The European Court of Human Rights in Nicklinson and Lamb v. UK has rejected as ‘manifestly ill-founded and… inadmissible’ the appeals of Jane Nicklinson and Paul Lamb. The decision is far from surprising. It only confirms what was said in the case of Pretty v. UK where the Court unanimously rejected Diane Pretty’s application for Convention rights to a medically induced death. In Pretty, the Court held that there had been no violation of Articles 2 (right to life), 3 (prohibition on inhuman and degrading treatment), Article 8 (right to respect for private life – the ‘autonomy’ Article), Article 9 (freedom of conscience) and Article 14 (prohibition of discrimination).
The European Court of Human Rights case in Nicklinson and Lamb follows the ruling of the UK Supreme Court in the same case last year. The judgement of the nine Supreme Court justices in the cases of Nicklinson/Lamb and Martin was handed down on 25 June 2014. Those of Nicklinson/Lamb and of Martin were dismissed. However, the test case of the Director of Public Prosecutions was allowed. This rejection of the case as ill founded and inadmissible is the ECtHR’s decision on the matter.
In short, the European Court found that the UK Parliament was “best placed” to rule on so a sensitive a matter as euthanasia with all its ethical, philosophical and social ramifications. By showing an unwillingness to engage in judicial activism, the European Court of Human Rights has affirmed that the law in England and Wales remains unchanged. At various points in the judgement the Court highlighted a concern for the vulnerable, elderly and disabled people.
This is why Parliament has debated and repeatedly voted against changing the law in recent years.
‘You only have to look at what is happening in Holland and Belgium to see the dangers of weakening laws designed to protect the vulnerable. In Holland, euthanasia is often performed ‘without explicit request’ while according to reports, twins who might go blind and a transsexual have been euthanised by the state. In both countries euthanasia is being extended to disabled babies.
‘As Paralympian Baroness Tanni Grey-Thompson and other disability rights campaigners have said, changing the law would be dangerous and discriminatory. It would send out a very clear message to those who are disabled, terminally ill or just old that their lives are less worth living and protecting than the lives of the young and healthy. It is also worth noting that not a single major doctors group, including the BMA, Association for Palliative Medicine and the medical Royal Colleges backs changing the law on either assisted suicide or euthanasia.
‘The current law exists to protect the vulnerable and those without a voice: disabled, terminally ill and elderly people, who might otherwise feel pressured into ending their lives. It does not need changing – a fact recognised by the High Court, Court of Appeal and now in the Supreme Court ruling.’
Eroding respect for human life
One central concern about efforts to institutionalise homicide or suicide is that it erodes respect for human life. Recognition of the intrinsic and equal dignity of human life underlies any plain reading of the Universal Declaration of Human Rights and the European Convention on Human Rights. Both international instruments emerged after a period in history that saw the enactment of laws and regulations once thought progressive but which merely institutionalised gross human rights abuse. The World Medical Association (Resolution on Euthanasia Adopted General Assembly 2002) condemns euthanasia whether by lethal injection or by medically assisted suicide, and urges all domestic medical associations to refrain from complicity in such practice, even if domestic law professes to legalise it. The Hippocratic Oath denounces it. Numerous sacred traditions reject it.
Whenever euthanasia comes up for debate, disquiet is expressed by disability groups. These fears are far from irrational. Efforts to institutionalise the practice are predicated on the idea that certain subjects are appropriate for elimination, while others are of sufficient value to be worth preserving. Discrimination against the vulnerable, and thus Art 14 incompatibility, bedevils this ethical terrain. The sick, the terminally ill and the disabled are invariably the first to be regarded as proper subjects for medically assisted suicide. The logic of active euthanasia endangers the vulnerable by inviting one of the gravest of crimes in law. The practice undermines the dignity of those who may indeed be a burden.
Once enshrined in law, the practice invariably involves a move towards the elimination of those who have not asked to be killed, those who are unwanted, those who are lonely and low-income (KNMG Dutch Physicians Guidelines, Position paper, 23 June 2011), and those whose deaths offer some advantage to third parties controlling the process. It does so because it involves a radically altered mindset.
Organs for transplant are an ongoing incentive for active euthanasia. So too is cost-saving, litigation and payout minimisation, bed clearing, medical research, improper individual concerns about inheritance and even political Malthusianism. In this environment failures of transparency, ie lies and deception, are both pragmatic and inevitable. Belgium is now well-known for its failures of transparency with only 52.8% of acts of euthanasia reported to the authorities in Flanders. (Reporting of euthanasia in medical practice in Flanders, Belgium (BMJ 2010; 341: c5174).)
Marketed as autonomy-enhancing, pain-minimising and subject to watertight “safeguards”, euthanasia (and its variants) at first glance, appears progressive. The Dutch experience suggests otherwise—there voluntary euthanasia has given way to non-voluntary euthanasia, false reporting and under-reporting. Further, the practice undermines the goals of medicine by effectively destroying palliative care.
Falconer et al seriously underestimate human capacity for error and vice. Because, in this context, they beget an act as grave as unlawful homicide, as in other areas of law where individual autonomy is limited for reasons of public interest (eg helmets, seatbelts, drug possession, incest, tax, parking offences, etc), there is every reason to reject their ill-judged demands.
By dismissing the army of corporate, financial, medical and political interests that there are in controlling death, euthanasia’s corrosive effects on public and professional attitudes, and the discrimination implicit in its implementation, Falconer and his stacked commission with their foot-in-the-door approach to this programme, invite, institutionalise and incentivise murder—nothing less.