RespiteMatch.com Health Blog

IAN JOHNSTON
Key points
• Report reveals as many as one in three patients had deaths accelerated
• All deaths assisted by medical staff are illegal under British law
• The British Medical Association disputes the figures

Key quote
“The illegal decisions are extremely rare compared with other countries. Three thousand sounds like a lot, but it’s not. The rate in the UK is significantly lower than in other countries where this survey has been conducted” - Professor Clive Seale, author of report into assisted deaths

Story in full DOCTORS broke the law to help nearly 3,000 patients die in a single year, according to new research which has reignited the debate on euthanasia.

The independent report, based on interviews with hundreds of GPs and specialists, also revealed that an estimated one in three people who died in 2004 - 192,000 - had their deaths accelerated by doctors who administered pain relief.

The British Medical Association (BMA) disputed the figures last night, saying it believed there were only a handful of euthanasia cases involving British doctors.

But euthanasia campaigners seized on the report, saying it proved the need for legislation to bring the practice into the open where it could be properly regulated.

The study, by Professor Clive Seale, of Brunel University, was based on an anonymous survey of 857 GPs and hospital specialists. The results suggest 0.16 per cent of the 585,000 deaths in 2004 - or 936 - would be described by doctors as voluntary euthanasia, where medics had agreed to a patient’s request for drugs to end their life.

The survey, published in the journal Palliative Medicine, found a further 0.33 per cent - or 1,929 cases - would be described as “ending life without an explicit request from the patient” - a practice also known as non-voluntary euthanasia.

Such cases usually involved patients very close to death who had previously indicated their wishes for euthanasia but were unable to give a specific instruction to doctors, Prof Seale said.

Every one of the 2,865 deaths apparently resulting from voluntary or involuntary euthanasia would be illegal under British law.

Prof Seale said his results suggested almost exactly a third of all deaths - or 191,811 - had been accelerated by doctors using pain relief, known medically as “alleviation of symptoms with possibly life shortening effect”.

He found no cases of doctor-assisted suicide, where drugs are given to a patient which they use to end their own lives.

Prof Seale said: “The illegal decisions are extremely rare compared with other countries. Three thousand sounds like a lot, but it’s not. The rate in the UK is significantly lower than in other countries where this survey has been conducted.”

He insisted the figures were an accurate reflection of the situation and that the survey’s questions were “fairly unambiguous”. One asked doctors if they or a colleague had prescribed treatment with the “explicit intention of hastening the end of life”. Despite the results, only 14 per cent of the medics questioned said they were dissatisfied with the current law on euthanasia.

Deborah Annetts, the chief executive of the Voluntary Euthanasia Society (VES), said: “This research proves that some doctors break the law and deliberately help patients die. This is all done in secret and denied in public. Some of these doctors are acting compassionately on their patients’ wishes, but some clearly act without consent. This cannot be safe.

“We desperately need to put the patient at the centre of these decisions and make sure doctors are acting within proper safeguards to protect the patient and themselves.”

Last year, the BMA voted to drop its resistance to a change in the law on assisted suicide and take a neutral stance to allow for a wider debate in society. But Dr George Fernie, a Scottish council member of the BMA, cast doubt on the latest figures, saying there was a degree of “blurring” between euthanasia and giving high doses of painkillers to a patient who is suffering.

“There have been many occasions when I’ve had a patient who was terminally ill and I’ve given them pain relief to relieve the pain and, as an unintended consequence, I am sure it’s hastened their death,” he said.

“I’ve certainly been in a situation where a patient has said to me ‘I’ve had enough, I can’t go on’, and I’ve made sure I’ve given that patient adequate relief of pain. But my intention is not to end the person’s life. I do believe that is an important distinction.”

Dr Fernie said he believed there would only be a “handful” of cases where British doctors were involved in euthanasia.

“I doubt eight patients a day are being deliberately killed by their doctors. I don’t believe that’s happening,” he said.

Morag Mylne, convener of the Church of Scotland’s church and society council, said the Kirk was against legalising euthanasia or liberalising the law. “I find it difficult to conceive of eight doctors a day who would be opening themselves up to prosecution,” she said. “One would obviously have to know all of the facts of each case before you could say they should be prosecuted.”

How Europe differs on assisted death

TERMINALLY ill patients seeking assistance to die have in recent years looked to Europe to find places where it is legal.

In the Netherlands in 2002, a law legalising assisted suicide codified what had already become tolerated practice by Dutch doctors since the 1970s.

Belgium also legalised assisted suicide in 2002. The legislation instituted a complicated process, which has been criticised as a bureaucratisation of death.

Many countries simply make no laws against euthanasia. Swiss doctors are not persecuted if they can prove they acted unselfishly, meaning they must not do it for profit.