Sunday, 16 July 2017

The Conway Case – a change in the law to allow assisted suicide is dangerous and unnecessary

A 67-year-old Shropshire man with motor neurone disease (MND) is seeking to overturn the law banning assisted suicide.

Noel Conway is backed by the former Voluntary Euthanasia Society (now rebranded Dignity in Dying (DID)), whose lawyers will argue that the current blanket ban on assisted suicide under the Suicide Act is incompatible with his rights under sections 8 and 14 the Human Rights Act (respect for private and family life and protection from discrimination).

The four day hearing in the high court, involving three senior judges, begins on Monday 17 July.

Mr Conway's case is substantially the same as that of Tony Nicklinson and Paul Lamb in 2014, except that his condition is terminal.

There have been over ten attempts to legalise assisted suicide through British Parliaments since 2003, all of which have failed. The last of these was the Marris Bill in 2015 which was defeated by an overwhelming majority of 330 to 118 in the House of Commons amidst concerns about public safety.

Frustrated at their lack of success in parliament has led DID and other campaigners to pursue their agenda through the courts.

Conway is bringing his case against the Secretary State for Justice. Three other organisations have been granted permission to intervene in the case – Humanists UK (formerly the British Humanists’ Association (BHA)) on the side of Conway and Not Dead Yet UK and Care Not Killing (CNK) on the side of the defendant.

A change in the law is opposed by every major disability rights organisation and doctors' group, including the BMA, Royal College of GPs and the Association for Palliative Medicine, who have looked at this issue in detail and concluded that there is no safe system of assisted suicide and euthanasia anywhere in the world.

Laws in the Netherlands and Belgium that were only meant to apply to mentally competent terminally ill adults, have been extended to include the elderly, disabled, those with mental health problems and even non-mentally competent children.

While in Oregon, the model often cited by those wanting to change the law, there are examples of cancer patients being denied lifesaving and life extending drugs, yet offered the lethal cocktail of barbiturates to end their own lives.

Article 8 of the Human Rights Act 1998 (Right to respect for private and family life) states (8(1)) that ‘Everyone has the right to respect for his private and family life, his home and his correspondence.E+W+S+N.I.

However, this right is not unlimited but is qualified in 8(2). CNK will argue that a blanket prohibition on euthanasia and assisted suicide is ‘necessary in a democratic society in the interests of public safety for the prevention of disorder or crime, for the protection of health or morals, and for the protection of the rights and freedoms of others.’

CNK will also argue that to pursue this case in court is institutionally inappropriate given that parliament has repeatedly, rigorously and comprehensively considered this issue and decided not to change the law.

Legalising assisted suicide and/or euthanasia is dangerous because any law allowing either or both will place pressure on vulnerable people to end their lives in fear of being a burden upon relatives, carers or a state that is short of resources. Especially vulnerable are those who are elderly, disabled, sick or mentally ill. The evidence from other jurisdictions demonstrates that the so called ‘right to die’ may subtly become the ‘duty to die’.

The legalisation of assisted suicide and/or euthanasia is uncontrollable in practice because any law allowing either or both will be subject to incremental extension. We have observed in jurisdictions like Belgium and the Netherlands that over time there is an expansion of categories to be included beyond those originally intended and without any further change in the law: a shift from terminal conditions to chronic conditions, from physical illnesses to mental illnesses and from adults to children.

The essential problem is that the two major arguments for euthanasia - autonomy and compassion - can be applied to a very wide range of people. This means that any law which attempts to limit them, for argument’s sake to mentally competent people who are terminally ill, will in time be interpreted more liberally by sympathetic or ideologically motivated ‘assisters’ and may also be open to legal challenge under equality legislation on grounds of discrimination.

The legalisation of assisted suicide and/or euthanasia is also unnecessary because requests for euthanasia or assisted suicide are extremely rare when people’s physical, social, psychological and spiritual needs are adequately met. The overwhelming majority of people with terminal illnesses, including those with MND, want ‘assisted living’ not ‘assisted suicide’.

The safest law is one like Britain’s current law, which gives blanket prohibition on all assisted suicide and euthanasia. This deters exploitation and abuse through the penalties that it holds in reserve, but at the same time gives some discretion to prosecutors and judges to temper justice with mercy in hard cases.

