Another death in the family

You would think that having a personal physician would guarantee excellent health care. However, the conviction of Michael Jackson’s doctor for involuntary manslaughter suggests that this is not necessarily the case. Prosecutors described Dr Conrad Murray’s care of the pop singer as an “obscene” pharmaceutical experiment.

Even royalty are not exempt. One of the sensational claims made in a new book about Norway’s monarchs during World War II, King Haakon VII and Queen Maud, is that the Queen may have been a victim of involuntary euthanasia. Norwegian author Tor Bomann-Larsen writes in his book Æresordet (Word of Honour) that “Queen Maud had left home strong and healthy and would return in a coffin, without Norwegian doctors having had any connections to what happened.”

The evidence for this startling claim is largely circumstantial. Maud was English, the sister of George V. It was reported that she died of heart failure in 1938 in England, under the care of the most eminent and respected physician of the day, Lord Bertrand Dawson. However Bormann-Larsen unearthed documents which suggest that the real cause of death was cancer. Dawson wrote to his Norwegian counterpart: “When reading this account, you will agree that the Queen’s sudden death was a relief and which saved her from these last painful stages of the disease both you and I know only too well.”

In the light of what we now know about Lord Dawson of Penn, president of the Royal Society of Medicine, president of the Royal College of Physicians, president of the British Medical Association and originator of Britain’s National Health Service,  these words take on a sinister, if ultimately unverifiable, significance.

For not only was Dawson a supporter of euthanasia, but two years before he had euthanased her brother, King George V. It was the first regicide since Charles I, nearly 300 years ago. 

This only came to light in 1986 when Dawson’s biographer revealed a diary entry which he had deliberately omitted from his 1950 book. Dawson saved the King's life in 1929 after a dangerous chest infection and was in charge during his final illness. At 9.25 pm on January 20, 1936, Dawson issued a bulletin to the nation, "The King's life is moving peacefully towards its close." But it was not closing quickly enough. At five minutes before midnight, with no one else in the chamber save a discreet nurse, Dawson gave the King a lethal injection. In the words of his diary entry:

“At about 11 o'clock it was evident that the last stage might endure for many hours, unknown to the patient but little comporting with the dignity and serenity which he so richly merited and which demanded a brief final scene. Hours of waiting just for the mechanical end when all that is really life has departed only exhausts the onlookers and keeps them so strained that they cannot avail themselves of the solace of thought, communion or prayer. I therefore decided to determine the end and injected (myself) morphia gr.3/4 and shortly afterwards cocaine gr. 1 into the distended jugular vein.”

Why? Even by today’s standards, deliberately hastening a death is murder. Nor was the dying man in great distress.  

However, reasoned Dawson, the nation was waiting. If the cranky old man lingered on for a few more hours, news of his passing would have appeared first in London’s sleazy tabloids. Dawson felt that it was more fitting that the death of a sovereign be announced in The Times, the British paper of record. He even asked his wife to inform the Times that death was imminent. 

And, as a bonus, an early death enabled Lord Dawson to return to his busy practice in Harley Street.

With all this in mind, the sudden death of Queen Maud of Norway under his ministrations takes on a sinister significance. “There is no reason to think that King George V was the only patient he treated in this way,” wrote J.H.R. Ramsay in the BMJ. Why not Norway’s queen? The case is plausible, if not proven.

Some insight into Dawson’s mind can be gleaned from his contribution to a debate on a euthanasia bill in the House of Lords a few months later. (The terms of the euthanasia debate have altered very little.) Quality of life matters more than quantity, he told the noble lords. “One should make the act of dying more gentle and more peaceful even if it does involve curtailment of the length of life,” he said. “That has become increasingly the custom.”

In any case, moral standards evolve in this enlightened age. Contraception is widely accepted; abortion is widely practiced; why should we not accept euthanasia? “Is submerging of [a dying woman’s] sufferings to be denied her because her life might be shortened by two or three months?”

Lord Dawson voted against the bill -- not because he opposed a doctor’s “mission of mercy”, but because bureaucratic safeguards would have involved too much red tape and allowed too little discretion to doctors.  

A mediocre physician’s responsibility for the death of His Majesty George V, King by the Grace of God of Great Britain, Ireland and the British Dominions beyond the Seas, Defender of the Faith, and Emperor of India is instructive.

In the first place, doctors who accept euthanasia can be incredibly arrogant. Lord Dawson viewed himself as an enlightened apostle of progress. This gave him the right to decide the time of his patient’s death, without his or her consent. As he said in his speech, euthanasia is too delicate and personal an issue to be regulated by inflexible laws. Only doctors are entitled to decide.

Second, although euthanasia is regarded as killing out of mercy, it is commonly killing out of convenience. Lord Dawson killed his patient because he preferred to read the news in a broadsheet rather than a tabloid.

Third, deceit is inherent to euthanasia. However smugly confident Lord Dawson was in the righteousness of his actions, he was careful to conceal them from his colleagues and the Royal Family. Only the nurse knew, but she took the secret to her grave. If he had consulted other doctors, they might have questioned his clinical skills. A rival physician in the royal household even composed a jingle:

Lord Dawson of Penn
Has killed lots of men
So that's why we sing
God Save the King.

Notwithstanding Lord Dawson’s ability to collect honorifics, other doctors regarded him as “respectable rather than remarkable”, according to his obituary in The Lancet.  

Furthermore, out of misplaced loyalty, others will collude in the deception. In this case, Francis Watson, Dawson’s biographer, waited 36 years before he published the incriminating diary entry. “Perhaps I should have included it in the book at the time,” he said after publishing the true story of George V’s death. “Lady Dawson did not want it in the book and I quite readily agreed. I didn't think it appropriate.”

Fourth, as with child abuse, a culture of complacency, secrecy and deceit allows euthanasia doctors to kill again and again. We will never know how many people Lord Dawson killed. But we do know that one and perhaps two royals died in his care. To paraphrase Oscar Wilde, to lose one patient may be regarded as a misfortune; to lose two looks like carelessness -- carelessness on the part of both the British and Norwegian governments. Was Lord Dawson of Penn the Harold Shipman of Harley Street? Shouldn't there be a thorough historical investigation to unearth the truth?  


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