Legalisation of Euthansia
DR. BRIAN POLLARD
number of important factors, hitherto ignored or misunderstood
in the debate about the legalisation of VE, have now been
revealed in several large studies.
The legalisation of euthanasia is a constantly recurring topic for
debate, in which the chief themes include the status of good medical and
nursing care for the dying, its morality, legal detail and human rights,
especially respect for personal autonomy and perhaps privacy, and the
role of public opinion. Since there are deep divisions in society on all
those issues, it is not surprising that the debate seems to rotate
endlessly about them, without any reasonable prospect of consensus.
Those for and those against the proposal are both unwilling to yield on
what they see as immutable positions of principle. If progress is to be
made, a way needs to be found whereby personal views about the
medico-social role of euthanasia can be excluded, while the subject is
discussed on neutral grounds, capable of objective examination.
It is apparent now that such a neutral way has been discovered,
though perhaps by chance, it has already been used several times and the
results of that use have been published. I refer to the reports of the
large government-supported committees of inquiry held in recent years,
on four different continents, devoted to the consideration of the
consequences of legalising euthanasia.
In sharp contrast to the usual lack of resolution on debate on this
topic, every one of these committees independently reached the same
conclusion, namely that legalisation would be unwise and dangerous
public policy, because unpreventable abuses could not be eliminated.
More astonishingly, when it is difficult to find at random even a small
number of people who can agree on almost any aspect of euthanasia, three
of these four committees reached this conclusion unanimously, though
they all included individuals who held opposing personal views about
The committees and their reports were:
- Select Committee
on Medical Ethics, House of Lords, January 1994.
- New York State Task
Force on Life and the Law, titled Euthanasia and Assisted Suicide
in the Medical Context, May, 1994. 
- Senate of Canada,
June, 1995, titled Of Life and Death.
- Community Development
Committee, Parliament of Tasmania, titled The Need for
Legislation on Voluntary Euthanasia, 1998.
Of the fourteen members of the House of Lords Committee, only two
were known at the outset to be openly opposed to euthanasia. The
Chairman was reputed to be a medical consultant to the Voluntary
Euthanasia Society and one Law Lord had previously decided in favour of
‘passive’ euthanasia in the case of Tony Bland. Another member had
written a philosophical defence of both voluntary and non-voluntary
euthanasia, a view thought to be shared by three or four other members.
When it visited Holland, the Committee learned there of an alarming
number of patient deaths without patient consent, and were openly told
by Dutch advocates of euthanasia that effective safeguards against abuse
had proved impossible to devise. 
The Committee of the New York State Task Force had 25 members,
including some who thought that euthanasia and assisted suicide were
sometimes ethical and compatible with good medical practice. This
Committee issued a unanimous report rejecting legalisation, a most
valuable compendium of important information.
In early 1997, the Tasmanian parliament established a committee to
examine the need for legislation on voluntary euthanasia in that State.
When she released the final report of this Committee in 1998, the
Chairperson revealed that of its five MP members, four, including
herself, had originally been in favour of euthanasia. This Committee
unanimously found that ‘it would be impossible to frame a law that
included all the vital safeguards to protect the vulnerable, weak and
These reports, taken together, constitute an unexpected and valuable
body of expert findings, all pointing in the same direction. Thus, any
future proposal for the legalisation of voluntary euthanasia (VE) could
reasonably be regarded as incomplete and inadequate unless it displayed
familiarity with the arguments contained in those reports, and included
effective solutions to the many difficulties they uncovered.
Regarding laws on killing, the House of Lords Report said ‘The
product of an adequate, legal framework should be public confidence that
the law protects life...there can be no more important area in which the
law’s protection should be complete and transparent than where
individual’s lives are at stake’.
For a law to be unsafe, it does not have to be shown that it will be
abused, merely that it is clearly open to abuse. The more open it is,
the greater the likelihood that it will be abused.
