Some Big Public Policy Challenges in Bioethics we can expect in 2018

By Dr. Peter Saunders

Editor’s note. Dr. Saunders is a former general surgeon and CEO of Christian Medical Fellowship, a UK-based organization with 4,500 UK doctors and 1,000 medical students as members. This is excerpted from a longer post found here.

As we look forward to the challenges that 2018 will bring I am struggling to think of a time when we have faced more major public policy challenges in bioethics in so many areas all at once.

This is perhaps inevitable given the march of secular humanism through parliament, the courts and institutions.

Here is some background on the five major threats currently looming.

1. Assisted Suicide

Given that 11 attempts in British Parliaments to change the law to allow assisted suicide or euthanasia have failed since 2003, our opponents, not surprisingly, have shifted their attention to the courts in an attempt to change the law through the back door.

Conway, who has motor neurone disease and is seeking assisted suicide, lost his case in which CNK [Care Not Killing]Alliance intervened in the Divisional Court in October, and his appeal to the High Court was denied. He now plans to appeal directly to the Court of Appeal. See my previous comments on the case here.

Omid, who has multiple system atrophy and is also seeking assisted suicide, had a preliminary hearing on November 21and has appealed to the judges to allow a full enquiry in which all witnesses can be cross-examined along the lines of the Carter case in Canada. We await their decision.

There have been three worrying judgements by the Court of Protection in the last few months. Formerly all patients with Permanent Vegetative State (PVS) and Minimally Conscious State (MCS) had to go to court for appeals about the removal of artificial nutrition and hydration (ANH). But now there are moves to withdraw ANH from these and less severely brain-damaged patients who are not imminently dying without going to court provided that both doctors and relatives agree that it is in the patient’s ‘best interests’. The Official Solicitor will appeal these judgements in the Supreme Court on 29 January.

A recent case involving a pharmacist (Desai) who helped his father end his life with a morphine and insulin overdose resulted only in a nine-month suspended sentence. The general trend is toward fewer prosecutions and convictions for assisted suicide and the DPP’s [Director of Public Prosecution’s] prosecution criteria on assisted suicide are being interpreted very liberally.

2. Abortion

The ‘We Trust Women’ campaign, masterminded by Ann Furedi of BPAS, [Britain’s largest abortion provider] is gaining momentum and now has the support of the Royal College of Obstetricians and Gynecologists, the British Medical Association, and Royal College of Midwives. Whilst there is no bill currently before Parliament (and none likely to appear before 2019), pro-abortion activists may seek to amend a government health bill to achieve their aim of completely decriminalising abortion.

This will most likely involve repealing Sections 58 and 59 of the Offences Against the Person Act 1861 (OAPA) which make procuring an abortion for oneself or others a crime punishable by life imprisonment. The effect would be to make abortion legal for any reason up to 28 weeks and, if the Infant Life (Preservation Act) 1929 is repealed too, up to birth.

Were this to succeed the Abortion Act 1967 with all its provisions (two doctors, licensed premises, reporting, conscience clause etc) would fall as it is contingent upon the OAPA.

There are also calls to relax the abortion laws in Northern Ireland, Ireland and the Isle of Man.

3. Freedom of Conscience in healthcare

Currently there is statutory conscience protection for health professionals only for involvement in abortion and activities authorised under the Human Fertilisation and Embryology Act. The scope of the former is restricted because of a Supreme Court judgement on the case of two Glasgow midwives.

Freedom of conscience for other activities is covered only partially by equality legislation.

The General Pharmaceutical Council, which regulates Pharmacists and Pharmacies, modified new guidance which would have replaced a ‘right to refer’ with a ‘duty to dispense’, in response to protests from interest groups. …

Baroness O’Loan’s Conscientious Objection (Medical Activities) Bill is to have its second reading in the House of Lords on January 26. 2018. Although this bill is much narrower in scope than we would have preferred (covering only abortion, IVF and related technologies and withdrawal of treatment) it has our support.

So, a busy year awaits. Watch this space for further developments.