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Stop and think!?Are pharmacists really prepared to assist people to die?

The ethos of the pharmacy profession is to help people to live, writes Rosemary Baker. Are we really going to ask pharmacists to provide the drugs that will be used in assisted dying?

By Rosemary Baker

The ethos of the pharmacy profession is to help people to live, writes Rosemary Baker. Are we really going to ask pharmacists to provide the drugs that will be used in assisted dying?

Will you assist me to die? When my time comes I hope that someone will be there to assist me to die. I hope it will be one of my family but, if not and you are free, will you be there for me? I would like you to hold my hand, to talk some of the time but to know when to be quiet, too. I know you will make sure I have adequate pharmaceutical intervention to ease my passage but please remember that hearing is the last sense to go. “Intermezzo” from Mascagni’s “Cavalleria rusticana” is my favourite piece of music but anything soothing will do.

Will you gently read to me so that I can cast my mind back to the times as a child when my mother read to me in her lilting Irish accent?
Will you keep my lips moist and rub my back? Will you talk of old times and let me enjoy so many happy memories of this life?

New meaning

Oh! But I have made a big mistake. This is 2012 and assisted dying has a new meaning. If I ask you to assist me to die you will assume that I want you to help me to end my life. How true it is that to assume makes an ass of both you and me.

In 2005 the Euthanasia Society changed its name to Dignity in Dying and started a renewed escalation of pressure to legalise assisted dying for the terminally ill. The title “Dignity in Dying” sounds so attractive. We would all want to die with dignity and anyone would be forgiven for thinking that Dignity in Dying is a pressure group solely for better palliative care. Be assured that it is not.

The pressure is on to legalise assisted dying for the terminally ill and already the thought process is moving from “will pharmacists support this?” to “how will pharmacists support this?” and “what will happen to those who cannot agree with such tactics?”.

The arguments for assisted dying are strong and emotive. Nobody wants to see a loved one suffer but, even if one can in conscience support such action, how on earth can it be put into practice without abuse?
We are told that the law will only allow people to be assisted if they have less than 12 months to live. Who is going to make that prediction? I remember speaking to the consultant when my mother was suffering from advanced terminal lung cancer which had already spread to her brain, and we were trying to identify the best place for her to be nursed. “How long are we talking about,” I asked him. “How long is a piece of string,” he answered. “Maybe two months, maybe two years.” How is any doctor going to predict a patient’s lifespan? However, that does not really matter because they would not be able to be proved wrong.

One well rehearsed argument against assisted dying is that people will take the path because they do not want to be a burden on their family or the health service. What sort of society condones that? What has happened to our duty of care to each other? Are we all so busy that we cannot spare the time to look after the weakest members of our society? And what about those people who do assist? Will they be happy with their decision after the event? In the dark hours of the night will they wonder if they did the right thing?

What if you object?

You have, no doubt, heard all this before and maybe you can convince yourself that legalised assisted dying is the right way forward. But what about those who cannot support such action? Are we going to force them out of pharmacy? Are we going to say “you may have opted to join a profession which aims to help people to live but now you have to help people to die as well”.

I hope there will be provisions for those who conscientiously object but, as the practice becomes more acceptable, might we begin to ostracise those pharmacists who do not want to take part in the hope that they will eventually give in and comply? It is hard to take a stand against the majority and we may lose conscientious pharmacists, not because they do not want to practise their profession but because they are not prepared to take part in an act that opposes the whole ethos of a profession based on helping people to live.

We supported with gusto the reduction in paracetamol pack sizes to reduce suicide by paracetamol poisoning and the numbers have come down dramatically. We have put our skills into raising the standards of palliative care. Are we now going to allow our profession to be turned into the one that will help you to live but will also help you to die? How is that going to be perceived by patients? Do we want to be thought of as a profession that will do anything whatever the consequences?

It is time to stop and think.

Citation: The Pharmaceutical Journal URI: 11100055

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