Memorandum by the Royal Collage of Paediatrics
and Child Health
This sets out the conditions, need for second
opinions, safeguards and penalties that apply in situations where
a competent adult seeks the help of a medical practitioner in
ending their own life because of their terminal illness and the
unbearable suffering it imposes.
We consider that there are a number of ways
in which the interests of children might be involved, as set out
below:
1. A competent adult may have dependent
and incompetent children
Presumably there needs to be some mechanism to
safeguard the interests of such children if their parent chooses
to exercise their rights under the Bill. It could be argued that
this would be an issue anyway for a terminally ill parent, but
the Bill does need to consider the possible impact of an earlier/accelerated
death on the child including the means by which this is achieved.
2. Competent children with terminal illnesses
A child is legally competent to consent to medical
treatment at 16 years and earlier than this if they are deemed
competent to understand the nature and purpose of that treatment
and its impact on their family. Some children with terminal illness
may express a wish to die, especially if they have a long experience
of illness and its consequences for them. In fact children in
these circumstances may be just as competent as adults to express
their views and know what their implementation means. Given the
safeguards the Bill proposes it might be felt unjust to exclude
them from its humanitarian provision unless there were public
policy or best interests reasons for doing so.
3. Incompetent children with terminal
illness
Whilst only the courts can make decisions about
medical treatments on behalf of incompetent adults, parents can
and do make decisions and provide consent for their incompetent
children. Faced with the terminal illness and unbearable suffering
of their child what action is open to parents who wish to relieve
that suffering by bringing about the death of their child. The
RCPCH position has been against euthanasia in practice because
of its illegality as well as concerns about whether it creates
a slippery slope and is open to abuse. However a situation in
which assisted dying becomes legal for adults will inevitably
create circumstances in which the position with respect to children
will need to be re-examined.
Although the Bill excludes children there do
seem to be moral reasons based on fairness and rights as to why
the situation with respect to provision for both competent and
incompetent children, their parents and the health care teams
who provide treatment for them might be reconsidered.
September 2004
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