Assisted Dying Debate
Life has got even more complicated since my last post, but I hope to pick up the threads of this blog from now on. Do comment or email me if you want to discuss anything I write.
A debate on “assisted dying” is planned to take place at the end of November. Against the presumed benefits a change in the law risks some terrible consequences, so I wrote to my MP asking her to vote against this. Below are the arguments I made in my letter; if you agree with them then I urge you to write to your parliamentary representative too.
Those arguing for a change in the law stress the right of patients to choose and the risk of uncontrolled suffering in terminal illness. An issue less often mentioned is the cost of good end-of-life care, which in my experience can almost always control suffering in terminal illness. In a cash strapped and under-resourced NHS where consequentialist arguments are commonly used this may lead some well meaning people to see assisted dying as a way to free up resources for others. A dead patient is a cheap patient.
There are however well known and valid arguments against any change in the law:
The risk of vulnerable people feeling pressurised to choose assisted dying so as to leave money to relatives or relieve stress on carers: the right to die becoming the duty to die.
Function creep, also called “the slippery slope” which has been seen in other countries where assisted dying has been introduced.
The lack of ability to predict how long someone has got left, life expectancy being impossible to predict with any certainty until the last few days of life, and sometimes not even then.
But I would like to raise an issue less often considered. What happens to clinicians and to patient trust when you turn health-carers into potential killers?
In one of the explorations of assisted dying recorded on Hansard, there was a doctor saying that the first time he ended someone’s life was difficult, the second time was easier and the third time it was a ‘piece of cake’. Is this an attitude we want to cultivate in healthcare professionals and, if so, what will be the ramifications on them, those around them and on wider society?
And how will it affect the trust of patients in doctors and nurses if they become part of a system that enables assisted dying? I remember the damage to patient trust of the Tory policy of “fund-holding” in the 1990’s. When practices were given budgets to buy care for their patients many thought when doctors advised that a treatment would not be helpful they were doing it to save money. If controlling money eroded trust in clinicians , how much more will controlling life and death?
I have argued that culture change is needed in the health service
(see https://bjgplife.com/regarding-general-practice-an-appeal-to-the-new-uk-government/)
but this is very much NOT the sort of culture change we need.
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