RCGP Chairman Clare Gerada moves to gag doctors on 'assisted dying'

I’ve had a flurry of correspondence recently from GPs expressing deep concern at RCGP Council Chair Clare Gerada’s recent move to shift the College to a neutral position on 'assisted dying'.

Dr Gerada’s latest newsletter devotes four paragraphs to the issue which she has placed on the agenda for the February 2013 meeting of the Royal College of General Practitioners’ governing body.

She has now published an editorial written ‘in a purely personal capacity’ in the December edition of the Journal of the British Journal of General Practice (BJGP) (£) which was mailed to members this week.

In it she argues that that:

‘all Royal Colleges and Medical, Nursing, and other, umbrella medical organisations should… take a neutral stance on the issue of assisted dying and should not be publicly opposed to or support any change in legislation that may allow assisted dying for terminally ill, mentally competent adults.’

Her conclusion is that:

‘Parliament, not the profession, must decide this issue, based on their experience, knowledge, wisdom, and taking into account the views of their constituents.’

Although she seems not to be an official member Gerada’s line is exactly that taken by the pressure group ‘Healthcare Professionals for Assisted Dying’, a subdivision of Dignity in Dying (the former Voluntary Euthanasia Society).

This group’s members deluged the British Medical Association’s Annual Representative meeting last June with a battery of almost identically worded motions seeking to move the doctors’ trade union to a similarly neutral position.

The move spectacularly failed but was supported prior to the meeting by a concerted campaign waged through the pages of the British Medical Journal by editor Fiona Godlee working in close cooperation with HPAD and DID.

Gerada has re-run most of the same arguments, without reminding readers of this recent history.

She quotes a controversial survey of GP opinion commissioned by Dignity in Dying and employs the ‘hard cases’ of Ann McPherson, founder of HPAD, and Tony Nicklinson, a severely disabled man who died recently after an unsuccessful high profile court case, as reasons to revisit the law.

She uses throughout her article the propaganda term ‘assisted dying’, a vague euphemism which was coined by DID and has no actual meaning in law, but which is widely accepted as a blanket term covering both euthanasia and assisted suicide.

Given that Nicklinson’s case was an attack on the law of murder (and not the Suicide Act) in so doing she implicitly includes within her remit euthanasia as well as assisted suicide.

Gerada refers to Lord Falconer’s highly controversial ‘commission on assisted dying’, which concluded that 'there is a strong case for providing the choice of assisted dying for terminally ill people', as ‘independent’ and mentions that she herself gave evidence to it.

What she neglects to tell us is that this ‘independent commission’ was conceived by Dignity in Dying, financed by one of its Patrons Terry Pratchett, chaired by Falconer himself who had previously tried to decriminalise assisted suicide in an amendment to the Coroners and Justice Bill in 2009 and composed of well recognised members of the pro-euthanasia lobby, with 11 of its 12 members having previous form.

She also neglects to tell us that 46 individuals and 40 organisations who were invited to give evidence to Falconer's commission refused to do so. These included the RCP, RCN, RCPsych and the BMA, who later passed a motion expressing concern about bias.

The pro-euthanasia lobby are well aware that one of the major barriers to legalising assisted suicide and/or euthanasia is the opposition of the medical profession to such a move. This is why they worked hard in 2005 to move the RCP, RCGP and BMA to a neutral position prior to the introduction of the Joffe Bill in 2006.

That bill was defeated and all three medical bodies were turned back to opposing any change in the law during 2005-6 after grassroots members expressed concern about the direction that their respective leaders were taking them.

Gerada will be well aware that in 2013 two new bills seeking to legalise assisted suicide will be coming before the House of Lords and Scottish Parliament respectively. She will also be well aware that the ‘Martin’ case, that of another patient with ‘locked in’ syndrome seeking doctors’ help to end his life, will come before the Court of Appeal.

Neutralising medical opposition ahead of these events is therefore an attractive campaigning option.

Gerada claims that doctors should only speak on areas ‘where we have an expertise that goes beyond that of the public; for example, advising on the necessary safeguards and codes of practice should any law be passed, and on matters such as assessing prognosis and setting guidelines for optimal end-of-life care.’

She argues that doctors ‘should be concerned with areas of regulation, monitoring, and establishing criteria for implementation of the law, not whether the law should happen or not.’

But in reality the specific insights that doctors have into difficulties of diagnosis and prognosis, into the question behind the question, into coercive confounders and the vulnerability of disabled, elderly and dying patients are very strong arguments against legalisation and the public does not have this same expertise. Doctors also, more than the general public, appreciate the political and managerial and pressures that could be brought to bear were assisted dying to become a cheap ‘therapeutic option’.

It is not therefore surprising that a clear majority of doctors have consistently opposed a change in the law on grounds that pressure would be placed on vulnerable people to end their lives and that we should rather be promoting good palliative care. Moreover the Hippocratic Oath itself contains the statement, ‘I will give no deadly medicine to anyone if asked nor provide such counsel’.

In view of these facts it seems extraordinary that the chairman of one of Britain’s leading medical bodies should be advising that doctors absent themselves from this crucial debate.

As those who would be administering the lethal prescriptions, and working in a system in which such an approach became yet another ‘option’ to be considered, doctors have not only a right, but even more a duty to be fully involved at the forefront of these discussions

Can we imagine someone in Gerada’s position suggesting that the health and Social Care Act, GP commissioning and the privatisation of the health service should be a matter for parliament only to decide? Why then assisted suicide and euthanasia?

Gerada’s neutrality approach got short shrift from the BMA last summer, and I suspect that once grassroots members get wind of it, it will get short shrift in the RCGP.

She is of course fully entitled to her personal opinions but many doctors would feel that she should not be using her influence as chairman to inflict these personal views on the governing body of the RCGP.

With the health service straining under the pressures of reorganisation and financial cuts and all the publicity around bad care and the neglect of elderly patients, one would have thought that there were far more important matters for the RCGP Council to consider than whether or not doctors should be helping to end their patients’ lives.

Giles Fraser says conservative evangelicals are 'extremists' who should be ignored

Giles Fraser is a Church of England priest who was Canon Chancellor of St Paul's Cathedral from 2009 until 2011 and is now the parish priest at St Mary's, Newington.

He contributes to BBC Radio 4's Thought for the Day and writes a weekly column in the Church Times.

He does not like conservative evangelicals.

In an article he wrote for the Independent in 2008, ‘Enough is enough. The extremists must be confronted’, Fraser argued that the Church of England ‘is fundamentally a theological peace treaty’ which was created so that ‘those of widely different philosophies could kneel together and worship God through the appropriately named Book of Common Prayer’

It is perhaps worth noting at this point that the imposition of the prayer book in 1662 led to over 2,000 dissenting ministers being expelled from the church in the ‘great ejection’ meaning that they were not included amongst 'those of widely different philosophies'.

