The NHS response to Covid-19 has been incredible. It has shown the strong commitment by the medical profession and society more generally to the principle of the sanctity of human life.
This is encouraging to see in the face of an orchestrated campaign by advocates for the legalisation of assisted suicide and euthanasia for disabled people and those with terminal and chronic illnesses.
I do not doubt that it would be easy in this time of national crisis to embrace such a view. Doctors will face difficult decisions over the coming weeks and months as the capacity of the healthcare system is pushed beyond its limits. But we must resist these siren voices, because we can’t allow a return to the eugenics movement and its dark past.
The eugenics movement started in Britain during the late 19th Century, arising in the context of social Darwinism and the theory of the survival of the fittest. It quickly spread to other Western countries. It led to abuses such as the sterilisation of people with mental illness or learning difficulties in the USA during the 1920s. The movement reached its awful peak in Nazi Germany during the late 1930s with the euthanising of disabled people and those who had learning disabilities.
The underlying philosophy was of racial and genetic superiority and anyone who did not fit this model, or that was considered to be less than perfect, had “a life not worthy to be lived”. This dangerous philosophy ultimately resulted in the slaughter of six million Jews and five million other people in the horrors of the Holocaust.
Following the war, eugenics was discredited because of these atrocities. However, in recent years, a new eugenics movement has begun to appear with the opportunity provided by scientific advancement to alter the genetic make-up of human beings and to “breed out” disability and genetic conditions. The re-emergence of the idea that some lives are not worth living is being applied to vulnerable people who are deemed to have become a burden on society.
Worryingly this view has been given oxygen by former BBC Today presenter John Humphys, writing in the Daily Mail: “I know I’m among the vulnerable group for coronavirus, but just don’t believe all lives are equal.”
Similarly, Max Hastings, speaking on BBC World at One, stated that the elderly are “becoming a dead weight on the NHS”. Such thinking and sentiments are troubling.
Already stories are beginning to emerge of GPs contacting their patients with existing health conditions to ask whether they would want a Do Not Resuscitate (DNR) order to be included in their notes.
This might simply reflect a desire to ensure that if one of their patients with another serious medical condition also develops Covid-19, or gets admitted to hospital for another reason, there is no lack of clarity over the patient’s wishes. But whatever the reason, we must be cautious when extending clinical judgements to the subjective measure of quality of life.
We have already heard reports of DNR notices being placed on groups of vulnerable patients, such as those in care homes, in a carte blanche manner and without any consultation with the patients involved or their wider families. This has now been forbidden by the health secretary, and care homes have been instructed to rip up existing agreements. But concerns remain about whether vulnerable people will receive life saving treatment should they be admitted to hospital with Covid-19, and whether they will even be admitted in the first place.
Although such examples do not constitute euthanasia or assisting suicide because doctors are not actively hastening the end of patients’ lives, there is a danger that the same eugenicist thinking can feature.
Disabled rights spokespeople such as Baroness Campbell or Baroness Tanni Grey Thompson have expressed concerns that disabled people are increasingly being seen as “expendable”.
While we live through these unprecedented times, inevitably, very difficult decisions have to be taken about who to treat in a context of grossly overstretched healthcare resources. But we must be aware of the danger of changing medicine in a way which would be detrimental to the most vulnerable in society.
In responding to the Covid-19 virus, we must ensure no back door is left open to the dangerous philosophy of eugenics.
Gordon Macdonald is chief executive of Care Not Killing.