Update on Life Issues – June 2011


Abortion statistics in England and Wales
The annual figures for 2010 were released last month – they are not pleasant reading  www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_126769.  After two years of decline, they are up again to a total of 196,109. This figure is composed of 189,574 residents plus 6,535 non-residents.  This latest total may be just 0.3 per cent more than in 2009, but it is still 8 per cent more than ten years ago.  And these statistics do not include the unknown thousands of early abortions brought about by the abortifacient action of morning-after pills.

Consider some other related facts and figures.  The vast majority (97.7 per cent) of abortions during 2010 were carried out under ground C, the infamous social clause, with 2,290 (1.2 per cent) cases undertaken under ground E, the so-called handicap clause.  Most (96 per cent) abortions were funded by the NHS, with over half (59 per cent) taking place in the independent sector (using Marie Stopes, bpas, and the like) under NHS contracts.  The trend for earlier abortions continued with 91 per cent carried out at less than 13 weeks gestation and 77 per cent at under 10 weeks.  The trend towards medical (as opposed to surgical) abortions, using the so-called abortion pill (mifepristone plus misoprostol), continued to rise, accounting for 43% of the total.

Repeat abortions are becoming more common.  Last year, 64,303 women (34 per cent of the total) who had a termination, had had at least one previous abortion.  This included 1,280 (7 per cent) girls under the age of 18.  Also among the total were 85 women who had already had seven or more abortions.

Is there any consolation in any of these figures?  Perhaps the continuing downward trend among teenagers offers a glimmer of hope.  A total of 38,269 teenagers had abortions in 2010 compared with 40,067 the year before.  Similarly, the under-16 total was 3,718 versus 3,823 for 2009.  True, there are small decreases amid a field of increases, yet even these are masked by MAP usage.

And as if to confirm to horrors of abortion in general, buried in all these statistics is this seemingly-bland statement, ‘In 2010, of the 1,173 abortions performed at 22 weeks and over, 70% were reported as preceded by a feticide and a further 25% were performed by a method whereby the fetal heart is stopped as part of the procedure.’  Read it again and realise its reality.  Kicking babies, who could survive if prematurely born, were either injected with poison or stabbed through the heart before being removed from the womb.  Cruel is not an adequate word.

Sex selection abortions
The widespread practice of sex-selective abortion continues to upset the gender balance in China and India.  A recent report, published in the Canadian Medical Association Journal, showed that within the next two decades there will be a 10 to 20 per cent excess of young men in parts of these two countries.

The preference for sons plus the advent of relatively cheap ultrasound scanning, have led to increasing abortions of unborn girls.  The natural sex ratio at birth (SRB) is about 105 males to 100 females.  In some Chinese provinces, from Henan in the north to Hainan in the south, this ratio has become 130 to 100.  In India, the ratio in Punjab, Delhi and Gujarat is 125 to 100.

This is not just an ideological drama – there are serious societal implications.  For example, because of the scarcity of women, a significant percentage of these men will not be able to marry and have children.  Already in China, 94 per cent of unmarried people, aged 28 to 49, are men.  The fear is that their inability to find wives may result in psychological issues leading to increased violence and crimes, such as rape.

These sorts of statistics are not new.  Public awareness campaigns against the ingrained preference for sons and laws forbidding fetal sex determination and selective abortion have already been implemented, but to little avail.  Yet what remains surprising is that the liberal, pro-choice sisterhood of the West continues to stay largely silent about this situation.  You would expect them to be up in arms outside the Chinese and Indian embassies.  You would expect them to be lobbying their governments to stop funding this social engineering, these so-called women’s reproductive rights (aka abortion) in the Orient.  The British Government, through its Department for International Development, gave £150 million to support international abortion providers over the period 1997-2002.  Yet this killing, directed specifically against their own sisters, raises hardly a feminist murmur.

