The right to die
Donald Gould
The Court of Appeal's decision, last weekend, to order an intestinal operation for a 10-day-old mongol girl, who would otherwise have died, bears a disturbing relationship to one of the nastier news items to have issued from the USA during recent weeks. It concerns a pair of Siamese twins, who, joined at the waist, had three legs between them, and largely shared a common bowel. The horror of the story lies not so much in the tragedy of the birth of such a sadly distorted and irreparable travesty of human flesh, as in the cruelty shown by authority toward the distraught parents.
Last month, at Dennville, Illinois, they, together with a nurse and their family doctor, were charged by the state with attempted murder, neglect, and various lesser offences. They had, it was alleged, conspired to let the twins die by witholding nourishment and drugs. On 16 July an apparently humane and sensible Illinois judge, Richard Scott Paris, ruled that there was insufficient evidence to justify the prosecution of any of the accused, but this decision angered the State Attorney, a certain Mr Litak , who said 'I'm not through with this case', and announced his intention of taking it to a Grand Jury. The children were placed in the custody of the state. I do not know how far the state has succeeded in pointlessly postponing the inevitable early quietus of the fatally malformed babes, but there can be no doubt that it has done so.
Last April, Dr Leonard Arthur, a Derby paediatrician, was committed for trial, charged with the murder of a three-day-old mongol boy who had been rejected by his parents. After the baby's condition had been diagnosed the mother and father decided that they did not want him. He was placed in a side ward, and the mother discharged herself from hospital and did not see her son again. Dr Arthur is alleged to have written on the case notes, 'Parents do not wish baby to survive', and the instruction 'Nursing care only'. He is further alleged to have prescribed a morphine-like drug at a dosage which could have favoured the development of the pneumonia from which the child died. He is said to have told the police that the drug was given solely in order to reduce suffering, and not to kill.
Dr Arthur, who has reserved his defence, is a senior and highly respected consultant. At the committal proceedings he said, through his counsel, that he felt `profoundly sad for all doctors, and for the parents concerned, that his professional response, made in good faith to this severely malformed child, is now called an act of murder.' Apart from the shared distress occasioned by the birth of gravely defective babies, and the well-nigh intolerable burden of decision imposed, unsought, upon the doctors involved, the two legal actions, in Derby and Illinois, almost certainly have a further factor in common. It is pretty safe to assume that both prosecutions resulted from information laid by private citizens, having no personal stake in the tragedies, who resented what they considered to be an offence against their own moral or ethical codes.
Unhappily about one in every 50 babies born suffers from some significant congenital defect, and about one in ten of these is serious. Advances in medical and surgical techniques mean that it is now possible to preserve the lives of many of the more gravely disabled infants who, a decade or so ago, would not have stood any chance of survival. Spina bifida, for example, is an incomplete closure of the backbone, so that the membranes which envelop the spinal cord protrude. It is a condition commonly accompanied by damage to the nerves supplying the lower parts of the body, and by water on the brain, so that the victim suffers severe paralyses and deformities, and incontinence of urine and faeces, and, often, mental deficiency. Left untreated, such a defect, when it is anything more than slight, will soon lead to a fatal infection of the central nervous system. But a surgical repair can eliminate the risk of infection and preserve the life of a baby who may never walk or talk or in any way enjoy the existence for which it has been preserved.
There are, of course, many defective babies born for whom remedial measures are wonderfully rewarding, but there are others for whom a heroic salvage exercise leads only to an extension of pain and misery, both for the child 'saved' and for the family concerned. Thus it is that every day, somewhere, some doctors are faced with having to decide whether to use the powerful techniques now at their disposal for keeping alive beings whom God or nature, left to themselves, would have let go.
Grossly defective newborn babies are not, of course, the only creatures for whom death may seem a better deal than life, and the members of EXIT are not the only people to believe that the law should be changed to allow doctors to aid suicide when it is sought as an escape from intolerable suffering.
But there are powerful arguments against the legalisation of euthanasia, including fears that any provisions for 'therapeutic killing' could be abused, or that any breach of the absolute proscription against taking life could gradually lead to the legal and deliberate destruction of all manner of people who might be judged, by the criteria of the time, to be unfit to share the world with the rest of us. (I realise, of course, that these same cogent arguments are advanced by the opponents of abortion, but believe, with many others, that abortion is, indeed, a 'special case', and that the humane and pragmatic rule should be to treat the time of birth, or at most the time at which the foetus becomes capable of an independent existence, as the moment at which the individual's legal right to life becomes established.) So a majority (including a majority of doctors) feel that the present unconditional protection which the law affords the living should be retained. And yet there are desperately ill and sadly suffering beings who would, in the name of mercy, be better off dead; and an increasing number of those to whom death would have afforded a blessed release but a few years ago can now be preserved in their misery because of 'advances' in medical science — witness the obscene fashion in which Franco and Tito were subjected to weeks of humiliating torture for political rather than humanitarian ends.
Faced with this dilemma, and the law as it stands, many doctors employ a compassion ate compromise. Whilst not overtly hasten ing or procuring death, they avoid measures which needlessly prolong suffering. This may not be the perfect solution to an agonising problem, but it is probably the best we have.
Recently, however, certain zealots have seriously interfered with this humane and sensible practice. Organisations such as LIFE, primarily formed to oppose abortion, have instructed their members and sympathisers working in hospitals to be on the look-out for such instances of 'merciful neglect', and to report them to the author ities. And, once involved, the lawyers must act in the orthodox manner prescribed by Parliament.
Dr Arthur may have been 'shopped' in this fashion. Other equally responsible doctors most certainly, and admittedly, have. And it is not unreasonable to assume that the authorities who last weekend persuaded the courts to order a serious operation of questionable value for a grossly disadvantaged baby girl took such a step because of a fear of dangerous trouble from spies in the camp, had they, with wisdom and compassion, let nature take its course.
If this kind of officious and unfeeling pursuit of a bigoted conviction continues and spreads, and if there are many more cases like that of the Illinois Siamese twins, or the persecuted Dr Arthur, or the Hammersmith mongol child, then public opinion may well revolt, and there may arise an irresistible demand for the legalisation of mercy killing; then we would all be worse off.
Previous page
