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Give patients their own notes

At last the Joffe Bill is being discussed in the medical press, and views on both sides are beginning to be heard. I would, however, like to respond to some of the comments made by Dr Simon Kenwright (Letters, November 15).

First I do not believe 'ad hominem' arguments are relevant or appropriate in this issue.

Whatever world view we hold, doctors have a common aim which is the optimal care of our patients. My world view is irrelevant to the discussion on physician-assisted suicide. What is important is the validity of the arguments. I would also like to assure Dr Kenwright that I have read the Bill.

Second, I would like to address his key argument ­ that of patient autonomy. By legalising the autonomous decision of what Dr Kenwright believes will be a very small number of patients who might desire physician-assisted suicide, one will compromise the autonomy of many others.

These include the relatives of the patient concerned (the form of declaration in the Bill states: 'I have decided to inform/not inform my family of my decision'), conscientious objectors who are duty bound to refer to another physician, and the vulnerable.

Dr Kenwright quotes low figures for physician-assisted suicide in Oregon. The figures for euthanasia in Holland, quoted at the Bill's second reading (June 6, 2003), are much higher, with 3,500 cases of euthanasia in 2002, of which 900 were involuntary.

The Dutch government also reported that in 2001 only 54 per cent of cases were reported. At these rates, the equivalent in the UK would be about 14,000 deaths per year.

How many have felt pressured into requesting euthanasia by relatives, or by the desire not to use up the family inheritance?

Dr Rhona Knight


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