Wednesday, 13 June 2012

British Medical Journal adopts campaigning stance on euthanasia

The British Medical Journal this week contains three articles aimed at neutralising medical opposition to euthanasia.

The BMJ, which remains editorially independent from the British Medical Association, but is sent to all members, has a long track record of backing liberal causes, amongst them the legalisation of assisted suicide and euthanasia.

A comment piece from Ray Tallis (pictured), chairman of the pressure group ‘Healthcare Professionals for Assisted Dying’ (HPAD) calls for the BMA and Royal Medical Colleges to take a position of ‘studied neutrality’ on euthanasia.

An emotive ‘personal view’ by Tess McPherson, relates the story of the death of her mother Ann, an Oxfordshire GP who died from cancer of the pancreas last year and was the founder of HPAD.

Finally the journal’s editorial by Fiona Godlee, ‘supports’ HPAD’s call.

The BMJ sought wide exposure for the articles by sending out an embargoed press release yesterday ensuring that the story would get prominent media coverage (See Daily Mail, Daily Express, Daily Telegraph, Press Association and Evening Standard).

Godlee acknowledges in her editorial that 65% of doctors are opposed to a change in the law but makes much of a ‘poll of 1,000 GPs’ commissioned by the pressure group Dignity in Dying last year which allegedly showed that ‘62% supported neutrality’.

The poll is referenced to the HPAD website events page but the link from there to PJ Online can only be viewed by paid up subscribers meaning that is difficult to ascertain what question was actually asked and of whom. How convenient! (I see they have now finally posted the link - I will blog on this very soon)

Healthcare Professionals for Assisted Dying backed by Dignity in Dying, the former Voluntary Euthanasia Society, have flooded this year’s BMA annual meeting with motions calling for doctors to take a neutral stance on assisted suicide and euthanasia.

This is a carefully orchestrated move by a small minority of doctors with extreme views aimed at neutralising medical opposition and softening up public and parliamentary opinion in advance of new pressure to change the law. HPAD has just 520 supporters, representing less than 0.25% of the medical profession.

It has been carefully engineered to coincide with two high profile cases being heard in the high court next week, plans for a new private members bill and a mass lobby of parliament by the pro-euthanasia lobby on 4 July.

The majority of doctors and the major medical royal colleges (RCGP, RCP and Association for Palliative Medicine) however remain strongly opposed to a change in the law and British parliaments have three times in last six years, twice in the House of Lords and once in Scotland, voted against the legalisation of assisted suicide.

The BBC this morning reports a BMA spokesperson saying that the organisation is 'firmly opposed' to the legalisation of assisted dying adding: 'If assisted dying was legalised, effective safeguards could not be implemented without the involvement of doctors. It is therefore appropriate for doctors to voice their views on this issue.'

A powerful article in last week’s BMJ by Iona Heath, president of the Royal College of General Practitioners, argued strongly against a change in the law and is well worth studying.

Heath eloquently voiced her ‘deep concern that it will be impossible to draft a law robust enough to protect the vulnerable’ and expressed her discomfort ‘that medicine seems once again to be preparing to offer a technical solution to an existential problem’.

‘One of the huge challenges of human life’, she argues, ‘is to find ways of living a meaningful life within the limits of a finite lifespan that will always involve loss of love and the inevitability of grief. Doctors have a regrettable tendency to ignore this reality and to persist in active and invasive treatment beyond the point at which it has become futile and even cruel.’

She acknowledged that some of the drive to legalise assisted suicide and euthanasia is driven by fears about inappropriate invasive treatment but insisted that the right answer is not changing the law, but rather better care that recognises the limits of medicine.

She concludes:

‘When doctors fail to recognise and acknowledge existential suffering in the dying and take refuge in excessive technological interventions, patients become frightened and, no longer able to trust their doctors, may request assisted dying. But two technological wrongs do not make an existential right. I don’t want assisted dying, but I also don’t want a PEG tube.’

Any change in the law on assisted suicide and euthanasia would place pressure on vulnerable sick, elderly and disabled people to end their lives for fear of being a financial or emotional burden on loved ones.

