To my sorrow, I witnessed both my brother and my sister moving towards their final moments on this earth, but they did so, I am also thankful to say, with the assistance of morphine. My brother died in Dublin; my sister in a hospice in New York.
When my sister was very poorly and I was present as next of kin, I asked the medical authorities if we could increase the dose of morphine.
This was considered and duly carried out, but before it could be done I had to sign a waiver form assuring the hospice that I would not sue them for making my sister an addict to morphine, or claim that they had acted improperly in any way.
As if I would, I thought. But in an age of keen litigation and keener demands for compensation, people have to watch their legal backs. I signed and Ursula's pain was much relieved. She drifted into a sort of reverie and in a short time she died.
God bless morphine, I thought. Here is an example of the proper use of the opium poppy — to relieve pain, to comfort the moribund. When my last hours come, I would like to think such compassionate use of medicine will be available. I certainly would not want lawyers arguing about the dangers of a deathbed addiction or discussing deliberate euthanasia.
An easeful death, supported by morphine, is in quite a different category from a deliberate 'right to die', and is not at all related to a 'licence to kill' as Nell McCafferty argued on Prime Time.
I am sure that Nell did not mean to offend, and perhaps she wanted to open up an honest debate over the 'right to die'.
To some people, the 'double effect' approach in allowing death to occur in a terminally ill patient is hypocritical. The 'double effect' entails a physician administering a large dose of medication, knowing that it is likely to carry off the patient. However, the doctor does not directly intend to kill. Therein lies the 'double effect' — the medication will soothe, but it will probably also help nature to take its course.
There can be shadowy areas here, yet there does exist a marked difference between a doctor administering a heavy dose of morphine, to end pain, and a doctor administering a heavy dose of cyanide to end life.
A significant historical medical case is that of the King of England, George V, who died in January 1936. It emerged 50 years later — in official papers released only in 1986 — that King George had been directly killed by his physician, Lord Dawson of Penn.
The reason was deplorable. Dawson wanted to be able to announce the King's death in The Times of London — a 'respectable' morning newspaper. He did not want it to occur at a moment when a more popular evening paper might get hold of the story. So he took control.
King George had a serious heart condition, but he was not terminally ill. Bertrand Dawson — a friend and supporter of Marie Stopes and an advocate of euthanasia — decided that the King would now be better off dead. He prepared a lethal cocktail to inject into George's jugular vein and asked the nurse to administer it.
The unnamed nurse refused. She said she was a Christian and did not enter medicine to kill off patients.
So, Lord Dawson did the job himself, and it took effect. The King passed away peacefully and The Times duly announced George's death, the following morning, as planned.
The BBC was also given a hint of developments, and was able to make a reliable announcement, late in the evening, that: "The King's life is drawing peacefully to a close." Very handy for the broadcast media too!
When Dawson's action was disclosed in the 1980s — he had died in 1945 — it was a matter of heated debate among medical ethicists. But few experts could, or would, defend what the King's physician had done.
Indeed, it was an outrageous example of the distortions made possible by the practice of euthanasia. Dawson had killed the King not only deliberately, but for a trivial reason: to catch a newspaper deadline.
He had taken the action not to spare George from pain, but to control the dissemination of the news in the media. The King was ill, but not moribund. Dawson had also tried to pressure a junior colleague — the nurse assistant — into an act which she considered highly unethical. He may have believed that his judgment was for the best, but it was also an example of a man imagining that he was entitled to the supreme power over life and death.
And what was categorically wrong about Dawson's actions lay in his intentions. In law, as in ethics, intention certainly does matter (in homicide cases, it can be the difference between mishap, manslaughter and murder).
A debate about end-of-life issues is worthwhile. Medicine and technology often change circumstances. But it is wise to retain that principle of the 'double effect' — of doing all that is possible to help and comfort the dying person, without a deliberate intention to kill.