Politics: Euthanasia ruled out as use of living wills backed

A Green Paper on how to protect people unable to make crucial decisions for themselves was published yesterday. Suggestions include greater use of living wills and formal powers for relatives or friends - but not euthanasia. Michael Streeter and Fran Abrams look at the issue.

The Lord Chancellor said yesterday that the law on the rights of the mentally incapacitated was "confusing and fragmented" and needed reform. It affected not just those unable to make decisions but those relatives and friends who cared for them too.

On the day an MP introduced a Bill on doctor-assisted dying, Lord Irvine of Lairg said many of the issues involved in the Green Paper, such as so-called living wills, were controversial and needed careful public consultation.

The document, Who Decides?, modelled on a 1985 Law Commission report, lays out the categories of people who would be covered by any new laws.

These are: those who have never had "capacity", for example people who grow up with severe learning difficulties; those who have had such capacity removed, for example by an accident, and those who, when elderly, lose their capacity.

Some living wills - called "advanced statements" - in which people rule out certain treatment in the future, on moral or other grounds, are already recognised by law but the Government is suggesting this should be extended.

In particular the wills could be used to specify the kind of treatment wanted. Officials describe this as "clarification" after the recent case of Annie Lindsell, a motor-neurone disease sufferer who sought a High Court declaration that her doctor could use drugs to ease her suffering, even though these were likely to hasten her death. She died last week.

However , Lord Irvine told the House of Lords that there was no question of doctors being forced to act illegally.

"An advance statement could not, for example, ask a doctor deliberately to end life," he said.

He also made it clear that euthanasia - a deliberate act by a third party to shorten someone's life - was not up for consultation and would remain illegal.

Another key element is the proposal to extend the existing power of attorney - which deals with financial matters - to personal and health care.

This new Continuing Power of Attorney could be used by someone who feared that he or she may one day lose their decision-making capacity to nominate a trusted relative or friend to authorise treatment on their behalf.

The paper also seeks suggestions on defining "incapacity", and setting up a legal framework to govern day-to-day decisions made by carers.

After a Commons statement on the paper, Ann Widdecombe, the Conservative MP for Maidstone and the Weald and a long-term pro-life campaigner, said that the measures on living wills and plans to extend the power of attorney to health decisions made her feel "very uncomfortable indeed".

She added that it would be wrong if patients in adjoining beds received different treatment because one had made a living will.

The statement came just before Joe Ashton, the Labour MP for Bassetlaw, introduced a Bill calling for terminally ill patients to be able to choose to die with dignity. His measure was rejected by 234 votes to 89.

"The Bill gives the right to a totally voluntary, merciful shortening of life and gives dignity to an inevitable death," Mr Ashton said.