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Assisted suicide

No place in pharmacy

From Mrs J. Sweeting-Hempsall

I have advanced terminal cancer and was dismayed to discover a motion requesting that the Royal Pharmaceutical Society provide guidance on physician-assisted suicide has been passed (PJ, 13 June 2009, p726).

Gordon Dykes’s apparent eager anticipation of the legalisation of assisted suicide was, in my view, unseemly and unprofessional. He may now be encouraged by the Law Lords’ ruling that the director of public prosecutions must clarify the criteria he uses in exercising his discretionary powers not to prosecute in certain cases where people have been helped to travel to countries where euthanasia is legal.

This will also apply to cases of assisted suicide in Britain, but we should be in no doubt that the law remains unchanged at present and it remains a criminal offence, whether or not a person is prosecuted.

On 7 July 2009, Lord Falconer’s amendment to the Coroners and Justice Bill was thrown out in the House of Lords. It would have removed the threat of prosecution from any person helping a terminally ill patient who travels to a country where euthanasia is legal.

Baroness Campbell, who is seriously disabled and has a progressive disease, made a powerful contribution to the debate. She has pointed out that not a single organisation representing disabled people, terminally ill patients or those who are old supports euthanasia legislation.

“If ever it were to succeed, those who are ill or elderly might well come to believe they are simply a burden on their families or the state especially in these times of huge public debt,” she said.

What most terminally ill patients want is an assurance that they will receive good palliative care and effective pain relief in the final stage of their illness and pharmacists have a major contribution to make in this important area.

My daughter, who is a hospital pharmacist, recently devised a “rule-of-thumb” set of prescribing standards for a number of medicines commonly used in end-of-life care, which were highly acclaimed by the consultants responsible for care of the dying and are currently being put to good use for the benefit of patients.

We must never forget the important distinction between giving just sufficient medicines to control pain adequately (even if it has the secondary effect of hastening the patient’s death) and administering or dispensing a lethal injection of drugs with the intention of killing the patient, which should have no place in the practice of medicine or pharmacy.

Mr Dykes’s allegation that physician-assisted suicide already happens is serious because it remains a criminal offence. Despite what a “serious figure in medicine” told him, the British Medical Association and the royal colleges are opposed to any changes in the current law. The Society should join them in making such opposition its official policy.

I am aware that the Royal College of Nursing has recently changed its official stance on euthanasia from one of opposition to one of neutrality, but this was based on a survey in which less than 1 per cent of the its membership replied and could well be an unrepresentative sample.

The Times published a robust letter of censure from Baroness Emerton, a fellow of the RCN, who made it clear that this neutrality does not now allow nurses “to engage in dialogue” with their patients on assisted suicide, as the general secretary of the college had been quoted as saying was the case, and emphasised that the law is unchanged.

Furthermore, I believe that Mr Dykes’s comment that he is “always amazed why, if the after-life is such a wonderful place, the people who believe in it are the least keen to get there” is offensive and ignorant.

Joan Sweeting-Hempsall

Sunderland

Citation: The Pharmaceutical Journal URI: 10975786

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