Doctors Struck off for Denying Patients the Right to Die? What a Sinister Distortion of Medical Ethics

Daily Mail (London), March 9, 2009 | Go to article overview
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Doctors Struck off for Denying Patients the Right to Die? What a Sinister Distortion of Medical Ethics


Byline: Melanie Phillips

ONE OF the key aspects of a free society is the independence of the medical profession from the state.

All professions are bound by a code of ethics which ensures that they always put the interests of the public who use their services above any outside interference.

When it comes to the practice of medicine this protection for the public is of the utmost importance, since doctors have the power to affect the continuation of life itself.

That's why their cardinal rule is 'first do no harm', and why the Hippocratic Oath which frames

Hippocratic Oath which frames their ethical guidelines states 'a physician shall always bear in mind the obligation of preserving human life'.

But now, astonishing as this may seem, the doctors' own profession is changing its rules to force its members in certain circumstances actually to do harm.

The issue concerns advance directives or 'living wills' through which people can indicate that, should they ever become so ill that they can no longer communicate their wishes, they want their treatment in those circumstances to be stopped.

Priority

The General Medical Council has decided that if in future doctors ignore such directives and continue to treat such patients, they will be struck off the medical register.

But surely, you may well say while rubbing your eyes in amazement, treating patients is what doctors are supposed to do? Think again. For in certain circumstances treatment is to be redefined as harm -- because regardless of what may actually be in a patient's best interests, to act against their wishes is now deemed to be harmful.

The overriding priority now given to what people want, rather than what they need, was what lay behind the Mental Capacity Act which has given legal force to 'living wills'.

What that already means is that doctors can be prosecuted and jailed for assault if they treat a patient who has given an advance directive not to be saved. Even where such directives aren't actually written down, doctors are expected to act upon what they believe to have been the patient's wishes.

But what people want when they express such a wish may be very different from how they feel when they actually find themselves in such a situation. The very possibility that a doctor might end the life of someone who might have changed their mind but be unable to communicate this is horrifying. Yet that is what the law now forces doctors to do.

Since such patients who cannot communicate are intensely vulnerable, there is also a high possibility of their becoming victims of relatives with a vested interest in their deaths.

For these reasons if nothing else, it is imperative that doctors are free to take decisions which they consider to be in the best interests of their patient at that time.

Yet this is what the law now prohibits -- and what the General Medical Council will now strike them off the register for doing.

As a result, the terrible truth is that doctors may be sent to prison for refusing to kill their patients.

How on earth did this country arrive at such a monstrous situation? And how can the medical profession go along with such a betrayal of its deepest ethical principles? The crucial point is what is now included in the accepted definition of 'treatment'. It has always been an important medical principle that no patient should be forced to have treatment against their will.

Patients have always had the right to refuse treatment, whatever the consequences to their own lives.

Ever since the landmark case of Tony Bland, however -- the Hillsborough disaster victim whose feeding tubes were disconnected after he was left in a persistent vegetative state -- 'treatment' has been held to include giving patients food and liquids through feeding tubes.

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