Fraser says that this ‘peace treaty’ idea, however, was not exported abroad with the result that Anglicans in many other parts of the world are ‘hotter and more ideological’.

‘Conservatives’, he argues, have now ‘decided that they can exploit the deep homophobia of many African Christians in order to stage a coup for the soul of the church’. ‘Suddenly’, he says, ‘we are once again fighting the unresolved battles of the Reformation, with narrow-minded puritans seeking to impose their joyless and claustrophobic world-view on the rest of the church’.

He concludes, ‘the open space that is the traditional mark of the English church is being undermined by a determined minority of well-funded extremists. It is time for (Archbishop Rowan Williams) to fight back.’

He writes about ‘conservative evangelicals’ with even more passion in the Guardian this week, this time on the subject of women bishops.

The article is provocatively titled ‘The puritans who scuppered female bishops revel in our criticism of them’ and argues that ‘Conservative evangelicals cannot be argued with. The more we say they're wrong, the more convinced they become they're right.’

In case you missed it, the Church of England voted last week on whether to allow the appointment of women bishops. Of the three houses in General Synod, two, those of bishops and clergy backed the move by large majorities, but the house of laity failed by just six votes to achieve the two thirds majority required and the motion accordingly failed.

The 74 members of the laity who voted against were largely anglo-catholics or conservative evangelicals.

Fraser’s latest piece is an attack, not on conservative evangelicals’ arguments, but on conservative evangelicals themselves. It is almost purely ad hominem. In his own words:

‘I am trying to paint a picture of the mentality of conservative evangelicals, the people who have recently scuppered the female bishop legislation, without invoking the standard caricature of these modern-day puritans as life-denying fun-sponges obsessed with being right and with other people not having sex. Not that this latter image is all that far from the truth…. the more we laugh at puritans, the more it confirms their worldview (that) the more hated you are, the more right you are… (this) is why the opprobrium that is currently being poured upon conservative evangelicals for voting against women bishops will make no difference whatsoever. It confirms them in feeling right.’

He goes on to accuse conservative evangelicals of experiencing ‘as some sort of secret pleasure’ the fact that ‘they have put a spanner in the works for everyone else… For the essence of the puritan mindset is revenge – as Nietzsche accurately described it, the revenge of the bullied who are subconsciously getting back at those who once made their life a misery.’

‘So what can be done?’ he concludes:

‘Argument is pretty useless. Conservative religious people are generally locked in a self-referencing worldview where truth is about strict internal coherence rather than any reaching out to reality… So rather than laugh at them or argue with them, the best thing is probably ignore them.’

I am not currently a member of an Anglican church (the fellowship to which I belong was thrown out of the Anglican communion 350 years ago)and am not here expressing an opinion on the issue of women bishops, but I am deeply concerned about what I see as a growing trend within the wider church to marginalise and sideline conservative evangelicals as ‘extremists’ who are not capable of intelligent debate.

I know personally several members of synod who in good conscience exercised the democratic right the church grants them to vote against women bishops. They came to their view in good faith after careful examination of the Scriptures and argued their position in democratic debate. They do not share Fraser’s views, but they are equally members of the Church of England and hold their views with sincerity and conviction. Fraser, it seems, would prefer it if they were not members of the church at all.

Last October, when Occupy London based their protest against capitalism outside St Paul's Cathedral, Fraser said that he was happy for people to ‘exercise their right to protest peacefully’.

He then resigned as he could not sanction any policy of the chapter of St Paul's to use force to remove the protesters. He defended his actions by saying that ‘The Church should not put its name to any course of action that may lead to violence against the protesters. I can't in conscience go down the road on which they are embarked.’

Fraser seems to apply two different sets of rules to these two groups. ‘Anti-capitalism’ protestors outside the church are to be treated with the greatest respect. In fact any move to stop them protesting is a resigning issue for him.

But by contrast, when dealing with ‘conservative evangelicals’ within the church, it is justifiable to mock and ridicule their sincerely held views, accuse them of ulterior motives, misrepresent their beliefs, attack their characters and, rather than try to understand and engage with their arguments, encourage others to ignore them.

Fraser is perfectly entitled to hold and express his personal views and his frustration that all others do not share them is perhaps understandable. But demonising one’s opponents in a national newspaper, rather than engaging seriously with their arguments, is not a constructive way forward even for worldly politicians.

It will rather serve only to exacerbate existing tensions.

Changing Ireland’s abortion law will not save any mothers and could lead to 11,000 more abortions annually

Savita Halappanavar was an Indian woman who tragically died on 28 October in Galway University Hospital, Ireland from overwhelming infection after allegedly being denied an abortion.

Her death, on 28 October, is now the subject of two investigations by Ireland's Health and Safety Executive (HSE) and by University Hospital Galway.

The death has led to an international campaign calling for Ireland’s abortion laws to be changed.

Currently abortion in Ireland is illegal under section 58 and 59 of the Offences against the Person Act 1861.

However in 1992 Ireland’s Supreme Court ruled in the X case that abortion is admissible in the case of a ‘real and substantial risk’ to the mother’s life (as opposed to her health).

Section 21.4 of Ireland’s Guide to Professional Conduct and Ethics for Registered Medical Practitioners also recognises that in exceptional circumstances, it may be necessary to intervene to terminate the pregnancy to protect the life of the mother.

So both Irish law and Irish medical professional codes already allow abortion to save the life of the mother (see detail on my earlier blog).

As I have previously argued if faced with a choice between intervening to save one life (that of the mother) or standing by and allowing two (both mother and baby) to die, then I would have no hesitation in intervening and have previously already done so in the case of ruptured ectopic pregnancy.

I have never heard a doctor say he or she would not intervene in this type of situation although some such doctors might possibly exist.

Thankfully bringing a pregnancy to a premature end in order to save the life of the mother is vanishingly rare. In the UK it was reported in 1992 that in the first 25 years of the operation of the Abortion Act 1967 only 0.013% of all abortions were performed 'to save the life of the mother' and it is even questionable whether many of these required such radical action.

Some people are arguing (for example see Jen Gunter’s blog) that this is a case of negligence or mismanagement and they may well be right. But there are already disputes about the real facts of the case as well documented here.

Personally I would like to see the full report before coming to a conclusion rather than relying solely on the testimony of Savita’s bereaved husband as reported in the Irish Times and Spectator.

But the real issue is whether Ireland’s law needs changing as a result of this case.

