Sunday, 26 July 2009

Assisted dying

Yesterday the Times lead with the emotive headline, Huge public support to allow right to die, based upon the findings of a new Populus poll. It was dishonest since in the body of the text the author states, 'the poll found only 13 percent of the public supported a blanket right to assisted suicide regardless of the individual's health.


There is much to be worried about by our media's stance on assisted dying and the pressure growing to change the law to make all forms of euthanasia permissible in law. This article illustrates just one of the concerns that doctors like me have about the issue; for human beings are inclined to twist the truth and fundamentallly are not to be trusted. Alas that's the whole basis of laws-for if trust were endemic lawyers would be largely redundant. In the matter of euthanasia I fear we just cannot trust each other enough for it to be permissible. It's too open to abuse, even with legal restraints.

6 comments:

Anonymous said...

Assissted suicide works in th Netherlands!

Anonymous said...

Re your piece on assisted suicide, your accusation of media dishonesty seems extreme. Headlines are designed to draw your attention to the article (usually penned by sub-editors rather than the author) and this evidently achieved its purpose. The key phrase in the text is “13%...regardless of the individual’s health”. That’s very different from supporting the case for someone who is suffering intolerable pain and a degenerative illness, where the majority of the population are in favour of euthanasia. Throughout my adult life I have been responsible for making the decisions that have distinguished the course of my life, yet it seems I am to be denied responsibility for making a decision regarding my death. Surely, aside from any religious taboos (which should in any case not be allowed to impinge on non-believers) the issue which legislators seem reluctant to face up to is simply one of carefully framing laws which ensure competency at the time of decision, adequate counselling, and freedom from coercion. From the poll figures it is evident that the public have come to a fairly sophisticated view of the issues, and this article, far from “twisting the truth” as you allege, presents a useful profile of where public opinion is at. The “slippery slope” argument is a mythical one and is not supported by evidence from countries and American States where the practice is legalized. I don’t believe your premise that human beings are inclined to twist the truth and fundamentally are not to be trusted, nor, I feel sure, do you. True there is plenty of evil in the world, but there is plenty of goodness too, and that spans people of all dispositions and mindsets and beliefs.

David Bartlett said...

It's possible to over simplify and idealise the situation in Holland. Even at the level of the mechanics of euthanasia, physician assisted suicide, there remain problems, as detailed in this New England Journal of Medicine article Lhttp://content.nejm.org/cgi/content/abstract/342/8/551

David Bartlett said...

'm not coming at this argument merely on the basis of ' religious taboos' (would you concede that there are 'non-religious taboos'?), but as a practicing doctor who upholds the sanctity of life and the imperative to 'maintain the utmost respect for human life (from the Geneva declaration - a secular document guiding the practice of medicine).

You mention 'intolerable pain', but this is largely an urban myth which occurs extremely rarely - with much gratitude to the palliative care movement- indeed I have never witnessed uncontrollable pain at the end of any patient's life in my 31 years as a doctor. A 2005 report by the Department of Human Services in Oregon which analysed the end-of-life concerns of all who had actually obtained a medically assisted death between 1998 and 2004 showed that the major concerns were losing autonomy (87%), being less able to engage in enjoyable activities (84%), losing dignity (80%) and losing control of bodily functions (59%). Astonishingly, relief from pain or concern about pain were only cited by 22% as a reason. In fact 'no one who obtained assistance to die actually suffered from uncontrolled pain'.

With regards to slippery slopes I'm afraid it is far from a mythical concern. I have cared for many ladies requesting and undergoing termination of pregnancy and have much sympathy for those placed in extremely difficult situations. But who envisaged in the 1967 Abortion Act that the case which was made for a few 'hard cases' would lead to 200,000 legal abortions performed every year? Sadly just last week the Telegraph reported the trial of a woman accused of attempting to murder her husband because he had motor neurone disease-his concerns had not been considered at all-it's a very salutary case.

There is obviously much to debate, and I acknowledge that the issues are complex. But I continue to believe that the trajectory of the law should be to uphold the sanctity of life. More work needs to be done in researching incurable conditions (it as often been stated that the impetus for research must inevitably decline if the 'treatment ' becomes a tendency to accept defeat and merely recommend suicide -assisted or otherwise). And more work needs to be done in the field of palliative care. Autonomy is a dangerous god, which has a habit of not only putting my interests first but of ultimately trampling on other peoples autonomy-and so on and on. I realise comment this will annoy you, but it really all did go wrong in the Garden of Eden. But thank God for Jesus who at his moment of extreme pre-death stress said 'not my will, but yours be done'.

Anonymous said...

I am not qualified to add to this debate save that I could be affected by it, does that 'qualify' me? All I can offer is an opinion based on - based on what? The media? The media is twisted and distorted... just look at what they are doing with swine 'flu, 'they' repeat scare stories and quote people on-the-street who say "no I'm not confused"!
Or do I base my fears on an impending painful death? I will die, no question there, but I never think about it despite seeing it all around and - if I'm honest - expecting it! Does this qualify me to add an opinion? I don't think so because in my experience I have never met or known anyone personally who has, or is having, one of these 'intolerably painful' deaths. I'm not denying they exist but am speaking from experience.
Doctor David and his peers however do have the experience and the education - so why not leave it to them and trust them? Maybe I am an innocent here but a £ goes against a penny to say that the vast majority are in my boots!!!
I suppose that all the frenzy could be to cover our innate fear of death or what comes after it, this irrational fear would seem to have existed in all cultures and throughout time, could euthanasia be the current means of coping in an increasingly godless age? (I mean godless to cover ALL gods, eastern or western)

Anonymous said...

A Sunday Times article on the Purdy case claimed that “We all know that doctors have been killing people for years”. It got me to wondering if you have or would ever over-prescribe morphine as an act of compassion for a terminally ill patient?

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