A GP’s personal concerns about legalising euthanasia/assisted dying

As a GP for the last 20 years, I have been looked after many patients in their last days. But I have not practised euthanasia – or as Jeremy Purvis would like to call it ‘assisted dying’. Rather doctors and nurses work hard to try to meet all the needs of dying people – our aim being to care for, not to kill our patients.

When folk have asked me for ‘the blue peel, doc’, it does not mean they have a ‘death wish’- usually it is a ‘cry for help’, which may have physical, psychological, spiritual or social issues which need to be addressed. My experience – and that of the overwhelming majority of those who work at the coal-face caring for the dying is when these issues are dealt with people do not want to end their lives.

People should be concerned that there is a strong pro-euthanasia lobby, fronted by Lord Joffe in the House of Lords and Jeremy Purvis in Holyrood who seek to undermine the basis of medical and nursing care, with grave implications for society.

Today P&J reported ‘MSP says half of Scots support the right to die’ in a banner headline. This is blatant mis-information. From his website it seems that he is counts each submission singly despite the fact that many submissions are from large groups who spent significant time in considering the issue. These include the Royal College of GPs (2,943 individual GP members), the Scottish Partnership for Palliative Care (53 member organizations representing thousands of individuals), the British Geriatric Society Scotland and to quote from Mr Purvis’ website many ‘Religious Organisations’ - Twenty eight submissions were placed in this category. Responses came from many of the major faith denominations in Scotland including Christian, Catholic, Jewish, Mormon and Baha’i. They also included responses from the Christian Medical Fellowship, the Nurses’ Christian Fellowship of Glasgow, one member of the Guild of Catholic Doctors, and a personal response from the Chairman of the Lawyers Christian Fellowship.’

Perhaps you should address this balance and ask Mr Purvis to re-do his sums.

Finally, here are some very good reasons why ‘assisted dying’ should not be legalised:

1. Palliative care is advancing very rapidly both in relieving the spectrum of suffering experienced by those with a terminal illness, and in supporting their families. Good Palliative Care can give dignity to people last days; as doctors we want to kill pain, not our patients.

2. Countries which have legalised assisted suicide or euthanasia are experiencing serious problems. Patients will not trust , and even fear their doctors, not knowing whether medicine prescribed is to cure or to kill. In Holland 1 in every 32 deaths arises from legal or illegal euthanasia: a similar law here could lead to some 13,000 deaths a year. 1000 people every year have been given euthanasia WITHOUT request in Holland since 1990. In Oregon the reluctance of many doctors to participate in legalised assisted suicide is leading to ‘doctor-shopping’ with the result that many patients who receive lethal drugs, including reports of some with psychiatric disorders, are not known to the doctors who supply them. There is also no oversight of lethal drugs released in this way into the community.

3. The great majority of British doctors and nurses are opposed to a change in the law. This was made very clear to a recent House of Lords Select Committee examining Lord Joffe’s Assisted Dying for the Terminally Ill Bill . The Royal College of Nursing (RCN) and Royal College of General Practitioners (RCGP) are both opposed to a change in the law. On 21st September 2005 the RCGP issued this press release:

‘The RCGP is the largest medical Royal College with over 23,000 members. Great care and attention has been taken over this debate which has now been considered by Council twice. Overwhelming support was given by RCGP members and faculties to the statement on assisted dying for the terminally ill opposing any change in legislation. Taking account of comments received, the following position statement was agreed:

‘The RCGP believes that with current improvements in palliative care, good clinical care can be provided within existing legislation and that patients can die with dignity. A change in legislation is not needed.’

A recent and much-publicised vote at the BMA annual conference to adopt a position of neutrality towards any future bill was unrepresentative of the Association’s 134,000 members. It was carried by a very narrow majority (93 votes to 82) at a barely quorate meeting on the last day of the conference when over half of the delegates had either left or were otherwise engaged. In the debate on the matter two days before, the majority of speakers had opposed any change in the BMA’s opposition to euthanasia.

4. Opinion polls purporting to show that a large majority of people would favour a change in the law are misleading. They are based on answers to Yes/No or Either/Or questions without any explanatory context and without other options – eg good quality palliative care - being offered. Most people have little understanding of the complexities and dangers in changing the law in this way and opinion research consists therefore to a large extent of knee-jerk answers to emotive - and often leading – questions .

5. Assisted suicide and euthanasia will radically change the social air we all breathe by severely undermining respect for life. The previous Lords’ Committee on this issue opposed assisted dying because of concern that ‘vulnerable people - the elderly, lonely, sick or distressed - would feel pressure, whether real or imagined, to request early death.’ This concern is just as valid today. The so-called ‘right to die’ would inexorably become the duty to die and potentially economic pressures and convenience would come to dominate decision-making.

Yours Sincerely

Dr Peter Kiehlmann
GP, Danestone Medical Practice, Aberdeen
Macmillan Lead Cancer GP NESCCAG (NE Scotland Cancer Co-ordinating & Advisory Group)