There’s nowt so queer as folk. We expect Scousers’ ‘mawkish sentimentality’; and the red-tops to bleed for mothers who kill ‘with love in their heart’. But what we do not expect – well Dr No did not expect – was a doctor going online with an account of how he too assisted suicide with a “secret gift to a dying friend’ and had ‘never for a moment regretted’ his actions.
The tale – and tale it is: it is most carefully crafted – nonetheless plays a little out of tune to Dr No’s medical ears. The wording is medical, and yet not medical at the same time. Little details, such as the difficulty in establishing the lethal dose of the chosen drug (easy: just google ‘phenobarbital lethal dose’), and the nervous visit to Boots to get the private prescription made up, just don’t quite ring true. Could it be, Dr No found himself wondering, that this mawkish account of mail order assisted suicide was in fact not fact, but faction, or even pure fiction, penned to fan the flames of calls for a relaxation of the law on assisted suicide?
Certainly, if the comments are anything to go by, the flames have been fanned. Overwhelmingly, with very few exceptions, they praise the noble doctor’s actions. In fact, the praise is so overwhelming, with so few dissenting voices, that it seems possible (though not of course proven) that this is an orchestrated response, easily enough organised by way of an email network. At one point, Dr No even found himself wondering whether the Torygraph was itself part of the orchestra or – God forbid – the Conductor. There was certainly some jiggery-pokery going on – at one point, comments were appearing and disappearing faster than a conjuror’s cards.
Be the orchestration as it may, what concerns Dr No is that the flood of praise is praise for the most dodgy of practices. Here we have a doctor who offers – he says he offered because she did not ask – to help not a patient, but a distant friend, kill herself, without even so much as seeing her. It is all done at an easy remove, by a postal supply of a lethal prescription. At their final phone call, he remarks he ‘had a terrible difficulty knowing how to end the conversation’. As well he might – the usual pleasantries: ‘take care’, ‘au revoir’ even ‘goodbye’ don’t quite strike the right note. To Dr No, it seems even more of a difficulty that he didn’t have the same ‘terrible difficulty’, not over how to end the conversation, but how to end her life.
Now: wise doctors don’t treat their friends. Wise doctors don’t prescribe without seeing the patient. Wise doctors don’t accept a declaration of suicidal intent without considering the wider clinical picture. Wise doctors don’t guesstimate – as he did – a critical dose. Wise doctors don’t help kill their patients. And – tellingly – ‘wise’ doctors who do help kill don’t tell.
Which brings us back to what is this story really about? Why was it written and published? Perhaps the clue is in the last sentence, a thinly veiled Call to Spartacus:
‘I wonder if any of my medical friends would help me in this way if I asked them to’.
Clever. If we’re all doing it, then we are all Spartacus, and none can be tried. And the pro-right to die lobby would get, err, a powerful shot in the arm.
I think it is difficult for any of us to remove the vested interest we all have in ourselves when it comes to contemplating our own turn in the great waiting room in the sky?
Many commentators have already identified major problems in accessing appropriate care at the end of life – for example, the Royal College of Physicians working party found;
“Access to palliative care services is inadequate and inequitable, with unacceptable variation in
care geographically, across different demographic groups and across diagnoses. Services for
patients dying of diseases not related to cancer are lacking. All patients who are suffering and
dying should have equivalent access to palliative care. Everybody should have the opportunity
for a good death, with control of symptoms and practical, social, emotional and spiritual support.
Funding for palliative care services is entirely unsatisfactory, with the NHS contributing only
about 30% of the costs of funding for specialist palliative care”.
http://www.rcplondon.ac.uk/pubs/contents/ec579e02-64fd-4f36-bb5d-5159a276077f.pdf
In short woe betide many people who must rely on the NHS when they are dying – the usual calls for more resources are likely to fall on deaf ears, especially in the current climate.
I am not saying that we should start killing patients for economic reasons, but we cannot overlook the self-evident reality that there NEVER has been enough palliative care, and no prospect that there will be in the forseeable future.
For many, the loss of dignity and control makes life meaningless.
So the RCP London are flaunting the fairy-tale “good death.” I hate that term almost as much as I hate the term “ethnic cleansing!”
The RCP have even shaken hands with death – they hosted Pratchett’s Dimbleby Lecture.
A&E Charge Nurse – I agree palliative care is under-funded and all too often badly done. On the one hand we have Barton and the LCP bumping people off; on the other poor inadequate care – see Thomas Milner’s Palliative Care Experience.
Had another look at this article. It is very odd. Perhaps it is a fake and the aim is to pull out doctors who might also be willing to make a secret gift ie anonymously demonstrate support for euthanasia.
I can’t imagine the identity of someone writing an article like this would not be known to the newspaper involved.
It is very odd – but Dr No didn’t want to over-labour the point: he felt the article more than made the case itself.
