Joffe's Physician Assisted Suicide Bill

**heed** · 20-04-2006, 03:47 AM

I posted this on the Glasgow Forum following an email circulated as a mail shot to all GUMS students. Pretty poor response there - so lets see what you guys think.

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As many of you will know, an email was circulated around the med school today informing us students of an opportunity to "Save thousands of lives in one lunchtime" by going along to a letter writing session where letters of protest will be sent to the 700 members of the house of lords due to hear the second reading of Lord Joffe's physician assisted suicide (PAS) bill next month.

The bill proposes a statutory change in the law regarding ending the life of a patient in our care: by attempting the legalization of physician assisted suicide in the UK (ie patient requests medical help in ending their own life).

The authors argue that by legalizing PAS, we would be opening the floodgates to euthanasia, and making manslaughter just another "job on the doctors list" and in in doing so would turn our backs on centuries of caring wisdom::

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Dear All

The Joffe Bill which seeks to permit 'Physician Assisted Suicide' is to have
its second reading in the House of Lords in May.

If passed, there is the chance that it may change the law to allow doctors
to prescribe lethal drugs to patients who have expressed a wish to die. This
would open the door wide open to Euthanasia.

Some Glasgow doctors are students are hosting a protest letter sending
meeting this Saturday, the 22nd of April at 9 Roxburgh St (just off byres
road, opposite Woolworths) between 12 and 4. We aim to send the protest
letter to EVERY member of the house of Lords and need your help to do so.

Although this is being organised by the Christian Medical Fellowship, it is
open to people of any faith or none who are concerned about the future of
our country should this bill become law.

This has implications for ALL in the medical profession.

It would change what is currently manslaughter into another 'job' on the
doctor's list

It would overturn thousands of years of caring wisdom. Every code of ethics
from Hippocrates to the current GMC regulations has forbidden doctors from
ending life.

It would expose a great many vulnerable people to a previously unknown
pressure to request PAS.

It would start us along a slippery slope and endanger the lives of those who
cannot protest against doctor's decisions. In Flanders where adult
euthanasia is permitted, doctors began practising euthanasia on babies
DESPITE THIS BEING ILLEGAL. There are now moves to legalise euthanasia in
the paediatric population.

It would make it difficult to practice within the NHS. One friend of mine
was told not to apply for a gynaecology job if he was not willing to carry
out abortions. How difficult might it become to work as a doctor if we are
not willing to hasten the demise of those entrusted to our care?

Most of the Lords are ill informed about this Bill and will probably side
with the BMA which has refused to offer a moral stance on this issue. As the
doctors of tomorrow, your influence is considerable. We are aiming to write
a protest letter and send one to EVERY member of the House of Lords. There
are over 700 members and we would value your help in sending them off.

We propose to host a lunch'n'letters event at (address removed for confidentiality)
The plan is simple but world changing

Turn up
Eat your free lunch
Watch the Care not killing DVD at leisure (optional- can get you a copy if
you like)
Put some letters in envelopes and send them off.
Save the lives of your patients

Food, envelopes, the protest letter and stamps will be provided.

If you want to learn more try either the cmf website ( www.cmf.org.uk) or
the 'care not killing' website.(www.carenotkilling.org.uk)

And remember..

All that is required for evil to triumph is for good men to do nothing

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SO, as the doctors of tomorrow to which this letter refers - what are our views (on the letter and on the practice of PAS) ??

Lets see where this one goes........

**heed** · 21-04-2006, 06:52 PM

so why are the other people who voted pro-joffe for the bill? and anyone whos against it want to make a comment?

**red_dillan** · 22-04-2006, 08:08 AM

I'm basing my decision to vote for the Bill on my experience of working as a HCA on a care for the elderly/ stroke ward. I have seen people with no hope of ever making it out of the hospital detiriorate day after day, contracting hospital aquired infections, pulling out their NG tubes day after day and refusing their medications. I know if I was in their situation I would want the option of dying with dignity and have stated so in a living will (pain relief and fluids to be administered under certain conditions). I think if the bill were to succeed it would not be a carte blanche for mass 'exterminations' but would give patients the right to chose if and when to end their lives should there be no hope of attaining a resonable quality of life.

There, I've stuck my neck out - now let's hear from some of the other other voters on both sides!

**Anjali** · 22-04-2006, 08:09 AM

Irrespective if whether or not one think assisted suicide is right, I voted against it for two reasons:

1. Why should we as the doctors be given the responsibility of assisting the suicide?? How can we be seen to give and aid life, and at the same time have the power to take it away? How is it ethically going to look from a patients perspective, and will it affect patient consultations?

2. I guess the most common reason for wanting assisted suicide in UK, is because people have a fear that they will suffer unbearable pain when they reach the terminally ill stages and die an undignified death, however with good palliative care this is not often the case. If this bill is passed will palliative care cease to exsist in the future as a branch of medicine? Surely the answer lies not on assisting suicide, but more on addressing the concerns, and investing more money into improving palliative care so that no terminally ill patient suffers unbearable pain.

**heed** · 22-04-2006, 09:34 AM

in response to Anjali, there is considerable provision in the bill for palliative care. The patient may only opt for PAS after having been assessed by a palliative care specialist - the patient then choses palliation or PAS. And doctors always have had the "power" to end life - however your statement would tend to suggest an executive decision on the part of the doctor. PAS is to empower the patient - to give them the choice of a controlled, painless and dignified suicide. The doctor is not empowered to decide when a patient should die - it is a process instigated through the informed consent of a competent patient with a terminal illness.

