Leading Article: We should not be scared of euthanasia

IF EVERY silver lining has a cloud, then this century's progress in medical technology is surrounded by the mists of euthanasia. As technology and drugs have become ever more effective, so has our ability to keep people alive in conditions that would have been impossible a generation or two ago. Paradoxically, as death can be held off for much longer, the desire to hasten its arrival can often increase.

It is too easy to criticise doctors who have made the wrong decision. Often they are watching patients in acute suffering, and their desire to bring on death and the end of pain is motivated by compassion. However, the recent case of Dr Ken Taylor, who starved to death a patient in his care over the course of 58 days, exposes the perils inherent in so-called mercy killing.

The discreet pragmatism of the past, which allowed doctors to exercise their judgement on the few cases that they had to encounter, is, by necessity, coming to an end. The conditions of home delivery that once allowed doctors to smother malformed babies at birth have given way to a situation in which doctors routinely appear before the courts on charges of negligence and malpractice.

The problem with the rise in litigiousness is that difficult cases make bad law. As yet there has been no Jack Kevorkian - the so-called Dr Death, on trial in America at the moment - to perplex a British jury and thereby create some precedent that doctors and patients are stuck with willy-nilly. In the gap before some follower of Dr Kevorkian arises on these shores - and it cannot be long before that happens - there needs to be a decision on how Britain's doctors and nurses are to cope with the reality of euthanasia.

The General Medical Council's advice to medics considering assisting death is simple: "it's illegal; don't do it". But blanket prohibition is no longer sensible. The pressure to allow some form of assisted death will only mount, and the longer the decision is put off the more likelihood there is of an unsatisfactory conclusion. The controversial status of euthanasia in Holland, where it has been legal for some time, reflects the difficulty with public opinion over the issue. Older people are far less welcoming of euthanasia than younger generations. Any kind of life for the old, even the most disabled and devastated, is often and understandably preferred to none.

The guidelines that are brought in would have to fulfil certain criteria: first of all they must be clear, and they must protect older people from the pressure that they can too easily be put under by relatives. It is as impossible to make an objective judgement about another person's quality of life as it is to know how much pain someone else is suffering. Therefore involuntary euthanasia, as in the case of Dr Taylor, will have to be hedged around with extreme safeguards.

If the patient is unable to make a decision, for example if he or she is in a persistent vegetative state, the co-operation and approval of the family are essential. It is no longer possible for doctors to take the strain and continually face the sanctions of criminal law.

A more liberal attitude to euthanasia is not motivated by any desire to rob someone of their most fundamental human right - the right to life. It comes from an awareness that life does not exist outside time and space, but within the specific contexts of contemporary technology and mores. We must allow people to die, to protect both our doctors and ourselves.