By Hilary White

LONDON, September 24, 2009 (LifeSiteNews.com) - Evidence is mounting that Britain may already have not only de facto legalised assisted suicide thanks to new prosecution guidelines issued this week, but also involuntary euthanasia by means of a tangled combination of rationing of government-funded medical care, end of life medical practice protocols that allow the withdrawal of hydration and the existing Mental Capacity Act.

British and international anti-euthanasia and disability rights groups are expressing their alarm at the publication of prosecution guidelines earlier this week by the Director of Public Prosecutions (DPP) for England and Wales. These guidelines make clear that those who assist someone commit suicide, but who do not have anything personal to gain by doing so, will not be prosecuted, even though assisted suicide technically remains a crime.

Alison Davis, head of the disability rights group No Less Human, told LifeSiteNews.com (LSN), "If the guidelines remain in force, we will see that those who assist suicide, whether for misguided 'merciful' or for merciless reasons, will be able to do so with impunity. Like many other disabled people I am alarmed by the DPP's guidelines."

But these same anti-euthanasia groups are also warning of a legal situation that already exists in Britain, in which patients and residents in hospitals and nursing homes are increasingly under threat of involuntary euthanasia, usually by a combination of deep sedation and dehydration.

While bills intended to weaken the legal prohibition on assisted suicide continue to be defeated at Westminster, existing guidelines for end of life care called the Liverpool Care Pathway, guidelines on healthcare rationing from the government's National Institute for Health and Clinical Excellence (NICE) and the 2005 Mental Capacity Act, have combined to create de facto legal euthanasia, which activists say is already being widely practiced.

John Smeaton, Director of the Society for the Protection of Unborn Children (SPUC), Europe's leading pro-life organisation, told LSN, "We have a government policy of silent euthanasia right now in this country.

"This is being brought about through a number of different factors, but significantly the Mental Capacity Act of 2005, that formally defined the provision of food and fluids as medical treatment."

Under the Act, such "medical treatment" can be withdrawn as "futile" - even from patients who are not terminally ill and can benefit from it - on the advice of a physician, until the patient dies. Anti-euthanasia activists have said that the determination that food and water constitute "futile treatment" in a patient who is not terminally ill really means only that it is the patient's life that is considered "futile."

According to an increasing number of reports, food and hydration is being removed from patients on the Liverpool Care Pathway in many cases where patients are not terminally ill but are merely elderly or suffering from dementia or stroke and would benefit from normal medical care. Under the protocol, the patient can be sedated or given pain medication; food and water are then withdrawn until death by dehydration.

A recent national audit by researchers with the Royal College of Physicians and the Marie Curie Palliative Care Institute found that, of 4,000 patients put on the Liverpool Care Pathway last year, 28 per cent of their relatives were not told that the patient was being cared for under the protocol. The report found that about 20,000 patients die this way each year in Britain. Only thirty-nine per cent of patients on the Pathway suffered from cancer, while others had conditions such as pneumonia, stroke, organ failure and dementia. The average age of patients was 81 and they were typically on the pathway for 33 hours before death. 76 per cent of families were told that their loved one "had entered the dying phase." The report also said that hospitals and care homes that routinely put patients under deep sedation should review their practices. 

The Pathway is now in use in 300 hospitals and 560 care homes across the country. Peter Millard, emeritus professor of geriatrics at the University of London, told media, "The risk as this is rolled out across the country is that elderly people with chronic conditions like Parkinson's or respiratory disorders may be dismissed as dying when they could still live for some time."

Millard blamed government downsizing of the British socialised medical system. "Governments have got rid of respite care and geriatric wards, so we're left with a crisis," he said.

"The Government has said let's develop a service to help people die at home - what they should be doing is helping them live. Only when death is unavoidable should you start withdrawing treatment."

SPUC's Anthony Ozimic said that euthanasia opponents had warned all along that the Labour government's 2005 Mental Capacity Act had "massive potential scope for euthanasia combining denial of food & fluids with sedation."

Ozimic said that although "assisted suicides usually involve mentally competent and ostensibly consenting persons, a significantly larger number of intentional killings may well emerge under government-endorsed end-of-life policies."

Referring to the guidelines on end of life care already in use in hundreds of hospitals and care homes, Ozimic said, "The Liverpool Care Pathway and the Mental Capacity Act involve the far larger number of patients who are not intent on suicide and whose diminished mental and physical powers leave them very vulnerable."


Read related LifeSiteNews.com coverage:

Britain Won't Prosecute Assisted Suicide: Chief Prosecutor
http://www.lifesitenews.com/ldn/2009/sep/09092109.html

Britain's Pathway to Euthanasia - NHS Protocols for Dehydrating Disabled Patients to Death
http://www.lifesitenews.com/ldn/2008/jul/08070303.html

British Doctors Practising "Slow" Euthanasia through Deep Sedation: BBC Report.
http://www.lifesitenews.com/ldn/2009/aug/09081803.html