Adverse effects of abortion and informed consent
The Royal College of Obstetricians and Gynaecologists (RCOG) is currently revising its controversial document, The Care of Women Requesting Induced Abortion.  The ‘multi-professional group’ in charge of the review is largely pro-abortion, including representatives from the two largest UK providers, bpas and Marie Stopes International.  Astoundingly, there is no psychiatrist on this panel.  You may wonder what their recommendation will be.  The RCOG has consistently underplayed, even ignored, any adverse physical or psychological outcomes subsequent to abortion.  Yet, the evidence, from around the world, and from both proponents and opponents of abortion is mounting.  So how can women give proper informed consent to abortion when the evidence is denied or withheld?

While the UK prevaricates, some states in America are forging ahead.  For example, it looks as though North Carolina is set to about-face on its abortion policy.  Its Woman’s Right to Know Act is making steady progress through the various legal hoops.  The proposed legislation would require abortion providers to give women information about the risks and side effects of abortion as well as other pregnancy options at least 24 hours before the scheduled termination.  Moreover, women would need to undergo an ultrasound scan four hours before the abortion.  This may sound revolutionary, but at least 24 other US states already have similar informed consent laws in place.

Meanwhile there are stirrings in the UK.  The unlikely pairing of Frank Field and Nadine Dorries, MPs for Birkenhead and Mid-Bedfordshire respectively, has tabled amendments to the Health and Social Care Bill.  Their purpose is twofold.  First, they want all women contemplating abortion to have ‘independent information, advice and counselling services’, not from those with a vested financial interest, namely the abortion providers.  Second, they want abortion guidelines to be produced not by the Royal College of Obstetricians and Gynaecologists (RCOG), but by the National Institute for Health and Clinical Excellence (NICE).  These Field/Dorries amendments seem sensible, but some questions hang over their sponsors since neither of them holds a clear pro-life stance or voting record.

Those five little words, ‘If only I had known’, may well be the haunting catchphrase of many women who have undergone an abortion, and now wish they had not.  Who can oppose telling the truth?  Again, it is time to exercise the principle of co-belligerence.

LIFE at the high table
The pro-life organisation, LIFE, has recently been invited by the Department of Health to sit on the new Sexual Health Forum, which replaces the old Independent Advisory Group on Sexual Health and HIV.  This news got the pro-choice camp, from the Guardian to the British Pregnancy Advisory Service (bpas), hopping mad.  Tolerance may be the byword of these people, but they can be vehemently intolerant when crossed.  The bpas was especially irate because, though it boasts that it provides more than a quarter of all abortions in England and Wales, it has been refused its regular place at this high table.  Well, boohoo!

But what is so wrong with inviting LIFE, with its pro-abstinence agenda and 40 years of experience in educating thousands of schoolchildren each year, and counselling and practically helping and accommodating girls and women with problem pregnancies, to sit on the new Forum?  There will still be 10 other organizations at the table pushing their tired old line of ‘more pills and condoms’ and explicit sex education.  Is it not time for a breath of fresh air and ideas?  After all, would not most people expect any ‘forum’ to consist of those with a range of viewpoints?

Stuart Cowie, the head of LIFE’s education team, is a winsome, young family man, who attends the evangelical Myton Church in Warwick.  His presence at the Forum deserves our encouragement and prayers.

Bernard Nathanson, 1926-2011
During the 1960s and 1970s, Bernard Nathanson worked as an obstetrician at abortion clinics in New York, where it is estimated he oversaw more than 75,000 abortions and performed over 5,000 himself.  In 1970, he became the director of the Center for Reproductive and Sexual Health (CRASH), which he often described as, ‘the largest abortion clinic in the western world.’  In 1969, he co-founded the National Association for the Repeal of Abortion Laws, now known as NARAL Pro-Choice America.

