The newly established Justice and Peace Group, based at St John the Baptist Church in Andover, met to discuss the Draft Mental Incapacity Bill with Sir George Young.
The meeting was chaired by Jeremy Lelean, who introduced the subject, and he was assisted by Michelle Bradford, who had done intensive background research into the subject. About 30 members of the congregation attended.
Speaking about the Bill, Sir George said
"The Bill tries to navigate through very difficult waters. On the one hand, there are the rights of all of us as individuals to have our own wishes respected and to make meaningful and responsible decisions about our own lives and destinies. On the other hand, there are the obligations of doctors, nurses and the health professionals, whose job it is to care for us, to act professionally, ethically and lawfully. And then there is the position of our closest friends and family to whom we may have given responsibility to interpret our wishes, if anything happens to us. And then, above all of that, are some important moral issues to do with life and death that help define the sort of society we live in.
There is much in the Bill that is worthy and uncontentious. The difficult bit is about Advance Directives.
What is an advance directive or living will? Basically, it is a statement, oral or written, which we may make about our future medical treatment in case we may be unable to express that wish ourselves – because we have had a stroke or we are in a coma or otherwise cannot communicate.
In that directive, we cannot force a doctor to provide a particular treatment – that is a matter for his clinical judgement – though we can indicate a preference. Nor can we make a doctor do something illegal, like carry out euthanasia or assisted dying. What we can do is sign up to an anticipatory refusal of treatment. If this happens, I don’t want that treatment.
These are legally binding not because Parliament has said so, but through case law. If the person who made the decision understood the implication of their decision, and that decision is applicable in his or her case, then society is obliged to respect it.
The relevant House of Lords judgement says this “It is unlawful to administer medical treatment to an adult who is conscious and of sound mind without his consent. Such a person is completely at liberty to decline to undergo treatment, even if the result of his doing so is that he will die. This extends to the situation where the person, in anticipation of his entering into a condition such as Persistent Vegetative State, gives clear instructions that in such event he is not to be given medical care, including artificial feeding, designed to keep him alive.”
It must be an informed choice and free from pressure.
The Draft Mental Incapacity Bill was published in June last year. It basically codifies, or puts into statute law, what is currently case law.
I understand the concern that putting an advanced directive into law might be seen as a worrying move towards voluntary euthanasia. I want to make it clear that I am opposed to euthanasia.
Why legislate? There is a lack of clarity at the moment – families and friends have no legal right to be involved in making decisions. And there is a lack of clarity about for example incapacity.
The Bill defines lack of capacity. There would also be a statutory duty for anyone making decisions on behalf of a mentally incapable person to act in their best interests.
The Bill codifies the present position while at the same time proposing to increase safeguards.
I know that there are concerns about the Bill, set out by the Catholic Bishops Conference. I want to listen to those concerns now and see how the Bill, when it is finally introduced, might be amended to meet them. Those concerns relate to improvements in medical treatment after someone has made an advanced direction. There is concern about undue pressure being exercised on the individual while they are still capable."
Sir George said he found the subsequent discussion very helpful. "I have a much clearer view of the concerns of the Catholic church. Many present believed that advance directives should be written, not oral. And that there might be difficulties with those who had suicidal tendencies. I hope we can renew the discussion if and when the government plans to make progress with the Bill. I am most grateful to Jeremy and Michelle for organising the meeting, along with John Corney who was on holiday on the day."