Physician Assisted Death

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Physician Assisted Death

• A Contradictory Role ?

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Latest News Headlines

• Clinic assists doctor's suicide
• BBC News 24.01.06
• Cheers Before Dying
• Daily Record 28.01.06
• Britons in Switzerland
• VES

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Definition

• Noun euthanasia
• Adjective euthanatos
• Adverb euthanatôs
• Verb euthanatein (dying nobly)

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History
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• AD 65 - Statius Annaeus
• 1935 - Formation of Voluntary Euthanasia Society
• 1936 - Alleged physician assisted death of George
  V ( Viscount Dawson Of Penn )
• 1930s - T-4 Euthanasia Programme in Nazi Germany

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• 1992 - Dr Cox
• 1999 Dr Kevorkian
• 2000 Dr Moore
• 2005 Dr Irwin

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• 1936 - First Voluntary Euthanasia Bill rejected
  by the House Of Lords
• 1969 - Further debate and rejection of voluntary
  euthanasia in the House Of Lords
• 1984 - Lord Jenkins presents clause to English
  Suicide Act defeated
• 1990 - Roland Boyes MP presents Bill to
  Parliament for Euthanasia defeated

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Where Do We Stand ?
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The Hippocratic Oath

• Literal translation
• And I will not give a drug that is deadly to
  anyone if asked for it
• In the Greek text, the anybody to whom the
  deadly medicine is not given is in the dative,
  whereas requested is nominative, going with the
  subject, the I who swears.

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The Law

• Within English law, a difference is made between
  acting and refraining to act
• Passive euthanasia is when treatment to which the
  patient has not consented is ended.
• Active euthanasia occurs when treatment is
  administered with the intention of ending the
  patient's life.

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GMC Guidance

• Doctors have a duty to protect the life and
  further the health of patients. A number of legal
  judgements on withholding and withdrawing
  treatment have shown that the courts do not
  consider that protecting life (the 'sanctity of
  life' principle) always takes precedence over
  other considerations
• An act where the doctor's primary intention is to
  bring about a patient's death would be unlawful .
• Withholding or withdrawing treatment is regarded
  in law as an 'omission' not an 'act'.

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BMA Guidance

• Assisted dying
• October 2005The BMA has a neutral stance in
  relation to legislation on assisted dying. It
  must be strongly emphasised that this does not
  mean that the BMA supports legal change but
  rather that it believes that the question of the
  criminal law is primarily a matter for society
  and for Parliament.

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Issues
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• Ethical
• Sanctity of Life
• Relationships - Patient / Doctor , Family
• Religious
• Law
• Suicide vs Assisted suicide
• Conflict Of Interest
• Do No Harm
• Human Rights
• Article 2 vs Article 3 vs Article 8
• Monetary
• Insurance

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The World
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Just A Statistic ?
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The Future ?
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Lord Joffe Bill

• Initial bill ran out of time during last
  Parliament , reintroduced 9.11.05
• Subject to the provisions of this Act, it shall
  be lawful for
• (a)   a physician to assist a patient who is a
  qualifying patient to die
• (i) by prescribing such medication, and
• (ii) in the case of a patient for whom it is
  impossible or inappropriate orally to ingest that
  medication, by prescribing and providing such
  means of self-administration of that medication,
  as will enable the patient to end his own life,
  and
• (b)   a person who is a member of a health care
  team to work in conjunction with a physician to
  whom paragraph (a) of this section applies.

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Jeremy Purvis MSPs Proposal

• Lodged 25.10.05
• The current proposal before the Scottish
  Parliament largely mirrors the law in Oregon and
  would allow for a terminally ill patient to
  request medical assistance to die (to obtain from
  their doctor a prescription for lethal medication
  to be self administered) if they are
• An adult
• A resident of Scotland
• 'Capable'
• Diagnosed with a terminal illness that will
  result in death within 6 months
• Those who meet these requirements could receive a
  prescription from a doctor if the following
  criteria are met
• The patient must make two verbal requests to
  their doctor separated by a period of time
• The patient must provide a written request to
  their doctor
• The doctor and another independent doctor must
  confirm the diagnosis and prognosis, and
  determine whether the patient is 'capable'
• The doctor must inform the patient of feasible
  alternatives
• A reporting mechanism and an annual report would
  be required to be published which details
  incidents of prescription as well as results of
  interviews taken with those requesting the
  prescription.
• Doctors and the patients health care authorities
  are not compelled to participate in the Act.

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References

• BBC
• BMA
• BMJ
• GMC
• Human Rights Act
• Wikipedia

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Any Questions ?