A good deal of the reasoning in the reports may be summarised in this
extract from the report of the New York State Task Force: ‘For purposes
of public debate, one can describe cases in which all the recommended
safeguards would be satisfied. Bur positing an ‘ideal’ or ‘good’ case is
not sufficient for public policy, if it bears little relation to
prevalent social and medical practices. No matter how carefully any
guidelines are framed, (assisted suicide and) euthanasia will be
practised through the prism of social inequality and bias that
characterises the services in all segments of our society, including
health care. The practices will pose the greatest threats to those who
are poor, elderly, members of a minority group or without access to good
This paper cannot do justice to the whole of the content of the cited
reports which need to be read in full, because they cover an extensive
range of subjects. It will include:
- discussion of the
essential incompatibility of any euthanasia law with the objectives
of sound criminal law some discussion of the human rights thought
relevant to euthanasia
- the role of public
opinion in law making, and
- some of the medical
factors that would make any such law unsafe.
INCOMPATIBILITY OF LEGALISED EUTHANASIA WITH
EXISTING CRIMINAL LAW
Since euthanasia is the intentional taking of innocent human life, it
is a form of homicide, and even if it were legalised, it would be
legalised homicide. The basic aims of criminal law are to provide equal
justice for every citizen and to protect the weak. Additionally, the
consent of the victim is by legal tradition no defence to a crime.
Equal. The criminal law of every nation holds that all innocent human
life is inviolable, innocent persons being those who pose no threat, or
have done no harm, to others. The value placed equally by law on each
life is such that its intentional destruction is the greatest of crimes,
deserving of the greatest penalty. Euthanasia law would provide the
first exception to the prevailing universal protection of innocent life,
by creating a category of persons whose lives may be taken
intentionally, under certain conditions. It would thus constitute a
precedent for repeating the process later to further enlarge the scope
of the new principle, where no such precedent had previously existed.
The concept of equality before the law would have been abandoned.
Justice. For a law to be just, it should be grounded in sound ethical
principle capable of receiving general acceptance; its definitions and
provisions should be set out in clear terms so they can be interpreted
in the same way by all who read them. This would constitute a particular
problem with euthanasia, since many of the phenomena associated with
death are difficult to define with such precision; its provisions,
particularly those intended to act as safeguards, must be capable of
being realised and of being monitored, and it must contain no obvious
avenues for abuse. If any of its important elements relied for their
observance on opinion rather than fact, that would introduce
arbitrariness and would be incompatible with justice.
A patient who requested euthanasia would have concluded that his/her
life was no longer worth living, and a doctor who agreed to the request
would have reached the same conclusion, by an independent but arbitrary
judgment. In the same circumstances, different patients and different
doctors would have come to different conclusions, depending on their
personal values. Thus, under a euthanasia law that simply accepted these
personal choices as grounds for lawful killing, the result would
represent a kind of lottery of life, whereby a subjective request was
met with a subjective response, and neither would be, or could be,
objectively validated. The idea that legally taking life may be made
dependent on the untestable choice or opinion of persons is at odds with
any mature notion of justice.
Protection of the weak. The lives of individuals or groups who are
unable to participate fully in the life of the community are especially
protected by the current law, because it allows of no exceptions. These
groups include the poor, the aged and the very sick, and those who make
heavy demands on the community’s time or resources, such as physically
or intellectually handicapped, or permanently unconscious, people. Once
it had been decided in law that the equal right to life may be waived on
account of a low quality of that life, it would seem, to some at least,
that individuals in the above categories would be the most logical for
the extension of that principle, should other circumstances seem to
Mutual consent. Voluntary euthanasia involves one person asking and
another agreeing to the taking of life. Though, in criminal law, consent
is no defence to a breach of any of its provisions, with lawful
euthanasia both parties would have acted in defiance of that principle.
