Update on Life Issues - November 1996
If the days of last summer were not memorably long and hot, the
ethical debates certainly were. "Life issues" were again top
of the media agenda and consent, in its various forms, was a major
Caesarean sections without consent.
It all started during June, in two separate cases, when doctors
were given permission to perform Caesarean sections on two women
against their express wishes. Almost unbelievably, the
judgements were made while the women were in labour because the
High Court judge thought that the pain and stress of labour would
prevent them from making the right, informed choice.
However, there was no evidence from the medical staff accompanying
either woman that they were anything other than mentally
competent. These, and other previous similar cases, do seem
to contradict the well-established principle that informed and
mentally competent patients should not be forced to undergo
operations without their consent. After all, we are told,
“the patient does have the right to choose”.
Orphaned embryos and the
HFEA. On Wednesday 31 July, the HFEA (Human
Fertilisation and Embryology Authority) insisted that upto 4,000
human embryos must be destroyed because their 5-year storage
period was up. These embryos had been stored since 1991 and
been abandoned by their parents. At least, the HFEA and the
IVF clinics could not trace the parents to gain their consent to
store their embryos for a further 5 years.
It was indeed a macabre moment to witness the white-coated
technicians on TV withdrawing the glass vials, containing the
embryos, from the fuming, freezing liquid nitrogen, opening them
and then allowing the embryos to warm up and perish so they could
be discarded along with the hospital waste. This ghastly
activity was going on at IVF clinics up and down the UK for
several days at the beginning of August.
The only sensible answer to this dilemma is quite simple.
Parliament must act immediately to halt the freezing of all human
embryos. However, even this solution will mean that many
more embryos will have to be destroyed over the next five years
because tens of thousands are already stockpiled, 'deserted' by
their parents and awaiting the date of their 5-year storage period
to run out. But at least this solution would stop this awful
practice continuing too far into the 21st century.
Selective reduction and the
16-week twins. Then in August there
was the news of the 28-year-old mother, pregnant with 16-week-old
twins, who wanted to abort one of them because she felt she was in
“straitened circumstances” and could not cope with both. In
poured money, apparently about £50,000, as well as indignation
from around the world that a so-called civilised society could
allow the destruction of a perfectly healthy baby (not that the
handicapped deserve to be aborted). This so-called
“selective reduction” of multiple unborn children is nothing new -
it was practised on at least 74 occasions in the UK during 1994,
mainly because of fetal handicap, or the presence of quads or
quins resulting from IVF treatment. What was “new” about
this particular case was that selective reduction was, for the
first time, being used for economic and social expediency.
A High Court injunction was obtained to stop the abortion, but it
was later revealed that it had already occurred. Indeed, it
was later revealed that the mother was a married, wealthy career
woman with no social problems. Amid all the rumours, deceit
and misleading of the media, politicians and the public there were
some excellent articles in the press. Some of these pieces
were written by those who would normally support the idea that
abortion is “a woman's right to choose” - even they had been
shocked by this recent development. Among them was Libby
Purves, who, writing in The Times (6 August), traced the
history of the last 50 years of medical ethics and demonstrated
that, "Imperceptibly, disgracefully, we have lost our reverence
for the unborn."
She finished her piece by lambasting the majority of churchmen,
the moralists and the liberal and kindly people for saying little,
and doing even less. She concluded that, "Only a few
organisations have taken the fully Christian route, welcoming the
unwillingly pregnant, offering praise and sympathy when they
decide to go through with the birth, looking after them in the
months of helplessness, enabling them either to care for their
babies or give them for adoption and to bear the resulting
grief." I think, without so much as a smidgen of
triumphalism, that she was pointing, at least, to the wonderful,
largely unsung, caring work of LIFE.
Mandy Allwood and her octuplets. Perhaps
the biggest ethical news of the summer was created early in August
by Mandy Allwood, who managed to superovulate and conceive
octuplets. She went against medical advice and had sexual
intercourse while being treated in a private clinic in Birmingham
with fertility drugs. Why a previously fertile woman (with a
5-year-old child, a previous abortion and a recent miscarriage)
was recommended such treatment, especially in the absence of
counselling with her partner, who apparently lives with another
woman, is still a mystery.
However, what was clear was that by September she was pregnant and
determined to go for a world record and carry all eight babies to
term. If sex and money make the biggest headlines then here
was the near-perfect story, because Mandy Allwood had, to the
annoyance of many, sold her account to The News of the World for
an alleged six-figure sum.
What followed was most instructive. Much of the medical
profession, rather than rise to the challenge, spoke only in terms
of gloom and doom. The universally offered treatment was the
barbaric selective reduction - “kill six to save two”. Mandy
Allwood refused. That is, she took advantage of that
well-known liberal slogan, “a woman’s right to choose”. And
then what happened? The pro-abortion press immediately
rounded on her, often with near hysterical spite.
But late in September she started contractions and was moved to
King’s College Hospital, London. On Monday 30 September she
lost three of her boys. The very next day one girl was
stillborn in the morning, and that afternoon the remaining three
boys and one girl all died.
Much of the medical profession was aching to say, ”We told you
so. You should have aborted six.” But the ends do not
justify the means and it is simply wrong for doctors to kill their
patients. Poor Mandy Allwood - she was devastated She
was a mother, who wanted, but suddenly lost, eight of her
children. Undoubtedly she will grieve, but her one
consolation is that she did her best for them all and did not
consent to killing any of them - for that she need experience no
First legal euthanasia act.
