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Life Issues Update

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11th May 2007

In this update:

- New Bill to amend the abortion law, and other abortion news

- House of Lords debate stem cell research, and other bioethics news

- Mental Capacity Act

- Palliative Care


ABORTION


INFORMATION AND ACTION UPDATE


PLEASE SUPPORT ANN WINTERTON BILL TO AMEND THE ABORTION LAW


Mrs Ann Winterton MP (Con) is introducing a Bill (under the Ten-Minute Rule procedure) to amend the present abortion law. She is supported by pro-life MPs of all parties, including Mr Jim Dobbin (Lab) who is Chairman of the All-Party Parliamentary Pro-Life Group.


The Bill is to be introduced on Tuesday, June 5 and it is vital that MPs are alerted as soon as possible urging them to attend the debate and to support Mrs Winterton. They may need time to cancel other possible engagements, so please write to your MP as soon as you receive this. Also have notices published in your church Bulletins or placed on your Church notice board as soon as it is possible, urging as many people as you can to write. The more letters MPs receive the more they will be made aware of the Bill and the more support we will receive.


The Bill is very modest and seeks only to clarify the grounds for abortion as well as giving women who apply for abortion balanced counselling which will ensure that they are properly informed about the
possible ill effects of the abortion on their physical and mental health, and also of the alternatives they may follow if they decide to continue with the pregnancy. The Bill will also require women to be given one week after counselling before having the abortion to give them the opportunity to change their minds.

The Bill has been recommended by leading psychiatrists and gynaecologists who quote the latest major research project – published in The Journal of Child Psychology and Psychiatry (January 2006). This
shows that even women with no past mental health problems are at greater risk of psychological ill-effects after abortion. In the survey women who had had abortions had twice the level of mental health problems and three times the risk of major depressive illness as those who had given birth or had never been pregnant. The study caused the American Psychological Association last year to withdraw an official statement denying a link between abortion and psychological harm.


The present abortion law allows termination to be carried out because of risk of injury to the physical or mental health of the pregnant woman. The Ann Winterton Bill would require the notification form to state specifically whether the abortion was carried out on physical grounds OR on mental grounds. The two would no longer be coupled together making it far easier for those needing to examine the figures. We would recommend that you make the parish notice as simple as possible. We would suggest the following:


ABORTION BILL


June 5th, 2007


Write to your MP without delay urging support


Ann Winterton MP – supported by Labour, Lib-Dem and Conservative MPs - will be introducing a Bill on Tuesday, June 5th as a first step in curbing the present abortion law. The aim is to ensure that women
receive proper counselling warning them of possible dangers to their physical and mental health, informing them of alternative help available, and providing them with a delay of seven days before making a final decision. The Bill will also require doctors to state on the notification forms whether the abortion was carried out on physical OR on mental grounds (instead of clubbing the two together as at present and thus obscuring the real reasons for the abortion).


Please write to your MP at the House of Commons, Westminster, London, SW1A 0AA. Or you can telephone him/her at 020 7219 3000. Ask for your MP (by name) or his/her secretary. Give your name and address to show that you are a constituent. Alternatively, you can find out who your MP is and email them at www.writetothem.com


Urge the MP to attend the debate on Tuesday, June 5th and to vote in support of the Bill.



OTHER ABORTION NEWS


Abortion ship readies to sail again

http://www.timesonline.co.uk/tol/news/world/europe/article1699514.ece

Mexico defies Church on abortion

http://www.timesonline.co.uk/tol/news/world/us_and_americas/article1706380.ece

Abortion: let's start to say no

http://www.express.co.uk/ourcomments/view/5664

School defends morning-after pill

http://news.bbc.co.uk/1/hi/england/leicestershire/6608297.stm


BIO-ETHICS

Stem Cell Research

A debate was held in the House of Lords on Thursday 3rd May about stem cell research. While it is important that the amazing developments in adult stem cell research, which have led to new treatments for many diseases, are encouraged, it was worrying that the debate was characterised by support for embryonic stem cell research (which has so far produced no new practical treatments).


Of the 22 speakers in the House on 3rd May, the vast majority were outspoken in favour of embryonic stem cell research. Perhaps more worryingly, about half of the speakers took the opportunity to call for
allowing the creation of hybrid animal-human embryos for research purposes. Baroness O'Neill of Bengarve stated that there was strong reason not only to permit, but to require the creation of such entities, and Baroness Warnock called for a need to "rethink the status of the human embryo and to take into account the possibilities of the use of the hybrid embryos".


This debate is of particular importance as the government are expected to publish a draft bill reforming the Human Fertilisation and Embryology Act this month. This Bill is expected to clarify the law on the creation of hybrid human-animal embryos.


