This is of major importance in Britain at the moment with unrelenting pressure being exerted by organised activists to allow a change in the law so that a direct action of a healthcare professional with the intention to end the life of a patient is permitted under the law.
Various circumstances are described including that of the terminally ill patient, whose symptom control is excellent, but who wishes to end their life more rapidly than their prognosis suggests or the situation of a terminally ill patient whose symptom control is not adequate. Otherwise, a patient may not be terminally ill but may find their physical, psychological or emotional condition unbearable and want to end their life. These involve voluntary euthanasia.
Non-voluntary euthanasia may be promoted by others who know the patient and attempt to demonstrate that they know what the decision of the patient would have been, considering a hypothetical situation before they became ill and lost capacity. These situations do not always include the provision of an ‘advance directive’ or any written form of statement of patient wishes. The inclusion of evidence of reported conversations with patients when they had capacity has an added risk of abuse.
Involuntary euthanasia has been increasingly witnessed in countries where healthcare professionals are permitted to administer voluntary euthanasia, this has eroded patients’ rights until they are euthanized without ever having expressed a wish for this. In these countries, there are an increasing number of reports of patients being euthanized after previously expressing their opposition to the practice.
The publicity given to distressed individuals, who become tools for campaigners for law change but may have the capacity to state their case, belies that of the more usual vulnerable and less articulate elderly patient healthcare professionals meet on a daily basis. We all know patients who could be manipulated, when faced with treatment and social support decisions, so that they cost less time, care and State funding.
At a time when family members are stressed, worried about their jobs and the financial welfare of their children, we need to be aware that historically in Britain it is always in times of recession that eugenics and pro-euthanasia movements have gained strength as the State has withdrawn effective support. Philosophically, British ethicists, scientists and healthcare professionals have been prominent and influential pro-euthanasia protagonists in the international debate since the late nineteenth century.
When junior doctors have to prescribe regular drinks of water on drug charts to ensure that their frail patients do not dehydrate and deteriorate until moribund, it says as much about the understaffing of wards and exhaustion of nurses and healthcare assistants as it does about the patchy phenomenon of lack of basic care so publicised by the media after a damning, recent report on standards of care for the elderly in the NHS.
It is a truism that we can provide to others what we have received ourselves. When so many healthcare professionals today are survivors of a British abortion rate of between one in five and one in three of all established pregnancies, they have been on the receiving end of conditional regard by society. Such a society can become psychically damaged so that even those who enter healthcare find it difficult to be patient with those, who are less attractive or less productive to the State. Catholics are not immune from this slide into lack of compassion and respect for the vulnerable.