It is instructive that the statute laws on killing in the Netherlands
are much the same as elsewhere, and that the Dutch have to date
preferred to try to justify their expanding euthanasia practices by case
law or precedent, not by statute. They have wanted to have euthanasia
regarded as an arguable exception to the legal principle that they see
as vital to maintain, namely that innocent life should be regarded as
inviolable. Most of those who promote lawful euthanasia elsewhere fail
to see that the retention of this principle is needed to sustain the
credibility and strength of the rest of the criminal law, for a person
must at least be alive in order to be subject to its provisions.
HUMAN RIGHTS AND THE LAW
As outlined above, any proposal to legalise VE would constitute, not
only an attempt to change the present laws, but to overturn them. If the
proposal appealed to any human rights for its justification, they would
have to be acknowledged natural rights, those derived from
considerations of the nature of mankind. That right would also need to
be properly defined and understood in the same way by all who discuss
Natural rights were originally conceived as the entitlements of
citizens that would protect them against injustices. Respect for
autonomy can be argued to be a genuine natural right, and as such, it
would oblige its acceptance by others. Autonomy is the right of every
person to decide freely the course of his/her own life, within the
limits set by the competing genuine rights of others, and it will oblige
compliance when it respects those rights. That is, autonomy involves
both the privilege of choice and the duty to restrain one’s choice, when
that is required. Difficulties arise in relation to VE when (a) autonomy
is not defined or not correctly defined, since clarity is essential when
discussing such a contentious and emotional subject, and (b) when it is
commonly discussed as though it were no more than a welfare right.
Autonomy is now commonly presented as, and often thought to be, merely
an individual’s expression of preference, which is never claimed to be
binding on others.
Welfare rights have a well deserved reputation for being divisive and
confronting, because they tend to favour one individual above others.
Natural rights, which place equal emphasis on furthering the well-being
of both the individual and of society, promote harmony and friendship.
The facts that rights are so often incorrectly understood and unequally
applied led one observer to comment ‘when rights come in, love goes out
Though any proposal to take innocent life has unarguably high moral
content, any suggestion that this merits close examination is apt to be
met with accusations of ‘religious bigotry’ or the like, as though
secular morality did not hold similar claims to fundamental importance.
However that may be, a common practice now is simply to ignore any
discussion of it. When absolute morality is rejected, traditional ways
of deciding morality become diluted, without any consistent ethic found
to replace them. Questions of right and wrong can then be transformed
into questions about individual rights, so that ‘What is right?’ becomes
‘What are the rights?’, an entirely different topic.
Autonomy is misunderstood or misrepresented when it is assumed to
apply to whatever an individual may happen to want sincerely, or when it
is assumed that the significance of the consensual killing of VE is a
private matter, with no harmful consequences for others. Both
assumptions are wrong. Further, it is widely but incorrectly assumed
that choice itself is the essence of autonomy, not what is chosen.
Individuals have no entitlement at all to be given what they happen to
want - that would be nearer to self-indulgence than self-determination.
Depicting euthanasia as no more than a private matter is dangerously
naive, ignoring the fact that euthanasia law would set new and lower
standards of respect for human life, because in the eyes of many, making
a matter legal signifies it has the approval of authority. VE would then
become one of the options that may be put to all vulnerable sick
patients, and it would be proper to promote and encourage it. In light
of the gross imbalance in power between doctors and their patients, some
patients would than be powerfully and unfairly influenced. This would
place an unnecessary burden on dying patients when they may already be
seriously taxed and confused by so many aspects of their illness.
If the right to request death were a genuine right, it would oblige
compliance, though VE supporters are careful always to point out that
that is not their aim. A human right cannot be claimed at the same time
to be genuine and yet only permitted to be exercised arbitrarily. To be
consistent, if the right were genuine, VE should then be available to
all who ask, sick or not, at any time, for any or no given reason. The
young who now commit suicide in alarming numbers should no longer
distress us, but be congratulated for showing how to take control of
one’s dying, as a matter of right.
Further, to depict VE as no more than an individual patient’s wish is
to ignore the presence of the person asked, the doctor. This second
person is an independent moral agent who must make his/her independent
and separate autonomous response, be required to justify it when asked,
and take due responsibility for it.