The issue has come to a high boil after the European Court of Human Rights issued a ruling in the A,B and C case saying that Ireland must ‘clarify’ under what circumstances abortion could be legal under the current law.

While the Court did not say that Ireland must legalise abortion, this has not stopped abortion activists from insisting that abortion be declared legal. The report on abortion’s legal situation by the government’s expert group, which has been expected imminently for months, was reportedly delivered to the Health Minister on Tuesday.

Minister for Health James Reilly has confirmed he will be bringing the report of the expert group on abortion to Cabinet on Tuesday week but said that it could be early 2013 before a clear Government position is made.

Amnesty International has also called on the Irish government to change the law.

Prochoice activists around the world, who were circulating emails announcing the case before it even appeared in the newspapers, have meanwhile mobilised people to protest in Irish cities and outside the Irish Embassy in London.

But it is clear that many of these groups are seeing this case as an opportunity to advance a much more radical agenda.

53 MEPs have signed a letter asking Ireland to legalise abortion when the mother's 'life or health' is at risk. This would be a quantum shift to a law like Britain's which has resulted in over seven million abortions since 1967.

The abortion ‘provider’ ‘Planned Parenthood’ is running a campaign to ‘support a woman’s right to make her own medical decisions’ which sounds to me like an appeal for abortion on request (see tweet below).

Remember #Savita. Support a woman's right to make her own medical decisions. ow.ly/i/18hwN @ppglobe

— Planned Parenthood (@PPact) November 15, 2012

Similarly ‘Education for Choice’ is asking its supporters to write to the Irish Prime Minister (Taoiseach) saying that ‘This tragic case demonstrates once again that the prohibition of abortion in Ireland is not just undermining the autonomy of the women across the country, it is leading to unacceptable suffering and even death’.

The pro-abortion group ‘Population institute’ has said that the case ‘is a tragedy that should never have happened, and unfortunately it is not an isolated incident. Tragedies like this happen every day in countries where abortions are illegal or highly restricted.’

So is it really true that tragedies like this happen ‘every day’ in Ireland? This is actually a very easy question to answer as maternal mortality statistics are readily available.

The maternal mortality rate (MMR) is the annual number of female deaths per 100,000 live births from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes). The MMR includes deaths during pregnancy, childbirth, or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, for a specified year.

Ireland actually has one of the lowest MMRs in the world at just six deaths per 100,000 live births. This compares with 12 in the UK, 15 in the US and 200 in India.

As there are about 75,000 live births a year in Ireland this means that there are an average of four maternal deaths per year from all causes.

So to suggest as the Population Institute does that ‘tragedies like this happen every day in countries where abortions are illegal or highly restricted’ is a gross misrepresentation of the truth.

In other words, despite the fact that abortion is illegal in Ireland, there are very few places where it is safer to have a pregnancy or delivery. The standards of Irish medical care are very high indeed.

Now it may transpire after this case has been fully investigated that there has been mismanagement or negligence but that will not be an argument for a change in the law if the object is really saving women’s lives.

But what about pre-born babies' lives?

We know from Department of Health Statistics that 4,149 women with Irish addresses had abortions in Britain last year. By contrast there are about 200,000 abortions in Britain each year involving women from England (189,000) and Wales (12,000).

Just under 4.6 million live in the Republic of Ireland as against 60 million in England and Wales. So if Irish women were having abortions at the same rate as English and Scottish women there would be not 4,149 a year but over 15,300.

In other words abortion being illegal in Ireland saves over 11,000 Irish pre-born babies from abortion every year (This assumes that a change in Irish law will mean that Irish abortion rates will approach British rates – a not unreasonable assumption given how British rates have escalated in spite of what is on the surface a very restrictive law).

If the law did change Ireland would probably still have a maternal death rate that was well below that in the UK (6 per 100,000 live births versus 12 per year 100,000 per year), that is, a total of four maternal deaths annually (that is if no women then die as a result of abortion).

But there would be thousands more babies who would lose their lives.

Of course if you think a preborn baby is nothing other than detritus then that won’t bother you.

But if you think it is worth anything at all then you will support the law in Ireland staying as it is.

Savita’s tragic death is not a reason to change Ireland’s law on abortion

Savita Halappanavar (pictured) was an Indian woman who tragically died in Ireland from overwhelming infection after allegedly being denied an abortion.

The ‘facts’ (yet to be confirmed) have been reported as follows:

‘On October 21, Savita Halappanavar visited Galway University Hospital, Ireland. The 31-year-old dentist was 17 weeks pregnant and suffering terrible back pain. Savita was told that she was having a miscarriage, so she requested an abortion. The doctors denied her request because they said that they detected a foetal heartbeat and that Irish law ruled out a termination. Savita’s pain continued for three days and she eventually died of septicaemia.’

The case has predictably evoked much criticism from the pro-choice lobby of the Irish abortion law, the Irish medical profession and the Catholic faith.

Savita’s death, on 28 October, is now the subject of two investigations by Ireland's Health and Safety Executive (HSE) and by University Hospital Galway.

I am reluctant to comment on the case itself before the full facts are established but there is a useful review of the medical management of mid-trimester miscarriage on Jen Gunter’s blog.

The judgement of whether there was mismanagement will turn ultimately on the actual sequence of clinical events and the management decisions made. Even then it may not be possible to know whether ending the pregnancy would have saved Savita's life.

Regardless, however, this case is not a reason to change Irish law or Irish medical guidelines because, even if inducing premature labour had indeed been necessary in order to save Savita's life, both law and guidelines would already have allowed this course of action. In addition many Christians, both Catholic and evangelical, would also have supported it.

The Irish law on abortion

Abortion remains illegal in Ireland under section 58 and 59 of the Offences against the Person Act 1861. However in 1983 the Irish electorate approved the Eighth Amendment to the Constitution of Ireland by referendum. It inserted the following paragraph into the constitution:

‘The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right.’

In 1992, Ireland’s Supreme Court ruled that it had jurisdiction derived from the constitution to allow abortion in the case of a ‘real and substantial risk’ to the mother’s life. This right did not exist if there was a risk to her health but not her life.

So if the doctors caring for Savita had felt that the continuance of the pregnancy posed a ‘real and substantive risk’ to her life the current law would already have allowed them to induce the baby’s premature delivery to save her.

Irish Medical Guidelines

Section 21.4 of Ireland’s Guide to Professional Conduct and Ethics for Registered Medical Practitioners would also have allowed this course:

'In current obstetrical practice, rare complications can arise where therapeutic intervention (including termination of a pregnancy) is required at a stage when, due to extreme immaturity of the baby, there may be little or no hope of the baby surviving. In these exceptional circumstances, it may be necessary to intervene to terminate the pregnancy to protect the life of the mother, while making every effort to preserve the life of the baby.'