Leaving the law as it is will mean that some people who desperately wish help to end their lives will not have access to such a service. But part of living in a free democratic society is that we recognise that personal autonomy is not absolute. And one of the primary roles of government and the courts is to protect the most vulnerable even sometimes at the expense of not granting liberties to the desperate.

Friday, 14 July 2017

Troubled times - Is God giving Britain over?

The rollercoaster journey of the last twelve months has left many UK citizens feeling dislocated and anxious about the future of our country.

Political events – Brexit, Trump, a snap general election, a hung parliament, confidence and supply arrangements and the Queen’s speech – have laid bare deep divisions between old and young, right and left, urban and rural. These tensions have been exacerbated by four terrorist incidents in London and Manchester, plus the Grenfell Tower fire, in turn politicised and rechanneled into blame and recrimination.
There is no clear consensus emerging about how to resolve debates about ‘austerity’, security, cuts in public services, the burgeoning national and personal debt and the mode of our exit from the European Union. Our political leaders also seem to lack the confidence and skills necessary to show us the way forward. Furthermore, this cultural and political deadlock has divided friends and families and toxified social media. Britain is imploding.   
Alongside all this is a rising hostility to Christian faith and values. The British General Election may have turned the world of Westminster upside down, but in its aftermath evangelicalism has emerged as a key theme: the resignation of Liberal Democrat leader Tim Farron over his views on homosexuality and the extraordinary level of public criticism of the Democratic Unionists (DUP) for their Christian beliefs and opposition to same-sex marriage and abortion. With this resentment toward the DUP and its partnership with the Tory government has come a political resolve to extend the Abortion Act and same-sex marriage to Northern Ireland.
This intensifying backlash against conservative moral values on life and sexuality betrays a conviction amongst many mainstream politicians that Bible-believing Christians ought not to hold public office.
With social policy following such a liberalised trajectory in the media and corridors of power, one wonders if there would any longer be a place for evangelical luminaries like William Wilberforce or the Earl of Shaftesbury in contemporary British politics.  
It is not all one way – the recent decision of the General Pharmaceutical Council to allow scope for freedom of conscience in its latest guidelines was a welcome surprise as was the Belfast Court of Appeal decision to declare Northern Ireland’s restrictive abortion law compatible with the Human Rights Act. But the recent decision of the British Medical Association to back the complete decriminalisation of abortion and the government’s reflex decision to fund abortions for Northern Irish women traveling elsewhere in the UK were truly astonishing.
There are serious challenges ahead. The Queen’s Speech foreshadowed plans to combat ‘non-violent extremism’ and establish a Commission for Countering Extremism, which will ‘support the government in stamping out extremist ideology in all its forms’ (see here and here). Already voices such as the Evangelical Alliance have pointed out that ‘extremism’ is a slippery concept and there is no consensus about what it means. Might Christians holding biblical views on life issues and sexuality lie in its cross hairs? ‘Hate speech’ accusations and reports of ‘thought-policing’ in the public service do not bode well. The government already ‘has tried and failed in recent years to define extremism in a way that tackles terrorism and its causes without restricting freedom of ideas’.
The metropolitan liberal elite seem less tolerant of opposing views and more likely to believe that those with alternative convictions must be either evil or unenlightened or both. Former UKIP leader Nigel Farage has remarked, ‘We are bringing up a generation to believe there is only one acceptable view on every issue… Schools are terrified of saying or teaching anything that might be considered inflammatory. Kids think people don’t have the right to opposing opinions. It’s Orwellian!’
We are living in a post-Christian society where an atheistic mind-set and the ethics of secular humanism have growing influence. The myth of secular neutrality holds that this is some kind of neutral default position, unlike the ‘faiths’ of Christianity and Islam. And yet secular humanists have their own strong philosophical and ethical convictions which are based as much on ideology as evidence, and which exponents are forcing on others using political and legal mechanisms. ‘Tolerance’ once meant ‘respectful disagreement’. Now it seems to mean ‘affirm my beliefs and celebrate my behaviour or else’.
The apostle Paul, speaking of a society that had similarly turned its back on God highlighted the link between unbelief and moral decay in talking of men who ‘suppress the truth by their wickedness’, neither glorifying God nor thanking him and futile and foolish in their thinking. That generation was guilty of three ungodly ‘exchanges’. They exchanged ‘the glory of the immortal God for images’, ‘the truth of God for a lie’ and ‘natural relations for unnatural ones’. Homosexual acts – along with greed, depravity, envy, murder, strife, deceit, malice, slander, arrogance and hatred of God – were a key marker of such cultural decline (Romans 1:18-32).
As a result, God ‘gave them over to a depraved mind, to do what ought not to be done’. Is God similarly giving Britain over? If so, we can expect these challenges to increase in coming years – and as Christian doctors the need to preach Christ and walk in his footsteps will be as great as ever.
‘God is our refuge and strength, an ever-present help in trouble. Therefore we will not fear…’ (Psalm 46:1,2)
Editorial from the Summer 2017 edition of Triple Helix, the magazine of Christian Medical Fellowship 