The full debate can be read at:

http://www.publications.parliament.uk/pa/ld200607/ldhansrd/text/70503-0002.htm# 07050365000002


Lord Alton's speech, challenging the use of embryonic stem cell research, can be read at:

http://www.publications.parliament.uk/pa/ld200607/ldhansrd/text/70503-0006.htm

OTHER BIO-ETHICS NEWS


First designer babies to beat breast cancer

http://women.timesonline.co.uk/tol/life_and_style/women/families/article1706614.ece


Doctors screen embryos to avoid babies with squint

http://www.timesonline.co.uk/tol/life_and_style/health/article1752351.ece



END OF LIFE


MENTAL CAPACITY ACT - CORRECTION AND UPDATE


The last life issues update included a briefing on the Mental Capacity Act, which came partly into force in April and will be fully enforced in October. There are two points which need correction and clarification.

An advance directive ("AD") is an instruction given by a competent person that in the event that specified circumstances should occur in the future he/she does not wish to receive specific medical treatment. The Court has recognised that such directives are binding upon medical practitioners provided that they are "clearly established and applicable in the circumstances" (Lord Donaldson in RE T [1993] Fam. 95 at 103).

Where the result of an AD would be the death of a patient and it comes before the Court, the Court scrutinises the AD with particular care in order to ensure that the patient was of sound mind when he/she made the directive, that his/her choice was truly voluntary, that he/she knew the treatment that was being refused and the consequences of such refusal. Subject to these constraints an AD is effective. It need not have been made in writing and it can be withdrawn at any time. The burden of proof is on those who seek to establish the existence and continuing validity and applicability of an AD (HE v A Hospital Trust [2003] EWHC 1017 (Fam) [2003] 2 FLR 408). There is no reason to suppose that this will change after the Act comes into force. Then, as now, it will be the health care professional who is placed in the dilemma of having to decide whether an AD is valid.


In Bland the House of Lords classified the provision of artificial nutrition and hyrdration ("ANH") as "treatment". There is, as yet, no reported case in which the Court has upheld the withdrawal of ANH to any patient other than a patient in a permanent vegetative state. The Court of Appeal recently affirmed that "where...life is at stake, the evidence must be scrutinised with especial care. the continuing validity and applicability of the advance directive must be clearly established by convincing and inherently reliable evidence" (W Healthcare NHS Trust v H [2005] 1 WLR 834 at 839). On the facts of that case it was held that there was not an AD which was sufficiently clear to amount to a direction that the patient would have preferred to be deprived of food and drink for a period of time which would lead to her death in all the circumstances.


Sections 24-26 of the Act for the first time give ADs the force of statute, i.e. Parliament's express support.


The Act imposes various requirements on AD and modifies the common law by requiring that an AD relating to "life-sustaining treatment" must be in writing signed by the patient or by another person in his presence on his behalf and witnessed by a third party. ("Life-sustaining treatment" means treatment which in the view of a person providing health care for the person concerned is necessary to sustain life.)


Secondly, the example given in our last update of an AD refusing treatment for a condition that has since become curable/treatable neglected to take into account the safeguard in the Act that states that an AD will not be applicable to a treatment if there are reasonable grounds for believing that circumstances exist which the patient did not anticipate at the time he made the AD.


There are a number of safeguards in the Act which might go some way in curtailing our fears. However, it remains to be seen how effective these safeguards will be in practice.


The Act has already spurred into action a Voluntary Euthanasia Society campaign encouraging people to write 'living wills'. In addition, they supported the case of Kelly Taylor, who was seeking to use a suicidally motivated AD to force her doctors to withdraw ANH with the inevitable consequence that she will die.


The Act may result in more AD's being made than would otherwise be the case. If a health care professional is not satisfied that an AD exists which is valid and applicable to the treatment he will not be liable if he commences or continues the treatment. If he reasonably believes that an AD exists which is valid and applicable to the treatment in question he will not be liable if he obeys the directive. In the case of life sustaining treatment in case of doubt, the treatment should be continued and an application made to the Court for guidance.


The effect of the Act was largely to restate the position in common law. However, there remains the following concerns.


Firstly, so long as ANH is regarded as treatment it remains the case that ADs may be used to deny an incompetent patient ANH with the result that the patient is starved to death. The borderline between this and euthanasia seems so thin as to be non-existent.

Secondly, if ADs can be used in order to obtain death by starvation one can imagine this will be a stepping stone towards legalising euthanasia because it will be argued that it would be inhumane to cause someone to starve to death over a period of three weeks when the option of a 'painless' lethal injection is also available.

The Act is to be fully implemented in October.


If you want more information on the MCA or have any questions please contact us.


PALLIATIVE CARE

The Care Not Killing website has updated it's homepage with a lot of useful and interesting new information, particularly on palliative care. To access the website click on the following link:

http://www.carenotkilling.org.uk/