The sum of these deficiencies in the common understanding of autonomy
to justify VE means that the argument is distorted. No matter how often
or how vehemently it is asserted that an individual’s wish binds others
to comply, just because that is what he/she sincerely wants, the mere
expression of a wish is not autonomy. The wish, and all that may flow
from it, must be closely examined within the context of its social and
medical setting, and in this paper, some of those factors are discussed.
A different form of distortion, in the opposite direction, is the
virtual exclusion from the debate of the right of every innocent person
to his/her life, the genuine natural right on which the criminal law is
founded. Not only must this right be included, logically it should be
The 1948 United Nations’ Universal Declaration of Human Rights is the
most widely acclaimed and accepted statement of human rights. It was
compiled at a time when member states of the UN, horrified by their
discovery of the then recent extent of the abuse of natural rights, were
resolved to ensure that this should never happen again. It describes the
right of each person to his/her life as equal, inherent, inviolable,
inalienable and deserving of the protection of law. This means that the
right is not to be made dependent on its quality at a particular time,
there are no exceptions and the right may neither taken away nor given
There is an urgent necessity for full consideration of this natural
right to be reintroduced whenever the legalisation of euthanasia is
being discussed, if the proper role of law in the governance of society
is to retained.
The doctrine of personhood is a relatively recently added plank in
the platform for VE, and is now receiving broad assent. While it may not
directly be connected with human rights, the concept is a denial of the
right of every person to his/her life, and is therefore an attack on the
ethical basis of law. ‘Personhood’ claims that the value and dignity of
a person, which are the reasons that entitle every individual to be
treated with equal justice, are said to depend on the prior development
of certain currently usable psychological abilities. This raises
questions as to which abilities there must be and how developed they
must be. Since there are no standards by which every observer could
reach the same conclusions, such questions can be answered only by
choosing the criteria that will lead to the conclusion one wants. Thus,
this will always be an arbitrary exercise, reliant on the values of the
observer, and cannot be just.
If it were asked ‘What benefits does this new idea confer on society
in order to justify the displacement of the traditional understandings
of who may be regarded as a person?’, the answer can only be ‘None, that
do not permit and rely on the taking of the lives of certain individuals
who are already unwanted by society, for other reasons, without their
knowledge’. Those individuals will be some of the disabled, the senile,
the seriously ill and the unconscious, whose lives are at present
protected by law, and whose specific human rights are proclaimed in
various declarations. When the malignant intention of personhood is
realised, with its inherent disregard for both law and rights, its
advocates’ real lack of concern for all human life is exposed, to which
is added duplicity when they also purport to appeal to other human
THE ROLE OF PUBLIC OPINION IN LAW MAKING
One reason given for wanting the laws on killing changed is that a
majority of the community have declared, via opinion polls, that that is
what they want.
Opinion polls were developed to test views about political issues,
but VE is clearly a moral issue, secular or otherwise. When an issue is
as complex in almost every respect as VE is, no valid conclusions can be
drawn from polls when the respondents’ real understanding of them is
both unknown and unknowable. To use such results as an argument to
change part of the criminal law would be foolish and dangerous. This
would be self evident if it were proposed to change other parts of the
law, using the same mechanism.
Morgan opinion polls have been asking the following question in
Australia since 1962: ‘If a hopelessly ill patient, in great pain, with
absolutely no chance of recovering, asks for a lethal dose, so as not to
wake again, should the doctor be allowed to give the lethal dose?’ The
proportion of respondents answering ‘yes’ has increased from about 50%
at first to nearly 80% now. As one commentator noted, it would be hard
for an uninformed person to say ‘no’ without feeling negligent, dogmatic
But when the current ability of good palliative care to relieve the
severe pain of terminal illness is known, though it is also known that
such care is still not sufficiently available for many, the same
question could be more accurately phrased ‘If a doctor is so negligent
as to leave a terminally ill patient in severe pain, severe enough to
drive him/her to ask to be killed, should the doctor be able to compound
that negligence by killing the patient, instead of seeking expert help?’
