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Letters to the Editor
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Assisted dying
Does not comply with duty of care
From Miss H. M. Shaw, MRPharmS
Although British
doctors have apparently dropped their long-held opposition to physician-assisted dying (PJ, 21 January, p68), this appears to be
the result of an unannounced vote held at the end of the British Medical
Association’s conference, when many people had already left.
Members of organisations who are frequently dealing with the terminally
ill, ie, the Royal College of Nursing, the Royal College of General Practitioners,
the Royal College of Physicians, the British Geriatrics Society and palliative
care organisations, are among those opposed to physician-assisted suicide.
It is clear that palliative care has reduced suffering enormously and
good practice needs to be standardised throughout Britain; this is where
pharmacists have a big part to play. These organisations have also highlighted
the fact that the duty of a physician to care for his or her patient
is incompatible with a duty to bring about death — even at the
request of a patient.
Assisted dying changes the relationship between the health professional
and patient and the role of medicine in society. Once quality of life
becomes the yardstick by which the value of human life is judged, the
protection offered to the most vulnerable members of society, eg, the
mentally ill, the elderly, the disabled and dying, is weakened. I have
seen this recently, with respect to a 53-year-old man with chronic symptoms
of schizophrenia, cardiac problems and lacking capacity to make decisions
about his treatment. A senior house officer stated that we should consider
a “do not resuscitate” policy for him — in his view
the patient did not have much to live for. The assisted suicide bill
will not serve people like this patient well. It is not easy to evaluate
the case of someone considering ending their life and many making this
decision are influenced by a feeling of being a burden to family and
society.
It is obvious that pharmacists need to make their own minds up about
assisted suicide and face the issues, taking into account that medicines
are intended to relieve symptoms and cure illness, not take away lives.
We must not think that it is the responsibility of the person prescribing.
When we dispense medicines we are accountable for our actions and have
a clinical responsibility towards the patient. I am regularly involved
with patients who want to end their lives; I do not consider it a duty
of care to facilitate this by supplying them with medicines to assist
them to die.
Helen Shaw
Lead Clinical Pharmacist
Oxfordshire Mental Health
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The
Pharmaceutical Journal