At 17 weeks gestation the baby, even if it is alive at the time labour is induced, is too young to survive. But again Irish medical guidelines would not have stopped doctors inducing labour to save the mother's life.

In 2000, Professor John Bonnar, then chairman of Institute of Obstetricians and Gynaecologists, which represents 90%-95% of Ireland's obstetricians and gynaecologists, explained the situation to the All Party Oireachtas Committee's Fifth Report on Abortion as follows:

'In current obstetrical practice rare complications can arise where therapeutic intervention is required at a stage in pregnancy when there will be little or no prospect for the survival of the baby, due to extreme immaturity. In these exceptional situations failure to intervene may result in the death of both the mother and baby. We consider that there is a fundamental difference between abortion carried out with the intention of taking the life of the baby, for example for social reasons, and the unavoidable death of the baby resulting from essential treatment to protect the life of the mother.'

'We have never regarded these interventions as abortion. It would never cross an obstetrician’s mind that intervening in a case of pre-eclampsia, cancer of the cervix or ectopic pregnancy is abortion. They are not abortion as far as the professional is concerned, these are medical treatments that are essential to protect the life of the mother. So when we interfere in the best interests of protecting a mother, and not allowing her to succumb, and we are faced with a foetus that dies, we don’t regard that as something that we have, as it were, achieved by an abortion.

Abortion in the professional view to my mind is something entirely different. It is actually intervening, usually in a normal pregnancy, to get rid of the pregnancy, to get rid of the foetus. That is what we would consider the direct procurement of an abortion. In other words, it’s an unwanted baby and, therefore, you intervene to end its life. That has never been a part of the practice of Irish obstetrics and I hope it never will be.'

Speaking to the Irish Independent this week clinical professor of obstetrics and gynaecology at the Royal College of Surgeons in Dublin Dr Sam Coulter-Smith confirmed this view:

'I think most of us who work in obstetrics and gynaecology, there may be individual differences, but the majority would be of the view that if the health is such a risk that there is a risk of death and we are dealing with a foetus that is not viable, there is only one answer to that question, we bring the pregnancy to an end.'

Christian ethics

There may be differences of opinion amongst Christian commentators about whether ending a pregnancy to save a mother’s life can ever be ethical. But I was interested to see, for example, that Catholic Voices have argued there is nothing in Catholic teaching that would stop such an intervention.

Personally I would see this as a choice between intervening to save one life (that of the mother) or standing by and allowing two (both mother and baby) to die.

And as Christian doctor, husband and father I would intervene. In doing so I would not be saying that the baby's life is less important than that of the mother, but simply (since the baby will die regardless) that in a desperate situation one must simply try to do the most good one can.

I have personally operated in an emergency to save the life of a mother with a ruptured ectopic pregnancy not knowing whether the embryo, who could not have survived anyway, was alive or dead. I would have no hesitation in doing so again. And in the situation where labour needed to be induced to save the life of a mother in an emergency (as in severe sepsis or eclampsia) I would induce it if I sincerely believed that nothing I could do would save the baby.

Often in such situations, even if the baby is premature, it is sometimes possible to deliver it alive in such a way that the parents can have some short time to bond with it and say their goodbyes. But, even if not, such bonding is equally possible after death.

Thankfully bringing a pregnancy to a premature end in order to save the life of the mother is vanishingly rare. In the UK it was reported in 1992 that in the first 25 years of the operation of the Abortion Act 1967 only 0.013% of all abortions were performed 'to save the life of the mother' and it is even questionable whether many of these required such radical action. The 2009 Abortion Statistics for England and Wales do not report a single case meaning this is a scenario that the vast majority of doctors, and even most obstetricians, will never face in a lifetime of medical practice.

So let’s not be bumped by this extreme case into arguing for a relaxation of the law and professional guidance in Ireland when the existing law and guidance do not actually prevent doctors intervening to save a mother’s life. That would be to start Ireland down the slippery slope to the situation in Britain where we have over 200,000 abortions per year with most performed on grounds of failed contraception, economic difficulty, social inconvenience or unwanted pregnancy.

No, let’s rather support Ireland in upholding a law which is actually the best in Europe for both mothers and babies. It protects babies from abortion with its blanket prohibitions and stiff penalties, whilst at the same time making allowance for intervention to save a mother’s life in an emergency when her baby cannot be saved. And rather than trying to legislate for every situation it allows the courts to dispense justice with mercy in hard cases. It does not need changing.

BBC Panorama findings will heighten calls for review of Tony Bland judgement

Tuesday night’s BBC Panorama told the story of a Canadian man who was believed to have been in a vegetative state for more than a decade, being able to tell scientists that he was not in any pain.

According to BBC health correspondent Fergus Walsh (pictured), it's the first time an uncommunicative, severely brain-injured patient has been able to give answers clinically relevant to their care. He writes:

‘Scott Routley, 39, was asked questions while having his brain activity scanned in an fMRI machine. His doctor says the discovery means medical textbooks will need rewriting.

Vegetative patients emerge from a coma into a condition where they have periods awake, with their eyes open, but have no perception of themselves or the outside world.

Mr Routley suffered a severe brain injury in a car accident 12 years ago.

None of his physical assessments since then have shown any sign of awareness, or ability to communicate but the British neuroscientist Prof Adrian Owen - who led the team at the Brain and Mind Institute, University of Western Ontario - said Mr Routley was clearly not vegetative.

"Scott has been able to show he has a conscious, thinking mind. We have scanned him several times and his pattern of brain activity shows he is clearly choosing to answer our questions. We believe he knows who and where he is."

Prof Owen said it was a groundbreaking moment.’

In a second article on the BBC website Walsh raises questions about the current law which allows vegetative patients to have food and fluids withdrawn after a court order:

‘The case is important because in the past two decades, more than 40 vegetative patients have been allowed to die after High Court judges approved the withdrawal of feeding tubes.

This followed a landmark case involving the young Hillsborough victim Tony Bland,
who was crushed in the stadium disaster in 1989, suffering terrible brain damage which left him in a vegetative state.

Before any judge decides to sanction the withdrawal of treatment, a thorough behavioural assessment is ordered. But they do not ask for brain scans of the type used by neuroscientists in Cambridge and Ontario to search for hidden awareness.

It is possible that may eventually change.

Much will depend on the view of the working party of the Royal College of Physicians which has been reviewing the College's 2003 guidelines on low awareness states.’

People with so-called persistent vegetative state (PVS) may live for ten, twenty or thirty years – in fact the record survival is more than forty.

