Tuesday 10 April 2001

The death of reason

News: Historic vote makes mercy killings legal (local copy)

DOCTORS have many rights, but in civilised countries they have not had the right to kill their patients. This may be about to change. Today in the Hague, the states-general is expected to pass a Bill to legalise euthanasia.

The Netherlands will thus become the first country to enshrine euthanasia in law. It has taken the Dutch just three decades to reverse nearly two and a half millennia of medical progress. Ever since Hippocrates, the duty to preserve life has been pre-eminent - except in Nazi Germany and other police states. The decriminalisation of euthanasia in Holland began in the courts, which declined to convict, and was given de facto parliamentary endorsement in 1993, when doctors were given guidelines.

Even so, more than half of all cases of euthanasia still go unreported because doctors fear prosecution. The Dutch government concluded that proper regulation required legalisation. Now, even children as young as 12 will, with parental consent, have the legal right to demand euthanasia. Britain has already travelled some way down the Dutch road. Since the landmark Tony Bland case in 1993, it has been legal for doctors to withhold food and water from comatose patients.

Courts are reluctant to convict doctors who claim to practise "mercy killing", despite Dr Harold Shipman, who used their arguments to justify his career of mass murder. The burden of long-term care may impress the present Government (of which Keith Vaz is still a member), which has tended to take a utilitarian view of the sanctity of life.

The attractions of euthanasia in an era of unprecedented longevity are, however, superficial. When incurably ill patients are offered proper palliative care, for example in hospices, they do not demand euthanasia. There is evidence that the practice of euthanasia in the Netherlands has undermined the readiness of doctors there to undertake such palliative care. In about a third of the cases of euthanasia examined in the 1991 Remmelink report, the patient had not given consent. As legalisation removes the remaining inhibitions, the incidence of involuntary euthanasia can be expected to rise.

Even voluntary euthanasia is deceptive. Dutch courts have held that physically healthy patients suffering from depression may request lethal injections. The dead cannot change their minds. However many legal safeguards there are, some families will pressurise sick or elderly relations, who already fear becoming a burden. Voluntary euthanasia is largely a myth.

Those - the majority - who do not want Britain to follow the Dutch example should not be complacent. Patients are often confused, anxious and in need of guidance. They deserve to be told the truth: to die with dignity, we do not need doctors to kill us.