Saturday, 9 October 2010

Sir Michael Caine’s report of his father’s death is an opportunity to educate the public about what good palliative care can achieve

Sir Michael Caine (pictured) has revealed how he asked a doctor to help his terminally ill father to die. Maurice Micklewhite, a Billingsgate fish market porter, apparently died in hospital at the age of 56 in 1955 after suffering from liver cancer.

Sir Michael told Classic FM: ‘My father had cancer of the liver and I was in such anguish over the pain he was in, that I said to this doctor, I said “Isn't there anything else you could, just give him an overdose and end this”, because I wanted him to go and he said “Oh no, no, no, we couldn't do that”. Then, as I was leaving, he said “Come back at midnight.” I came back at midnight and my father died at five past 12. So he'd done it...’

He said his father had been given just three to four days to live when he asked the doctor to perform the mercy killing. Asked if he agreed with voluntary euthanasia, Sir Michael, 77, said: ‘Oh I think so, yeah. I think if you're in a state to where life is no longer bearable, if you want to go. I'm not saying that anyone else should make the decision, but I made the request, but my father was semi-conscious.’

We know nothing about this sad case apart from what Sir Michael Caine has told us and should therefore be very wary in drawing conclusions about what actually happened, especially in the light of the recent controversy around Ray Gosling’s discredited confessions about smothering a gay lover. Elderly celebrities have their own vulnerabilities which should not be exploited by media people hungry for a good international news story or campaigners looking for another friendly face to drive their campaign to soften up public opinion on euthanasia.

We are told that Caine’s father had only days to live but cannot know whether he died from a lethal injection or from the disease itself and have no objective medical evidence to draw on that might help us to know for sure. Witnesses apart from Sir Michael may be long dead.

We also need to take note that this case occurred 55 years ago in 1955 when palliative care was not as it is today and when many dying patients were not managed well. It is simply not necessary to kill the patient in order to kill the pain and any doctor who uses pain as a defence for ending a patient’s life is either incompetent, inadequately trained or just being disingenuous.

Earlier in July this year an international survey by the Economist Intelligence unit ranked Britain first in ‘Quality of End-of-Life Care’ which includes indicators such as public awareness, training availability, access to pain killers and doctor-patient transparency.

The British Medical Association, at its annual general meeting in July this year passed a motion affirming that requests for assisted suicide and euthanasia are very rare when patients are being properly cared for and called for better training of doctors and education of the public about palliative care.

That this Meeting, recognising that persistent requests for assisted suicide and euthanasia are very rare when patients' physical, social, psychological and spiritual needs are being appropriately met, calls on the BMA to campaign for:
(ii) better training in palliative medicine for all GPs and hospital doctors involved in managing dying patients;
(iii) better education of the public about what good palliative care can achieve.

We should also be wary of any media reports linking this case with the recent DPP guidelines on prosecution criteria for assisted suicide.

If Michael Caine’s father was indeed killed intentionally by his doctor with an overdose of painkiller without actually requesting it (being semi-conscious at the time) then this would not be a case of assisted suicide or voluntary euthanasia but rather non-voluntary euthanasia. And the DPP has recently refused to excuse any kind of euthanasia on compassionate grounds.

Is was somewhat inevitable that pressure groups such as Dignity in Dying, formerly the Voluntary Euthanasia Society would seize on this case involving a high profile celebrity as an opportunity to further their agenda of legalising so-called ‘assisted dying’ for the ‘terminally ill’ (two terms they are not willing to define precisely).

However if they are asking for the law to be changed for cases such as this then they are extending their agenda beyond assisted suicide for the mentally competent terminally ill to include non-voluntary euthanasia for the mentally incompetent.

Are we seeing more evidence of incremental extension here? I wonder.

The House of Lords has twice in the last five years (in 2006 and 2009) rejected any change in the law to allow ‘assisted suicide’ for so-called compassionate reasons on grounds of the danger such a move would pose to public safety – especially for disabled and elderly people who might feel their lives to be a burden to others. All medical institutions including the BMA, RCGP, RCP and Association for Palliative Medicine remain opposed to any change in the law for similar reasons.


  1. My mother told me long ago that the last sense we lose is our hearing: the thought of someone semi-conscious hearing his son request that he be killed, even if well-meant (though it sounds as though it was the son who couldn't bear it - whose interests was he acting in?) has me horrified!

    My own mother is now at a stage when she needs live-in care and is distressed at being helpless. We work as hard as we can to persuade her that she is as vital to us now as she was when we were the ones that were helpless and dependent on her: she need not feel guilty at needing care; it is our turn to return the care she gave us, and we want her to have the best possible.

    It is not for her, or for us, to decide when she dies. As long as she is alive, there is purpose in her being so (we have one astonished GP and one astonished district nurse); it may be that her purpose in staying alive is to teach the medical profession not to dismiss the life of a frail old lady even a moment too soon. One example of a determined family who do not give up on her may do more to persuade them to value life than any number of pronouncements from the Vatican.

    If euthanasia were legalised we would have even more trouble convincing her of her value simply as a human being (not merely as a competent, capable, sassy human being - all those are aspects of being, being itself is greater than the limitations we put on it when we define aspects of it). She may, at times, feel she would like to fall asleep and not wake up: we all can feel that under stress and it does not mean we wish to die! The answer is not euthanasia, but better, more co-ordinated care.

  2. Fair comment above, but who nowadays gives a monkey about anyone else . We have turned into a selfish society, such philosophical argument does not mean much nowadays and is increasingly less meaningfull as time goes on. I personally in my middle age, beleive that I would like to be assisted, should I become incapacitated, severly ill, etc. Firstly I would be conciensous That I was a burden on someone and this would play on my mind and would be extremely stressfull for me, secondly my standard of living would be so poor that it could be unbearable particularly if I was in pain aswell and if I was unable to communicate my wishes to die; this would be like a living hell. I sometimes imagine that it could be as horrific as being burried alive. I would only wish that someone would have the sense to assist me.

    It is a natural instinct to live and try to survive, and we are always fearing death and thinking of what we might lose. Families become selfish because they dont want to lose a loved one. Dying is a part of living and when your body becomes dysfunctional, life has really ended. In most other ages in the past or in the wild, your as good as dead once you become severely ill of dysfunctional.

    Its ok for some families like the one above if both parties are happy and want to continue, but think of the thousand of poor soles left rotting in nursing homes etc, some of them are living hell on earth.