“We must take sides. Neutrality helps the oppressor, never the victim. Silence encourages the tormentor, never the tormented. Sometimes we must interfere. When human lives are endangered, when human dignity is in jeopardy, national borders and sensitivities become irrelevant. Wherever men and women are persecuted because of their race, religion, or political views, that place must – at that moment – become the center of the universe.” Elie Wiesel,
In 2006 I attended an International Right to Die conference in Toronto. At that conference many strategies were discussed but two of them stood out then and haunt me now as we sit in the dark shadow of the passage of Bill C-14 which was railroaded through by a cowardly, arrogant Canadian government – formally legalizing the abandonment of Canadians at our most vulnerable stage. In a letter to our Prime [sic]Minister I told him that his legacy would be one of condemnation by those of us now and by many generations of Canadians to come. Many of us, as well as fighting against the legalization of medical assassins, have called for universal palliative care, and a national suicide prevention network for over two decades. In my opinion it says a lot about character when a government would rather offer universal medical killing to its people than appropriate medical treatment and care – gotta save money – and the people really believe it will be their decision. Strikes me that “Joe public” has not cottoned on to the fact that for the first time in our history a government has sanctioned the killing of innocent human life (an authority and power it does not possess in either human or heavenly terms) and set up a system to protect the killers. Never before has anyone been able to kill another human being in Canada without facing legal redress – but the public really do not get it! In fact like lemmings they appear to embrace their own devaluation and killing when at their most vulnerable.
Going back to 2006 though, the two strategies which we were told would tip the balance involved the “words” we use and the “neutrality” which was required from those representing medical bodies. Both these strategies have been well employed here in Canada to fool the public into putting their heads on the block. Society still has a remnant of horror regarding suicide and euthanasia is understood to be killing and so these words were replaced in our Canadian debate by “medically assisted death” (MAD) and then “medical aid in dying” MAID. But it does not matter what you call it – it is suicide and killing and those who do it will be medical assassins.
In Canada our Canadian Medical Association had a tradition of opposing assisted suicide and euthanasia until recently when it took a position of “neutrality” as some of its members (about a third) supported these insults to the medical profession. Seems to me the democratic position would be to keep the position of opposition. The Canadian Hospice and Palliative Care Association also had strong opposition to euthanasia and assisted suicide which over the last five years melted into a document which offered a neutral position. The Parliament of Canada looks to these institutions for guidance having itself, only 8 years ago totally defeated and stomped into the ground any idea of either assisted suicide or assisted suicide being legalized in Canada.
The Euthanasia lobby in Canada, did its job well, the medical institutions were neutralized, they insisted on such soft weasel words, the public were duped and of course we have this gold standard of “personal autonomy” which resulted in the Supreme Court decision in Carter that somehow there is a right to die within the right to life! All this at a time we have an arrogant, egotistical, inexperienced, awkward and juvenile ( my apologies to juveniles) leader with delusions of grandeur, running a Government by dictatorship and what do we get but the most liberal law in the world and hardly a squeak from most Canadians.
Yesterday, the British Medical Association firmly rejected assisted suicide and euthanasia preferring to treat and care for their patients and upholding hundreds of years of tradition. The British Government also recently rejected the idea of killing patients as did the Irish Court based on the International evidence available. (Seems strange that our Canadian Courts took the opposite position on the exact same evidence – must be something in the air although marijuana isn’t legal yet is it?)
I have included two articles on the British Medical Associations position following these brief comments and I just wish that the medical profession in this great country had shown the same heroic leadership and let its tradition withstand and override the pressure of today’s “whichever way the wind blows” politics. I for one will never stop my opposition to medical killing and I will call it what it is “homicide”. If their was honour in Canadian medicine the euthanasia lobby and health professionals who are willing to kill or assist with suicide have tarnished and indeed stolen that from a once noble profession.
