A Few Thoughts on My Excellent Adventure in the UK

I spent a very interesting and enjoyable week in London, speaking, meeting people involved in the issues about which I engage, doing a little BBC and other media, and generally enjoying the town. A few thoughts: The UK is a wonderful country but it seems to be heading down a bad utilitarian road when it comes to health care. Part of this, I think, has to do with the resource crisis in the National Health Service, and part with a changing belief system that we see throughout the West.

The assisted suicide bill is just a small part of it. Of equal concern are the draft regulations published to govern the Mental Capacity Act passed last year. Alas, most of the problems that opponents of that bill predicted appear to be coming true. Specifically, the draft regulations would lock Futile Care Theory (medical futility) into concrete law.

The draft regulations require absolute fealty to the pre-stated desires of an incapacitated patient who signed an advance directive requiring termination of treatment. But if the advance directive instructed that care be given, according to the terms of the draft rules, they would not have to be followed. Rather, patient and family desires would be merely one factor in determining whether the continued treatment are in the “best interests” of the patient. More alarmingly, this analysis would not be restricted to medical issues, or even quality of life judgments, but could also include issues such as the desire to be a good citizen, altruism, and the like. Talk about opening the door to a duty to die!

On the positive side, I met with some leading disability rights activists who are beginning to understand the threat that these policies pose to disabled and dependent people. Hopefully, if the disability rights community engages these issues with the energy and commitment we have seen from their colleagues here in the States, they can have a very salutary effect.

I hope to write more about these matters as time allows. In the meantime: Cheers!