The newspaper will know who the author is. They will plead – correctly – they need to protect their sources. And because the article – which is cleverly written – makes it clear we can never know the cause of death – that means no crime has definitely occurred – and so the police/CPS wont touch it.
Dr No thinks it is a call to Spartacus: what rhe Witch Doctor calls pulling “out doctors who might also be willing to make a secret gift ie anonymously demonstrate support for euthanasia.”
Oh, the RCN called the nurses to Sparticus some time ago, Dr No – a surprisingly good item from the Cavendish Square bunker here;
http://www.rcn.org.uk/__data/assets/pdf_file/0003/230709/04.09_Assisted_suicide.pdf
As you can imagine colleagues of the A&E Charge Nurse are obliged to resuscitate just about anybody that ever loses output in A&E – in most cases there is literally no time for discussion, or reflection, but even in A&E there are cases when enough becomes enough.
I do remember one case in particular – a bloody, horrible affair, involving an elderly patient with liver cancer (suffering uncontrolled haematemisis and malaena).
Rather like the final shoot out in a spaghetti western eyes darted round the trolley at the dose of diamorphine and haloperidol prescribed by the senior intensivist (who arrived after failed endoscopy) – nobody argued with him though.
Seriously, though, Dr No’s understanding is the the RCN changed its position last July, and is now ‘neutral’ on assisted suicide, a move criticised at the time by cross-bench peer and RCN Fellow Baroness Emerton.
Of course there are some who might say that even a neutral position is still a position – that is to say it is still a position that has meaning…
…perhaps all the more so when the more was from a position of opposition. The movement certainly has meaning: it is a relaxation in opposition.
“RCN Council’s UK position, which followed an extensive and detailed consultation process, means that the RCN moves from opposing assisted suicide to a position where the College neither supports nor opposes a change in the law to allow assisted suicide”.
The all encompassing creep in action – the RCN no longer oppose assisted suicide, what next approval for death panels?
The medical profession have been at it too!
A position? Pragmatism? Sitting on the fence? Creep?
Or another diet of d’oh!
The following was written after an event that happened a few years ago ie the annual meetng of the British Medical Association:
“June 30 was a Homer Simpson moment for the British Medical Association. At the end of its annual representative meeting, delegates voted to withdraw the BMA’s firm and long-standing opposition to euthanasia and assisted suicide. This leaves the world’s most prestigious gathering of medical professionals in the absurd position of having no opinion on whether killing their patients is good or bad. Doh!
Admittedly, this is an advance on the double-Doh position of the Royal College of General Practitioners. At the moment this august body has a policy of total ignorance: it doesn’t support euthanasia; it doesn’t condemn euthanasia; and it is not neutral.
MA for moral agnostic is not a qualification that most people want on their doctor’s brass plaque. If their teenaged son wants steroids so that he can have a body like Arnold Schwarzegger, they expect their GP to say No. If their teenaged daughter has anorexia nervosa, they expect their GP not to tell her that it is a lifestyle choice. And if the aged parent is depressed and wants to die, they expect cheery advice and a pat on the hand, not a needle.”
Neutrality on euthanasia is so daft a policy for doctors that only two things can account for it: monumental stupidity on the part of the profession or a Byzantine plot to legalise it. Perhaps fortunately for the health of the nation, the latter is the case.”
I had a link to the initial article on Witch Doctor but the link now goes nowhere!
It’s always interesting when links vanish after WD has tapped into them!
It makes My Black Cat wonder if there is a Byzantine Plot rather than monumental stupidity.
The grass roots of the medical profession then woke up and changed their view to against the following year.
Maybe the grass roots of the nursing profession are having a siesta.
Dr No does not like neutral.
It smacks of the three monkeys; and of “Not me, guv!”
It reminds him of “If you are not part of the solution, you are part of the problem” and “If you are not with us, you are against us.
It also reminds him of acts and omissions. Dr No expects the ethicists will tell us neutral is a valid position, but, to Dr No, standing by while a yob beats up a granny is not neutral. Nor is it neutral to stand by while Kay Gilderdale assists her daughter’s suicide; or Kerrie Wooltorton dies at her own hand.
Because there is a moral dimension to the matter at hand, neutrality is not an option. It only appears an option to the moral coward.
“neutrality is not an option. It only appears an option to the moral coward.”
Agree, but I would rephrase that to say ‘immoral coward’ Dr No. Because, by definition, morality would not allow you to stand by and watch a granny while being mugged, nor will it allow you to let cases like Kerrie’s to just pass by as if nothing has happened, but immorality would. And this is where the problem in our modern society lies, we have become so preoccupied with the stress of our day to day living to the point that we no longer have the time to reflect on what happens to others. And no longer have the time to discuss and teach our children about same too .. and ‘everything’ needs practice to make perfect, or there will always be room for errors in judgement leading to confused opinions and muddled up solutions.. as happens now.