One of Dr No’s light-bulb moments, which occurred many years ago, was when he realised that his then world-famous professor was, as we used to say in the old days, not mazda. Lights were on, but there was nobody at home. Prof was in post not because of the brilliance of his mind, but had arrived instead by the well trod route of dead men’s shoes. At the time, Dr No felt disappointed, even cheated.
None of which is to suggest that Dr No is more or less bright than anyone else; it is merely to observe the brightness of others. Dr No’s earlier light-bulb moment came to mind because something very similar happened a couple of days ago. He realised, not without a chill, that the group of lawyers and ethicists with whom he has been debating the care of the actively suicidal patient are, in large measure, pumpkin positive.
And, as is so often the case when the elevator does not reach the top floor, these armchair pontiffs are prone to over-inflate their own abilities. And – far worse – pontificate in matters that are above their pay-grade, a habit which, it must be said, casts a spectre of doubt over all that they say.
Now, how can Dr No be so sure? Well, he laid a trap. He didn’t really try too hard – he was sure they would rumble it. But they didn’t, and therein lies the first clue that maybe, just maybe, they aren’t the sharpest pencils in the box.
Much of the very recent debate has taken place on the Journal of Medical Ethics blog. Irked, it seems, by Dr No’s Malicious Seeds of Mischievous Doubt post, Mr B posted In Defence of Ethicists (Or: Dr No’s no-no). The comments started rolling in, and before too long the wheel was spinning: whether the hamster was still alive was another matter altogether.
So – in one of his comments, Dr No lobbed in a medical teaser – a barely hidden invitation for the lawyers and ethicists to comment on an area outside their expertise. He suggested that there might be a conspiracy – a conspiracy to legalise euthanasia (a suggestion which as it happens many have made), and in so doing he laid himself open to a charge that he, Dr No, did not in fact have both his oars in the water.
And they just jumped right in. The pontifically initialled JC lost a few more slates off his roof with:
“The conspiracy – I think if a patient presented with a view of a conspiracy on this scale you might question his/her capacity all together”
while Mr B added greater weight to the likelihood that he was NARS with:
“Your talk about the pro-euthanasia conspiracy is verging on the paranoid”.
Now it seems pretty clear to Dr No that these remarks, which do not have the air of jest, display a startling lack of understanding of both the assessment of capacity on the one hand, and the diagnosis of paranoid states on the other. And yet, both felt able to hold forth. One is left wondering: how much else of what they write is just plain wrong? Could there, Heaven forbid, be other kangaroos loose in the top paddock?
We shall probably never know. What we do know is that Dr No, and the many doctors who argue from the same position as he does, can understand the legal and ethical arguments, but happen to disagree with them. The lawyers and ethicists, it now seems compellingly clear, at least to Dr No, simply don’t get the medical arguments. The receiver is off the hook; their arguments all foam, and no beer.
Probably because they’ve been playing too much without their helmets.