At the beginning of this blog I quoted Eli Wisel and I repeat that in part; “Neutrality helps the oppressor, never the victim. Silence encourages the tormentor, never the tormented. Sometimes we must interfere…”
BMA members reject neutrality
21st June 2016
Delegates at the Annual Representative Meeting in Belfast rejected a move to neutrality on ‘assisted dying’ by 198-115
BMA members attending the influential policy-making gathering were asked, in the course of the Medical Ethics debate today (21 June) to consider two motions related to assisted suicide:
Motion 79 (EAST MIDLANDS REGIONAL COUNCIL) That this meeting, with respect to Physician Assisted Dying, notes the recent rejection by Parliaments of efforts to overturn the law on Physician-Assisted Dying and therefore feels that it is not appropriate at this time to debate whether or not to change existing BMA policy.
Motion 80 (SOUTH CENTRAL REGIONAL COUNCIL) That this meeting believes that the BMA should adopt a neutral stance on assisted dying.
Several speakers noted that BMA policy exists to represent the views and experience of members, so it was perhaps not entirely surprising that Motion 79, which reflected on MPs’ conclusions, was lost – if only by three votes (164-161). Motion 80, however, was rejected after strong speeches by a resounding 198-115 – that’s 63% to 37%, or more simply, 2-1. Members wishing to speak on Motion 80 were similarly split, with those opposed to neutrality outnumbering those in favour by 2-1. Thus, the BMA remains opposed to assisted suicide, as it has throughout its history (barring a brief period in 2005-6).
In the few days before the debate, in the time when delegates were packing for, travelling to and beginning to engage with the ARM, 5,000 members of the public thanked the BMA for its long-standing position and urged them to retain this stance. Individual activists made clear its value in their own lives:
@TheBMA Please protect lives and resist neutrality on assisted dying. We look to you for #supportnotsuicide. Thank you. PLS patient.
— mwenham (@mwenham) June 21, 2016
Campaigners in favour of assisted suicide – who had driven the calls for change at the ARM after they failed to convince MPs – spoke of a failure by the BMA to allow debate on the subject. Dr Mark Porter, the Chair of Council gave this short shrift. He noted that the debate marked the eighth time in 13 years that the BMA had considered the matter, and stated that ‘nobody can credibly say this issue has been suppressed, obfuscated…’ Dr Andrew Mowat, who moved Motion 79 went further, describing the constant returns to the issue as a ‘neverendum’; Dr Gary Wannan simply mused, ‘we’ve been here before…’
Many doctors spoke to the substance of the case against assisted suicide, especially foreign precedents. Professor the Baroness Finlay and Dr Will Sapwell highlighted, respectively, doctor-shopping and the increasing citation of not wishing to be a burden as a reason for assisted suicide in the US state of Oregon. Dr Sapwell also pointed to extensions of Belgium‘s euthanasia law, and medical student Heather Davis said that the Netherlands, with a healthcare system much like the UK’s, had seen euthanasia numbers rise and eligibility extended as far as a young woman who suffered from PTSD as a result of sexual abuse. Closer to home, Baroness Finlay said that UK doctors were still strongly opposed to actually assisting suicides.
All of this led to a key point, made several times. Ms Davis said that the BMA worked on the basis of evidence, and there was no new evidence to justify a changed stance. Dr Wannan said there was no new evidence – no, repeated opinion polling didn’t count. And Professor the Baroness Hollins said that there was no new evidence, and that they must turn their attention to better end of life care. Yorkshire GP Dr Mark Pickering said that doctors must listen to their patients, but must also consider unintended consequences.
Ultimately, much rested on the meaning of ‘neutrality’. Advocates said that by not taking a stance, the BMA could speak on the basis of the evidence while not excluding any members who are in favour. Quite apart from the fact that policy in opposition to assisted suicide is evidence-based, Baroness Hollins rightly commented that the BMA would never have any policies if all sides were always given equal weight. Dr Kevin O’Kane asked: why would the BMA go neutral on whether doctors can help kill their patients? He described neutrality as ‘facilitative’; Dr Pickering said it wasn’t about choosing neutrality, but being neutralised and would be read as dropping opposition; and Baroness Finlay said it would be perceived as doctors actively changing their minds on assisted suicide.
