| • Community pharmacy (3)
• Pfizer proposals
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• Physician-assisted suicide (3)
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Letters to the Editor
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Physician-assisted suicide
People can use living wills to make their wishes known
From Mrs R. B. Arnold, MRPharmS
There have been several correspondents voicing concern over the ethical
dilemmas for pharmacists who may be faced with physician-assisted suicide.
I agree that this concept of health care does not sit easily with some,
and that the Royal Pharmaceutical Society should promote a conscience
clause for those who do not wish to dispense medicines for this purpose.
As far as I am aware this has worked for those who do not wish to supply
medicines in other circumstances that provoke ethical dilemmas. I think
it is important that the Society takes its members’ views into
consideration and does not force them to act against their consciences.
However, I think that Mark
Donaghy (PJ, 3 February, p133) takes opposing
views to physician-assisted suicide to an extreme. He states that “the
Society should make a clear policy decision to make a political stand
stating that pharmacists, as the guardians of the nation’s medicines,
object to the use of pharmaceuticals for intentionally killing patients”.
I think this attitude is wrong. Surely this would be seen as imposing
a view with no alternatives, which may not be supported by all pharmacists.
We have all seen changes in views to ethical dilemmas over the years.
I think that the concept of physician-assisted suicide is, and will be,
one of them. As with abortion, there will always be those who feel strongly
for or against it.
A few years ago it was rare for “living wills” to be made,
but they are now considered more frequently. Living wills allow individuals
to make decisions about their health care in advance, in case they ever
are incapacitated and unable to do so. It allows a competent adult to
direct the provision, withholding, or withdrawal of life-prolonging procedures
in the event that such person has a terminal condition, has an end-stage
condition, or is in a persistent vegetative state. A life-prolonging
declaration can also be included.
For those who have experienced the severe decline in health, with associated
physical and mental distress, of one who is dear to them, physician-assisted
suicide would perhaps be less of a contentious issue. I do not think
that it is a decision that should be taken lightly and as pharmacists
we need to review the topic from all angles, as I am sure other health
care professionals will.
Rosemary Arnold
Derby
Let PAS not be swept under the carpet
From Mr A. Plumridge, MRPharmS
I should like to respond to Mark
Donaghy’s letter (PJ, 3 February,
p133) and Anthonia
Chalmers’s reply (PJ, 10 February, p164).
My father died from non-Hodgkin’s lymphoma at 49 years of age.
During his last week of life he asked me to get him “a splatter
gun to stop the pain from his cancer and help him on his way”.
I found myself extremely torn, as you want to do anything for your parents,
and yet obviously I could not comply with his request.
Consequently, I believe I have an insight into physician-assisted suicide
(PAS) from both the viewpoint of a professional and as a relative. PAS
is something that we need to tackle, discuss and, if it ever happens,
draw up appropriate guidelines so that medical professionals have the
opportunity to opt out of contributing to the event. Legally this will
be a minefield and loopholes will no doubt be exposed. People will be
taken advantage of — doctors and pharmacists included — and,
if they are, they must not be vilified.
A blanket “yes or no” answer at present is not enough on
this matter. The more PAS is spoken about, the more it will be debated
and this debate can only be a good thing. There are certain European
countries where PAS is already legalised. If the current situation continues,
people who decide to end their life by PAS for whatever reason will continue
to go abroad. Their decision will be sensationalised by the media and
scorned by some, and the police may want to become involved, as has happened
previously. I realise that I do not have all the answers. However, PAS
does need to be talked about and must not get swept under the carpet.
Adam Plumridge
Cheltenham, Gloucestershire
I have to act according to my conscience
From Mr S. J. Lewis, MRPharmS
I write in response to Anthonia
Chalmers’s letter (PJ, 10 February
2007, p 1648) regarding physician-assisted suicide.
Although I sympathise with the intention behind her views, ie, the relief
of human suffering, I cannot agree with her premise that pharmacists and
other health care professionals should only act in the best interests of
the patient.
I have spoken to people who work in hospices, who say it is only in relatively
rare circumstances that a patient experiences intolerable suffering. The
hospice movement and others have made tremendous advances in pain control
and palliative care.
Also, for those of us who have a theistic faith (as well as many others
who do not subscribe to a particular faith), the sanctity of human life
takes precedence over actively helping a patient to die.
Although I may be accused of being unsympathetic, I have to act according
to my conscience before God. Consequently, I am totally opposed to physician-assisted
suicide and would hope that the profession as a whole would not support
the deliberate killing of a patient. At the least, a conscience clause
for health care workers must be included in any proposed legislation regarding
physician-assisted suicide.
Simon J. Lewis
Hove, East Sussex |
The
Pharmaceutical Journal