But since the Tony Bland judgement (picture) in 1992, in which the Law Lords ruled that a young man’s nasogastric feeding tube could be removed with the intention of ending his life, it has been possible in Britain to apply to the courts to withdraw hydration and nutrition from people who are severely brain-damaged but not dying.

But this is possible only for those in PVS and does not apply to other less serious brain damage.

There are estimated to be between 1,000 and 5,000 patients with PVS in Britain today, but so far only 43 have died after court rulings allowing feeding tubes to be removed.

At the time of the Bland case Christian Medical Fellowship expressed serious misgivings about that judgment which we felt crossed a legal rubicon. Three of the reasons for our concern feature in the above account; three concepts embodied in the terms ‘in her best interests’ and ‘further treatment would be futile’.

These terms embrace three important legal precedents established by Bland.

The first precedent is that nutrition and hydration constitute treatment. Our argument was that they constitute rather basic human needs that all of us share. Treatments are aimed at reducing or reversing the effects of an illness. But hydration and nutrition, like air, are simply essential requirements for life. Withdrawing all nutrition and hydration from any human being will result in death. But withdrawing a treatment will only result in the deaths of those who rely on that treatment to stay alive.

The second precedent is that having one’s life actively ended, when one is not actually dying, can be in a person’s best interests. But that is a philosophical position based on a particular world view. We can only make a judgment that death is in a person’s best interests by starting with a set of presuppositions about the nature of life, suffering, morality and death that lead to that conclusion. Our argument was that we have no right to decide what another person’s best interests are. Or alternatively that if we are in any doubt, then the benefit of the doubt should be in the direction of preserving life. Deciding for another person that it is in their best interests to have their life ended is a very dangerous precedent indeed, especially if that person is unable to express an opinion on the matter.

The third precedent is that providing basic care to a person with PVS would be futile. But nutrition and hydration has a real and measurable effect in that it stops a patient dying from dehydration and/or starvation. So how is it futile? It can only be so if a patient’s continued existence itself is judged to be futile. Our argument was that whilst doctors are justified in deciding whether or not a treatment was futile – in that it had no measurable effect or imposed burdens disproportionate to any benefit – they have no right to make judgments about whether a patient’s life is futile.

The assumptions that nutrition and hydration constitute treatment rather than care, that being starved and dehydrated to death can be in a person’s best interests and that the lives of some people are futile are all false assumptions. They should never have been given legal force. But sadly they have.

Having said that it is important to stress that in 20 years since Bland, some thousands of PVS patients have died of natural causes. So the 43 cases that have been taken to court have been a very small minority. In other words, almost always, the intuitions of family and professional carers are that there is a person there with a worthwhile life, even more reason to toughen up the law.

The Bland judgment was seriously flawed and this new data about PVS patients having awareness will heighten calls for its review. Bland and the 43 others who have died after him should not have died in this way. Just how many of them were aware we will now never know. But regardless they should have been given basic care, including nutrition and hydration, until they died naturally.

'The Mind Reader: Unlocking My Voice' - a Panorama Special - will be broadcast on Tuesday 13 November at 22:35 on BBC One. Or catch up later on the BBC iPlayer using the link above.

Social myths about abortion after rape

The Elliott Institute has just published a powerful article titled ‘My Rape Pregnancy and My Furor Over Social Myths’ by Deana Schroeder, a member of the Ad Hoc Committee of Women Pregnant By Sexual Assault (WPSA).

She recounts the story of being drugged and raped at 17 and then, after becoming pregnant, being persuaded to have an abortion by family, counsellors and doctors who ‘intended the best’ and ‘wanted to help’.

But the result was to add ‘more layers of trauma, self-doubt, grief and guilt’ to the trauma of the rape itself.

Schroeder argues that ‘they had total confidence in the social myth that abortion is the best option, even the only option, in cases of sexual assault’.

She quotes a national study published in 1996 which found that only half of the estimated 32,000 rape pregnancies which occur each year end in abortion.

The fact that so many women choose to give birth after rape, despite the social expectations and pressure to abort, should give us pause, she says : ‘Why aren’t all rape victims embracing the conventional wisdom that abortion is the best treatment for rape pregnancies?’

A hint, she says, is found in another study of 164 women who had rape pregnancies (conducted for the book Victims and Victors) in which the majority of those who had abortions said it only caused additional problems and the vast majority regretted having abortions.

By contrast, among those who delivered the child, satisfaction was higher and none stated any regret for giving birth.

Some people may remember a powerful testimony from 2008 in the Daily Mail: 'I was raped and left pregnant at 16... but I still love my baby'.

'People have been horrible,' said the mother. 'But that just made us more determined to fight for this innocent little child. She had not asked to be conceived, had she? If I have to, I will say that she was the good that came out of something bad. And I will tell her that, however she came to be, I have never ever regretted having her, and I would not be without her for the world.'

With abortion after rape - the issues and emotions involved are not as straightforward as most people presume.

Japanese Robots proposed as solution for declining birthrate, shrinking workforce and increasing elderly care needs

I have previously highlighted Japan’s huge demographic time bomb and the fact that virtually all Western countries now suffer from this same problem to a greater or lesser degree.

In 1950 Japan’s population of elderly citizens (65 years and over) accounted for just 4.9% of the total population. This had risen to 21.5% by 2007 and will rise to 39.6% by 2050.

This growth of older people has been matched by a shrinking of the younger population.

In 1950 those under 15 made up 35.4% of the total population but this had fallen to 13.5% by 2007 and will fall further to 8.6% by 2050.

A series of articles available on line outlines the causes to the problem and some approaches to dealing with it but has also been suggested that robot technology may provide an answer.

Japanese scientists have foreseen many applications for their robots. They could be used in hospitals, provide help for the elderly, be play-friends for children and replace humans in various activities.

Japan wants robotics to be for their 21st century economy what automobiles were for the 20th.

Humanoid Japanese robots characteristics include abilities such as blinking, smiling or expressing emotions akin to anger and surprise. One of the newest Japanese robots, HRP-4C is a female-robot programmed to catwalk.

It walks and talks and with the help of 30 motors it may move its legs and arms. The facial expressions that are capable of are driven by 8 facial motors to make it smile or blink and change the facial expression as a response to anger or surprise.

Take a look at some of the linked you tube videos below to see just where the technology is up to.

The Japanese image of a robot is that of a friendly helper rather than something to be feared or avoided. So it is certainly not inconceivable, as technology improves, that wealthy elderly Japanese without family support (or with absent or unhelpful children) might turn to robots to care for them in old age.

There is already a robot which can tell a forgetful elderly person to take their pills, or not to take them twice.

The Turing test is a test of a machine's ability to exhibit intelligent behavior, equivalent to or indistinguishable from, that of an actual human.

The indications are that Japan is not far off achieving this with some of its more sophisticated robots.

