Dominic Lawson: Doctors, disabled children and euthanasia

Those who wish to make it easier to destroy lives are not thinking about the interests of the child

Supporters of euthanasia are fond of quoting the following couplet. "Thou shalt not kill; but need'st not strive/ officiously to keep alive." I sometimes wonder if they are being deliberately obtuse. For the verse, by the poet Arthur Hugh Clough, is part of a satirical attack on what he saw as the brutally pragmatic pseudo-morality of Victorian Britain. Clough's bitter irony is clear throughout; the next couplet of The Latest Decalogue is: "Do not adultery commit;/ advantage rarely comes of it."

Given Clough's desire to reassert specifically Christian values, it is almost beyond satire that the latest person to quote his verse in precisely the opposite sense that the author intended is the Very Reverend Colin Slee, the Dean of Southwark. He told a newspaper yesterday that these words summed up "in good King James language" a paper by his Bishop, the Right Rev Dr Tom Butler, which argued that in the treatment of mortally ill premature babies, Christians should sometimes "override the rule that life should inevitably be preserved."

As a matter of fact, neither of these two reverend gentlemen appears to be arguing in favour of euthanasia. Unfortunately for the Bishop of Southwark, his paper to the Nuffield Council on Bioethics has been publicised in the same week as one for the same organisation by the Royal College of Obstetricians and Gynaecologists (Rcog), which was widely read as advocating the killing of some premature babies. As a result, Dr Butler has suffered some sort of guilt by association; it was presumably this which his Dean was attempting to rebut, however hamfistedly.

Having read Dr Butler's full submission, I can see why he might be annoyed by the charge that he is deviating from the Church's traditional approach to such matters. For example, he writes that: "The primary principle from the Christian tradition is that all life is a gift from God, whether inside the womb or outside, whether disabled or not ... The conceiving and bearing of a child is not for the purpose of producing a perfect baby ... The fetus and neonate are unique individuals under God. We cannot therefore accept as a justification for killing them the argument that their lives are not worth living."

On further examination, it is not even the case that the Rcog was arguing for the killing off of seriously ill neonates. In its submission the medical body says that, "We do not have a view that we would like euthanasia [for new-borns] to be discussed ... [but] if assisted dying legislation is to be anticipated or enacted at the other end of life, now would be a pertinent time to discuss this."

It turns out that this submission - although it has only now been published - was sent to the Nuffield Council on Bioethics last summer, while Lord Joffe was attempting to persuade the Upper House to pass a Bill in favour of "voluntary euthanasia". With that Bill's defeat, accompanied as it was by a 73 per cent majority within the Royal College of Physicians declaring outright opposition to "physician-assisted suicide", it is no longer so very "pertinent".

Nonetheless, while the issue is attracting headlines, it might be worth addressing a few misunderstandings. There seems to be a great confusion about what constitutes "a very ill child". Many of the conditions which are frequently spoken of as illnesses are nothing of the sort. A person born with a severe physical handicap is not physically sick. A person with a mental handicap does not have a mental illness. In neither case is there anything to be cured.

A baby born with Down syndrome is not "suffering" from anything. Accordingly, it could never correctly be described as a compassionate act to do anything to bring about the end to such a life. At the risk of sounding harsh, I think it is necessary to state clearly that those who wish to make it easier to destroy such lives are not thinking about the interests of the child: they are thinking about the interests of the parents.

The more interesting question is: how clearly are parents in such a situation able to assess their own future? As I know myself, when you are told that your newborn child has some kind of genetic abnormality, you are in no condition to make any sort of decision, still less one involving life and death. Most prospective parents have a horror of having a child with Down syndrome: but there are very few, who, having had such a child, are not fiercely protective and loving.

On an edition of David Starkey's Last Word a few days ago, I was debating this issue with the 82-year old (and still razor-sharp) Baroness Warnock, who spoke nostalgically of the good old days when a doctor delivering a home birth could simply smother a handicapped newborn and no questions would be asked. I replied that those days were not entirely over and described the recent case of "Child MB", a two-year-old boy with spinal muscular atrophy, a condition which can result in complete physical paralysis, but in which the brain develops normally. Because of his physical condition, MB could not breathe without the aid of a ventilator. MB's doctors decided that his life was without purpose and asked the parents to consent to his ventilator being turned off - which would have caused his immediate suffocation.

The parents - who are not Catholic, by the way - refused. As a result, the case reached the Courts, where no fewer than 14 doctors argued that the child's life should be ended immediately. Mr Justice Holman backed the parents, arguing that "No court has before been asked to approve that, against the wishes of a child's parents, life support should be discontinued, leading to the inevitable death of a child with sensory awareness and assumed normal cognition and no reliable evidence of brain damage."

Although Mary Warnock did not respond to this on air, as we left the studio she remarked to me that she had read about the case of Child MB vs the NHS, which she thought was "shocking" and added that doctors were often "very bad" at dealing with such cases - unlike judges. I was startled by this, but shouldn't have been: it's in the nature of debates on television that its participants take positions which are harder than those we adopt when liberated from the need simply to win an argument in public.

On or off air, moreover, Mary Warnock is always free of cant - unlike those who pretend that their peculiar loathing of the most vulnerable of all children is no more than a disinterested desire to see the National Health Service's funds allocated for the benefit of all. Or, as Arthur Clough wrote: "Bear not false witness; let the lie/ have time on its own wings to fly."

d.lawson@independent.co.uk