**heed** · 22-04-2006, 09:36 AM

IMPORTANT: Just though i should make it clear that the email which started all this was not written by the medical school at Glasgow university - nor does it necessarily represent the views of the staff or the student body.

just incase...... lol

**Spencer Wells** · 22-04-2006, 10:32 AM

There is nothing in the GMC's duties of a doctor about preserving life. I am entirely for the bill and the right to chose. I don't like several things about the email. The last line talking about evil in a provocative one. Why should ending someone's life, with their consent, be evil? Why is alleviating great suffering evil, isn't it humane, isn't it human? Vets put down animals that are in incureable distress, why shouldn't an autonamous person be able to decide to die in the same way? If a human is "more" of a moral entity than an animal, shouldn't we respect a person's wishes and end their life if they want it and are unable to do it themselves?

Save the lives of your patients

This suggests that the life of your patient is worth more than all else. Why should this be? It is easy to bring religion into this, many would argue that it is against god's will to terminate a life as such, but firstly; who says what god's will is and how do we know that they're right, secondly; why does it matter? thirdly; many people do not believe in god, and fourthly; duties of a doctor tells us that the medical professional must act in a way that is free from religious beliefs.

It would change what is currently manslaughter into another 'job' on the doctor's list

This paints an innaccurate picture of the process that would be required to euthanise a patient. It is not just another "job" and would not become routine. It would be a rare thing to enact and the decision would not be taken without great consultation and thought.
The slippery slope argument is always flawed; one concession does not have to lead to further, more extreme trespasses of the concession, and with regulation this makes it even less unlikely. While I respect the right to protest, this email and its message appauls me. I don't want to start another debate about religion on this site, so these questions are rhetorical.

**stargazer** · 22-04-2006, 12:45 PM

As (I think) Heed mentioned in another post, I deeply resent the high moral tone adopted in the email. In particular, I find the use of Edmund Burke's quote "All that is required for evil to triumph is for good men to do nothing" both inappropriate and offensive.

Discussion concerning euthanasia should be based on rational debate, not dogma from religious organisations like the CMF, who are signatories to the email. I fully support this Bill.

**heed** · 22-04-2006, 08:39 PM

Thought I should explain why I feel so strongly about this one::

surely it would be to turn our backs on "thousands of years of medical wisdom" to deny a competent patient their right to self determination (and the right to have that opinion respected by those responsible for their care)?

At what point would the authors of the email argue the right to choose becomes the doctor's and not the competent patient's? Do we grant autonomy so long as the outcome of our patient's autonomous choice does not offend our sensibilities or religions as doctors? I would have to agree with previous posters that it is not only inappropriate but also highly unethical to allow our beliefs as medics determine what treatment our patients receive.

As far as PAS is concerned - if it were legal, patients who do not agree with it need not consider it as an option. But if it remains off the statute books, then are we not denying patients who wish this choice their chance to end their life with dignity and with as little suffering as possible?

The email employed thin arguments and poorly veiled manipulative language to make a point - the implication that medics like myself who are in favour of PAS are "evil" and that those in this vocal group somehow occupy a moral high ground over the rest of us is abbhorent and totally self-gratifying. I also doubt that doctors would be going round "putting down" their patients as routinely as taking blood cultures or putting in venflons, nor would they be forcing anybody to opt for PAS against their will.

I know that many of my fellow students were similarly disturbed by the way in which this message was presented - and I would hope that the university may think twice about allowing similar mail-shots in future.

It would be interesting to see how many people who claim to be so against PAS have actually read Lord Joffe's bill - something which at least should have been included in that email to allow people to make an informed decision - just like we should be affording our patients.

**the_last_1_left_again** · 23-04-2006, 01:07 AM

Originally Posted by red_dillan

I'm basing my decision to vote for the Bill on my experience of working as a HCA on a care for the elderly/ stroke ward. I have seen people with no hope of ever making it out of the hospital detiriorate day after day, contracting hospital aquired infections, pulling out their NG tubes day after day and refusing their medications. I know if I was in their situation I would want the option of dying with dignity and have stated so in a living will (pain relief and fluids to be administered under certain conditions). I think if the bill were to succeed it would not be a carte blanche for mass 'exterminations' but would give patients the right to chose if and when to end their lives should there be no hope of attaining a resonable quality of life.

There, I've stuck my neck out - now let's hear from some of the other other voters on both sides!

having worked as a HCA myself, i completly agree with your point.... and strongly feel dat keeping some1 alive against their wishes at al costs (wen it is obvious dat they r at the terminal stage and clearly suffering, physically as well as emotionaly) is the most awful and inhumane way to treat som1....its almost as if u r enforcing an undignified death on them..... a serious breach of human right at all levels

so, am all pro-euthansia given dat it is well-informed and consented AS WELL AS in the best interest of a patient (from a doctor's point of view)

but i do have 1 real deep concern about the legalisation of euthanasia.... arent we sort of creating a society where we are sending an open and clear message especialy 2wards the aging population dat if u r elderly and bcome ill.... start thinking in terms of commiting suicide as we cant afford 2 keep u alive anymore..... i know, i know..... cost shouldnt be a factor but wid ever increasing blair's "NHS reforms" and "target setting"...... i hop this bill isnt used to put som sort of in-direct pressure on doctors 2 free up more beds!!!!!!!!!!....... so som how a balance needs 2 b struck....

and also..... even though i am pro-euthanasia (at least in theory)..... i dont know how would i actually feel administrating some1 a lethal dose..... would i do it? i dont know!!!! so a doctor's wishes MUST also be respected...... it shouldnt automatically b assumed dat legalisation of euthanasia means that every doctor is expected to perform it...... mayb ther should b a dedicated team which specialises in euthansia and addresses the issues around it..... but den again would i like to work in dat team? i dont think so!!!!!!!

in conclusion...... euthanasia = yes, but we need 2 b very careful as it is an xtrmly sensitive issue