Monday, 3 July 2017

Reflections on the BMA’s vote to ‘decriminalise’ abortion – ten key observations

Last week delegates at the BMA annual representative meeting (ARM) voted to support the decriminalisation of abortion. You can listen to the whole debate here and five brilliant two-minute speeches against the motion here. Two previous blog posts give the background in more detail here and here.

The opposition speakers spoke with grace, eloquence and courage but were unable to sway the meeting.
Many people may be surprised to know that abortion is still illegal in Britain. After all, there have been over 8 million abortions in Britain since the Abortion Act came into being 50 years ago in 1967. 

Department of Health figures for England and Wales released last month show that there were 190,406 abortions in 2016 and that 98% of these were carried out on mental health grounds. The Abortion Act was intended to be restrictive, allowing abortion only in limited circumstances, but its provisions have been very liberally interpreted by doctors so that now one in every five pregnancies ends in abortion.

So in practice, although abortion is still technically illegal, the law is widely flouted. But, nonetheless, abortion remains illegal under the Offences Against the Person Act (OAPA). The clue as to why this law exists is the name - it’s based on the idea that the baby in the womb is a person who deserves legal protection along with the mother; in other words, that both lives matter. Every abortion stops a human heart beating and that is why abortion has been treated as legally different from any other medical procedure. It takes a human life.

Here are ten observations on the vote to legalise all abortion.

1.       This change was brought about by a very small number of doctors. The BMA, Britain’s medical trade union, currently has 156,000 doctors and 19,000 medical students as members. That’s a total of 175,000.  Only 500 members, however, attended the annual representative meeting and the five parts of the six-part motion supporting decriminalisation (ii-vi below as i was uncontroversial) were backed by fewer than half of these. There were also a significant number of abstentions which were not recorded as the electronic voting devices only gave 'yes' and 'no' options leaving delegates to wave cards to abstain. I’ve appended the full voting details at the end of this article, but between 155 and 180 people voted in favour of each decriminalisation clause. This is about 0.1% or one thousandth of the total membership of BMA. Given that those who attend trade union meetings tend to be more socially liberal in their outlook the vote can hardly be taken as representative. It is striking that over 1,500 doctors and medical students signed an open letter in just six days leading up to the vote calling on the BMA to reject the motion. This vote is reminiscent of a small number of members moving the BMA neutral on assisted suicide back in 2005. That vote produced similar outrage and was actually overturned a year later.

2.       The BMA has betrayed its own ethics and turned its back on 2,500 years of history. The Hippocratic Oath (400 BC), which all doctors used to take on graduation, gives a blanket prohibition on all abortion: ‘I will give no deadly medicine to anyone if asked, nor suggest such counsel, nor in like manner will I give a woman a pessary to produce abortion’. It is somewhat ironic that just 70 years ago in 1947 the BMA called abortion ‘the greatest crime’. The Declaration of Geneva (1948), which the BMA once affirmed, declares ‘I will maintain the utmost respect for human life from the time of conception even against threat’. So by becoming abortion’s greatest promoter and facilitator the medical profession in this country has betrayed its own historic position.