In 1974, he wrote in the New England Journal of Medicine that there was, ‘no longer serious doubt in my mind that human life exists within the womb from the very onset of pregnancy.’  In 1979, he performed his last abortion.  It was the introduction of ultrasound imaging and advances in neonatal care that caused his change of mind.  From then on, this champion of abortion became a high-profile pro-life lecturer and campaigner.  In 1984, he directed and narrated The Silent Scream, a controversial film depicting the abortion of a three-month-old unborn child. It included graphic footage, which, in Nathanson’s words, showed, ‘… for the first time … a child being torn apart, dismembered, disarticulated, crushed and destroyed by the unfeeling steel instruments of the abortionist.’  As the abortion starts, Nathanson states that, ‘The child's mouth is wide open in a silent scream.’  In 1987, Dr Nathanson produced Eclipse of Reason, a film about late-term abortion.

In his 1996 autobiography, The Hand of God, he wrote, ‘I am one of those who helped usher in this barbaric age.  I know every facet of abortion.  I helped nurture the creature in its infancy by feeding it great draughts of blood and money; I guided it through its adolescence as it grew fecklessly out of control.’  In his later years, he often stated that abortion is, ‘the most atrocious holocaust in the history of the United States.

His fourth wife, Christine Reisner-Nathanson, recalled how he had been vilified by both sides of the abortion issue.  ‘When he was an abortion doctor he was seen as a pariah by the medical community,’ she said, ‘and when he went pro-life he was scorned by the women in the pro-abortion movement.’  He died of cancer at his New York City home on 21 February 2011.  He was 84.


Assisted Reproductive Techniques

The ‘three-parent IVF’ technique
A so-called ‘three-parent IVF’ technique has been pioneered at Newcastle University to enable parents-to-be with serious inherited disorders, known as mitochondrial diseases, to avoid passing them on to their would-be children.  Mutations in mitochondrial DNA are quite common and often non-serious, but about one in every 6,500 children, about 100 each year, is born with a serious mitochondrial disease, such as muscular weakness, blindness and heart failure, which can be fatal.

Mitochondria are found in every cell in the human body and contain a very small amount of DNA (37 out of 23,000 genes) compared with that found in the cell’s nucleus.  This mitochondrial DNA is inherited exclusively from the mother through the mitochondria present in her ova and so is passed down the female line only, so it is not present in the nucleus of a zygote.  Using a method called pronuclear transfer (PNT), it is possible to extract an embryo’s nucleus, prior to the first embryonic division, and transplant it into a second, donor zygote.  The resulting embryo contains DNA from the nuclei of the mother and father, but mitochondrial DNA from only the maternal donor, the ‘third parent’.  The ‘new’ embryo would then be transferred to the putative mother using standard IVF techniques.  The Newcastle team used 80 ‘spare’ human embryos from an IVF programme and cultured them for up to 8 days, after which the lot were destroyed.  Remember those human admixed embryos?  They came from the same laboratory in Newcastle and their production achieved nothing medically worthwhile.

As if IVF alone, with its inevitable destruction of human embryos, were not a sufficiently bioethical nightmare, here comes another destructive eugenic adjunct (like preimplantation genetic diagnosis, PGD), plus a collision with the conventional two-parent offspring (like surrogacy), plus permanent genetic changes affecting subsequent generations.  Currently, the use of such genetically-altered embryos is banned for treatment purposes by the 2008 Human Fertilisation and Embryology Act, but a review, published in April 2011 by the HFEA, declared that, ‘Although potentially useful clinical techniques, further safety experiments need to be done before introducing them into clinical practice.’  That review is now with the Department of Health to be approved or rejected.

Assisted reproductive technologies and money
This twosome seems inseparable.  It is never very difficult to find abuses of the law or the HFEA regulations.  For example, earlier this year a leading NHS fertility doctor was accused of making money by sending couples abroad to choose the sex of their unborn baby – a procedure that is illegal in Britain, unless it is to detect serious gender-linked diseases.  Charles Kingsland, the clinical director of the Hewitt Centre for Reproductive Medicine in Liverpool and a former inspector for the HFEA, was apparently referring at least one couple a week to a clinic in Northern Cyprus, in which he is a shareholder, so that an embryo of the desired sex could be selected and transferred.  It is thought that couples paid up to £14,000 – at least three times the cost of standard private IVF treatment – for this controversial service.  Liverpool Women’s Hospital has launched an internal inquiry into the matter.