The question is really about appropriate standards of medical care, not
It cannot be doubted that most of the community’s information and
opinions on VE have been obtained from the media which, almost without
exception, give an emotionally charged and partial, if not distorted,
account. When opinion polls claim to show that most people are in favour
of VE, the media, which have created this opinion by their advocacy and
lack of balance, then cite these figures as evidence of the need to
change the law to allow it! Such behaviour is self-serving and lacking
in both truth and justice.
If such issues could really be settled satisfactorily by opinion
polls or referenda, parliaments could largely be dispensed with, in
favour of endless polling.
SOME OF THE MEDICAL REASONS WHY ANY BE LAW
WOULD BE UNSAFE
Draft VE laws easily become intellectual constructs within an
idealised context, with a false appearance of safety, unless the medical
environment in which they will operate is well understood. One of the
most tragic medical facts, tragic because it is so remediable, is that,
while palliative care is now able to mitigate most of the distresses of
dying persons, large numbers of these patients still receive substandard
treatment because doctors are uninformed about its practices and/or do
not refer their patients to those who are more expert, when they have
reached the limit of their own abilities.
The following points are to be found in the cited reports:
- Necessity for adequate disclosure of medical detail.
Since it would clearly be wrong to allow VE for dying patients with
unrelieved symptoms that could be treated by good palliative care,
but who had not received such care, information about the quality of
their medical care should be an essential requirement before
approval could be given for the taking of their lives. No draft
euthanasia law in Australia (or elsewhere, as far as the author can
discover) has required these facts to be available for scrutiny - it
is usual to find only a requirement for medical certificates. These
concern opinions, not facts. Thus, the doctor’s actions would be
unsupervised at the time and could not be reviewed later. Only open,
expert scrutiny of a patient’s medical care, before euthanasia was
carried out, could satisfy the community’s need to be assured of a
doctor’s good judgment and probity.
The community at present properly demands the highest standards of
supervision, even when the state has the power to take life. Open
hearings, legal representation, avenues of appeal and mechanisms for
review are supplied before permitting any legal taking of life, even
when deciding the fate of convicted criminals, such as serial
killers. In contrast, draft euthanasia bills fail to offer more than
token protection for the seriously sick. When examined, their only
really effective safeguards are found to be those that protect
doctors from civil or criminal action, after euthanasia.
- Pain and suffering cannot safely be made the basis for taking
life because they cannot be measured or compared.
Although palliative care doctors insist that it is not necessary to
take life in order to relieve pain, a common reason given by other
doctors for wanting VE is to relieve pain. It must be presumed that
some doctors take life to relieve the pain that could have been
relieved by experts, but who are not consulted. Even many advocates
of VE now concede that unrelieved pain is probably no longer
sufficient justification for taking life. Among the reasons given
for euthanasia in the Netherlands, the relief of pain is not
If pain were a genuine reason to take life, it could not rationally
be restricted to the pain of terminal illness, since many other
causes of pain are equally distressing.
The mental anguish or suffering associated with life-threatening
illness requires different strategies for its management, but it too
usually responds to good emotional support. Suffering is evident in
a wide range of human conditions, since it is an existential
problem, not a medical problem. It has many causes, only some of
which are of medical origin, even in those with terminal illness.
Most of the causes of suffering are social, requiring understanding
of the underlying social, relational and cultural factors.
If suffering were a genuine reason to take life, it could not be
restricted to those with terminal illness, since many others causes
of suffering are equally distressing. To allow it as a reason would
not only be discriminatory, it would be tragic and a gross abuse to
empower doctors to take life for what would commonly be chiefly
Neither pain nor suffering can be objectively measured or compared
between persons, and so, neither could be subject to the objective
standards on which sustainable, just public policy would need to be
based. What one person can bear, another finds intolerable.
Everything would have come down to the opinion of the patient, based
on his/her personal characteristics.
