Nuffield Council on Bioethics

Background Briefing. Reader can peruse this book-length report here (see the link to the pdf; note the 'Executive Summary' at the beginning). Two key conclusions: rejection of action deliberately to end life (Section 2.37); but (Section 2.11) in some cases life-sustaining treatment of a disabled infant would merely prolong 'intolerable' suffering. The latter could be interpreted in a sense compatible with Catholic teaching (as when treatment is 'useless', in the light of the good it does the patient), but where it is question of prolonging the life a disabled person for perhaps decades (since this is a newly born baby), it seems to be the application of a deeply worrying attitude that disabled lives are not worth living. The complexity of the issue explains the different reactions, below, from the Anglican/Roman Catholic bishops, 'No Less Human (SPUC)', and 'Care Not Killing'.

Comment from Bishops

The following joint comment by Rt Rev Tom Butler, Bishop of Southwark, and Most Rev. Peter Smith, Archbishop of Cardiff, has been issued on behalf of the Church of England House of Bishops and the Catholic Bishops' Conference of England and Wales on the publication of the Nuffield Council's report 'Critical care decisions in fetal and neonatal medicine: Ethical issues'. 'We warmly welcome the clear recommendation from the Nuffield Council today that 'the active ending of life of newborn babies should not be allowed, no matter how serious their condition. ' This reaffirms the validity of existing law prohibiting euthanasia, and upholds the vital and fundamental moral principle that the deliberate taking of innocent human life is always gravely wrong. There is a clear distinction between interventions which are deliberately aimed at killing, and decisions to withhold or withdraw medical treatment when it is judged to be futile or unduly burdensome. In our joint submission in 2004 to the Select Committee of the Assisted Dying for the Terminally Ill Bill the Church of England House of Bishops and the Catholic Bishops' Conference of England and Wales said: 'Doctors do not have an overriding obligation to prolong life by all available means. Treatment for a dying patient should be 'proportionate' to the therapeutic effect to be expected, and should not be disproportionately painful, intrusive, risky, or costly, in the circumstances. Treatment may therefore be withheld or withdrawn, though such decisions should be guided by the principle that a pattern of care should never be adopted with the intention, purpose or aim of terminating the life or bringing about the death of a patient. Death, if it ensues, will have resulted from the underlying condition which required medical intervention, not as a direct consequence of the decision to withhold or withdraw treatment. ' (para 18) 20 In applying this principle we believe that every case should be judged on its merits and like the British Medical Association, we would have concerns about any blanket recommendation regarding the treatment of babies born before 22 weeks. Decisions regarding treatment should always be made on an individual basis having regard to all the circumstances of the case. We will wish to study the detail of the Nuffield Council's report but welcome the extremely important recommendation opposing any action aimed at the active ending of life of newborn babies. [CCN]

Comment from No Less Human:
Alison Davis of the 'No Less Human', SPUC's disability rights group, has commented on the Nuffield report: 'The Nuffield Council seems to have decided that severe disability is a fate worse than death, and a good enough reason not to treat a premature baby. The Council thus ignores the inherent right to life of all babies, disabled or not, as well as the right to treatment on an individual basis according to clinical need. It is nothing short of eugenics to decide that because a baby has, or will have, a disability, or because the chance of survival is low treatment should be denied. It is a denial of basic human rights, and a form of fatal discrimination on grounds of disability. Disabled people view this as an encouragement of the attitude that we are better off dead, and that it represents a further step towards active killing of disabled newborns. ' [SPUC]

Comment from Care Not Killing

Bioethics Comittee says 'No' to infant euthanasia
In its report published today (Critical Care Decisions in Fetal and Neonatal Medicine: Ethical Issues) the Nuffield Council on Bioethics concludes that active steps to end the life of newborn babies should not be allowed, no matter how serious their condition. The professional obligation of doctors, says the report, is to preserve life where they can. The Council states that among the problems of allowing euthanasia for seriously ill newborns is that it would be very difficult to identify an upper age limit beyond which the practice would be permitted.

The report also endorses current medical practice and law which allow decisions to be made either to withhold or to withdraw treatment in cases where treatment would be futile or cause intolerable suffering for no benefit. And, equally important to endorsing current law and medical ethics in this area, the Council calls for palliative care to be given to newborns who are not to be treated, so that they can die peacefully and in comfort instead of simply being left to die suffering the symptoms of their illness. (The rest of this report is here.)