A similar theme emerged in May during a debate in the House of Lords, when Professor Lord Robert Winston launched a scathing attack on some of his fellow IVF practitioners accusing them of charging exorbitant fees for treatment at their private clinics.  ‘In my view’, he declared, ‘it is a scandal.’  ‘There are clinics that treat patients for around £3,400 a cycle.  It is only when you look at their websites that you see they are charging up to £1,100 to £3,200 for drugs that should be obtained on contracts at around £500 to £700 per cycle.’  And he continued, ‘The HFEA has shown itself to be completely unable to deal with this issue at all.’  In addition, he accused some clinics of using misleading information to enhance their success rates. He claimed that, ‘Desperate couples spend an average of £5,000 in pursuit of a child of their own, often blind to the harsh truth that clinics’ claimed statistics about success bear little relation to the number of IVF babies who make it to live births.  In extreme cases, couples are spending up to £40,000 to have a child.’

Surrogacy and money are also close friends.  The altruistic element of surrogacy is waning.  While commercial surrogacy remains banned in the UK, the amount of legitimate ‘reasonable expenses’ for the surrogate continues to be questioned. It is muddy water, both legally and ethically.  In May, Mr Justice Hedley, a judge in the Family Division of the High Court, highlighted these difficulties whenever commercial surrogacy arrangements are made abroad.  He said, ‘Commercial surrogacy is a highly controversial matter ethically and at the end of the day, by the time the case gets to me, the best I can do is focus on the welfare of the child.’  His comments came after he passed judgement at the Royal Courts of Justice in the case of a baby known only as IJ.  A British couple had gone to the Ukraine in search of a surrogate mother.  Ukrainian law states that this couple are IJ’s parents.  British law regards the Ukrainian surrogate and her husband as the baby’s parents.  Poor IJ was effectively parentless and stateless.  In the interest of the child’s welfare, Mr Justice Hedley agreed to recognise the Britons as the legal parents and retrospectively approve the more than ‘reasonable expenses’ of the commercial surrogacy arrangement, something he has done on at least four previous occasions.  The judge warned such prospective parents to take immigration and legal advice before embarking on any cross-border surrogacy arrangements.  It is a bioethical truism – once an abnormal practice is permitted, it escalates unpredictably and uncontainably.  Surrogacy is no exception.

Same-sex fertility facilities
In hindsight, it was inevitable.  A lesbian couple have set up Britain’s first same-sex gay-only fertility service.  Natalie Drew and Ashling Phillips, who have two children by a sperm donor, started an online fertility resource centre in 2007.  Such has been the interest that in April they opened an office, the Gay Family Web Fertility Centre, in Birmingham.  The Centre offers to ‘match-make’ potential parents with sperm donors, egg donors or surrogates.

This enterprise is somewhat reminiscent of Gamble and Ghevaert LLP, which started in May 2009 as, ‘the UK’s first specialist fertility and parenting law firm.’  It was run by Natalie Gamble and Louisa Ghevaert, who had donor-conceived children as well as legal experience covering international surrogacy and UK surrogacy, donor conception, co-parenting, embryo storage and testing, IVF, and gay and lesbian parenting.  They were behind the groundbreaking changes to the 2008 Human Fertilisation and Embryology Act, which allowed lesbian couples conceiving together through donor insemination to be named on the birth certificate together.  In April 2011, they split up to form Natalie Gamble Associates, which advertises itself as, ‘the only specialist fertility and parenting law firm in the UK, devoted exclusively to UK and international surrogacy, donor conception and co-parenting, fertility treatment and embryo law, and parenting involving same sex parents and other non-traditional families.’  Louisa Ghevaert meanwhile moved to become a partner in Porter Dodson Solicitors and Advisors as the head of its fertility, surrogacy and parenting law team.