On 22 September, Bob Dent, a 66-year-old carpenter with cancer,
became the first person in the world to die under euthanasia
law. This occurred as a result of the Right of the
Terminally Ill Act, which was recently passed in the Northern
Territory of Australia.
The event caused an ethical storm across Australia and the law may
soon be overturned by either a High Court challenge, or
Parliamentary debate. That notwithstanding, this incident
does represent one more step down the slippery slope towards
voluntary euthanasia. Apparently, at least five other people
in Australia are already queuing up for the same treatment.
Mr Dent used a computer-operated machine developed and supplied by
a Dr Philip Nitschke. The so-called “death machine” gives
the patient control over the time of his death and means that a
doctor does not need to be directly involved. The patient’s
consent is indicated by the answers he gives to three questions on
a laptop computer. If he answers ‘Yes’, ‘Yes’ and ‘Yes’ and
then hits the spacebar, the machine delivers a lethal cocktail of
drugs into his arm.
Dr Nitschke is reported to have said that, “It [voluntary
euthanasia] is the greatest thing you can do for a person. I
felt at the end of it enhanced by the experience.” All this
writer can say is, “I am glad he is not my doctor. And I am
glad that I am computer-literate and can type ‘No’.”
US late-abortion vote.
President Clinton recently vetoed a bill to ban late abortions
throughout the US. But in September the Senate voted to
override the President’s wishes. However, although the vote
for such a ban was 57 with 41 against, it was not the two-thirds
majority needed to change the law.
Sperm donation and posthumous children.
Also in September the HFEA said that a 30-year-old widow from the
Midlands must not be inseminated with her dead husband’s
sperm. The husband had contracted bacterial meningitis and
while he lay in a coma, his wife asked for sperm samples to be
removed from him. But the HFEA insisted that the samples
could not be used because her husband, who died four days later,
did not give his written consent. The HFEA does not require
written consent when a couple are treated together. Nor does
it consider a marriage contract as sufficient evidence of consent.
Assisted conception clinics outside the UK agreed to inseminate
the woman, who, for legal reasons, is known only as DB.
However, the HFEA has refused to allow the export of these gamete
samples, though that may be in breach of EC law on “access to
This case is an ethical can of worms. Apparently, according
to DB, the couple had previously discussed and agreed upon this
procedure if the husband was ever likely to die suddenly. On
the one hand, there is a general public sympathy for the woman -
could not a child so conceived help her through the grieving
process? On the other hand, there is something distinctly
eerie about taking gametes from a dying or dead patient and using
them (not in the straightforward way that for example, corneas and
kidneys are donated to support an already living person) to
produce deliberately a posthumous child. Can that ever be
sensible? Can that ever have in mind the best interests of
Report on fetal pain.
Back in 1988, a survey asked paediatric anaesthetists if they
thought newborn babies could experience pain. Somewhat
amazingly, about 33% answered “No” or “Don’t know”. Now in
1996, 100% of such medical personnel believe that the newborn
really can suffer pain. The next question, can the unborn
child suffer pain?, has become a hot topic. It is also a
controversial one, not least because there is currently no direct
way of assessing fetal pain. A proper doctor would say that
because we do not know, it is better to err on the safe side.
A soon-to-be published Parliamentary report states that there is
evidence to suggest that an unborn child, as young as 10 weeks,
may experience pain. From 14 weeks, most of the child’s body
responds to touch by moving away. Mr John Friend, senior
vice-president of the Royal College of Obstetricians and
Gynaecologists maintains that this is “unreasonable”. He
further states that, “We as doctors are not keen to do anything
that causes suffering.”
And one final thought.
The above catalogue portrays a gloomy picture of the state of
current medical practice. It is beyond cavil that medicine
has, within the last 50 years or so, drifted far from its high
ethical moorings, derived from that robust combination of the
pagan Hippocratic Oath and the doctrines of Scripture. Human
life was then seen as something special, to be protected and
cherished. The medical profession has, like most other
aspects of 20th-century life, largely abandoned any moral
absolutes and any such high ethical views. But would it be
any better if all our doctors were evangelical Christians?
Now, there’s a question!
During the summer the Christian Medical Fellowship (CMF) published
the results of a survey entitled, Members’ Attitudes to
Abortion. A total of 2580 qualified doctors and 348 student
doctors responded to the CMF’s questionnaire.
To the question, “When does human life have full value?”, about
70% of the students answered “at fertilisation”, whereas less that
40% of doctors gave that answer. Concerning the acceptable
reasons, or grounds, for abortion there was a wide range of
views. On the key question relating to the so-called “social
clause” (that is, ground C; risk of injury to the physical or
mental health of the woman (pregnancy has not exceeded its 24th
week)), which accounts for about 90% of abortions in England and
Wales, the responses were fairly liberal. As many as 5%, 12%
and 30% of qualified doctors would “always”, “often” and
“sometimes” abort. Put another way, about 50% of evangelical
doctors could be, at least sometimes, persuaded to recommend
abortion for social reasons. Less than 20% would “never”
One is left wondering if an entirely evangelical Christian medical
profession would result in the practice of better medicine.
Or would human embryo destruction and abortion simply
continue? There is, however, a little hope. The
student doctors were invariably more conservative in their
attitudes than their older mentors. The world belongs to the
next generation of men and women. Let’s pray for them and
encourage them to stand steadfast and to live by the
non-negotiable truths of the Word. Now, that is something
worth giving our consent to.
foundations are being destroyed, what can the righteous
do? [Psalm 11:3]