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Letters to the Editor
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Euthanasia
Terminally ill must have right to choose
From Professor A. R. Michell, MRCVS
The case argued in my Broad
spectrum article (PJ, 8 March 2008,
p272) is not based on a single emotive experience, as one
correspondent seems
to suggest (PJ, 12 April 2008, p438); I have written about these
issues in the national press, and spoken about them at meetings and on
television,
long before that.
It is based on a lifetime of experience in the only
profession — veterinary medicine — which, in the UK, has
experience of having assisted closure as an option for the relief of
irreversible suffering.
My experience of nursing a dying human patient reinforced, all too vividly,
the fact that pain and suffering can reach beyond the power of even the
finest palliative care. The question then is, if patients have made it
clear, while still thinking coherently, that in such circumstances they
would prefer the battle to end, why this most important of choices should
be denied to them. To continue to deny it, in a country with a secular
majority, and a majority in favour of such a change, is a cruel offence
against human rights.
The two bastions of resistance, the higher value on human life and the
danger of mistaken choice, are both addressed in my article. How can
a higher value on human life lead to human patients being treated in
a way that would be unethical, even illegal, if inflicted on animals?
And,
if the risk of regretted outcomes were a justification for withholding
choice, would we forbid riding, rugby, skateboarding or military service?
As for undermining confidence in doctors, it is the patient’s choice,
not theirs.
The essence of freedom is choice, the price of choice is the risk of
error and, if we believe in patient choice, few choices, if any, are
more important than those concerning the manner of our dying. These issues
will increasingly confront pharmacists as the NHS, rightly, tries to
facilitate the wish of the majority of the terminally ill, to be at home
rather than in a clinical environment.
We all need to recognise that
what seems right for us may seem wrong for others and should not be
forced upon them as an outdated relic of a religion they may not share. Bob Michell
Nether Worton,
Oxfordshire
Lay member of the Royal Pharmaceutical Society’s Council
We need spiritual debate and leadership
From Mr A. J. T. Low, MRPharmS
I read Bob Michell’s heartfelt Broad
spectrum article (PJ,
8 March 2008, p272) on “assisted closure” in terminal illness
and greatly admire him for addressing this issue.
It is good to see health professionals debating the circumstances of
dying. It cannot just be brushed under the carpet as we hope for the
best. As a society we have become alienated and distanced from the details
and processes of dying.
In pharmacy we are not usually involved directly in the care of the dying,
in that our role is usually confined to supplying medicines, such as
palliative analgesics for a patient who may be dying at home. So, perhaps,
we tend to forget the enormous emotional content of these situations.
Professor Michell makes the point that there are arguments both for and
against euthanasia and that arguments like the possibility of a miraculous
recovery (on the “contra” side) are “wheeled onto the
barbican” to defend the established position set against assisted
dying. These are much more abstract considerations than we usually face
in community pharmacy certainly, and it is good to see that those with
the beliefs and ability can debate these complex moral issues in an open
manner in the right forums.
Ultimately, Professor Michell addressed advanced and complicated questions,
and we need spiritual guidance from the right quarters to guide us forward.
These are not light issues and we would not want to be without some sort
of spiritual debate and leadership.
Andrew Low
Harrow,
Middlesex |
The
Pharmaceutical Journal