‘Let us make man in our own image’. Now where have I heard that before?

Robot videos

Singing robot

The world’s most humanoid robot

'Sexy' female robot

Robot catwalk model

Most convincing robot woman ever

'Most realistic android ever'

Geminoid Robot looks just like its human master

Obama re-elected. What will it mean for beginning of life policy?

The man whom pro-life leaders have called ‘the most pro-abortion president in US history’ has been re-elected.

Obama snagged the race after taking key swing states, including Virginia, Ohio, and New Hampshire.

Obama’s support for liberal abortion has already been well documented (see here, here and full list of all his actions here).

But what will his re-election mean more generally with respect to issues at the beginning of life? The Hastings Centre in Washington DC has compiled a useful summary.

Cloning

“[W]e will ensure that our government never opens the door to the use of cloning for human reproduction. It is dangerous, profoundly wrong and has no place in our society, or any society.”

Source: The White House website

Abortion

President Obama believes a woman’s health care choices are personal decisions, best made with her doctor—without interference from politicians. He continues to support a woman’s right to choose under Roe v Wade.

Source: Campaign website

Conscience Clauses, Contraception, and Family Planning

The Obama Administration’s Department of Health and Human Services has issued an Advanced Notice of Proposed Rulemaking that “guarantees women access to recommended preventive services including contraception without cost sharing, while ensuring that non-profit religious organizations are not forced to pay for, provide, or facilitate the provision of any contraceptive service they object to on religious grounds.”

Source: Department of Health and Human Services website

Stem Cell Research

“Today, with the Executive Order I am about to sign… we will lift the ban on federal funding for promising embryonic stem cell research. We will vigorously support scientists who pursue this research. And we will aim for America to lead the world in the discoveries it one day may yield…Medical miracles do not happen simply by accident. They result from painstaking and costly research – from years of lonely trial and error, much of which never bears fruit – and from a government willing to support that work… As a person of faith, I believe we are called to care for each other and work to ease human suffering. I believe we have been given the capacity and will to pursue this research – and the humanity and conscience to do so responsibly."

Source: Executive Order Signing

Whatever we may think of Obama’s policy in other areas there is no doubt that his re-election does not bode well for human embryos, pre-born babies and Christian conscience.

Expect this to have an impact not just in the US but also with international funding and policy pushed by American delegates to the UN through groups like IPPF and UNFPA.

Defeat for pro-euthanasia lobby as Massachusetts rejects assisted suicide on ballot

The US state of Massachusetts voted 51%-49% in a referendum last night to reject the legalisation of assisted suicide. The final vote was 1,516,584 to 1,453,742, a margin of over 62,000.

The proponents of the change conceded defeat after only 93% of votes had been counted when the margin was 38,000 votes (see statement here).

The question considered read ‘Should a doctor be legally allowed to prescribe medication, at a terminally ill patient's request, to end that patient's life?’

More background is available here and here.

This was a hugely significant vote given the influence and prominence of Massachusetts itself and despite the small margin it is a huge defeat for the pro-euthanasia movement given that the strongly Democrat state has a reputation for being one of the most liberal in the country.

The measure was defeated after a strong campaign by a diverse coalition called ‘No On Question 2’ comprised of disability rights organizations, doctors, nurses, community leaders, faith based groups and patient rights advocates (more detail here and also in Wesley Smith's excellent analysis of how the campaign was won).

Currently only two US states, Oregon and Washington, have legalised assisted suicide, each on the basis of a referendum. This has led to an annual increase of assisted suicide in each state as I have previously documented on this blog.

By contrast whenever a bill has been brought before a US state parliament it has been defeated. This has happened over 120 times in the last 20 years.

Thirty-four states prohibit assisted suicide outright. Massachusetts and six other states have banned it through legal precedent.

It is often argued by the pro-euthanasia lobby that opposition to the legalisation of assisted suicide is largely faith-based. But this is not true.

In Massachusetts, as in the United Kingdom, the opposition of doctors and disabled people has been very significant indeed.

This is because one of the most powerful arguments against it is public safety – any change in the law will put pressure on vulnerable people to end their lives and no law can be adequately safeguarded against abuse.

The Massachusetts Medical Society issued a statement saying it was opposed to Question 2 for the following reasons:

* The proposed safeguards against abuse are insufficient. Enforcement provisions, investigation authority, oversight, or data verification are not included in the act. A witness to the patient’s signed request could also be an heir.

* Assisted suicide is not necessary to improve the quality of life at the end of life. Current law gives every patient the right to refuse lifesaving treatment, and to have adequate pain relief, including hospice and palliative sedation.

* Predicting the end of life within six months is difficult; sometimes the prediction is not accurate. From time to time, patients expected to be within months of their death have gone on to live many more months — or years. In one study, 17 percent of patients outlived their prognosis.

* Doctors should not participate in assisted suicide. The chief policy making body of the Massachusetts Medical Society has voted to oppose physician assisted suicide.

The Massachusetts Medical Society had also reaffirmed its commitment to provide physicians treating terminally ill patients with the ethical, medical, social, and legal education, training, and resources to enable them to contribute to the comfort and dignity of the patient and the patient’s family.

Lynda M. Young, MD, MMS past president, testified about the MMS policy at a hearing of the House Judiciary Committee on 6 March 6, 2012:

‘Allowing physicians to participate in assisted suicide would cause more harm than good. Physician assisted suicide is fundamentally incompatible with the physician’s role as healer. Instead of participating in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life. ... Patients must continue to receive emotional support, comfort care, adequate pain control, respect for patient autonomy, and good communication.’

More recently they were backed by a group of disability rights organisations including: American Disabled for Attendant Programs Today (ADAPT), Association of Programs for Rural Independent Living (APRIL), Autistic Self Advocacy Network (ASAN), Boston Center for Independent Living, Cambridge Commission for Persons with Disabilities, Disability Policy Consortium, Disability Rights Education and Defense Fund (DREDF), Justice For All (JFA), MetroWest Center for Independent Living, National Council on Disability (NCD), National Council on Independent Living (NCIL), National Spinal Cord Injury Association, Not Dead Yet (NDY), TASH, The World Association of Persons with Disabilities (WAPD), The World Institute on Disability (WID).

John Kelly, Executive Director of Second Thoughts and former Chair of the Advisory Board to the Boston Disability Commission, said:

‘Ballot question 2 contains a number of problematic issues that raise red flags with progressive voters.‘

‘We already have seen serious cost cutting pressures. We constantly hear about the costs of caring for people in the last year of their lives. We can point to examples in Oregon and Washington, where assisted suicide is legal of these implicit and explicit cost pressures. Ballot question 2 legalizes a $100 lethal prescription and that sends a terrible message to people living with serious illness or disability.’

