Tuesday 19 February 2008

Fr John Fleming on the Mental Capacity Act

I am in Nottingham today with Fr Fleming, the bioethicist, member of the Pontifical Academy for Life, and adviser to the Society for the Protection of Unborn Children (SPUC). He is speaking to Catholic clergy in England this week on behalf of the Society. His talk includes an unflinching analysis of the Mental Capacity Act.

The Act provides for euthanasia by omission of reasonable care, Fr Fleming says. It does this by a faulty understandings of ordinary care, autonomy and “best interests”.

Ordinary care

Fr Fleming explains Pope John Paul's teaching that the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act. However, under the Mental Capacity Act, artificially-delivered food and fluids is seen as medical treatment.


Autonomy is the right to self-determination, the right to free choice. However, free choice is linked to fundamental human values and inalienable human rights such as the right to life. A person cannot exercise his autonomy by giving away his right to freedom, for example, by selling himself into slavery. Neither can he use his autonomy by denying his right to life as the Mental Capacity Act permits.

Neither can my autonomy be exercised by another person. The Mental Capacity Act falls prey to a false understanding of autonomy in this respect too. “Autonomy” cannot be handed on like a baton in a relay race, Fr Fleming says. You can make decisions on my behalf when I am not able to do that for myself but that is not an exercise in autonomy. It might be you acting autonomously on my behalf.

This leads to another danger: Relatives can be overcome with identifying with the patient's suffering and the problem of transference arises: "Please put grandma out of my misery".

“Best interests”

Hurt a child and the law intervenes, Fr Fleming says. The law ensures that parents' choices on behalf of their children are constrained by the child's objective “best interests”. However, the Mental Capacity Act 2005 imposes no such constraint on those with power of attorney for, and doctors caring for, mentally incapacitated patients.. The patient's “best interests” in the new law are not objective but are subjectively defined.

The Mental Capacity Act by enshrining in law euthanasia by neglect is the first legislative step to active euthanasia, and those behind it know that's the case, Fr Fleming says.