It is a sad comment on our society that there is serious money to be made from that most fundamental and necessary of human activities, childbearing.  Within the last generation a new growth area has sprung up, whereby doctors, lawyers and miscellaneous advisors can make rich financial pickings from those who are vulnerably childless and those who are unnaturally adamant.


Stem Cell Technologies

Patents for embryonic stem-cell lines granted
One of the biggest names in stem-cell technology and regenerative medicine is Advanced Cell Technology, Inc. of Santa Monica, California, and elsewhere.  Robert Lanza is its flamboyant chief scientific officer.  The company has sought and, in February, was granted a patent for its single-blastomere technique.  ACT claims that this technology provides a non-destructive method for producing human embryonic stem cells.

The method first requires an early human embryo, a blastocyst of 5 to 10 days old, composed of about 70 to 100 cells.  From this, a one-cell biopsy is made, similar to that of pre-implantation genetic diagnosis (PGD).  This single stem cell is then coaxed to generate a cell line, which might subsequently differentiate into all the cell types of the human body, such as insulin-producing cells, blood cells and beating cardiac cells.

ACT hopes that this patented method will not only produce cells of therapeutic importance, but that it will also duck the principal ethical argument against the use of embryonic stem cells, namely, that when harvested an entire embryo is destroyed.  But hold on.  What is novel about this method?  Is it not the old Winston-Handyside PGD procedure of the 1980s? And what of the future for the remaining 99-cell blastocyst?  Although such ‘cropped’ entities are transferred to women in the PGD-IVF context, who would want one that has been tinkered with in a biotech lab?  Is not the certain fate destruction?  So is not ACT guilty of disguising the destiny of the 99-cell embryo by some seemingly kind-hearted lexical engineering?

Patents for embryonic stem cell lines – banned
Meanwhile, back in the Old World, the European Court of Justice has recently signalled a ban on any such patent protection for embryonic stem-cell lines.  The action before the Court was originally begun in Germany by Greenpeace.  One of the advocates-general, who advises the Court, has argued that it should be unlawful to allow patents where research destroys human embryos.  Judges of the Court are not bound to follow this source of advice, but frequently do so.

Up went the arms of the stem cell scientists!  There will be no financial investment from industry unless our innovations can be protected by patents, they bemoaned.  A patent ban will threaten the future of European medical science and we will lose our place as a world leader, they opined.  And finally they played the emotive card – our work is driven by the ‘ethical need to treat disease’.  Professor Austin Smith from the Wellcome Trust Centre for Stem Cell Research in Cambridge spotted the tight spot.  He stated that, ‘It would also send the message that scientists are engaged in immoral activity so this is very negative for our community and it would erode public confidence in what we do.’  Yes, so?

US embryonic stem-cell funding ban lifted
In March 2009, President Obama issued an executive order which lifted a ban, originally implemented in 1995 by the so-called Dickey-Wicker Amendment, on the use of US government money to fund embryonic stem-cell research, in fact, any research that harmed or destroyed human embryos.  The move was challenged by two pro-life scientists who took the National Institutes of Health (NIH, the USA’s medical research agency) to court in August 2010.  US District Judge Royce Lamberth issued a temporary injunction while the wording and meaning of the Amendment were clarified by the courts.  On September 9, 2010, the Court of Appeals for the District of Columbia granted a temporary overruling of that injunction.  On 29 April 2011, the three-judge US Court of Appeals in Washington voted 2-1 to uphold that decision and stated, ‘We conclude the plaintiffs are unlikely to prevail because Dickey-Wicker is ambiguous and the NIH seems reasonably to have concluded that, although Dickey-Wicker bars funding for the destructive act of deriving an hESC [human embryo stem cell] from an embryo, it does not prohibit funding a research project in which an hESC will be used.’

