Volume 1

Assisted Dying for the Terminally Ill Bill (HL) / Select Committee on the Assisted Dying for the Terminally Ill Bill.

  • Great Britain. Parliament. House of Lords. Select Committee on the Assisted Dying for the Terminally Ill Bill.
Date:
2005
Catalogue details

Licence: Open Government Licence

Credit: Assisted Dying for the Terminally Ill Bill (HL) / Select Committee on the Assisted Dying for the Terminally Ill Bill. Source: Wellcome Collection.

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    in regard to conscientious objection by large numbers of doctors and nurses, though it is perhaps necessary to bear in mind that the composition of the medical and nursing professions in this country is rather different from that in, for example, Holland, where over 90% of doctors are of Dutch origin*’. Asked whether the operation of the 1967 Abortion Act did not provide a precedent, our witnesses drew attention to certain differences. Professor John Saunders, for the Royal College of Physicians, believed that abortion and euthanasia were perceived differently by doctors. “The one thing we can all agree on is that, if I give barbiturates or curare to a competent adult, I am killing that person... I do not think anyone can contest that that is killing someone” (Q 246), whereas there was some room for doubt, he suggested, over terminating the life of a foetus. Ms Buchanan drew attention also to a practical consideration affecting the nursing profession. “You can choose not to work in a gynaecological unit, but people die everywhere in health care. So how will you take the nurses and look after them in a nursing home where the local GP comes in to practise euthanasia?” (Q 263) We were also given the results of a survey carried out by the Association of Palliative Medicine (APM). We were told that in the APM survey of its members, which attracted an 84% response rate, 72% percent of respondents had said that they would not be prepared to participate in a process of patient assessment which formed part of an application for assisted suicide or voluntary euthanasia. Prognosis Terminal Illness is defined in the Bill as “an illness which in the opinion of the consulting physician is inevitably progressive, the effects of which cannot be reversed by treatment... and which will be likely to result in the patient’s death within a few months at most”*’. Of critical importance therefore is the accuracy with which doctors are able to predict the remaining lifespan of seriously ill patients. The evidence which we have taken from medical practitioners suggests that the prognosis of a terminal illness is far from being an exact science. “It is possible,” we were told by the Royal College of General Practitioners, “to make reasonably accurate prognoses of death within minutes, hours or a few days. When this stretches to months, then the scope for error can extend into years”*. Professor Tallis, for the Royal College of Physicians, told us that “medicine is a probabilistic art... In most cases the vast majority of prognoses are right, but there will always be situations where the diagnosis is wrong” (Q 244). Professor John Saunders, also speaking for the Royal College of Physicians, said that “prognosticating may be better when somebody is within the last two or three weeks of their life. I have to say that, when they are six or eight months away from it, it is actually pretty desperately hopeless as an accurate factor” (Q 253). The Royal College of Pathologists drew attention to “a 30% error rate in the medically-certified cause of death”, with “significant errors (i.e. misdiagnosis of a terminal