British Medical Journal adopts campaigning stance on euthanasia

The British Medical Journal this week contains three articles aimed at neutralising medical opposition to euthanasia.

The BMJ, which remains editorially independent from the British Medical Association, but is sent to all members, has a long track record of backing liberal causes, amongst them the legalisation of assisted suicide and euthanasia.

A comment piece from Ray Tallis (pictured), chairman of the pressure group ‘Healthcare Professionals for Assisted Dying’ (HPAD) calls for the BMA and Royal Medical Colleges to take a position of ‘studied neutrality’ on euthanasia.

An emotive ‘personal view’ by Tess McPherson, relates the story of the death of her mother Ann, an Oxfordshire GP who died from cancer of the pancreas last year and was the founder of HPAD.

Finally the journal’s editorial by Fiona Godlee, ‘supports’ HPAD’s call.

The BMJ sought wide exposure for the articles by sending out an embargoed press release yesterday ensuring that the story would get prominent media coverage (See Daily Mail, Daily Express, Daily Telegraph, Press Association and Evening Standard).

Godlee acknowledges in her editorial that 65% of doctors are opposed to a change in the law but makes much of a ‘poll of 1,000 GPs’ commissioned by the pressure group Dignity in Dying last year which allegedly showed that ‘62% supported neutrality’.

The poll is referenced to the HPAD website events page but the link from there to PJ Online can only be viewed by paid up subscribers meaning that is difficult to ascertain what question was actually asked and of whom. How convenient! (I see they have now finally posted the link - I will blog on this very soon)

Healthcare Professionals for Assisted Dying backed by Dignity in Dying, the former Voluntary Euthanasia Society, have flooded this year’s BMA annual meeting with motions calling for doctors to take a neutral stance on assisted suicide and euthanasia.

This is a carefully orchestrated move by a small minority of doctors with extreme views aimed at neutralising medical opposition and softening up public and parliamentary opinion in advance of new pressure to change the law. HPAD has just 520 supporters, representing less than 0.25% of the medical profession.

It has been carefully engineered to coincide with two high profile cases being heard in the high court next week, plans for a new private members bill and a mass lobby of parliament by the pro-euthanasia lobby on 4 July.

The majority of doctors and the major medical royal colleges (RCGP, RCP and Association for Palliative Medicine) however remain strongly opposed to a change in the law and British parliaments have three times in last six years, twice in the House of Lords and once in Scotland, voted against the legalisation of assisted suicide.

The BBC this morning reports a BMA spokesperson saying that the organisation is 'firmly opposed' to the legalisation of assisted dying adding: 'If assisted dying was legalised, effective safeguards could not be implemented without the involvement of doctors. It is therefore appropriate for doctors to voice their views on this issue.'

A powerful article in last week’s BMJ by Iona Heath, president of the Royal College of General Practitioners, argued strongly against a change in the law and is well worth studying.

Heath eloquently voiced her ‘deep concern that it will be impossible to draft a law robust enough to protect the vulnerable’ and expressed her discomfort ‘that medicine seems once again to be preparing to offer a technical solution to an existential problem’.

‘One of the huge challenges of human life’, she argues, ‘is to find ways of living a meaningful life within the limits of a finite lifespan that will always involve loss of love and the inevitability of grief. Doctors have a regrettable tendency to ignore this reality and to persist in active and invasive treatment beyond the point at which it has become futile and even cruel.’

She acknowledged that some of the drive to legalise assisted suicide and euthanasia is driven by fears about inappropriate invasive treatment but insisted that the right answer is not changing the law, but rather better care that recognises the limits of medicine.

She concludes:

‘When doctors fail to recognise and acknowledge existential suffering in the dying and take refuge in excessive technological interventions, patients become frightened and, no longer able to trust their doctors, may request assisted dying. But two technological wrongs do not make an existential right. I don’t want assisted dying, but I also don’t want a PEG tube.’

Any change in the law on assisted suicide and euthanasia would place pressure on vulnerable sick, elderly and disabled people to end their lives for fear of being a financial or emotional burden on loved ones.

This is the very last thing we need at a time when many families and the health service itself are already under considerable financial pressure.

Doctors should see this latest move for what it is and firmly reject it.

Abortion and Euthanasia dominate ethics agenda at BMA annual meeting

Abortion and euthanasia are to be debated at a major BMA meeting later this month.

The British Medical Association (BMA) holds its annual representative meeting, where it sets policy for the next year, in Bournemouth in the last week of June.

An almost unprecedented number of motions on abortion and euthanasia are listed on the agenda for the section on medical ethics on Wednesday 27 June.