Investigation into Liverpool Care Pathway is most welcome

The investigation into the Liverpool Care Pathway announced by Health Minister Norman Lamb is most welcome.

The Liverpool Care Pathway was developed at the Royal Liverpool University Hospital and the city's Marie Curie hospice to relieve suffering in dying patients, setting out principles for their treatment in their final days and hours.

But it has been dogged by controversy with claims that patients who were not imminently dying have been placed on it and that patients’ families were not fully consulted and informed.

A series of changes to the NHS Constitution to be announced by the Government today, as part of a twelve week consultation, will include giving patients and relatives an explicit right to be consulted at every stage of end-of-life treatment, where possible.

Mr Lamb has also called for a meeting of doctors and patients to discuss worries about the pathway by the end of this month. The Association for Palliative Medicine will be carrying out its own parallel inquiry.

The latest proposals for changes to the NHS Constitution would open the way for hospitals which depart from guidelines to face legal challenges on behalf of patients.

Under the proposals being outlined today, a section of the NHS constitution which says that patients have a right to a general say in their care will be toughened up to make clear they should be ‘involved fully’ in ‘all discussions and decisions’ about their care, adding: ‘including in your end of life care’.

It adds that people should be given special support to help them take it in makes clear: ‘Where appropriate this right includes your family and carers.’

Mr Lamb said shortcomings could potentially be challenged in the courts under new powers for the new Clinical Commissioning Groups.

Personally I welcome these investigations and strengthening of the NHS Constitution aimed at improving care for those in the last hours or days of life.

When used appropriately by skilled staff the Liverpool Care Pathway is a useful clinical tool which has improved the care of thousands of dying patients. But case reports of it being used with patients who are not imminently dying or without families being fully informed have fuelled concerns and need to be fully investigated.

I hope that this inquiry will, lead to better care for dying patients and improved confidence amongst the general public.

The care of the dying needs to be in the hands of people who are fully trained and adequately supervised with regular careful audit to ensure that all patients receive the best care possible and that abuses do not occur.

My recent interview on the pathway for the Daily Telegraph can be accessed here and my previous blogs on the subject are linked below.

Past blogs on Liverpool Care Pathway

1. Is the NHS really killing 130,000 patients a year with the Liverpool Care Pathway?

2. The Liverpool Care Pathway – consensus statement from 22 organisations

3. Palliative Medicine specialists to investigate Liverpool Care Pathway

4. Specialists in Palliative Medicine need to act swiftly to respond to these five key concerns about the LCP

5. Government ministers and MPs wade in on Liverpool Care Pathway

Robert Winston lends his support to families grieving miscarriages

Robert Winston is an English professor, medical doctor, scientist, television presenter and politician who was an early pioneer in developing treatments for infertility.

He has recently become an ambassador for a new charity called ‘Saying Goodbye’ which has just launched a series of remembrance services in Britain’s cathedrals for families who have had miscarriages.

These have generated huge interest and I gather that hundreds of people are attending to remember the babies they have lost.

The organisers, Zoe and Andy Clark-Coates, have over 11,000 followers on twitter and over 1,400 followers on facebook.

I was interested to see a lengthy quote from Robert Winston on the ‘Saying Goodbye’ website which acknowledges in very strong terms the humanity of the baby in the womb.

I guess this is not surprising as many mothers I know who have had a miscarriage talk about ‘losing a baby’ in the same way that pregnant mothers generally talk about ‘my baby’.

I don’t think I have ever heard a pregnant woman talking about ‘my fetus’ or ‘my embryo’ although arguably this is the more correct medical term.

In like manner I have never heard an obstetrician saying ‘your fetus’ when referring to a woman’s pregnancy in an antenatal clinic. It is always ‘your baby’.

There are about 80,000 miscarriages every year in England and Wales and few families have not been touched by this kind of loss.

As one who has personally lost both siblings and a daughter in this way I welcome and applaud Lord Winston's backing for this valuable initiative.

Here is his full quote from the ‘Saying Goodbye’ website. The emphasis is mine.

‘Miscarriage is often something that’s not acknowledged or talked about in the UK, and people certainly do not appreciate how utterly distressing it is for women, and indeed their extended families.

It’s a loss of a precious life, and whether the loss happens in early or late pregnancy it’s traumatic, and a natural grief process must be allowed to happen.

Sadly a lot of doctors and nurses see miscarriage on such a regular basis, the right support and follow up advice is just not offered, which results in the vast amount of women never coming to terms with losing their baby, and sadly they are not able to move forward with their lives as they become stuck in a cycle of grief.

I am delighted to be an ambassador for a marvellous new organisation called 'Saying Goodbye'. Following losing five babies themselves, Zoe and Andrew Clark-Coates, the directors of CCEM, decided to launch the first national set of commemorative services, which will allow families to come together to mourn their babies.

I hope that these services will be a turning point in the nation, and through this new organisation miscarriage will become more widely understood, and families will know that their pain and loss has been heard and recognized.’

The real meaning of the Tarot – 'The Lovers'

Many people use tarot cards for divination, but this is to miss their true significance and meaning.

It is far better to seek to understand their symbolism and the ancient wisdom that lies behind it because it tells us how to make sense of the world and live in it.

The Rider-Waite tarot deck is the most popular Tarot deck in use today in the English-speaking world.

I have already explained the rich symbolism behind the ‘Wheel of Fortune’ card and now move to ‘The Lovers’.

In this card we see two human figures, two trees and a third suspended figure with the sun shining behind its face.

We have already introduced in the first card the concept of the creator God – denoted by the Hebrew tetragrammatton YHWH – who stands outside the world distinct from it and is represented by a host of different symbols each of which tell us something about his character and purposes.

In the wheel of fortune card he is represented by the lion, bull, eagle and man. He is further depicted there as a lion bearing a two-edged sword – known as the Lion of Judah.

In this card we see him, in keeping with elements of this earlier symbolism, with the face of a man but bearing the wings of an eagle.

On this occasion he is seated not outside the world but is entering into it in order to enjoy a relationship with human beings.

The scene is one of perfect harmony. The human figures, male and female, are naked but not ashamed and enjoy close relationship with both each other and God.

There are two trees in the background, one bearing fruit with a serpent wrapped around its trunk, and the other bearing leaves.

As with the wheel of fortune card, in order to understand the symbolism we need to go to the symbolism in the Old and New Testaments that make up the Bible.

In Genesis 2 we learn that God placed human beings in a garden in which the two most important trees were the tree of life and the tree of the knowledge of good and evil.

