At present there is a clear principle: never intend to kill the patient, and never try to help patients intentionally kill themselves. That is the law. It is also the long-established common morality, it is the ethic of the health-care professions, it is article 2 of the European Convention on Human Rights. There is a bright-line and though likeother laws and principles it is not invariably respected, it is not in the least artificial, or brittle. It rests on a rational principle –that a person’s life is the very reality of the person, and whateveryour feelings of compassion, you can’t be intentionally trying precisely to eliminate the person’s reality and existence without disrespect to the person and their basic equality of worth with others.

The interplay between patient autonomy, suffering, prognosis, patient embarrassment, medical autonomy, and the hidden influence of relatives and carers with their own autonomy and interests, in the context of an officially sanctioned devaluation of human life under conditions of disease, debility and disablement – this interplay is inevitably a web of forces making it impossible to establish and hold an effective line once the present clear line and principle are abandoned. Violation of the right not to be killed and put in vivid fear of being killed, and violation of the right not to bepressed into suicidal decisions, would therefore become more widespread and burdensome – I suspect enormously more burdensome — than the present violation of the autonomy rights of a [relative] few.

This is an excerpt of a presentation made before the House of Lords January 2005. Download entire report

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