3.       This vote was carefully stage-managed. Last year the same BMA meeting agreed to do some research into decriminalisation of abortion and a 52 page briefing document was produced. This was purported to hold an objective centre ground but was heavily supportive of decriminalisation and selective in its presentation. The document was ‘discussed’ in an almost unprecedented one-hour meeting immediately prior to the debate and one attendee remarked to me that after this they felt the vote was already a ‘done deal’. It was very clear that some members of the BMA ethics committee who had contributed substantially to the report were heavily committed to decriminalisation. One, Wendy Savage, claimed to have performed 10,000 abortions personally.

4.       The debate was poorly informed and in fact actively misled. On two occasions, during the debate itself, incorrect information was given to delegates which would have affected their assessment of the issues. Several opposition delegates mentioned a ComRes poll which showed that only 1% of women wanted the abortion upper limit of 24 weeks to increase and 70% wanted to see a decrease to 20 weeks or below. In order to undermine this poll one pro-abortion delegate, Emma Runswick, gave a ‘point of information’: ‘The ComRes poll has been mentioned a number of times. I googled it and it had 2,008 people in it. 904 were men, more than 1,000 of these people were over 50, 24-34-year-olds 290 of them and no under 25s. Thank you.’ The obvious intention as to undermine the poll by implying that under 25s were not asked their views. The totals of 2,008 and 904 she quoted were actually correct but 186 of these were people aged 18-24. How Runswick missed this is hard to understand as these figures were all on the same page in the report. Another speaker, Coral Jones, responded to the point made in a prominent Canadian medical journal that Canada has become  ‘a haven for parents who would terminate female foetuses in favour of having sons’ after decriminalising abortion (see also here). Jones announced that she also had googled male/female ratios in Canada and found them to be one to one. She conveniently ignored the fact that these variations in ratios noted in the journal occurred only in certain ethnic subgroups. This disinformation had the effect of undermining the credibility of opposition speakers who were actually telling the truth.

5.       There was huge confusion among delegates about abortion gestational limits. The most obvious, and perhaps, the only way of decriminalising abortion would be to repeal section 58 and 59 of the OAPA, which makes carrying out abortions, or supplying drugs or equipment for that purpose, illegal. This would render the Abortion Act, with all its provisions including the 24 weeks gestation limit, null and void. The fall-back position would be then the Infant Life (Preservation) Act (1929), which makes it illegal to destroy a child ‘capable of being born alive’. The problem is that this Act defines this threshold as 28 weeks, although many babies born now as early as 23 to 24 weeks will survive with good neonatal care. So scrapping the relevant sections of the OAPA would leave us with a 28-week limit. If the ILPA were also to go it would make abortion legal for any and every reason right up to term. Delegates asked the chairman of the ethics committee, John Chisholm, to clarify this but the answer of 24 weeks was given with no legal justification or explanation. Later, after the vote had been taken there was an apology from the chair of the meeting about the confusion this created. As it is, the meeting referred the matter of ‘viability’ to the Royal College of obstetricians and gynaecologists to seek their advice. But it was not clear how long that would take.

6.       The decriminalisation move was backed by a campaign run by abortion provider BPAS (British pregnancy advisory service). BPAS have specifically acknowledged that they campaign for removal of all gestation of time limits to abortion. Their CEO Ann Furedi stated categorically at the London launch of the campaign, ‘I want to be very, very clear and blunt… There should be no legal upper limit.’ Abortion providers have a huge vested interest in decriminalisation because it would mean far less accountability and scrutiny for them. It’s fully understandable why they might seek this given the fact that the Care Quality Commission (CQC) had to step in to protect women from potential harm at Marie Stopes abortion clinics last year. Their report showed doctors had been block-signing consent forms, babies had been left in open beds, women were left at risk of infection, staff were not trained in how to respond to deteriorating patients and post-surgery safety checks had been completed before the surgery started.

7.       Regulation alone, which is what the BMA is seeking, pulls any legal teeth from abortion oversight. Regulation, as opposed to legislation,  would effectively leave doctors regulating themselves, and given how current guidelines are already flouted, we could only expect more of the same. Doctors are not above the law and they should be held legally accountable. We know that abortion can be used to cover up sexual crimes like rape, paedophilia, sexual abuse and incest.