In total 45 motions on ethics have been listed for the 95 minute session which is scheduled from 1000am to 1135am and no less than 33 deal with either abortion or euthanasia.

13 motions deal with abortion, with the majority either calling for women considering abortion to receive access to ‘neutral counselling’ which is ‘independent of the abortion provider’ or for abortion on the grounds of gender alone to be made illegal.

20 motions deal with euthanasia or assisted suicide with 14 supporting a relaxation of the BMA’s position and 6 supporting the status quo of opposition to a change in the law.

Nine of the 14 motions supporting relaxation call for the BMA to adopt a neutral position on ‘assisted dying’ and use almost identical wording despite coming through five different BMA divisions – Shropshire, North West Regional Council, Retired Members Forum, Islington and Suffolk.

The language of all these motions is that of the campaigning group Dignity in Dying (formerly the Voluntary Euthanasia Society) and without doubt they represent a carefully orchestrated ploy by the pressure group Healthcare Professionals for Assisted Dying (HPAD), which operates under the DID umbrella, to soften up medical and public opinion in advance of a new assault on the law.

This latest move is part of a larger campaign that Dignity in Dying is running over the next month leading up to a celebrity-endorsed lobby on parliament on 4 July.

HPAD originally registered as Healthcare Professionals for Change in October 2010 but has since changed its name.

It contains a number of well-recognised campaigners for the legalisation of various forms of euthanasia including former Liberal Democrat MP Dr Evan Harris. Overall it has 520 supporters listed on its website.

Being a trade union, the BMA is particularly susceptible to moves by small pressure groups.

Motions at the ARM are always prioritised and it is therefore virtually certain that only two abortion motions and one euthanasia motion (328, 329 and 332) will be debated (see below).

The other 30 motions on these two issues are very unlikely to be reached.

It is interesting that whilst the two abortion motions are seeking to tighten BMA policy the one euthanasia motion is seeking to loosen it.

The BMA has supported Britain’s abortion policy, which allows over 200,000 abortions annually for many years.

But the union has always been opposed to any change of the law to allow euthanasia or assisted suicide apart from one year of its history (2005-2006) when it was briefly neutral.

The wording of these three motions is below.

The motions set to be debated

* 328 Motion by THE AGENDA COMMITTEE (MOTION TO BE PROPOSED BY THE HARROGATE DIVISION):
That this Meeting:-
i) supports the universal availability of neutral counselling for women considering abortion;
ii) believes that any counselling provided for women considering abortion should accord with NHS standards;
iii) believes that women considering abortion should be able to access counselling that is
independent of the abortion provider;
iv) deplores picketing and intimidation around abortion services.

* 329 Motion by THE AGENDA COMMITTEE (MOTION TO BE PROPOSED BY THE GREENWICH, AND BROMLEY DIVISION):
That this Meeting believes that abortion on the grounds of gender alone is unacceptable and demands that :-
i) such practice should cease forthwith;
ii) the law should be changed to make this practice illegal in the UK.

* 332 Motion by THE AGENDA COMMITTEE (MOTION TO BE PROPOSED BY THE SHROPSHIRE DIVISION):
That this Meeting:-
i) believes that assisted dying is a matter for society and not for the medical profession;
ii) believes that the BMA should adopt a neutral position on change in the law on assisted dying.

BMJ archives demonstrate BMA’s 180 degree turn on abortion to embrace wholeheartedly what it once called ‘the greatest crime’

On 25 June in a blog titled ‘BMA still not listening to public or science on late abortion’ I reported on the vote at the British Medical Association annual representative meeting against a motion which sought to provide legal protection for babies at the threshold of viability.

Delegates objected to a lowering of the upper abortion limit for babies without disability to 20 weeks by a two to one majority.

The BMA produced a seven page briefing paper opposing the motion and delegates were encouraged by both BMA Council Chairman Hamish Meldrum (pictured) and Ethics Chairman Tony Calland to vote against it.

The BMA is deeply committed to abortion and has been in recent years an ardent exponent of abortion rights. This is not surprising given that doctors have carried out over 7 million abortions in Great Britain since 1967.

But it has not always been so.

A recent article in the British Medical Journal refers to Christian Medical Fellowship as a ‘lobby group’ and specifically criticises by implication its views on abortion.

But in fact CMF’s views on abortion are in accord with all historic codes on medical ethics such as the Hippocratic Oath, the Declaration of Geneva and the international Code of Medical Ethics. They are also in accord with the historic position of the BMA!

The British Medical Association itself was once strongly opposed to abortion as revealed in BMJ archives recently published on the journal’s website.

In June 1947 the BMA published a statement on ‘War Crimes and Medicine’ which it later submitted to the General Assembly of the World Medical Association in September1947.

