Assistance to die
A change in the law to allow assisted suicide would require stringent safeguards to be in place — informed by pharmaceutical expertise.
Source: Callie Jones
How comfortable would you be to dispense a lethal dose for the purpose of ending the life of a dying patient? That is a dilemma pharmacists in the UK will need to consider if the assisted dying bill is passed by parliament. The private members’ bill, which had its second reading in the House of Lords last week, would offer the means for an adult in England or Wales who is terminally ill to be provided lawful assistance to end his or her life.
The shape of the bill was informed by a 2012 report from the Commission on Assisted Dying, chaired by Baron Falconer of Thoroton. Introducing the Bill’s second reading, Falconer said the legal framework is modelled closely on the law in the state of Oregon that has been in place for 17 years, as opposed to the voluntary euthanasia laws in some European countries.
Two doctors would need to verify independently that an individual is terminally ill, with less than six months to live, has the capacity to make the decision to end his or her own life and has reached the decision without coercion and with full information about the options for ongoing care.
Just over 750 terminally ill people in Oregon have ended their lives with medical assistance since 1997; around a third of patients who had the drugs dispensed chose not to take the lethal dose. Those numbers might seem small but, for the sake of comparison, the state of Oregon is not much more populous than Wales. It would be difficult to estimate what kind of demand for assisted suicide there might be in Britain as it is not currently an option for terminally ill patients to consider.
The law, as proposed, would not obligate pharmacists to have any involvement in assisted suicide if they have a conscientious objection.
Among the views in objection to the bill is that the choice could be distressing for vulnerable people who believe they are a burden to their carers or who might be pressured to make the decision. Proponents say that those in the throes of agony would have the choice to die with greater dignity, without putting families and doctors in the position of having to intervene illegally or stand by and watch their suffering.
Pharmacists would need adequate guidance and support in the event of the bill being passed. Yet the law, as proposed, would not obligate them to have any involvement in assisted suicide if they have a conscientious objection.
The General Pharmaceutical Council’s standards of conduct, ethics and performance has a conscience clause which allows pharmacists not to offer a service on moral or religious grounds so long as they direct patients to alternative providers. The pharmacy regulator is due to review these standards over the coming year.
Falconer’s bill is unlikely to be passed in what remains of this parliamentary session. But the debate on assisted suicide will continue and pharmacists should consider their own views on the matter. If assisted suicide is ever legalised in Britain, pharmacists must be in a position to inform the finer details of the supporting legislation. And there are several issues — such as selecting and sourcing the barbiturates that might be used, determining lethal doses and having robust procedures and governance around their use. Any decision should not be made without pharmaceutical expertise.
Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.20065920
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