If VE were legalised while the prevailing standards of palliative
care were as patchy and unpredictable as they are at present, it
would be inevitable that some lives would be taken on account of the
medical ignorance of the doctor, even though effective treatment was
available. The conclusion is inescapable that such a situation is
the probable cause of at least some of the known instances of
illegal euthanasia at present, and this would not change, even
though the law was changed, in the absence of a widespread
correction of the present medical deficiencies in palliative care
training and practice.
- A right to involve another person in one’s intentional killing
does not exist.
Autonomy has already been discussed, including the point that
personal autonomy cannot be extended to others. A right to ask
another person to take one’s life is not found in any code of ethics
or the law or in any statement of human rights. Despite this, such a
right is often confidently asserted, even claimed to be ‘sovereign’
or ‘supreme’, entirely without warrant. The fact that it is not more
often challenged is a reflection of how little is commonly known
about rights. Failing its validation by argument, this putative
right must continue to be seen for what it is - no more than a wish.
Nor is there a ‘right to die’, if by that one means a ‘right to have
one’s life taken on request’. There is however a genuine right to
die, by which dying persons are entitled to expect that they will be
afforded every comfort in their dying, and when it is in their
interest to die, not to have their dying unnecessarily impeded.
VE is sometimes said to be permissible as an expression of a claim
to privacy, as though it were a matter only of importance between
patient and doctor. If a doctor agreed to perform euthanasia, it
could only be because he/she had concluded that that life had lost
sufficient value - nobody would destroy a life they valued. But if a
doctor became comfortable with the idea that it was acceptable for
him/her to assign low value to certain patients’ lives, backed by
law, that could be fateful for others of his patients who were in a
similar state, but who had not asked to die. He/she would be
entitled to interpret any discussion of euthanasia in positive
terms, ignoring the evidence that many such discussions are
initiated by patients in their desperate need to have their lives
affirmed, not rejected. It is well known that to-day’s medical
systems increasingly depersonalise patients.
- It would never be certain that a request to be killed was
There are no criteria for detecting undue influence on another
person, and doctors are no better able to do so than other people.
When considering euthanasia in 1982, the Canadian Law Reform
Commission observed that coercion would be ‘an ever present
possibility’.  The report of the House
of Lords declared ‘It would be next to impossible to ensure that all
acts of euthanasia were truly voluntary, and that any liberalisation
of laws would not be abused’. Coercion, particularly if it were
subtle, would be very difficult to detect with certainty, and would
be impossible if concealment was really wanted.
But would it be likely? After a long inquiry into mental health, a
former Australian Human Rights Commissioner said he had discovered
that the sick were already ‘the most systematically abused, and the
most likely to be coerced’. 
To be seriously ill has been described as being in the
‘quintessential state of vulnerability’. Doctors can act coercively
even without intending it. Regarding the sexual abuse of patients by
doctors, a newspaper editorial claimed ‘Even apparent consent is
coerced by the power of the professional person in whom the client
has placed his or her trust’. The imbalance in power between patient
and doctor is far greater than is usually supposed. Just as a
doctor’s response can forestall suicide, a doctor’s ready acceptance
of a patient’s request to be killed can encourage that outcome, and
make the patient feel abandoned.
In such an environment, a patient’s request for euthanasia could
never be guaranteed to be voluntary.
- It would never be certain that a request was informed.
Although a draft VE law may require a doctor to inform the patient
of the different treatment options, their effects and their likely
chances of success, this information will be given in private.
Unless an independent, informed observer was present on every
occasion, it could never be known whether the information was
adequate, correct, unbiased and/or non-coercive. If anyone wished
later to check, the only other witness would not be available. Many
doctors do not know enough about palliative care - how could they
give adequate information about it?
Doctors are often subject to significant stress in dealing with
terminally ill patients and their families, arising from frustration
at being unable to cure, from uncertainty when faced with difficult
problems for which they have not been prepared by their training,
and subject to competing and perhaps unfair pressures from
distracted patient and family. To suppose that all doctors will
behave rationally in these emotionally charged situations is itself
irrational, and it would be dangerous to presume it.