8.       The BPAS campaign is titled ‘We Trust Women’ but there is no evidence that women are actually seeking a change in the law. A ComRes poll in May 2017 (see above) found that only 1% of women wanted to see the time limit for abortion extended above 24 weeks and that 70% wanted to see the abortion limit reduced to 20 weeks or below. 91% of women favoured a total an explicit ban on sex-selective abortion. So women want the law to be stricter on the legality and regulation of abortion, not laxer. This whole campaign has been based on the false premise that women who seek abortions are living under the constant shadow of arrest. This is simply not true. Prosecutions are exceptionally rare – in many years there have been none at all - and in the past two years there were just two convictions both in extreme and disturbing scenarios.

9.       Decriminalisation will move Britain in a direction that has not worked in other countries. China and Canada are currently the only countries which have gone down this route and after two states in Australia did so, concerns about an increase in late abortions, abortion tourism and babies being born alive after abortion, led other Australian states not to follow suit  (see herehere and here).

10.   The move at the BMA ARM has been cynically planned just ahead of a new private member’s bill in the House of Commons. Earlier this year a 10-minute rule bill, tabled by Diane Johnson, attempted to decriminalise abortion. It passed by a slim majority but later ran out of parliamentary time. It is expected that this bill will return, quite possibly in the current private members’ ballot. We’ll know in just a few weeks’ time.

It was noteworthy that the BMA made its decision to decriminalise abortion the very same week that the Minister of women and equalities, Justin Greening, agreed to fund abortions in England and Wales for women from Northern Ireland, where it is currently illegal. The move followed a threat to place the measure as an amendment to the Queen’s speech, which could well have put the government itself at risk of a vote of no confidence at a very critical time in British history.

It’s clear that there has been a huge cultural shift within Britain in attitudes towards abortion amongst the general population, but especially amongst doctors. Sociologically, this is the consequence of the sexual revolution of 1960s which led to a huge increase in sex outside marriage, and accordingly a large increase in unplanned pregnancies. But, undoubtedly, the decline of the Christian faith and with it the view that the baby in the womb is a person made in the image of God due respect, wonder, empathy and legal protection, has undoubtedly played a part.

Some doctors have already resigned from the BMA after the vote. I will not be doing so myself, because I believe it’s best to try and fight these battles from within. Furthermore, I object to the doctors’ trade union being hijacked by a small number of activists with extreme views to achieve their ideological and political goals.

This decision could be reversed, but unless we act quickly to prevent any ensuing bill going through parliament, it may be too late. Regardless, doctors who respect human life before birth could easily overturn the decision by bringing opposing motions next year and ensuring that they turn up in sufficient numbers to win the vote. Whether this happens or not, time only will tell. However, I can’t help thinking that the real blame lies with the bulk of the medical profession who have either capitulated to the new ethic or acquiesced in silence whilst allowing others steer the ship. The church has also been largely silent.

The aim of medicine is to prevent and treat illness. Abortion, the intentional taking of human life before birth, neither prevents nor treats any illness. Pregnancy is not a disease. Abortion runs contrary to the general strategy of medicine which is why it is against all historic codes of medical ethics.  

When the OAPA was first passed in 1861 it was inconceivable that doctors would ever be involved in abortion. However, now they are leading the way in the destruction of innocent human life. It is not too late to stop this, but only if we have the collective will and courage to do so.

The abortion decriminalisation motion with votes

The six-part motion (motion 50), from the BMA agenda committee, was proposed by the BMA’s City and Hackney Division and was passed in full on 27 June. Votes and percentages are shown for each clause. Abstentions were not recorded which is why the total numbers fall so short of the 500 delegates present at the ARM.


That this meeting:
i) supports the principles set out in part three of the February 2017 BMA discussion paper on decriminalisation of abortion; (Passed by 247 votes to 29; 89% to 11%)
ii) believes that abortion should be decriminalised in respect of health professionals administering abortions within the context of their clinical practice;(173 to 74; 70/30)
iii) believes that abortion should be decriminalised in respect of women procuring and administering the means of their own abortion;(155 to 91; 63/37)
iv) believes that decriminalisation should apply only up to viability in respect of health professionals; (173 to 69; 71/29)
v) believes that decriminalisation should apply only up to viability in respect of women procuring and administering the means of their own abortion;(160 to 72; 69/31)
vi) believes that abortion should be regulated in the same way as other medical treatments.(180 to 75; 71/29)