek to live
good and responsible lives without religious or superstitious
beliefs. It is committed to human rights and democracy, and has
a long history of active engagement in work for an open and inclusive
society. The BHA's policies are informed by its members, who include
eminent authorities in many fields, and by other specialists and
experts who share humanist values and concerns.
CONSULTING OUR
MEMBERSHIP
2. The subjects of assisted dying/assisted
suicide/voluntary euthanasia are regularly aired in BHA newsletters,
web forums and local humanist group discussions, although for
most humanists these are not controversial matters and members
rarely express opposition. The very few reservations that have
been expressed by humanists over the years have focused on the
adequacy of proposed safeguards, and we do not know of any members
who oppose assisted dying on ethical grounds. The Executive Committee
(trustees) of the BHA are members of the Association who have
been elected at an Annual General Meeting, and three of them serve,
alongside two staff, on our Parliamentary Working Group. Opinion
in both groups is unanimously in favour of the principle of this
Bill. A BHA members' web discussion in August 2004 received no
postings arguing against the Bill. Individual members will also
have participated independently in this consultation, and one
member organised "Humanists for Patients' Choice."
HUMANIST PRINCIPLES
3. Humanists defend as important ethical
principles the right of each individual to live by her/his own
personal values, and the freedom to make decisions about her/his
own life so long as this does not result in harm to others. Humanists
do not share some of the attitudes to death and dying held by
some religious believers, in particular that the manner and time
of death are for a deity to decide and/or that interference in
the course of nature is unacceptable.
4. The vast majority of humanists believe
that we should have the choice of deciding these matters for ourselves,
as do the general public.[3]
A clear request to die with dignity is a rational choice when
the postponement of an inevitable and imminent death can offer
no benefit to the sufferer. This is a situation where personal
autonomy is clearly important and does no harm to others—so
most humanists support voluntary euthanasia and many would probably
support an even more permissive Bill.
RELIGIOUS OPPOSITION
TO ASSISTED
DYING
5. The Roman Catholic Church has traditionally
expressed the strongest opposition to assisted dying. It is worth
noting here that only between 8.5 per cent and 10 per cent of
the UK population are Roman Catholics, and that, according to
a NOP survey in 1993 as many as 73 per cent of Catholics oppose
official Church policy on assisted dying and agree that doctors
should be allowed to help an incurably ill patient to die.
6. Those with religious beliefs may sincerely
hold that life is sacred and that people have no right to end
it, but the law should not assume that all do,[4]
or impose the views of the religious on other people, and cannot
do so on the basis of supernatural arguments.[5]
7. It is also worth pointing out here that
at least 15.5 per cent of the population is non-religious according
to the 2001 census, making this the second largest "belief"
group in the UK. Other surveys on religious belief in Britain
have found 30-40 per cent of adults (and 61 per cent of young
people[6])
declaring themselves atheists or agnostics.
HUMANIST SUPPORT
FOR THIS
BILL
8. The BHA supports the current Bill and
believes that change is well overdue.
9. We believe that regulating assisted dying
is better for patients and doctors than the current system, where
the needs and autonomy of patients are often disregarded and where
compassionate doctors risk being charged with assisting suicide
or murder. The BHA maintains that the existing situation, where
helping a patient to die is covert, unreported and unregulated,
involves considerably greater risks to patients than does this
Bill, which fully and openly involves the patient decision making.[7]
We believe that vulnerable groups will be better protected and
treated as a result of this Bill.
10. The current system sometimes also results
in close relatives being faced with immensely difficult choices:
whether to assist a loved one who is begging for help to put an
end to their suffering knowing that it is unlawful, or to deny
their loved one the death they want. We do not believe that anyone
should be put into the position of having to make such choices,
or indeed into a position where they believe that they have no
other option but personally to end the life of someone they love.
11. We note that the Joint Committee on
Human Rights, having examined the issues in considerable detail,
concluded that "the intentional taking of life at the request
of someone who wants to die" was not incompatible with the
right not to be intentionally deprived of life under Article 2
of the European Convention on Human Rights, and that the safeguards
in the Bill were likely to be adequate to ensure compliance with
the Convention.[8]
This was also the view of the Dutch Government when considering
similar legislation.[9]
12. We believe that the Bill provides sufficient
safeguards for patients and their doctors, with a regulatory system,
provision for witnesses to requests, legal oversight and monitoring.
13. We also welcome the requirement to offer
alternatives such as palliative care—no-one should request
assistance to die simply because appropriate palliative care or
medication is not available.[10]
14. We welcome the open definition of "unbearable
suffering" (1, 2). This will include more than just physical
pain.[11]
Quality of life is important, and the person best able to judge
this and what constitutes "unbearable suffering" or
is unacceptable must be the patient.
