JILL PARKIN - More by this author » Last updated
at 23:21pm on 25th September 2007
decision: Should doctors be criminals for keeping
None of us likes to imagine such a terrible fate,
but this much I do know: If I am ever in a coma
I would like to be treated by Muslim or Catholic
doctors, because if they're in charge,
at least I know I will not be starved to death.
extraordinary to think that in doing so - in the
simple act of keeping me alive - they could be
breaking the law.
the beginning of October, the Mental Capacity
Act comes into force, making criminals out of
doctors if they insist on feeding coma patients
who have earlier said they'd rather die.
will be a black Monday for healthcare
in the UK.
only glimmer of hope is that the Islamic
Medical Association has now followed
the Catholic Church's earlier response in saying
that its doctors should break the law, rather
than enact so-called 'living wills', in which
patients have - at some point in their past -
left written instructions requesting that doctors
should allow them to die if they suffer a medical
condition that appears beyond recovery.
seems to me that Muslims have got this one right,
and I'd certainly rather be in their hands than
in those of a lawabiding medic waving a bit of
paper which I had once signed when feeling a bit
want someone to be in charge of my feeding tube
who is wiser than I was then.
he thinks he gets that wisdom from a hotline to
the Almighty, so be it.
once, the dogma and the ideology is coming not
from the world's faiths, but from rationalists
such as the British Medical Association and the
British Humanist Association who have actively
campaigned for living wills to be made legal.
both support the new act, which not only allows
patients to instruct doctors not to try to save
them but also allows patients to give powers to
a relative or friends to instruct doctors to starve
such a patient to death.
own religious convictions should never be allowed
interfere with patients' rights,' says the British
have a lot of time for the BHA normally.
in this case they are falling into the same trap
as the religion-bashing scientist Professor Richard
are so keen to denigrate and dismiss religion that
they don't always see the humanity underlying it.
a start, there have been several cases where coma
patients have been written off and have woken up
happened to the sister of a neighbour of mine.
She lived a rewarding and able life in her own
home for several years after 'waking up'.
when she was in the depths of her coma, her siblings
had even reached the point of voting on whether
or not to turn off the life support machine - an
agony for all.
God they had no 'starve me' instructions to follow.
there is the ethical question of how many of us
would want the responsibility of refusing food and
drink for someone, of not knowing - because the
patient cannot tell us - what pain and bewilderment
that might cause?
from the fact we cannot know how the patient feels
or whether they might recover, there's the problem
that we all change our minds.
one thing to sit on the parapet with your legs over
the edge staring into oblivion, as a young man did
on a high building near our house for several hours
the other day.
quite another - as he did not - to jump to your
under the Mental Capacity Act, you may well have
your beloved daughter or nephew creeping up behind
you and giving you a metaphorical big push - after
all, there may be a lot of money in your will.
don't always know best, and we don't always know
how we will respond in any situation,especially
when it comes to anticipating the medical treatment
we need: ask any woman who has written a birth
plan in the months before labour.
I'd been able to move at the time I'd have made
a bonfire out of my 'no intervention' plan about
a quarter of the way through giving birth to my
have seen it over and over again.
says here she doesn't want pain relief whatever
she says at the time," protests the husband
while the mother-to-be can't decide which to do
first: impale herself on the epidural needle or
brain the father-to-be with the gas and air cylinder.
such cases it's the role of those who govern us
to be wise on our behalf.
isn't a religious 'life at all costs' argument.
let babies go - those who are so disabled they
will never know anything but pain.
I wouldn't do it by starving, just by letting
nature take its course, with help from pain relief.
could no more starve my husband in a coma just because
he once said I should than I could stop feeding
a faddy toddler or offering food to a bulimic teenager.
would be cruel, irresponsible and inhuman.
might it end? Faced with a difficult medical decision,
might doctors not allow a living will and the arguments
of a relative, even a well-meaning relative, to
have undue weight?
about inconvenient older relatives not sure about
exactly what they are signing?
which deal with houses and inheritances can be
contested in a court, but the coma patient has
no such recourse.
it be right that we can appeal to a judge to reverse
Aunt Ethel's bequest to her budgie and yet we can
set up a system which can starve us because we once
signed a bit of paper?
course the health service is over-burdened and
coma cases cost money.
in a civilised society there are many, many times
we have to risk wasting money, whether it's on
healthcare for people who will never eat sensibly,
lifelong prison for people whom we no longer hang,
or post-14 education for reluctant pupils.
and humanity don't come cheap.
Mental Capacity Act came into being partly because
of the case of Tony Bland, crushed in the Hillsborough
disaster in 1989.
House of Lords ruled in 1993 that doctors could
end his life. It led to tube feeding being called
a treatment rather than a necessity.
was the thin edge of the wedge, but at least the
decision was made transparently by independent individuals.
Would it not be fairer if all such cases could individually
go to such a higher authority, rather than be subject
to the sweeping edict of the new Act?
would not be a perfect answer and it would not
be as cheap, but at least this matter of life
and death would be lifted out of the emotional
realm of friends, relatives, and bits of paper
signed in the days we felt low or incapable of
ever accepting diminished quality of life.
surely even in our dehumanised irreligious age,
the old belief - central to most religions - that
life is sacred cannot be lightly dismissed.
is why we should beware these science-is-god rationalists,
just as much as we should beware religious fundamentalists.
They all too easily dismiss what they don't like
as ' paternalism', or 'religious fanaticism'.
a way of twisting usually liberal rhetoric and using
it against genuinely liberal and humane thought.
week it has taken an Islamic group to point out
where true humanity lies: not in extremes but
alongside the recognition of doubt and of human
a sad day it will be next week when we outlaw
all those doctors of faith or no faith who have
our best interests at heart, who indeed - in a
sense that the rationalist wing may not quite
understand - actually do have a heart.