- Even in terminally ill patients, a persistent wish to die is
abnormal, while the diagnosis of the underlying psychological
disturbance is hard to make and is often missed in those already
under medical care.
The true nature of a sustained wish to die, even in the dying, is
widely misunderstood, too often being accepted as a natural response
to the threat of death. Many persons with terminal illness have
suicidal ideation at some time, but never attempt or commit suicide.
The great power of fear was revealed in a study that found that more
people over 50 committed suicide in the mistaken belief that they
had cancer than among those who actually had cancer and committed
Factors that are consistently found to be strongly associated with a
sustained wish to die include: unrelieved severe distress due to
pain or other symptoms, previous psychiatric disorder or history of
suicide attempt, and the presence of depression or despair.
Depression is widely under-diagnosed and under-treated in the
elderly, being mistaken for a natural response to aging or dementia.
Treatment for depression can remove suicidal ideation in up to 90%
of these patients.
The significance of these facts is only half grasped when it is
supposed that having a psychiatrist see the patient will provide an
effective safeguard. In a recent poll of psychiatrists, only 6%
thought they could properly assess mental status in a single
consultation. More importantly, only those psychiatrists with
training with terminally ill patients will be able to make these
diagnoses with confidence in these circumstances.
One experienced Professor of Psychiatry maintains that if these
patients were always seen by a psychiatrist with the appropriate
training, ‘euthanasia would virtually never take place’.
 The scope for abuse in this area would
Nor are doctors immune to the high emotional content of their
patients’ situation. A committee of psychiatrists, established in
the Netherlands to assist and counsel doctors faced with requests
for euthanasia, reported that ‘without such consultation, the
professionals would often have assisted suicide, even though viable
treatment alternatives were available, because of an emotional
involvement with the patients’. This caused an American
psychiatrist, an expert on suicide, to comment: ‘One suspects that
those doctors who are most emotionally involved in euthanasia, and
most interested in performing it, may be those who whose own needs
in the matter should disqualify them.’ 
This important point was emphasised by the comment of a forensic
psychiatrist: ‘I have, on more occasions than I care to recall,
failed professionally to recognise depression because I have been
caught up in, and dazzled by, the tragedy of my patient’s life. I
have accepted their wish for death as a rational and proper desire
only to see these desires melt away with their depression
when...less involved colleagues treated the process in which the
patients were trapped.’ 
- Progression from voluntary to non-voluntary euthanasia would be
Non-voluntary euthanasia (NVE) is discussed more fully in a separate
paper, but the core of the message in this title may be simply
stated. While VE is regarded by many as a compassionate act, it is
assumed that taking life without a patient’s expressed wish or
consent could only be motivated by some degree of malice. How then
could the known incidence of NVE in the Netherlands, United States
and Australia be explained, since doctors are not malicious people?
It is because such life taking is seen by its practitioners as an
exercise in beneficence. Once taking life on request is regarded as
a benefit for that person, it can be thought unfair and
discriminatory to withhold that benefit from others who are in a
similar plight, just because they cannot ask. That view is logical,
if taking life truly supplies a benefit.
No arguments have prevailed to prevent the spread of one practice to
the other, and no guarantee could be given that such extension would
not occur wherever and whenever VE was introduced. Lawmakers can
never guarantee that the law they make will not be modified, perhaps
in ways which they could not foresee and would oppose, by subsequent
lawmakers. In fact, by making the first exception to the principle
of universal protection for innocent human life, they would have
created the first precedent for change.
It is sometimes heard that it would be better to have a law to
regulate euthanasia practice, even though that law may not be
perfect, than to persist with the present position, where euthanasia
is practised in secret, without control. That raises several points.
First, there is currently a law to regulate euthanasia - it is the
criminal code, which forbids euthanasia as a form of murder, though
that law is not commonly invoked. This is because hard evidence is
not easy to obtain and the community properly sees a distinction
between mercy and malice, even though motive is not taken into
account by the law. Thus, euthanasia is presently practised by
lawbreakers, who put their own view of their duty above the law,
while other practitioners find their duty in the same circumstances
fulfilled by different means, such as good palliative care. The
former respond to the patient’s demands, while the latter look to
the demands of the patient’s illness.