15. We agree with the provision for opt-out
on grounds of conscience for medical staff. The Bill should not
interfere with the right of the religious to obey their own conscience.
We support the requirement (7.2) that, in cases of conscientious
objection, physicians must refer the patient without delay to
another physician who does not have such objections. However,
we point out that in some cases, eg hospices run by religious
organisations, the entire staff may have conscientious objections
to meeting a patient's request, and so referral to doctors from
another institution would be required and must be enabled.
SOME RESERVATIONS
ABOUT THE
CURRENT BILL
16. We are concerned that the requirement
to have a solicitor witness the declaration (4, 2) may deter some
patients—those who have no experience or relationship with
a solicitor and/or those worried about the cost. We would suggest
that solicitors have no particular expertise in assessing the
mental health or identity or the patient and that other disinterested
witnesses would serve equally well.
17. We are concerned that the minimum 14
day "waiting period" (1, 2) after requesting assistance
may cause unbearable delay and suffering to some patients.
18. We would prefer that such declarations
could be made well in advance of terminal illness, not just during
such an illness, and that they remained in force until revoked—not
just the six months proposed (in 4, 8). This would permit someone
with all their faculties intact to make advance decisions about
their treatment in case of sudden accident or complete incapacity,
physical or mental. It would also cater for those with degenerative
illnesses who should be allowed to declare in advance the circumstances
in which they would want assistance to die. The facility to revoke
the declaration at any time (6, 1) allows for changes of mind.
August 2004
3 81 per cent in favour according to NOP, 28th October,
2002. The Philosophers' Magazine (Summer 2004) found that
84 per cent of 926 visitors to its website (rising to 94 per cent
of professional philosophers) thought voluntary euthanasia acceptable. Back
4
For example, the Home Office Research Study 274, Religion in
England and Wales: findings from the 2001 Home Office citizenship
survey (http://www.homeoffice.gov.uk/rds/pdfs04/hors274.pdf),
found that religion plays little part in the lives of most of
people calling themselves Christians. Back
5
Gilmour v Coats [1949] AC 426, 444. Lord Simonds
"The court can only act on proof". Back
6
In a survey of 13,000 13-15 year olds, 61 per cent declared themselves
atheist or agnostic (Revd Professor Leslie Francis and Revd Dr
William Kay, Trinity College Carmarthen, Teenage Religion and
Values, Gracewing, 1995). Back
7
Belgium is one of three countries to have commissioned extensive
research into what happens to people at the end of life. The Belgian
research found doctors were ending patients' lives without the
patient's consent or request. Compared to statistics from the
Netherlands, where assisted dying was regulated by legal safeguards,
the Belgians found they had four times more cases of "non-voluntary
euthanasia". The Belgian Government was concerned that vulnerable
people were at risk and so passed assisted dying laws in 2002.
"The main aim of the [Dutch voluntary euthanasia] policy
is to bring matters into the open, to apply uniform criteria in
assessing every case in which a doctor terminates life, and hence
to ensure that maximum care is exercised in such cases" (Dutch
Ministry of Foreign Affairs website: http://www.minbuza.nl/default.asp?CMS_ITEM=MBZ257609). Back
8
Joint Committee on Human Rights, Twelfth Report of Session 2003-04:
http://www.publications.parliament.uk/pa/jt200304/jtselect/jtrights/93/93.pdf Back
9
See Dutch Ministry of Foreign Affairs website: http://www.minbuza.nl/default.asp?CMS_ITEM=MBZ257609. Back
10
The Dutch health care system is accessible to all and guarantees
full insurance cover for terminal and palliative care. However,
even where patients are receiving care of the highest quality,
some still regard their suffering as unbearable and plead with
their doctors to terminate their lives (Dutch Ministry of Foreign
Affairs website: http://www.minbuza.nl/default.asp?CMS_ITEM=MBZ257609).
In Oregon where "death with dignity" is permitted, the
recent annual report of the Department of Human Services (http://www.ohd.hr.state.or.us/chs/pas/ar-index.cfm)
found that a very small number (42) availed themselves of the
law in 2003, that they were all covered by health insurance and
most were being cared for in hospices. More than 90 per cent were
able to die at home. This indicates that an assisted death is
a genuine choice for some, and that a law permitting it need not
lead to abuse or overuse. Back
11
The most common concerns expressed by those in Oregon requesting
"death with dignity" were loss of autonomy, decreasing
ability to engage in enjoyable activities and loss of dignity
(http://www.ohd.hr.state.or.us/chs/pas/ar-index.cfm).
Pain, degradation and the longing to die with dignity are the
main reasons why patients request euthanasia (Dutch Ministry of
Foreign Affairs website: http://www.minbuza.nl/default.asp?CMS_ITEM=MBZ257609). Back
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