FaithWorld

Pressure is growing in Europe for some form of legalised euthanasia but few governments have gone as far as the Benelux countries in allowing assisted suicide in clearly defined cases. The mix of growing public support for ending lives of the terminally ill or brain dead but continued prohibitions on it in the law has led to some long and hard-fought legal battles in Italy (Eluana Englaro) and in France (Vincent Humbert). (Photo: Multiple sclerosis sufferer Debbie Purdy, whose case prompted Britain’s new guidelines, 2 June 2009/Stephen Hird)

It has also created a legal and ethical twilight zone where for compassionate reasons the law did not really punish the doctors, nurses or relatives who helped someone die. In France, this became clear in a number of court cases where the person accused of assisted suicide were convicted but got only a short suspended sentence. In Britain, a frequently used way to get around the law has been the so-called “suicide tourism” route to the Dignitas suicide group in Zurich.

Pressed by the Law Lords to clarify British policy, the Director of Public Prosecutions in London has issued guidelines indicating when someone who helps another person to commit suicide might face legal action. At first glace, this may seem like a clarification. But it still leaves enough questions out there to leave the issue shrouded in uncertainty. The reception in London has been mixed. Some commentators say this strikes a sensible balance but others think it’s not enough and parliament has to debate and legislate on it.

The guidelines are listed below and here is our news report explaining the story.

Do you think governments such as Britain’s should take a clear decision to keep the euthanasia ban or scrap it? Or do you think they should leave some leeway, as in the case of these guidelines, to let families make the final decision for relatives who suffer from  terminal illnesses or want to end their lives because of severe and incurable physical disabilities?

It used to be an issue just for the terminally ill. Now as populations around the world age, governments are increasingly being confronted with the taboo idea of dying as something people can volunteer to do.

“The demand for the option, if not the practice, is growing rapidly,” said Dr. Philip Nitschke, 61, founder and director of the pro-euthanasia group Exit International. (Photo: Dr. Nitschke shows his ‘suicide kit,’ 7 May 2009/Stefan Wermuth)

The Australian doctor — nicknamed Dr Death for his work on suicide — is traveling the world to teach people how to end their lives safely with a suicide drug-testing kit.

Pope Benedict’s encyclical “Charity in Truth” proposed a sweeping reform of the world economic system from one based on the profit motive to one based on solidarity and concern for the common good. Like other such documents in the Roman Catholic Church’s social teaching tradition, the encyclical delivers a strong critique of unbridled capitalism. This can be uncomfortable for Catholics who champion free enterprise and some conservative Catholic writers reacted quickly and critically. One of them, George Weigel, wrote the encyclical “resembles a duck-billed platypus.” (Image: Charity in Truth/Ignatius Press)

We wanted to hear the views of a Catholic executive, one who’s involved in business rather than reacting from the sidelines. So I called Frank Keating, president and chief executive officer of the American Council of Life Insurers (ACLI). The former Republican governor of Oklahoma (1995-2003) is a former chairman of the National Catholic Review Board, which he said “sought to identify and correct the horror of sexual abuse on the part of the clergy.” He is a Knight of Malta and a Knight of the Holy Sepulchre.

DB: What’s your overall reaction to the encyclical?

FK:“I haven’t read the 30,000 words but I think what the pope is proposing is not inconsistent with other papal messages. The common denominator to all of them is the worth of the individual, the dignity of every human person. So Benedict XVI focuses on the right to life, he speaks against euthanasia, he speaks against the evil of abortion, he speaks against cloning. But at the same time he talks about duties and responsibilities to the vulnerable because the vulnerable are dignified human beings as well as those who are rich and powerful.

Former Health Secretary Patricia Hewitt is calling for a change in the law, to allow people to take terminally ill patients abroad for assisted suicide without fear of prosecution.

The law may say it is illegal but in practice, those who do assist suicide abroad are not being prosecuted in practice.

The anomaly has been highlighted lately by the case of multiple sclerosis sufferer Debbie Purdy, who lost a legal bid to force the government to clarify the law on assisted suicide to protect her husband from any future action.

UPDATE: Eluana Englaro died on Monday Feb. 9.

What’s been called “Italy’s Terry Schiavo case” is starting to resemble its U.S. precedent in more ways than one. Prime Minister Silvio Berlusconi ordered doctors on Friday not to disconnect the feeding tubes that the country’s top appeals court had ruled could be removed. Doctors had began withdrawing them on Friday before the order came from Rome.

Eluana Englaro, 38, has been in a vegetative state since a car crash in 1992. Her  case has looked much like that of Schiavo, the American who spent 15 years in a vegetative state and was allowed to die in 2005 after a long court battle. (Photo:Eluana Englaro in an undated family photo)

“Until we have a law about end-of-life issues, nutrition and hydration, because they are a form of vital life sustenance, cannot be suspended under any circumstances by those who are care-givers of people who are not self-sufficient,” Berlusconi said after making the case resemble the Schiavo drama even more by intervening to stop Englaro’s tubes from being removed. In the Schiavo case, President George Bush also stepped in at a late stage to try to block a court decision to disconnect her.

Imagine you go to a conference on major bioethical questions — controversial issues like abortion, embryonic stem cells, assisted reproduction and euthanasia — and a keynote speaker uses all his allotted time warning about global warming. Is this the wrong issue to discuss — or the only one worth talking about?

The question arose at the annual conference of the European Association of Centres of Medical Ethics (EACME) that ended at the weekend in Prague. Dr. Richard Nicholson, editor of the Bulletin of Medical Ethics, told the assembled bioethicists they had to look beyond their usual issues to consider the far larger ecological threat he said could soon end up destroying mankind.

The issue is urgent for bioethicists, he said, because the healthcare industry in the rich OECD countries is a major source of carbon dioxide emissions. It also spends vast amounts to prolong patients’ lives, about half of it in the final months before death. “The more effort we put into saving individual lives, the more likely we are to doom the human race to extinction,” he said.

“The Good Death,” a play about euthanasia, has brought the issue of “mercy killing” to Dutch theatres at a time when such deaths are falling. They dropped to 2,325, or 1.7 percent of all deaths in 2005, from 2.6 percent in 2001. Playing to packed houses throughout the Netherlands, which legalised euthanasia in 2002, the play shows the law has not removed the moral dilemma for many involved.

In fact, part of the reason for the drop in euthanasia deaths could be that agonised doctors are opting to give patients heavy sedation until they die, rather than putting an end to their lives. Even some patients who have asked for euthanasia are given continuous deep sedation instead. This feature by our Netherlands chief correspondent Emma Thomasson looks at the issues involved.

This raises the question of whether deep sedation, while being presented as palliative care that is ethically acceptable for many faiths, is not in fact “euthanasia lite.” Or at least whether it is being used as such. The British Medical Journal has suggested this in a report that prompted an editorial and a lively reader discussion. “Although the exact cause of this trend is unclear, there are indications that continuous deep sedation may in some cases be being used as a substitute for euthanasia,” a report in Science Daily said.