Listen to patients about suffering
Letter to The Times - April 7, 2009
Sir, Baroness Finlay of Llandaff highlights the progress made in, and the need for, palliative medicine ("Assisted suicide is fine in a perfect world. We don't live (or die) in one", Opinion, April 1). "Advances in palliative medicine" should not, however, be seen as a panacea and paternalism should not be encouraged. Patients are allowed to refuse treatment, even when this will lead directly to their death, because it is seen as their right. This may occur either as an act of commission or, more commonly, omission by the physician. The physician may disagree with the course of action but patients that make such an autonomous decision are not always assumed to be depressed. The Mental Capacity Act encourages patients to make their treatment requests known in the form of a living will or by the appointment of a power of attorney. If there is no treatment to withdraw, a patient in the UK, suffering from symptoms that are unbearable to them, must travel to the Dignitas clinic in Switzerland for assistance to die.
I do not believe that "processing a request for assisted suicide risks sending a signal that the doctor agrees that the patient would be better off dead". Rather, it would show that the doctor has listened to, and engaged with, the patient. To suggest that assisted dying "is not something for doctors" or contrary to "the ethics of good medicine" rather highlights the discordant paternalism of a bygone era. Many doctors are against the idea but there are also many of us who would support a change in legislation. Just because assisted suicide is a difficult subject, on many levels, is no reason to ignore the minority affected by the inadequate and confused state of our laws pertaining to end-of-life issues. Not to listen to the suffering of a patient and abandon them to the vagaries of a foreign jurisdiction is a poor example of "bringing patient-centred care to the most vulnerable".
Dr Peter Townsend
Consultant in Anaesthesia and Intensive Care Medicine
Birmingham