They were allowed to eat the fruit of any tree except for that from the tree of the knowledge of good and evil. For their knowledge of good and evil they were to rely directly on the word of God himself.

Genesis 3 (read the whole account here) tells us that the serpent (identified in Revelation 12:9 with the Devil) deceived the woman and the man into doubting the word of God and rejecting him by eating the fruit.

This led to their ejection from the garden and broke their relationship with God. This breaking of this key relationship also led to a breaking of relationships between the man and woman and between humans and creation.

But the symbolism in the card also carries signs of hope and a rescue not just for the alienated humans but also for creation itself.

The eagles’ wings point to the fact that God will initiate a rescue plan by calling out Israel into a special relationship with himself.

Exodus 19:4,5 and Deuteronomy 32:9-12 describe how God will rescue the nation of Israel (Jacob) by carrying them and protecting them with eagle’s wings. He would thereby keep his people safe out of the reach of the Devil (Revelation 12:14) and through a human descendant of Israel bring rescue to others.

The sun behind the human face is a reference to the fact that God himself will visit the planet again in the form of this human descendant with ‘a face like the sun’ (Matthew 17:2 and Revelation 1:16).

The outstretched arms point to the way in which this man will die and the clouds on which he is seated are a sign that he will later come in judgement (Daniel 7:13; Matthew 24:30).

Finally the leaves of the tree of life, depicted on the right of the picture, symbolise the healing of the nations that will arise as a result of this cosmic rescue (Revelation 22:2).

The Apostles' Creed – another take on Beethoven’s 9th symphony

‘Ode to Joy’ was written in 1785 by the German poet, playwright and historian Friedrich Schiller.

The ode is best known for its musical setting by Ludwig van Beethoven in the final movement of his Ninth Symphony (completed in 1824), a choral symphony for orchestra, four solo voices and choir.

Over recent years there has been an explosion of musical interpretations of Ode to Joy of which many are available on the internet.

Some of the most popular are those by the Melbourne Gospel Choir, ACM Gospel Choir, London Community Gospel Choir and of course Lauryn Hill’s memorable rendition in the Whoopi Goldberg film Sister Act 2.

It has been done by flash mobs and even the Muppets have got in on the act. Then of course there are numerous more traditional classical versions.

But I have searched long and hard, without success, for a version of the Apostles’ creed set to Beethoven’s ninth which we learned in New Zealand back in the late 1970s.

The Apostles' creed is one of the most succinct and beautiful statements of Christian belief ever written and has been set to a variety of tunes.

So here, from memory (and quite possibly not word perfect!), are the words which have been adapted from the original creeed. You know the tune already.

Maybe you could try it in your Sunday worship or like I have just make an addition to your own personal devotional repertoire.

The Apostles’ Creed

We believe in God the Father
We believe in God the Son
We believe in God the Sprit
Each is God yet God is one
We believe that God came to us
Born as the Virgin Mary’s child
Jesus Christ who died to save us
Man and God has reconciled

We believe that Christ died for us
Then rose living from the grave
And to those men he had chosen
All his power as God he gave
We believe that God has spoken
Through his church whose word is true
Always she proclaims his Gospel
Ever old yet ever new

We believe that in His Gospel
Way and truth and life are found
Power to live and love each other
If our lives to him are bound
We believe in his forgiveness
And in life that has no end
While in joy we wait here for him
As we sing this great Amen

If you prefer something a little truer to the original words then here is a more classical alternative version I nabbed off a church songsheet.

I’d love to see some Christian musicians having as much fun with the Apostles' creed set to Beethoven’s 9th as they have with ‘Ode to Joy’.

If anyone posts one on you tube then let me know.

Alternative version

I believe in God the Father, Maker of the heav’ns and earth
And in Jesus Christ, our Savior, God’s own Son, of human birth.
Virgin born, the Lord incarnate, Whom the Spirit did conceive;
Suffered under Pon us Pilate; He’s the God whom I believe.

Crucified, was dead and buried, Down to hell in victory;
From the dead he rose the third day; Up to heav’n triumphantly.
There at God’s right hand he’s ruling, By his will the world is led.
He will come to judge the na ons. Both the living and the dead.

I believe in God the Spirit, In his church, his chosen band.
They are joined in sweet communion, Holy in his sight they stand.
I believe in sins forgiven; That the dead will rise again;
I believe in life eternal. Amen! Amen! Amen!

One in three human deaths in England and Wales is that of a preborn baby

Last month I posted a blog titled ‘27% of all human deaths in England and Wales are due to abortion’.

It was prompted by an article on the Guardian website titled ‘Mortality statistics: every cause of death in England and Wales, visualised’ which claimed to give ‘a full listing of “all” deaths in England and Wales in 2010.

They used the graphic above left to illustrate it with the largest circles representing the 158,084 deaths from circulatory diseases, 141,446 from cancers and neoplasms and 67,276 from respiratory diseases.

I pointed out that it did not include the 189,574 induced abortions that took place in England and Wales that year and that, if one reworked the figures, these actually constituted 27% of all deaths – over one in four.

Another blogger, Mark Whalley, told me that he had earlier reworked the graphic to include abortions and posted it on his own website.

I have reproduced Mark’s revision here showing abortions (blue circles on right) as the biggest cause of death.

Mark made the point on my blog that I should also include miscarriages and another correspondent suggested that if I did so it would make my figures ‘less polemic’.

It is impossible to know the actual numbers of very early miscarriages or chemical abortions, those occurring without a lost menstrual period, and estimates vary widely based largely on guesswork. At best we could have only a very rough estimate.

In addition there are no national statistics for Britain are published on ‘miscarriages’ but a BMJ article has calculated them at 70,000-90,000 per year in England and Wales. So let’s say approximately 80,000.

If we include these 80,000 and add them to the 189,574 induced abortions and 493,242 deaths from all other causes we get to a total of just under 763,000 human deaths in England and Wales in 2010.

So of all human deaths this year induced abortions constituted roughly 24.8% and miscarriages 10.5%.

So in total 35.3% of all human deaths – over one in three - were preborn babies.

Now this is where it gets interesting.

Professor Lord Robert Winston (left) has recently given his support to a new charity running remembrance services in Britain’s cathedrals for families who have had miscarriages. He writes:

‘Miscarriage is often something that’s not acknowledged or talked about in the UK, and people certainly do not appreciate how utterly distressing it is for women, and indeed their extended families. It’s a loss of a precious life, and whether the loss happens in early or late pregnancy it’s traumatic, and a natural grief process must be allowed to happen.’

I agree with him that miscarriage is not talked about enough and that it involves the loss of a precious life.

But if the baby who miscarries is precious then doesn’t the same also follow for those babies who die as a result of abortion?

Or have I missed something?