Select Committee on Assisted Dying for the Terminally Ill Bill Minutes of Evidence

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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