Douglas Noble on Euthanasia

douglas nobleThe current issue of the BMJ includes four letters venting an angry response to an opinion piece on euthanasia on 22nd December 2010. The rapid responses reveal even greater depth of feeling. At the heart of the issue is the view that there has not been even-handed coverage, and the pro-euthanasia lobby has been given unfairly positive reporting.

Legalising euthanasia is not a new debate. The House of Lords rejected two recent attempts to legalise assisted suicide by Lords Joffe (2006) and Falconer (2009). Yet, despite this and reassurances by the Director of Public Prosecutions that assisting a person who wishes to commit suicide would not be met with prosecution (as long as certain public interest factors were met), the calls for legalising euthanasia have grown more vociferous. Most recently this has led to the launch of a new commission, heavily criticised by several commentators as biased because of the pro-euthanasia views of the Chairman and the major funder.

Further criticism was levied at the commission in the current issue of the BMJ, owing to the number of commissioners with pro-euthanasia views.  This includes a former president of the General Medical Council who also gave an inaugural address at the recent launch of a new organisation known as Healthcare Professionals for Assisted Dying. This small group of pro-euthanasia healthcare professionals includes in its signatories of support the same author of the BMJ opinion piece on December 22nd 2010 which inspired the angry letters referenced above.

The complaints in the current issue of the BMJ go deeper than lack of neutrality in the medical press.  There is a call for religious and philosophical perspectives to be given coverage, a desire for clarity about the influence of worldviews, criticism of inaccurate and misleading terminology, and a recognition that when euthanasia has been practised in other jurisdictions it has distorted the role of the doctor by making him both healer and killer. 

The argument that has repeatedly convinced Parliament not to change the law has been the concern to protect vulnerable and disabled people from being put under pressure to terminate their lives for fear of being a burden to their families and society.  Viewed through this lens, legalising euthanasia is arguably an infringement of article 25 of the Universal Declaration of Human Rights, removing the right to security in the event of sickness and disability. 

Clearly the issues in this important debate are complex and both sides need to be able to air their views equally if the discussion is to be properly informed.

Douglas Noble has worked in surgery, emergency medicine, public health and for the WHO . From 2006 to 2008 he was clinical adviser to the chief medical officer for England.

  • susanne stevensSoostevens

    Thank you for highlighting Article 25 which seems to have slipped most peoples' attention, including mine.

  • Desmond O'Neill

    Thanks for a helpful and calm repositioning of perspective – there is a fatal (in every sense of the word) attraction/frisson for some ethicists and in many journals for this unfortunate phenomenon. It also seems that the virtue of 'courage' has been distorted by a complete failure to link it to the other cardinal virtues of temperance and prudence, as in the BMJ's unhappy editorial 'Jack Kevorkian: a medical hero' (BMJ 1996;312:1434). Let us all work on developing the articulacy of the medical profession to see the dignity and humanity of our fellow men with disability and disease, and resist dangerous short cuts.

    Desmond O'Neill, Consultant Physician in Geriatric and Stroke Medicine

  • M Houghton

    It seems the BMJ cannot resist the temptation to promote medical killing. And this despite the BMAs welcome stance against euthanasia. So I am still not confident enough that this trade union the BMA will represent the majority view of doctors: against euthanasia. So I continue to remain a non-member.