Don’t you just love legal wrangles, especially those where the outcome is determined before the evidence is heard?  This was a case of two little pro-lifers against the might of the US scientific establishment plus the US President.  By hook or by crook, the victors were predetermined.  The case actually goes back before Judge Lamberth, but he now has virtually no wiggle room.  Could it yet go to the Supreme Court? Some think it could.

A setback for iPS cells?
The journal Nature has recently published two articles in which genomic and epigenomic analyses of iPS (induced pluripotent stem) cells have identified genetic mutations caused by the various reprogramming processes.  Such findings have been used by embryonic stem cell researchers to cast doubt over iPS cell safety and their medical utility because of the fear that DNA damage could lead to the onset of cell mutations and cancers.

Is this really a significant setback?  Probably not.  Numerous technical hurdles have been overcome since their discovery in 2006.  Moreover, nobody has seriously suggested that iPS cells are ready for human therapeutic use – that is perhaps a decade away.  In the meantime, they are immensely useful as models to study cellular activities and as tools for drug-testing.  And upbeat discoveries always seem to be just around the corner with iPS cells.  For example, the authors of one these reports state, ‘Remarkably, expansion of human iPS cells in culture selects rapidly against mutated cells, driving the lines towards a genetic state resembling human ES cells.’  In other words, as iPS cells grow they automatically weed out aberrant cells.  As these same authors optimistically conclude, ‘With a better understanding of the reprogramming process, we will increase the likelihood of finding ways to counteract the pitfalls and create human iPS cells that can safely be used for cell-based therapies in the future.’

Is all the above merely academic?  An article in one the June editions of Nature suggests that even the idea of treatments with iPS cells may be unnecessary.  Think of heart attacks – they render the muscle cells of the heart, cardiomyocytes, irreparably damaged.  Their replacement is essential.  Yet heart progenitor stem cells, which can develop into the required blood vessels and muscles, already exist in adults, but in a dormant, turned-off state.  Paul Riley and his colleagues at University College London Institute of Child Health have found a way to wake them up!  A small protein, known as thymosin β4 (Tβ4), can switch on a gene called Wt1, which in turn can trigger these ‘sleeping’ stem cells into self-repair action.  Remarkable, or what?  OK, this work was done in mice.  Could it also occur in human hearts?  Could a daily tablet or injection of Tβ4 be a future treatment before or after a heart attack?  Sounds like good news for the broken hearted.

CIRM begins to back adult stem cells
CIRM (the California Institute of Regenerative Medicine) was originally set up in 2004 to circumvent President George W Bush’s prohibition on the use of human embryonic stem cells.  Controversially, it raised billions of taxpayers’ dollars to pursue its blinkered scientific ideology.  Now CIRM appears to be turning away from its original mission statement.  It has recently awarded grants of $230 million to various Californian universities and biotech companies to pursue stem-cell treatments of cancers and AIDS.  But – note the irony – only 4 of the 14 funded projects will use embryonic stem cells.  The other 10 will use adult stem cells or conventional drugs.


Euthanasia and Assisted Suicide

The assisted suicide downgrade
For those who have only just realised the existence of a clever, well-orchestrated and cash-rich campaign to legalise some form of euthanasia in the UK, consider these facts.  These pro-euthanasia folk, mainly channelled through the Dignity in Dying organisation, are entirely media savvy.  Their mantra is this – a person must be terminally ill and mentally-competent before being assisted to die.  Yet they admire the work of Dignitas, the Swiss euthanasia ‘clinic’, and they crave a similar facility in the UK.  About 120 Britons have now travelled to Dignitas to die.  It started with those who were indeed terminally ill, such as cancer or motor neurone disease sufferers.  Then, it shifted to those with progressive, but not necessarily fatal, conditions, like multiple sclerosis.  Next, the traffic began to include those with severe, but non-fatal, conditions, like spinal cord injuries.  Now the middle-aged and elderly with chronic, but still non-fatal, conditions, such as arthritis are seeking assisted suicide there.  See the downgrade?  Two things.  First, Dignity in Dying’s insistence that assisted suicide is only for the terminally ill begins to look restrained, even reasonable.  Second, the mentally-competent person’s request must be voluntary and sustained, though how these qualities are assessed remains unclear.  Yet they are adamant that changing the law will not open the floodgates.  Two things.  First, once a law is established it is always amended permissively, never proscriptively (vide, abortion, IVF, etc.).  Moreover, ‘voluntary’ so easily slips into non-voluntary.  ‘Sustained’ can readily become transient with its own momentum in our tick-box age.  Second, once an illegal act becomes lawful, a new clientele emerges (vide, abortion, IVF, etc.) and the few become the many.