This is the very last thing we need at a time when many families and the health service itself are already under considerable financial pressure.

Doctors should see this latest move for what it is and firmly reject it.

7 comments:

  1. The poll is referenced to the HPAD website events page but the link from there to PJ Online can only be viewed by paid up subscribers meaning that is difficult to ascertain what question was actually asked and of whom. How convenient!

    I like the way that you make it sound like its their fault that you cant be bothered to sign up/subscribe. Maybe you should email them.

    HPAD has just 520 supporters, representing less than 0.25% of the medical profession.

    By your figures then, the Christian Medical Fellowship with around 2.5% membership of the medical profession is an equally poor reflection of what most doctors believe in. Christianity has been around for about 2000 years more than the HPAD, so on balance I would say they're doing a lot better than you at converting people to their beliefs.

    What I do find hard to get my head around though is that you are attempting to berate these people for being well organised, like that in itself is some sort of crime. At least half of your article bangs on about how ruthlessly well organised they are, that suggests to me that you had to bulk this piece because you have so little real argument to work with.

    Any change in the law on assisted suicide and euthanasia would place pressure on vulnerable sick, elderly and disabled people to end their lives for fear of being a financial or emotional burden on loved ones.

    Do you have proof of that or is this just, as I suspect, conjecture? Even if it is a proven fact (which I highly doubt) then it isn't an argument against euthanasia, its an argument for strict rules to be put in place for those who want to end their life, not for stopping them from doing so.

    There really is no good reason why assisted dying should not be legal, all that really matters is that we ensure anyone who wishes to do so has the chance to put their case before a judge, and that the judge is allowed to give them permission if he believes that they haven't been coerced into the decision and that they are of sound mind.

    Clearly this wouldn't be good enough for you though Peter. You want the law to follow what you think your ancient book tells you, why do you feel the need to try and force your archaic views upon others?

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  2. Godlee's championing of a change in BMA policy is appalling. She is clearly not neutral, and that compromises her position as an editor.

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    1. Neutrality is over rated, it might sound good, but evidence based decision making is far more productive.

      A good example is whether to teach Creationism or Evolution in schools. If we were neutral we may say that we could teach either, however if we base our decisions on facts and evidence we naturally teach Evolution.

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  3. Oh, I'm soooo fed up with opponents' complete lack of arguments and complete lack of empirical knowledge on this topic... Hearing the same badly established pretexts without any proof or evidence again and again...

    I don't even start telling you about that massive empirical data that clearly shows how wrong you are... Will you please get acquainted with a book called "Euthanasia and law in Europe" (2008)? Unlike you, it provides substantial evidence and insight of this practice both in countries where it is legalized and where it is not. It is really not difficult to come to a conclusion once you actually know what you are talking about...

    You mentioned the attitude of doctors. Good. And did you know that 80-82% of the general public supports the legal change? 80-82%!!! (confirmed by several independent polls). But of course you know it, you just forgot to mention... If anything is weird here is the fact that your miserable lobby can still win over what the significant majority of people really want.

    Please don't come with pretexts, the vulnerable and slippery slope etc. Just admit the truth: that you don't LIKE the idea. That you think it is immoral, it is not right, it is against God's and nature's law. And when you admit this, then we can start to openly discuss the real issue here, namely whether it is justifiable that some people force their views and moral convictions on other people (the majority hereby) in a democratic society in the 21st century.

    You should realize at last, that although you have every right to live your life and die according to your own belief, you have no ground whatsoever to deny the same right of other people. Unless you can prove that it is a harmful practice for other individuals or the society. Which you can't prove since all evidence is against you.

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  4. For many years, researchers have noted that people who live around the Mediterranean and stick closely to the traditional Mediterranean Diet have had lower incidences of Western world disease such as heart disease,

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  5. I don't even start telling you about that massive empirical data that clearly shows how wrong you are... Will you please get acquainted with a book called "Euthanasia and law in Europe" (2008)? Unlike you, it provides substantial evidence and insight of this practice both in countries where it is legalized and where it is not. It is really not difficult to come to a conclusion once you actually know what you are talking about...

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