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Get ready for high-impact change


Physician-assisted suicide could change the GP's role beyond belief, argues Dr Rhona Knight

Doctors in the UK are facing the greatest threat for many years. Close in the wake of Shipman, where the public were appalled by even the idea that a carer could become a killer, the House of Lords is debating whether that idea should become a reality enforced by law.

At a time when so many GPs are weighed down by the demands of the new contract, with very little time to look above the parapet and see dangers on the horizon, the role of the GP could change beyond belief, without anyone realising.

But when I discuss the Joffe Bill with colleagues, well over 80 per cent have no idea what I am talking about. The issue of physician-assisted suicide has barely been looked at in the medical press.

There is a danger that the decision of both the RCGP and the RCP to drop opposition to the Bill will be seen as an indication that GPs support the Bill and see physician-assisted suicide as a good idea. This may not have been the intention of the bodies who seek to represent us, but it is the perception ­ a perception that does not reflect the view of most GPs.

The trouble is, who else but those involved in caring for the dying and terminally ill can shed light on the disadvantages of physician-assisted dying? And if the caring professions stay silent there is no one, apart from religious groups, to raise the alarm and highlight the dangers of the proposed changes.

It is our job, as those involved in terminal care, to let people know about the unwanted implications of the Physician Assisted Dying Bill.

So what are the implications? For me, the first thing is the impact on the consultation. Currently, patients know that my duty is to care. Killing is not a therapeutic option in end-of-life issues. As a result patients have discussed their dark thoughts and feelings ­ needs have been identified and met.

It has also meant I have been asked by patients to hasten their death.

Interestingly, however, once I had spent time, and involved the multidisciplinary team to meet the underlying needs behind the request, in each case the request was retracted. By making killing an option, these kinds of consultations will be very different.

And how will terminal illness be defined and by whom? Many would say life is a terminal disease! What about COPD? Depression? Heart failure? Dementia? Down's syndrome? Who will define it?

As GPs we have a time to act and a time to sit back. If you are happy to include physician-assisted dying as a therapeutic option, write to the House of Lords and let them know. Your voice should be heard.

If you think the concept of carer as killer is one that you cannot reconcile with your role as a GP, you must also write.

Do not rely on your representative bodies to make your voice heard for you ­ they have abdicated responsibility. Take a few minutes to write and let those who would change your job in an even greater way than any new contract, know what you think.

You can do this by e-mailing your thoughts to, or by writing directly to the select committee at the House of Lords.

Dr Rhona Knight is a GP in Peterborough

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