Dr Calum MacKellar: Referendum vote could mean big changes

Europe can be compared to the conscience of Europe while the EU is the marketplace of Europe. Picture: Contributed

In June 2016 the UK decided to leave the EU. But what does this mean for medical ethics?

Maybe it should be noted, at this stage, that the UK is not leaving the Council of Europe which is a completely different organisation to the EU. It was Sir Winston Churchill (1874 – 1965), who first called for the creation of the Council of Europe, in 1946, in a speech in Switzerland. As a result, the Council was founded in 1949 by the Treaty of London and is now the continent’s largest and oldest political organisation grouping together 47 European countries including Iceland, Russia, Armenia and Turkey.

Its ruling council is the committee of foreign ministers of all the member States. It represents about 820 million people and is headquartered in Strasbourg, in north-eastern France with the aim, amongst other things, of (1) protecting human rights, democracy and the rule of law, (2) finding common solutions to the challenges facing European society and (3) consolidating democratic stability in Europe.

The Council of Europe is also responsible for the European Court of Human Rights (ECHR) which interprets the 1953 European Convention on Human Rights that supports international European medical law. In a way, the Council of Europe can be compared to the ‘conscience of Europe’ while the EU is the ‘marketplace of Europe’ having developed from the European Economic Community (EEC) which was created by the Treaty of Rome in 1957. But in April 2016 Mrs Theresa May MP complained that: “The ECHR can bind the hands of parliament, adds nothing to our prosperity, makes us less secure by preventing the deportation of dangerous foreign nationals – and does nothing to change the attitudes of governments like Russia’s when it comes to human rights”.

Adding: “So regardless of the EU referendum, my view is this: if we want to reform human rights laws in this country, it isn’t the EU we should leave but the ECHR and the jurisdiction of its court.” Of course, the ECHR is not perfect and Mrs May is also right that it does sometimes restrict national legislation. But it only does so when it believes that the inherent and equal human dignity of individuals in Europe is being threatened. What is striking, however, in Mrs. May’s quote is that she does not explain what other moral values would be used if ever the UK was to reform human rights and draft its own moral principles. In a post-Christian society, like the UK, and if inherent human dignity is put aside, there is not much left. Maybe a moral system based on autonomy and the reduction of suffering could be considered. But then the equality of all persons would be a thing of the past since many have very limited autonomy, such as persons with serious mental disorders, and everybody suffers to different extents. Maybe the new UK morality could be reduced to just protecting and defending UK citizens and taking away the rights of those who are not ‘like us’. But then it would be difficult to see how the UK could remain a civilised society in the eyes of the world.

The American physician, Leo Alexander (1905 – 1985), one of the leading examiners during the Nuremberg medical trials which took place just after the Second World War in Germany, emphasised the importance of looking back, with higher insight, and learning from the events of early 20th century. In this he warned that there was a certain kind of inevitable progression when the cost of civilised behaviour was rejected.

Society then becomes a moral and ethical wilderness where the value of some human lives are increasingly considered as being of poor or even substandard - where it is possible to grade the worth of every human life. If the European Convention on Human Rights is to be replaced with something else, it would be useful to know, therefore, what set of new values would be used and why these would be better than inherent and equal human dignity in the protection of the vulnerable such as many sick patients.

• Dr Calum MacKellar, Director of Research, Scottish Council on Human Bioethics