Dr Mowat was clearest of all though: a move to medical neutrality would indicate acceptance or indifference to assisted suicide, and where doctors have surrendered their opposition abroad, it removed a major obstacle to legislation.
A medical student who spoke towards the end of the debate said that she entered medicine to care for and value the lives of patients, not to arbitrarily agree that some lives are not worth living. Judging by the scale of the ARM’s rejection of neutrality, she spoke for the majority – and we are glad. Once again, doctors – including those working most closely with dying people – have reflected on their experience and the reasons they dedicate their lives to care, healing and support, and have once again told their chief representative b ody to oppose uncontrollable, unethical and unnecessary legal change in their name.
Tuesday, 21 June 2016
BMA rejects attempt to push it neutral on assisted suicide by 2 to 1 majority
Delegates rejected motion 80, ‘that this meeting believes that the BMA should adopt a neutral stance on assisted dying’, by 198 to 115 (63% to 37%).
The debate took place after a previous motion affirming that ‘it is not appropriate at this time to debate whether or not to change existing BMA policy’ was defeated by 164 to 160.
The BMA, the UK doctors’ trade union, has been opposed to the legalisation of assisted suicide and euthanasia for every year of its history with the exception of 2005-6 when it was neutral for just twelve months.
Fifteen doctors spoke during an impassioned debate on the two motions but the final vote was decisive, and reflected the 65% opposition to legalising assisted suicide shown in most opinion polls.
Dr Mark Porter, the Chair of BMA Council, noted that the debate marked the eighth time in 13 years that the BMA had considered the matter, and stated that ‘nobody can credibly say this issue has been suppressed or obfuscated’. Dr Andrew Mowat, who moved Motion 79, went further, describing the constant returns to the issue as a ‘neverendum’; Dr Gary Wannan simply mused, ‘we’ve been here before…’
The Royal College of Physicians, Royal College of General Practitioners and British Geriatrics Society are all officially opposed to a change in the law along with 82% of Association for Palliative Medicine members. Amongst all doctors, this latter group carries the greatest weight in this debate due to their understanding of the vulnerability of dying patients and their knowledge of treatments to alleviate their symptoms.
British parliaments have consistently resisted any move to legalise any form of assisted suicide or euthanasia. There have been a dozen unsuccessful attempts in the last twelve years. Last year the Marris Bill in the House of Commons and the Harvie Bill in the Scottish Parliament were defeated by 330-118 and 82-36 respectively.
Assisted suicide and euthanasia are contrary to all historic codes of medical ethics, including the Hippocratic Oath, the Declaration of Geneva, the International Code of Medical Ethics and the Statement of Marbella.
Neutrality on this particular issue would have given assisted suicide a status that no other issue enjoys. Doctors, quite understandably, are strongly opinionated and also have a responsibility to lead. The BMA is a democratic body which takes clear positions on a whole variety of health and health-related issues.
Furthermore, to drop medical opposition to the legalisation of assisted suicide and euthanasia at a time of economic austerity would have been highly dangerous. Many families and the NHS itself are under huge financial strain and the pressure vulnerable people might face to end their lives so as not to be a financial (or emotional) burden on others is potentially immense.
In rejecting an attempt to move it neutral at its ARM in 2012 the BMA said that neutrality was the worst of all positions. This was based on bitter experience. When the BMA took a neutral position for a year in 2005/2006 we saw huge pressure to change the law by way of the Joffe Bill. Throughout that crucial debate, which had the potential of changing the shape of medicine in this country, the BMA was forced to remain silent and took no part in the debate. Were it to go neutral again it would be similarly gagged and doctors would have no collective voice.
Going neutral would also have played into the hands of a longstanding campaign led by a small pressure group with a strong political agenda.
Healthcare Professionals for Assisted Dying (HPAD), which is affiliated to the pressure group ‘Dignity in Dying’ (formerly the Voluntary Euthanasia Society), at last count had just over 500 supporters, representing fewer than 0.25% of Britain’s 240,000 doctors.
Instead the BMA ARM wisely gave short shrift to this latest neutrality proposal and signalled by the margin of defeat that this matter should now be settled for the foreseeable future.