Friday, 21 September 2007

Mental Capacity Act

So, the Mental Capacity Act comes into force next month (October 1), but already people are signing the forms to request the withdrawal of life sustaining treatment.

Motor neurone disease sufferer Penny, from the Midlands, has already listed the treatment she doesn't want to receive if and when she loses her capacity.

I can't even begin (or have the time to go into) all of the facts and opinions about the Act, its implementation and it's implications. But for those of you that want a recap on what the MCA really is in a nutshell, here's a (very) brief summary:

The Bland judgement opened the door for doctors to dehydrate and starve to death certain mentally incapacitated patients. The Mental Capacity Act through advance decisions, lasting powers of attorney and the re-definition of "best interests" and "medical treatment", extends the principles of the Bland decision to all mentally incapacitated patients. It allows patients to request the withdrawal of treatment by means of an advanced directive or a power of attorney. These documents and statements are legally binding and require doctors to carry out the patient's wishes even if they think they are not in that individual's best interests.

Expect from October 1, then, to see the floodgates open and, as the Law Society predicted during the early stages of the passage of the bill, lots of dispute court cases between doctors, patients, their powers of attorney and their friends and relatives to open up. Expect the horrible stories of elderly people being starved and dehydrated to death, expect, within a relatively short space of time, the pro-euthanasia lobby calling for more "humane" killing as they see it.

I, as many of you have, got involved quite a bit in the campaign against this act and its sinister euthanasia by omission elements. We should continue to oppose it, by exposing any dodgy cases we get to know about where our families or friends have treatment, including food and water, withdrawn against their wishes. It will happen, because with this new act, comes a massive shift in the very nature of medical healthcare as doctors who refuse on clinical or other ethical grounds to implement an advance refusal of treatment face litigation and possibly criminal conviction even if they think it is in the patient's medical best interests.

Indeed, euthanasia by omission is happening already in our hospitals. That's according to counsellors on the end of the phone of the Patient's First Network, set up by SPUC. This helpline gives advice to people who find themselves in awkward situations where euthanasia by omission is a threat. Members of the network get a card and a medallion which alert medical staff, along with your family and carers, that you wish to receive appropriate medical treatment and care. People who join this also have the support of the confidential telephone service which can advise you and your family on end-of-life issues. It's a fantastic thing which SPUC have set up as a helpful response to a dreadful piece of legislation. For more details, see here.

But let's not forget that treatment can ethically be withdrawn which is of no benefit (not helping to sustain life, even making it more burdensome). It's when life sustaining treatment, including the basic care of food and water, is withdrawal WITH THE INTENTION of hastening the death of the patient that leads to euthanasia.

Recently, as you will probably know, the Congregation for the Doctrine of the Faith (CDF) released a clarification of the church's teaching in this area after a series of questions by the US Bishop's Conference in relation to the Terry Schiavo case. The statement was as follows:

First question: Is the administration of food and water (whether by natural or artificial means) to a patient in a “vegetative state” morally obligatory except when they cannot be assimilated by the patient’s body or cannot be administered to the patient without causing significant physical discomfort?

Response: Yes. The administration of food and water even by artificial means is, in principle, an ordinary and proportionate means of preserving life. It is therefore obligatory to the extent to which, and for as long as, it is shown to accomplish its proper finality, which is the hydration and nourishment of the patient. In this way suffering and death by starvation and dehydration are prevented.

Second question: When nutrition and hydration are being supplied by artificial means to a patient in a “permanent vegetative state”, may they be discontinued when competent physicians judge with moral certainty that the patient will never recover consciousness?

Response: No. A patient in a “permanent vegetative state” is a person with fundamental human dignity and must, therefore, receive ordinary and proportionate care which includes, in principle, the administration of water and food even by artificial means.

The MCA runs directly contrary to the Vatican statement's principles.

It was very encouraging to see the Islamic Medical Association in the UK wholeheartedly back the Vatican's clarification. The association has issued the following statement:

“On behalf of the Muslim believers, we wish to express our happiness with, and full support for, the recent Vatican statement on ensuring food and fluid for mentally incapacitated patients. We believe that the basic means for survival (food and fluid) should be ensured for every human being (and animal), whether or not they are healthy, ill or incapacitated. This is a basic human right for all. All human life is sacred, and only God, the Creator, has the right to end any human life, in its appointed time.

"British Muslims are worried today about the new Mental Capacity Act, which allows and in some cases requires food and water to be denied to mentally incapacitated, non-dying persons. In doing that, our innocent patients will die in pain and agony from the horrific effects of starvation and dehydration. We oppose strongly any court decision or power of attorney used to justify participation in starving or dehydrating anyone to death. All Muslim doctors, nurses and patients, expressing our Islamic beliefs, should oppose this inhumane Act.”

And it is that, an "inhumane Act". In fact, I still maintain that it will be one of, it not the most disastrous law passed by the Labour government under Tony Blair. It's just that most of the British public don't know about its horrific consequences as yet.

1 comment:

Mrs Jackie Parkes MJ said...

Frightening developments...