doctors and dignity

Just seen this link – ‘UK doctors consistently oppose euthanasia and assisted suicide‘. It describes a literature review of doctors’ attitudes to assisted suicide over the last 20 years, confirming that the medical profession as a whole remains reassuringly unconvinced of the value of modifying a doctor’s role to include intentionally ending their patients’ lives.

It jumped out as I’ve just recently read Against Physician Assisted Suicide: A Palliative Care Perspective, by David Jeffrey (2009).  (Amazon)

Jeffrey points out that palliative care and physician assisted suicide are fundamentally incompatible, and the perceived need for the latter arises only in the absence of the former. The UK is currently the world leader in palliative care, the approach which seeks to improve the patient’s quality of life through the prevention and relief of suffering.

It’s only a short book (120 page paperback)  but it covers a huge amount of ground – ethical, legal, and practical issues surrounding the care of the dying, with a helpful analysis of the failed Joffe Bill and the situation in Oregon and the Netherlands, where forms of assisted suicide have been legalised.

Most usefully of all, it calmly, gently, and thoroughly dismantles the myth that dying can only be dignified if it happens at a time and in a way under your own control. The ‘suffering’ component of any illness is much more of a psychological and social problem than medical, and once patients have their pain controlled, if they are assisted to address their fears and feelings of hopelessness, whatever attractiveness they had seen in ending their life prematurely seems to quietly disappear.

Scaring people about the horrors of old age and illness is a great way of instilling the idea that life is not worth living unless you’re young and fit, but it’s really just an unrealistic and defeatist attitude which treats human life with vastly less of the dignity it pretends to – as untold numbers of disabled and older people can testify.

a public safety issue

Apparently Lord Joffe is making renewed attempts to have assisted suicide legalised (and see a couple of posts ago for similar concerns in the Scottish parliament).

There are of course serious considerations deriving from a commitment to biblical ethics which make it impossible to legalise assisted suicide – but it would be wrong to think that opposition to assisted suicide can only come from a religious perspective.

This is made clear in a recent letter in the Times by Lord Carlile of Berriew:

“Lord Joffe’s Assisted Dying Bill was debated to its core and roundly defeated in the House of Lords in May 2006. Few of the speakers founded their objections on religion. The real concern was, and remains, public safety — the potential for collateral harm to the great majority of terminally ill people from giving a few individuals a “right” to prescription suicide pills. The so-called safeguards in Lord Joffe’s Bill were paper thin.

Lord Joffe claims that his Bill did not seek to encourage terminally ill people to ask for assistance with suicide but provided “an additional end-of-life option”. But laws aren’t like precision-guided missiles. Once a statute, they can quickly be used to encourage acts they were designed to enable and control. It’s easy enough to draft safeguards in the comfort of Westminster, but laws have to be real-world-proofed.
Lord Joffe says his opponents do not want a debate, yet criticises us for having held a full one. In the past five years there have been three debates, and a select committee. What has been in short supply is evidence that this significant change to our laws is safe. Already, in advance of another assisted dying Bill, we are hearing suggestions that people with dementia should consider whether they are a burden on their families. The slippery slope is no fiction: it is already well polished.
This is not about religion or autonomy or medicine: it is about public safety, legal certainty and the protection by the law of the vulnerable. It behoves Parliament to think very carefully once again, rather than be stampeded by highly emotional campaigns mounted by single-issue pressure groups.”

That’s only an excerpt; read the whole thing here.