ANOTHER VOICE
And tell sad stories of the death of kings
AUBERON WAUGH
Let's face it, I mean to say we all make the occasional slip-up in our professions or callings. Typists leave errors uncorrected, surgeons cut off the wrong leg, policemen arrest the wrong man, judges and juries convict the innocent, trapeze artists miss their footing on the high wire . . . even priests, I dare say, occasionally drown a baby in the font by mistake. For journal- ists, the penalties can be pretty bad, involving hours of unpaid work attending legal conferences and composing affida- vits. Even so, one should not complain too much. Think how much worse to be one of those people whose job it is to supervise intercontinental ballistic missiles and keep them pointing at the Soviet Union. A little inattention there, and one would be left with a very red face indeed.
So we should sympathise with Dr John Carr, who, as the result of what he described as 'a terrible and tragic mistake' in the Sunday Telegraph, 'a ghastly mis- take' in the Sunday Times, injected one of his patients, Mr Ronald Mawson, with 1,000 milligrammes of phenobarbitone in- stead of the 150 milligrammes intended. One should also sympathise a little, of course, with Mr Mawson who, according to his widow, had no wish to die, and was fighting for every day of life, supported by family, against the inexorable progress of terminal cancer. According to evidence, he complained as the doctor approached with his huge syringe: 'That's a blooming big double dose you're giving me there.'
However, it was not a double dose so much as a dose which was more than six and a half times the required amount. Dr Carr persisted with it, and Mr Mawson, who was 63, died two days later, although nobody can say whether his death was hastened by the after-effects of what would, in many cases, prove a lethal dose of barbiturate, or whether he died in the normal course of his illness.
After he was acquitted of Mr Mawson's attempted murder by a jury at Leeds Crown Court, Dr Can issued a statement through his solicitors: 'I have tried at all times to serve the best interests of my patients.' This may seem a curiously trucu- lent attitude from a man who has just been caught out in a 'terrible and tragic' or possibly a 'ghastly' mistake of this sort. Something a little more apologetic might have been more tactful, along the lines of: `Oops, sorry, I will try to be more careful another time.'
Before Dr Can becomes a Hero of the Euthanasia Society, it should be set down for once and all that his behaviour was not dictated by any high-minded decision to let Mr Mawson die in dignity. It was the result of simple incompetence — a terrible, tragic and possibly ghastly mistake. Many people nowadays — possibly most — believe that people dying in pain should be allowed the option of an alternative death. Nearly everybody I speak to hopes that a merciful doctor will be at hand to polish him off if necessary, although one cannot be sure this would represent his wishes at the time. It seems an intolerable burden to place on a doctor to expect him to risk prosecution for murder in order to accommodate his pa- tients in this way. Hence many feel that the law should be changed.
None of this, of course, applies to Dr Carr. Not only was he not intending to kill his patient, but the patient plainly had no wish to die. No likely change in the law would allow doctors to despatch patients against their will, protesting feebly: 'That's a blooming big double dose you're given me there', as the doctor approached about his fatal task.
It seems to me that one should be careful not to confuse the two things. It is one thing to say that terminal patients and their relations should be allowed some say in the timing and manner of their death, quite another thing to say that doctors can decide to knock off patients on their own authority, against the wishes of everyone else concerned. If doctors thought that they could get away with that, calculating that the disrepute in which the law is held will fudge the issue and secure an acquittal in the unlikely event of prosecution, then the time has indeed come to change the law — in such a way as to make it enforceable.
Lord Dawson of Penn, whom we now know to have been a practitioner of eutha- nasia, summed up the legal profession's objection to a change in the law when he successfully opposed the Voluntary Eutha- nasia (Legislation) Bill in the House of Lords in 1936: We do not lay down edicts on these things. It is a gradual growth of thought and feeling
that entwines itself with the texture of our
thoughts , . This is something which belongs to the wisdom and conscience of the medical profession and not to the rule of law.
Perhaps it was all right to leave things to the wisdom and conscience of Lord Daw- son, but I am not sure. A good Christian like he was might easily have been able to juggle around with primary intentions and secondary effects, but why did he have to put the lethal injection into King George V's jugular vein? To which jugular vein does he refer? Scarcely the carotid artery, I hope, which carries oxygenated blood to the brain, since such an injection would have been extremely painful (arteries, unlike veins, have nerves) and would almost certainly have resulted in instant brain paralysis. There is an internal jugular vein, but it is almost inaccessible. I have never heard of the neck being used for an intravenous injection which could equally well be put anywhere else. It seems to me that even Lord Dawson may have got a bit above himself on this occasion, over- excited by newspaper deadlines. But when we talk of the wisdom and conscience of the medical profession, we are not talking about Lord Dawson tip- toeing around the death-bed of King George V. What of the harassed young houseman on night duty, Comprehensively educated, from some disadvantaged north- ern background, in charge of a geriatric ward? He may want to get on with his beauty sleep which is being constantly interrupted. What about the registrar who finds he needs an empty bed in his ward? What about the general practitioner who is fed up with being called out at night by a difficult patient?
Perhaps a policy of trusting the doctor worked in the old days, but I am by no means sure that it does now. Some doctors may feel that anybody with secondary cancer would be better out of the way, yet we all know that nothing is so unpredict- able as cancer. Others refuse to give ten milligrammes of morphia to a patient dying in agony for fear that he develops an addiction. There are sadists and social inadequates on both sides of the fence. I should have thought we would all be a lot safer, and have a better chance of an easy death, if the law defined exactly the circumstances in which drugs could be administered which had the secondary effect of hastening death. Perhaps the revelations about King George V will help to bring it about. If not, we might consider the case of Mr Mawson, even though his doctor's incompetence appears to be the trouble there.
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