Second, there is already a proven incidence of secret NVE at the
hands of doctors who also carry out VE, because, as stated, they
believe it to be compassionate also. Because they include NVE in
their concept of duty to certain patients, there could be no
guarantee that a law that allowed only VE would not also be
disregarded by them. In fact, it would be foolish not to expect it.
Third, given the common finding by inquiries that the lives of other
vulnerable sick people could not be protected by any VE law, the
House of Lords Committee thought that more lives could be put at
risk by such a law than is the case at present. Because abuse would
be undetectable, often if not usually, it could then appear to
observers that matters had improved, when they had actually
deteriorated. To expose the most vulnerable patients to this risk
should be seen as unacceptable.
A number of important factors, hitherto ignored or misunderstood in
the debate about the legalisation of VE, have now been revealed in
several large studies. They concluded that no such law could be
guaranteed to be free of the possibility, if not the likelihood, of
abuse, chiefly centred on the lives of other sick persons who did not
want their lives taken. An especially dangerous aspect is that such
abuse may be easily made undetectable. Thus, impartial observers may
believe that a particular law was safe, while many or even every one of
its subjects were in fact victims of abuse.
The medical loopholes listed above would alone have justified the
common finding of the inquiries, that legalisation would be dangerous.
Rather than seek recourse to medical life-taking, all doctors with
responsibility for the care of terminally ill patients should accept
their duty to deliver this care at the known best standards, as they are
legally obliged to do in other branches of medical practice. That means
they will familiarise themselves with the principles and practices of
palliative care, at the standard required of their peer group, and when
for any reason they cannot do that, they will refer their patients to
others who can. If they have remaining doubts about the evidence
regarding the abuse of euthanasia law, they should acquaint themselves
with the contents of the reports listed in this paper, before supporting
further attempts to legalise VE.
- Select Committee on Medical Ethics. House of Lords.
January, 1994. Back to text.
When Death Is Sought - Assisted Suicide and Euthanasia in the
Medical Context. The New York State Task Force on Life and
the Law. May, 1994.
Back to text.
- Of Life and Death. Report of the Special Senate Committee
on Euthanasia and Assisted Suicide. Senate of Canada. June 1995.
Back to text.
- Report on the Need for Legislation on Voluntary Euthanasia.
Community Development Committee, Parliament of Tasmania. June 1998.
Back to text.
- Gormally L. Why the Select Committee on Medical Ethics of the
House of Lords Unanimously Rejected the Legalization of Euthanasia.
Proceedings of a Seminar held at St Vincent’s Hospital, Sydney. 10
November 1995. Back to text.
- Jackson J. Hobart Mercury. 5 June 1998.
Back to text.
- Working Paper 21, Euthanasia, Assisting Suicide and
Cessation of Treatment. Law Reform Commission of Canada. 1982.
Back to text.
- Burdekin B. Sydney Morning Herald. 21 October 1993.
Back to text.
- Varghese F. The Australian. 6 June 1995.
Back to text.
- Hendin H. Seduced by Death: Doctors, Patients and the Dutch
Cure. Issues Law Med. 1994. 10; 123-168.
Back to text.
- Zalcberg JR, Buchanan JD. Clinical Issues in Euthanasia. Med
J Aust. 1997. 166: 150-152. Back to text.
Pollard, Dr. Brian. “The Legalisation of Euthansia.” NSW Website
Published by permission of Dr. Brian Pollard.
Dr. Brian Pollard is a former anaesthetist (anesthesiologist) who
founded and directed, from 1982, one of Australia’s first palliative
care services. Dr. Pollard is the author of The Challenge of Euthanasia
and is involved in active opposition to legalised euthanasia in
Copyright © 1999
NSW Right to Life Association