8mm
Posted on 09/28/2007 5:22:51 PM PDT by wagglebee
Desperately ill patients will be at risk of being killed off by friends or relatives under "living will" laws, officials admitted yesterday.
The system that allows a third party to withdraw the medical treatment that is keeping a patient alive is open to abuse and fraud, they said.
The prospect of patients being killed on the orders of relatives who stand to benefit from their wills has reignited debate on the Mental Capacity Act, which comes into force on Monday.
Doctors warned there were too few safeguards to prevent exploitation of the ill.
Dr Philip Howard, a London gastroenterology hospital consultant, said: "The law will lead to real difficulties when a family member has the power to order that someone should die while at the same time they are a beneficiary of the will."
He added: "Law governing wills and property makes it very difficult to influence someone to make a will in your favour - the Mental Capacity Act has nothing like that sort of safeguard."
The Act, condemned by its critics as "back door euthanasia", allows people to write living wills which tell doctors to withdraw life-sustaining treatment if they become too ill to speak for themselves.
This will usually mean doctors removing tubes providing water and nourishment to an incapacitated patient.
It also allows patients to hand over "lasting powers of attorney" to family, friends or anyone else they choose, giving them the right to make decisions about their medical treatment if they become too ill to decide. For the first time, the new law gives such "attorneys" the right to order doctors to actually withdraw treatment, including nutrition and hydration.
Christian and Muslim doctors have already said they will refuse to obey the law if a living will tells them to kill a patient - even if they face criminal prosecution and a possible jail sentence.
Yesterday officials who will police the new law said as many as one in seven of the current "enduring powers of attorney" in which only financial decisions are handed to others - have involved fraud or abuse.
Former charity chief Richard Brook, the newly appointed Public Guardian in charge of investigating complaints about the new law, said: "Enduring powers of attorney have been one of the biggest areas for fraud and abuse."
Mr Brook said the new LPAs will carry safeguards and "make it more difficult for that to occur".
Critics of the Act believe the safeguards are insufficient.
Elspeth Chowdharay-Best of the Alert pressure group said: "People sign living wills thinking they will die a little bit earlier, and nobody minds that if they are dying anyway.
"But what this law does not say, and most people do not know, is that they will be condemning themselves to die terribly of thirst."
How our rights are changing
Euthanasia remains illegal in Britain. However the Mental Capacity Act makes it legally possible for the first time to end the life of a patient by medical intervention.
It gives legal force to "living wills", in which patients can set down what medical treatment they wish to be given, or not given.
The sting of the Mental Capacity Act is that, in law, medical treatment is not simply a matter of drugs or surgery. Since a landmark House of Lords judgment in 1993, providing food and water to those who cannot eat or drink for themselves counts as treatment as well.
That judgment was at the centre of the case in which Hillsborough football disaster victim Tony Bland, who was in a persistent vegetative state, was able to die.
The new Office of the Public Guardian will investigate complaints about the law.
A Court of Protection has also been set up to settle disputes.
You have no right to end your life before it naturally comes to an end. No one does. Doing so opens the door for more and more active euthanasia to patients who are less and less ill and incapacitated, until society is killing patients for any reason and/or no reason at all.
The key word is “naturally”. If I was in a decrepit state in the US, under the control of physicians who strove to extend my life with undesired care, it is not natural. I retain total control of my life in this way, and surrender it only to the judgment of trusted family in an official manner.
Were instead I to deny outsiders this opportunity by moving to a rural part of a third world nation, so that they could not control me, my death would be very “natural”, even if it could have been easily delayed by their interference.
I would, as would most people, prefer to die surrounded by family, with discomfort mitigated. But I bristle at the idea that anyone outside of my family could intervene in *either* direction, to extend *or* shorten my life, unless they did so at the behest of my family, and purely through a technical skill they could perform. They have no right to even an iota of control.
If I survive my family, then I so deeply distrust outsiders to perform my wishes that I would vie for a departure out of their grasp, again by retiring to a place where I am beyond their reach. My life or demise is not their concern.
Those with other agendas may speak of public policy, and with some legitimacy on either side. On one side are those who fear lingering debility, debasement and impoverishment; and on the other side those who note with great alarm the willingness to murder those who are helpless—already seen in such places as Britain.
Let them have their public policy debate. However, I see no transcendental goal of government in interfering with the personal decision and the wise familial decision; if they attempt it in either direction, at least I and my family will evade their dictates. Other families should do the same.
Those unfortunate enough to be caught without loving guardians or the ability to evade, do need options—the intervention of government, in a reasoned manner—something in which government does not excel. But that is for them, not for me.
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