Dear Colleague:

Could the United Kingdom's gradual slide into the culture of death show
where Western Civilization is going, and fast?

Steven W. Mosher
President

PRI Weekly Briefing
27 May 2005
Vol. 7 / No. 20

British Steps Toward Euthanasia
By Joseph A. D'Agostino

In the Netherlands, the routine killing of the ailing aged and disabled
newborns, even without their parents' or loved ones' consent, has become
public knowledge.  The rest of Europe does not seem far behind, and recent
developments in Britain, the nation perhaps most similar to the United
States, could tell us euthanasia's future in developed nations.

Regular readers of the Weekly Briefing know that First World nations,
particularly those of Western Europe and Japan, face the rapid aging of
their populations due to three factors: The failure of their peoples to
have enough children to replace them; the impossibility of importing
enough immigrants to make up the difference; and the much greater
longetivity produced by modern technology.  Nations are facing a tripling
of the proportion of their populations over 65 in the next 45 years, and
even worse, up to a quintupling of the proportion over 80.  Pension and
health care costs will increase accordingly.

How can a smaller workforce support these costs?  It will not be able to.
So is mass euthanasia of the old and unfit on the horizon?
Three recent developments in Britain point in that direction.  A
government agency has endorsed age discrimination in the provision of
medical treatment, a doctor's group is opposing the right of terminally
ill patients to decide on their own treatment, and the Mental Incapacity
Bill has classified food and water as withholdable medical treatment for
those deemed mentally defective.  The latter two developments do not apply
to the elderly exclusively, but most of the people affected by them will
surely be aged.

Because Britain, like most of Western Europe, has a socialist health care
system (called the National Health Service, or NHS), politicians and
government bureaucrats are empowered to decide what sort of treatment
people receive-or don't.  They are looking for more ways to cut costs, and
that search will become more and more urgent over time.

"The Labour government, having championed the population control policy in
the UK over the past 45 years, now finds itself with an aging population,
and can no longer afford to care for the sick and elderly in the health
service," says Greg Clovis, Director of Family Life International UK.  "It
has now changed the law with the Mental Incapacity Bill so that food and
water are now regarded as medication.  Now doctors have the right to
starve their patients and allow them to dehydrate if they regard the
patients' quality of life to be low.  We now have the most anti-life
government the UK has ever known under Tony Blair."

Age discrimination is politically incorrect, part of the pantheon of
incorrect discriminations whose number grows every few years.  NHS'
National Institute for Health and Clinical Excellence (the Orwellian NICE)
wants to prune that garden slightly.  It proposed taking age into greater
account when doctors prescribe medication in draft guidelines issued last
month.  The final guidelines won't be issued until the end of June.  On
the subject of age and drug treatments, the guidelines conclude, "Health
should not be valued more highly in some age groups rather than others.
Individuals' social roles, at different ages, should not influence
considerations of cost effectiveness.  However, where age is an indicator
of benefit or risk, age discrimination is appropriate."

These guidelines could be interpreted benignly.  Or they could be
interpreted to mean that an expensive drug should be denied to a
70-year-old woman because statistically, she's likely to benefit from it
only eight more years since women live, on average, to be 78.  Or she
shouldn't get the drug because her body is less likely to heal than that
of a younger person's.  As advocates for the elderly in Britain
complained, these new guidelines could be the thin end of the wedge.

NICE defended itself this month, saying that it won't apply these
guidelines to the NHS.  NICE Chief Executive Andrew Dillon said, "The
institute has to make difficult decisions about how well treatments work
and which treatments offer the NHS best value for money.  We know that
factors such as age and lifestyle can influence how clinically or cost
effective a treatment is, and we are asking people whether NICE is getting
it right when we take this type of factor into account during the
development of our guidance."

Dillon noted that NICE has recommended age discrimination in the past by
withholding some fertility treatments from women under 23 and over 39 "as
treatment is most likely to be effective in this age range."
Forty-year-olds need not apply, based on cost effectiveness.  That's
socialism: If you don't fit into the average, you don't fit at all.

Britain's General Medical Council (GMC), a doctor's group which sets and
enforces standards on doctors, decided that food and water delivered
artificially can be withheld from a patient if that "patient's condition
is so severe, or the prognosis so poor, that providing artificial
nutrition or hydration may cause suffering, or be too burdensome in
relation to the possible benefits."

Needless to say, the possible benefits of food and water include continued
life, and that benefit cannot be realized without their provision.

Leslie Burke, a man dying from cerebellar ataxia, filed suit, asserting
that he wanted to set his own treatment rules before his condition became
so bad that he might not be able to communicate.  He fears that doctors
will starve and dehydrate him to death when he is still conscious but
unable to swallow, and that he will suffer terribly while he is killed in
that manner.  Instead, he wants his desire to be feed through a tube
honored.  He won in court, but GMC appealed the ongoing case.  GMC wants
doctors, not Burke, to decide on his treatment.

GMC's lawyer argued that honoring such a request would put Burke's doctor
"in an impossibly difficult position, for a doctor should never be
required to provide a particular form of treatment to a patient which he
does not consider to be clinically appropriate."

Britain's Mental Incapacity Bill, passed by the House of Commons last
month, allows doctors to kill mentally disabled people.  It also requires
doctors to kill those who ask for death by withholding treatment such as
food and water by tube.  Pro-life doctors and nurses may have to leave the
medical profession.

The Royal College of Psychiatrists has matter-of-factly stated its own
view on the withholding of treatment from those judged mentally unfit.
"Advance decisions to refuse treatment may cause individuals unintended
distress, harm and prolonged suffering.  There should be a duty on
professionals to try and ensure that an advance decision is not leading to
unintended harm," says the college.  So you can decide in advance to kill
someone, but don't tell him.  "Patients should be given the right, which
must be taken into account, to express positive wishes about how they wish
to be treated.  Such wishes cannot be binding upon the health
professional," the college states flatly.  "Attorneys or Court-appointed
deputies should not have the authority to require a health professional to
provide any particular specified treatment, as opposed to the power to
refuse consent."

The same document praises "respect for self-determination."  This is the
kind of self-determination the aged and the disabled can expect in the
future Britain and Europe.


Joseph A. D'Agostino is Vice President for Communications at PRI.
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