Medical assistance in dying means the doctor’s best guess becomes the patient’s last day

November 15, 2024, 2:38 p.m.

The problem with the benign term “assisted dying” is that it is a euphemism for a much more macabre reality.

The term “euthanasia” – literally “good death” – was adopted in the 1870s to refer to the intentional medical killing of suffering patients by chloroform or other anesthetics.

Since then, a long list of misleading labels have been used by activists, from “Easy Death” to “Physician-Assisted Dying,” all of which serve to obscure the troubling reality of the problem: the administration of a deadly cocktail of medication has serious consequences. with long-term implications and potential for trauma for everyone involved.

Instead, reassuring words like “safety”, “choice” and “protection” abound in MP Kim Leadbetter’s private member’s bill, released on November 11, 2024, titled “Choice at the end of life.” , no doubt echoing the phraseology of Dignity in Dying, the leading campaign organisation, which uses the innocuous description “the dying deserve the choice to control when and how they die”, erasing the mess and emotional complexity involved in carrying out such an act, not to mention the real possibility that vulnerable people would be forced to die if the bill became law in the UK.

Sarah Wootton, chief executive of Dignity in Dying, assures us that “safety is woven into the fabric of the proposed changes to the law, introducing practical measures to assess eligibility, ensure rigorous medical oversight and rigorously monitor every step of the process “.

Kim Leadbeater said the proposed legislation would give us the right to “spend our days surrounded by those we love and care for, knowing that when we are gone, they can remember us as they would like to be remembered about us,” sentences that sound suspiciously like a funeral director’s marketing pitch.

Philosopher Kathleen Stock writes: “Sometimes we feel like we’re being offered a particularly relaxing spa treatment. With a pleasant message of support, you are now “helped” to achieve something, rather than being killed by a doctor or committing suicide.

The proposed bill requires doctors to certify that the patient has less than 6 months to live to qualify for medical assistance in dying. But as a consultant with over 20 years’ experience in the NHS, predicting how many years or months a person has left to live is notoriously unreliable – my colleagues and I were often inaccurate with such predictions.

A person who is diagnosed with a “terminal illness” may live for years or die within days. With misdiagnoses, new treatments, spontaneous remissions and random events, it is simply impossible to predict death with certainty.

Why then does this Bill assume that busy NHS doctors, with a disparity in technical expertise, will be accurate in their prognoses every time?

And once a lethal drug is prescribed, no one will ever know if a patient committed suicide unnecessarily, mistakenly believing they only had weeks left, when in reality they had years to go. with his children, his family, his friends and his partner.

Allowing this bill to pass is tantamount to making extreme, sweeping assumptions about life, death, and terminal illness and assuming that vague prognostic timelines are gospel truth rather than mere estimates.

The bill requires doctors to prescribe and provide highly lethal and toxic drugs intended solely for patient use. Yet this is a situation that could so easily be weaponized by abusers, especially in a society where we are still learning and recognizing the effects of coercive control.

Do we want a new supply of deadly drugs circulating in our community and accumulating in homes, potentially used by anyone? The UK is already grappling with a rise in deadly and addictive illicit drugs, including nitazenes, which can be up to 500 times more dangerous than heroin, according to The Lancet. The idea that deadly medical substances could be added to this mix is ​​a crisis we simply cannot afford.

Sir Keir Starmer and his colleagues have informed us that the NHS is broken, overburdened and failing. So why do we then add the enormous and heavy responsibility of causing death on demand (as well as the judgment that those who wish to die “have a clear and firm intention to end their own life, an intention which has been achieved” voluntarily, on an informed basis and without undue influence, coercion and coercion’), to doctors, pharmacists and NHS administrators who struggle under a system so burdened that people question its survival in its current form?

How can we expect doctors to have the bandwidth, time, and energy to effectively accomplish the impossible task of determining whether a person is free from restraint when making the decision to die?

Not to mention that “undue influence” is a vague phrase in a charged emotional context in which there may be subtle pressure and manipulation from those close to you.

Across the UK, the number of elderly and frail people is increasing, alongside the breakdown of traditional family support and community structures. Loneliness and isolation are worse than ever, especially for the most vulnerable in our society. Introducing the option of state-sponsored termination of life into this difficult mix is ​​simply irresponsible.

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John Wyatt is professor emeritus of neonatal pediatrics and medical ethics. His book “Right to die? – euthanasia, assisted suicide and end-of-life care” is published by IVP.

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