Nan Maitland and Ann McPherson
These two women had common cause – they were both leading campaigners for assisted suicide and both recently died, but under rather different circumstances.

In March, Nan Maitland, aged 84 and a mother of three, travelled to Switzerland to a clinic to die despite having no terminal illness – she was active and healthy, apart from some troublesome arthritis.  Yet Mrs Maitland was adamant that she did not want to go through what she described as, ‘a long period of decline, sometimes called "prolonged dwindling", that so many people unfortunately experience before they die.’  She was an enthusiastic member of Friends At The End (FATE) and a founder member of the Society for Old Age Rational Suicide (SOARS).

By contrast, Dr Ann McPherson was unreservedly terminally ill.  She had survived breast cancer in the 1990s, but was diagnosed with pancreatic cancer in 2007 of which she died this May, aged 65.  Some called her ‘Britain’s best known terminally-ill doctor.’  She was a patron of Dignity in Dying and founder of the recently-formed organisation, Healthcare Professionals for Assisted Dying.  Dr McPherson also acquired fame as the joint author of the million-selling guide to teenage health, Diary of a Teenage Health Freak and as the founder of the fascinating doctor-patient website, www.healthtalkonline.org.  Yet this immensely-talented physician was so mistakenly enamoured with euthanasia.  Though she saw the bioethical parallel, ‘Like the Abortion Act, an Assisted Dying Act would be about giving people – in this case the terminally ill – the right to choose’, she failed to see the dangers of the floodgate parallel.  Then again she failed to disentangle the reality of euthanasia from its lexical engineering – she said, ‘First of all it should be assisted dying not assisted suicide. I feel quite strongly about that.  Actually it’s very positive.  And that’s why I feel so strongly that it should be called assisted dying rather than suicide.  Suicide has all sorts of connotations that dying does not.’  Readers beware: euthanasia is more than a word game.

Unlike Mrs Maitland, who died on a Tuesday evening in a bleak room somewhere outside Zurich, accompanied by just two of her right-to-die campaigners, Dr McPherson died at her comfortable home in Oxford at lunchtime one Saturday, surrounded by her family and close friends.  Both women got their very different final wishes.  Or did they?  Two weeks after her death her husband, Klim McPherson, told a rather different story of his wife’s last days.  He wrote, ‘I watched my wife of 43 years suffering as she was forced to live in unbearable discomfort.  True, she wasn’t in pain and her final days were as comfortable as possible.  The death itself was chaotic.  The GP warned us on the Friday that Ann might be near death but we’d been told that a number of times before.  The nurse said quietly that Ann was ‘on her way’ – but somehow we weren’t at all ready for her to be going.  And so there was nothing peaceful about her death.  Instead, we, her loving family, were in shock, racing around urgently attending to her needs while she was alone.’  Can all this really be true?  Sure, dying and death are invariably difficult and stressful times.  But here was a ‘medical family’ – three of them were doctors – so above all they should have known about the needs of the dying patient, his wife and their mother, yet when the time comes, they are unprepared, distracted and apparently desert the patient.  What they all needed was good palliative care – this distressing scenario was anything but.  I am sorry that the McPhersons did not experience a good death of their loved one.

