Physician assisted suicide.

This evening I attended a seminar on physician assisted suicide. Lord Joffe's Bill is due to be debated in the House of Lords in May.

I am against the Bill for the following reasons:

It negates what doctors are there for. I went into medicine to save lives not to dispense with them. Although there would be an opt out clause for concientious objectors, the Bill would fundementally change the relationship between doctors and their patients.

It underestimates the ability of palliative medicine. The Hospice movement begun by Cicely Saunders (whose Memorial Service in tomorrow in Westminster Abbey) has had remarkable success in aleviating suffering. there is no reason why anybody should be in pain.

It is a slippery slope. In 1967 I fought a losing battle against the Abortion Act. The propaganda told us it was to prevent back-street abortions of which there were supposedly 100,000 a year. When the Bill was enacted the British birth rate fell by the number of legal abortions. How could it have done do if it was simply replacing the back-street abortions? In fact today 20% of all pregnancies end in legal abortions; virtually none because the life of the mother is threatened; virtually none because the mother has already had 7 pregnancies and she can't manage an eighth; virtually all because it is not the woman's choice to have a baby now. Once the door is open a chink, experience tells us that it will be forced wide open.

It is not safeguarded by having two doctors agreeing to do it. It was necessary for two doctors to sign a cremation form, but this did not stop Dr Harold Shipman from murdering more than 250 of his heartsink patients and then covering up his crime by having the body burnt.

It puts unfair pressure on the old and sick. Old people may feel that their lives are useless and opt for a pill to end it all simply because they are lonely.

It assumes that doctors know when patients are about to die. This is plain arrogance. Predicting death is like the weather forecast; you can be fairly accurate about today's outlook, less so about tomorrow's and after that it's largely guesswork.

It takes no account of medical discoveries. I have been continually surprised by medical advances that have turned terminal ilnesses into treatable conditions. A good example would be the treatment of pulmonary hypertension in babies. Previously it was rapidly fatal. Now we know it responds to Viagra. Who'd have thunk it?

It puts intolerable temptation in the hands of relatives. I have never been asked by a patient if I would kill her/him. But relatives have asked me to put gran out of her misery. With many having to sell the family house in order to pay nursing home fees, it doesn't take much to persuade a frail old lady that she would be doing everybody a favor by popping her clogs.

It devalues human life and dignity. I wouldn't allow a dog to suffer like that. You hear it said all the time. But a human being is not a dog. All human lives mean more than that. Just as the real response to an unwanted pregnancy should be care and support for the mother, so the correct response to the old and the dying should be care and support. Everybody has to die. But nobody should die alone, in pain and in sorrow. Shame on us that some should do so.

It smacks to me as a cost saving measure by a government strapped for cash. A famous "Yes Minister" TV program had the civil servants insisting that the most efficient hospital was one that didn't open to patients who would undoubtedly spoil the place. It may be a cheap way out to bump off these difficult patients, but that rather misses the point about what doctors are for.

I guess I could think of more reasons, but that should do.