I write in response to Dr Jagat Aulakh’s letter (A form of assisted dying already happens in hospitals, 8 May). It must be made clear that withholding or withdrawing futile treatments is not and never has been assisted dying. Stopping – or not starting – treatments that are not wanted, are not working or are not worthwhile is good medicine and the law of the land. Whereas “assisted dying” is the modern euphemism for physician-assisted suicide and euthanasia, both forms of medicalised killing.
The General Medical Council’s Good Medical Practice guidance states: “Patients must be able to trust medical professionals with their lives and health. To justify that trust [doctors] must make the care of patients [their] first concern.” Assisted suicide and euthanasia is incompatible with such a duty. How can patients trust professionals who facilitate their killing?
Elsewhere, the GMC outlines that high-quality care involves balancing benefits, burdens and risks of treatments; that life-prolonging treatment can lawfully be withheld or withdrawn from a patient who lacks capacity when starting or continuing treatment is not in their best interests; that there is no obligation to give treatment that is futile or burdensome; and that decisions concerning potentially life-prolonging treatment must not be motivated by a desire to bring about the patient’s death.
Intentions are important. When I withhold or withdraw a life-sustaining treatment, it is because I fear that the balance has shifted and that the burdens outweigh the benefits; my patient is now irreversibly dying, and it is time to “let nature take its course” with dignity and care. Physician-assisted suicide is another entity altogether. It is an independent causal act intended to prematurely terminate the life of a patient. My hope, particularly for those vulnerable patients in my care, is that it will never be lawful within these shores.
Dr James Haslam
Consultant in intensive care medicine and anaesthesia, Salisbury
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