Jack Kevorkian, 1928-2011
Reading and writing about advocates of euthanasia is a gloomy endeavour.  Here is another, Dr Jack Kevorkian, aka Dr Death. His real name was Jacob and his real job was as a pathologist rather than as a physician – but he was still a ghastly man.  During the 1990s, he assisted at least 130 people, most of whom were not terminally ill, to die.  In 1991, the State of Michigan revoked his medical licence.  He was brought to court four times for assisting suicides, but always managed to secure acquittals plus copious global publicity.  However, on 22 November 1998, the CBS TV programme, 60 Minutes, broadcast a videotape that Kevorkian had made a year earlier in which he was shown administering a lethal injection to Thomas Youk, a 52-year-old sufferer of motor neuron disease.  During the broadcast, Kevorkian dared the authorities to stop him from carrying out such killings.  They called his bluff – in 1999, he was arrested and convicted of second-degree murder and served 8 years of a 10 to 25-year prison sentence.  After his release, he lectured about, but apparently did not participate in, his favourite topic. He even ran, unsuccessfully, as an independent candidate for the US Congress.  A film, You Don’t Know Jack, based on his life and starring Al Pacino in the title role garnered some showbiz acclaim.  Earlier this year he was admitted to hospital with kidney problems and he died from a thrombosis on 3 June.  His death was apparently dignified and natural – something he denied his many ‘patients’.  He never married.

That BBC programme, Choosing to Die
On Monday 13 June, the BBC showed a documentary hosted by yet another euthanasia promoter, Sir Terry Pratchett.  This is not the place to present a critique of the programme, suffice to say that I zipped the following complaint to the BBC the next morning – the phone lines were jammed immediately after the programme.

‘I want to complain about Choosing to Die.  This was such a one-sided programme, especially in the light of Terry Pratchett’s opening remark that, ‘I want to explore the options.’  Where were they?  Where was the other side of the debate?  What about palliative care and the hospice movement?  The latter was glossed over with Mick, the relatively poor and inarticulate ex-taxi driver, yet he was the most fascinating character in the entire programme.

I trust the BBC is planning to screen a counter-balancing programme, perhaps presented by Baroness Finlay.  Truth and the public deserve that much.’

Euthanasia legislation here and there
In December 2010, the Scottish Parliament had roundly rejected Margo MacDonald’s End of Life Assistance (Scotland) Bill by 85 votes to 16, with 2 abstentions.  Such a trouncing would silence most people, at least, for a few years.  No way.  Proponents of euthanasia have a broken case, but an admirable tenacity.  Margo MacDonald MSP has recently bounced back and vowed to launch a fresh attempt to legalise assisted suicide in Scotland.

A similar story may come to pass on the Isle of Man.  In 2003, two members of the House of Keys sponsored an assisted suicide bill – it went to a select committee and its report was shelved.  Manx Parliamentary elections are due in the autumn and at least one member, if re-elected, has declared his intent to resurrect that earlier bill.

The Crown Prosecution Service still seems unwilling to do its duty.  In October 2009, Michael Bateman freely admitted helping his disabled wife, Margaret, to commit suicide, at their home in West Yorkshire, by putting a bag over her head and filling it with helium gas, while filming the incident as proof that his action was not murder.  The CPS now admits that though there is ‘sufficient evidence’ against him, it would not be in the ‘public interest’ to proceed.  It believed that Mr Bateman was ‘wholly motivated by compassion’.  So far, of all the scores of such cases investigated by the CPS, nobody has been prosecuted – of course not all lawbreakers, whether investigated or arrested, are brought to court, but surely by now someone must have breached the provisions of the 1961 Suicide Act.

In May, the electorate of Zurich went to the polls to vote whether to ban assisted suicides and outlaw suicide tourism in their city.  A large majority, 85% of the 278,000 votes cast, opposed a ban and 78% opposed excluding foreigners.  Next year, the voters in the Swiss canton of Vaud are having a referendum to decide if assisted suicides can be carried out in their local old peoples’ homes.  And you thought the Swiss were such nice people who spent their time making expensive watches, chocolates and cuckoo clocks.

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