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At the heart of general practice since 1960

Ministers must remember that GPs' time does not come free

It is a pity Dr Rhona Knight was so misleading. The highly emotive language had little to do with Lord Joffe's Bill. Perhaps she has not read it?

I gather she is a member of a pressure group (the Christian Medical Fellowship) and perhaps should have declared this interest. Crucial to the Bill is the emphasis that the patient has to be terminally ill, suffering unbearably and competent to make these decisions.

Other treatments including hospice care have to have been offered. The numbers going on to PAS (the physician assists by prescribing the drugs) are likely to be very small ­ in Oregon the numbers have ranged between 25 and 40 for each of the last five years ­ but a change in the law would allow a much more open discussion in trying to meet the anxieties of these patients.

Currently doctors doing this could fall foul of the law. The recent survey by Medix ­ a respected research body ­ showed nearly three times as many doctors supported assisted suicide (with stringent guidelines) for this group of patients as the number wanting it to remain a criminal offence. Much of the Bill is devoted to safeguards, but the underlying theme is one of compassion ­ the right of patients to ask for and receive medication to keep them as free as possible from pain and distress is spelt out.

One result in Oregon seems to have been a stimulus for doctors to improve their skills in palliative care. I am a hospital physician with 30-plus years in the frontline (but read my wife's copy of Pulse) and in recent years one has seen a worsening of end-of-life care as the life-at-all-costs philosophy gains ground. This was one of the reasons I joined the Voluntary Euthanasia Society.

We need to respond to the needs of these patients and their wishes in the last major decision of their lives. We need to be able to do this openly without the threat of a prison sentence and with adequate safeguards in place for all patients.

Dr Simon Kenwright

Consultant Gastroenterologist

East Kent Hospitals

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