The statement included the following:

‘The evidence given in the trials of medical war criminals has shocked the medical profession of the world. These trials have shown that the doctors who were guilty of these crimes against humanity lacked both the moral and professional conscience that is to be expected of members of this honourable profession. They departed from the traditional medical ethic which maintains the value and sanctity of every individual human being.’ (emphasis mine)

The statement majors, as one might expect, on the atrocities carried out by German doctors during the Nazi holocaust, but returns again and again to general principles about respect for life:

‘The doctors who took part in these deeds did not become criminals in a moment. Their amoral methods were the result of training and conditioning to regard science as an instrument in the hands of the State to be applied in any way desired by its rulers. It is to be assumed that initially they did not realize that the ideas of those who held political power would lead to the denial of the fundamental values on which Medicine is based. Whatever the causes such crimes must never be allowed to recur. Research in medicine as well as its practice must never be separated from eternal moral values. Doctors must be quick to point out to their fellow members of society the likely consequences of policies that degrade or deny fundamental human rights.’ (emphasis mine)

So what does this have to do with abortion you might ask? The answer lies in the document’s conclusion:

‘Although there have been many changes in Medicine, the spirit of the Hippocratic Oath cannot change and can be reaffirmed by the profession. It enjoins…The duty of curing, the greatest crime being co-operation in the destruction of life by murder, suicide and abortion.’ (emphasis mine)

The BMA was once strongly opposed to abortion. But it has chosen to discard its own ethics. A vigorously pro-abortion position has now been wholeheartedly embraced and is ardently defended by its present leadership.

By contrast the CMF still opposes abortion. This does not make the CMF a lobby group. It rather raises questions about the behaviour of the BMA.

British Medical Journal features Christian Medical Fellowship after playing a role in its inception over sixty years ago

I see that the British Medical Journal this week has featured the Christian Medical Fellowship in its ‘lobby watch’ column. Apparently CMF is a lobby group.

The article mainly focuses on the case of Richard Scott, a Christian doctor who is awaiting a hearing with the General Medical Council for talking about his Christian faith in the consulting room.

However, although it discusses the appropriateness of sharing faith within the consultation, no mention is made of the fact that the General Medical Council and Medical Defence Union have recently endorsed 'tactful' offers of prayer by GPs or that the GMC has similarly confirmed the appropriateness of sensitive faith discussions with patients.

Nonetheless I would like to take this opportunity personally to thank the BMJ for almost a whole page summarising our history and aims in the opening paragraph, linking to CMF's website and ending with details of our development fund appeal.

I hope the article brings in lots of new members for CMF.

This is not the first time that the BMJ has given publicity to CMF. In fact, as I discovered recently, the BMJ may have actually carried a key role in CMF’s inception through a notice it carried back in 1948.

The short piece makes reference to the Medical Prayer Union, which one year later in 1949 merged with the medical division of the postgraduate fellowship of IVF (now UCCF) to form CMF. The MPU’s secretary Neville Bradley is suggesting the formation of a new ‘Christian Medical Group.

Dr. NEVILLE BRADLEY, Hon. Secretary, Medical Prayer Union (South End Cottage, Turville Heath, Henley-on-Thames), writes:
Founded over 50 years ago the Medical Prayer Union has sought in various ways to foster fellowship among Christian doctors. It has organized the Missionary Breakfast at the Annual BMA Meetings and another for medical students every year in the spring. It would seem from many points of view that the time is opportune to link medical men and women in some more effective way in order to promote and maintain a distinctive Christian witness in what is tending to become an increasingly secularized and nationalized service and to foster and support the medical missionary activities of the Church at home and overseas. Will any interested send me their suggestions regarding such a ‘Christian Medical Group’?

I was not previously aware of this piece but I’m sure that the Christian Medical Fellowship’s formation shortly afterwards was no coincidence. So even more thanks to the BMJ is in order.

The ‘missionary breakfasts’ at the annual BMA meetings referred to are still running over 60 years later. This year’s ‘CMF breakfast’ was addressed by Prof Glynn Harrison and chaired by the BMA president David Haslam.

Just as the Church of England has been called ‘the Tory Party at prayer’, so the CMF in previous days was known as ‘the BMA at prayer’.

Back in the 1940s members of the BMA and the CMF shared common views on most ethical issues but this is no longer the case as a result of the secularizing process that Bradley mentions.

Interestingly the CMF has not moved its position over these sixty years and still holds to ethics based on the Judeo-Christian tradition and historical codes of ethics like the Hippocratic Oath and Declaration of Geneva.

But the BMA has moved its position considerably.

It is good that despite this the BMJ still grants the CMF considerable column inches.