Irish Medical Council's review of A Guide to Ethical Conduct and Behaviour

Friday 7th September 2007 16:18 London time

SPUC wishes to emphasise to the Council the importance of the following considerations, in response to the Council's review of its ethics guide.

Unborn children (in utero and ex utero)

The Council's guidance, where it relates to human procreation or reproduction, should reflect the following norms of international fundamental human rights law:

UN Convention on the Rights of the Child (1958): "Every child, by reason of his physical and mental immaturity, needs special safeguards and care, including appropriate legal protection before as well as after birth (preamble, paragraph 7).
Universal Declaration of Human Rights 1948 begins: "Whereas recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world," and affirms in Article 3: "Everyone has the right to life..."
European Convention on Human Rights (ECHR) 1950: "Everyone's right to life shall be protected by law. No one shall be deprived of his life intentionally save in the execution of a sentence of a court following his conviction of a crime for which this penalty is provided by law." (article 2) was among the ECHR's original signatories.

The Council's guidance should also reflect Article 40.3.3° of the Irish Constitution: "The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right."

Euthanasia (and assisted suicide)

Euthanasia in the strict sense is understood to be an action or omission which of itself and by intention causes death, with the purpose of eliminating all suffering. There is no moral difference between euthanasia by commission and euthanasia by omission, as both are intended to end a life.

The physician taking the Hippocratic Oath swears never to administer lethal drugs to a patient, even at the patient's request. He also swears to the highest personal and professional integrity, regarding medicine as a vocation rather than simply an occupation or trade. These values - respect for the sanctity of human life, prohibition of euthanasia and assisted suicide and the good character, the ethos, of the medical profession - are powerfully inter-related, indeed inseparable values.

Euthanasia and assisted suicide diminishes the autonomy of both patients and doctors. Autonomy works two ways. The right to autonomy must be exercised responsibly. Both ethics and the law say that, just as we cannot sell ourselves into slavery, we cannot consent to be murdered. This is because the right to life, like the right to liberty, is inalienable. The obligation to respect the right to life extends to respecting one's own life, and it would be unethical to intentionally deprive oneself of life. Making euthanasia and/or assisted suicide available to patients would lead to pressure on doctors and nurses to assist in euthanasia, thereby diminishing their autonomy to practice their profession according to their consciences and the Hippocratic Oath.

Conscientious objection

Freedom of conscience is a basic right that is enshrined in both the Universal Declaration of Human Rights (article 18) and the European Convention on Human Rights (article 9). It has also long been recognized amongst medical ethicists and many others that exercising one's well-formed conscience is a legitimate expression of autonomy. In the context of medical care, this means that no medical professional shall be under a duty to participate in any diagnosis, treatment or other action about which he or she has a conscientious objection.

Anthony Ozimic
Political Secretary
Society for the Protection of Unborn Children (SPUC)
London