Respecting the dignity of the person” “

The Bishops’ Conference of England and Wales and the Linacre Centre for Healthcare Ethics (a Catholic research centre on ethical issues relating to healthcare, euthanasia, acceptance or refusal of medical treatment) have replied, in recent days, to the government document “Making decisions: helping people who have difficulty deciding for themselves”, especially in the field of healthcare or in the forms of mental disability. We present a summary of their arguments sent to the Lord Chancellor’s Department. Refusal of treatment. The two organizations ask for a revision of the document, especially as regards the refusal of treatment by a patient (either through a signed affidavit by the patient himself or by members of his family on his/her behalf if the patient is in a coma), something which could lead to suicidal motivations, given that “euthanasia, by act of commission or omission, is a form of covert murder”. In their reply to the government document, they warn of “the danger of seeing the life of the patient as a burden that may lead to the refusal to provide him with treatment, with the aim of making him die. If members of the patient’s family, for example, are sincerely thinking of doing the patient a favour at the end of his life or if they are only thinking of their own convenience in obtaining a legacy (or avoiding future treatment), it’s inadmissible that they should take a decision on behalf of the patient in question for such homicidal motivations”. The question of what is in the patient’s “best interest”, in the view of the English bishops and of the Linacre Centre, raises doubts about what is the criterion for really measuring the patient’s own wishes (e.g. a “passive expression of infelicity” difficult to interpret or an oral declaration that could conceal suicidal intentions). Sterilization and abortion. Another problem concerns the sterilization, contraception or abortion practiced on mentally disabled women. Sterilization, apart from being “an act of permanent mutilation” – points out the document – may subject women to the risk of sexual abuse and “could reduce, in the eyes of their guardians, the duty to provide suitable protection to these women”. And, above all, “the probability of anyone abusing these women being discovered would be substantially reduced”. In the situations listed in the document the two organizations emphasize that “the role of the physician has been ignored”, in other words, “there is no recognition of the medical complexity of a prior refusal of treatment, and especially of the fact that prior or contemporary refusal may have suicidal motivations”. The response of the English bishops concludes as follows: “In spite of the good intentions contained in the document, they do not really protect the persons whose interests they have been called to safeguard”. Patrizia Caiffa