Tuesday, July 9, 2013

Assisted Suicide is not safe: Dr Stephen Hutchison

I was going through my emails and I found this excellent article written by Dr Stephen Hutchison and published on June 20, 2013 in the The Herald newspaper in Scotland under the title: Agenda: Assisted Suicide
Hutchison, a physician who specializes in palliative care, was commenting on assisted suicide based on the expected assisted suicide bill by Scottish MSP Margo MacDonald. MacDonald's previous bill was overwhelmingly defeated in the Scottish parliament.
Dr Stephen Hutchison, Herald - June 20, 2013
Hardly a week goes past without court cases about assisted suicide, or celebrities and politicians commending it.
The argument goes along these lines: "We are autonomous and assisted suicide is our right. Leaving people to die in agony or forcing them to go to Switzerland is terrible. Assisted suicide is safe and there is no slippery slope. Doctors here are doing it anyway, so let's make it legal. At the very least, let's have the debate."
Actually the debate has been pretty well had. Independent MSP Margo MacDonald's 2010 proposals were thoroughly considered in the public arena, among lay and professional groups and the media before being overwhelmingly defeated in the Scottish Parliament. Official reports show that 87% of public responses to her consultation were opposed, and nearly two-thirds were against her 2012 consultation. Casual public opinion is in favour, but considered opinion is against. On numerous occasions over the past few years assisted suicide has been debated in our parliaments and has been consistently rejected because it is unsafe. The duty of government is to protect its citizens.
Autonomy means to be self-governing, acting independently, regardless of others. But we are all interdependent, not autonomous. Autonomy is a myth. We have freedom to decide and act, but not without responsibility to others. The Parliamentary Committee examining Ms MacDonald's 2010 Bill came to the same conclusion. Being a burden to others is often cited as a reason for assisted suicide. But you can only be a burden because you have some form of relationship with others. You cannot have it both ways. It is irresponsible for politicians to peddle autonomy as the basis for any law, let alone something cataclysmic like this. Selfish individualism creates havoc.
I grow frustrated when I hear assertions that medical care of the terminally ill includes using such high doses of morphine to relieve pain that we hasten death. That is another myth. There is good recent evidence that UK doctors never practise assisted suicide. Even if they did, that would not be a sound basis for legalising it.
What about intolerable suffering? In our country you have access to the best palliative care in the world, according to an Economist Intelligence Unit report in 2010. It is usually fear of pain, not actual pain, that makes people think of assisted suicide. Where there is suffering we need to research and refine care to relieve it, not hasten death. If someone goes to Switzerland that is their choice. Nobody is forcing them, any more than if I move to that country because I prefer its tax laws.
Elder abuse is an increasing problem. The perpetrators are commonly friends or relatives of the victim. When you are facing an incurable illness, or the prospect of suffering, or the costs of care are eating into your family's inheritance, and you feel vulnerable and scared, just how little pressure would be needed to make you choose assisted suicide, particularly if you are elderly and frail or feel that you are a burden?
Assisted suicide is not safe. If it was why would proponents emphasise the need for safeguards?
There is evidence of risk to the vulnerable where assisted suicide is practised.
As for slippery slopes, how about the steady increase in people who die this way? How about progressive relaxation of diagnostic criteria? How about institutional disregard for initial restraints intended to promote safety? How about the killing of hundreds of patients every year without consent?
How about almost complete indifference towards psychiatric assessment designed to identify depression? These are happening where assisted suicide is practised. And how about the subtle anaesthetising of our own moral principles so that we think it is a good idea to kill people?
Keeping our law unchanged may be problematic for a tiny minority but it protects the majority. Superficially, assisted suicide may seem compelling. But we must not be fooled.
Dr Stephen Hutchison MD FRCP (Glasg) is a consultant physician in palliative medicine.

19 comments:

Winston said...

You mean like the prohibition against drugs is safe, Alex?

Alex Schadenberg said...

No Winston, I mean that legalizing assisted suicide will be abused and people will die with or without consent.

Depressed people will be killed, people with disabilities will feel pressured.

Death is an irrevocable decision.

Winston said...

Au contraire, Alex. There is far more medical murder in Canada, Australia, the UK and countries that have an absolute prohibition against assisted dying.

Harold Shipman got away with murder for decades precisely because there was no scrutiny. It was simply assumed that euthanasia of any sort never occurred.

Alex Schadenberg said...

The oversight in countries where euthanasia is legal is no better and probably worse.

The penalty for killing someone in Canada is potentially murder and in medical cases, manslaughter.

The penalty for not reporting or not following the rules in Belgium is --- no one has ever been prosecuted, and in the Netherlands, there is a potential fine.

Winston said...

How do you know? There is absolutely no reporting except in instances where the "double effect" appears to be abused.

In jurisdictions where it is legal, the population is aware of what is going on. Canada is living in blissful ignorance right now.

Alex Schadenberg said...

Winston:

How do you know? There is absolutely no reporting.

By the way, in Belgium the under-reporting may be as high as 47%.

Further to that, there are no attempted prosecutions in Belgium for deaths without consent.

Legalizing euthanasia would simply open the flood gates.

Winston said...

47% is considerably more than the 0% in Canada right now (outside anonymous surveys).

The floodgates to compassion would help people live longer. The lack of compassionate legislation leads to stratospheric suicide rates, especially among the elderly:

http://www.nationmaster.com/graph/cri_sui_rat_in_age_abo_75-suicide-rates-ages-above-75

http://www.nationmaster.com/graph/cri_sui_rat_in_age_65_74-suicide-rates-ages-65-74

It is also important to note that the social stigma against suicide in many countries leads to a reduction in reported suicides. If there is no note, or it looks accidental, the police will not classify a death as a suicide.

Alex Schadenberg said...

Winston:

You are wrong and your ideas are dangerous.

As for the suicide rate:
http://www.alexschadenberg.blogspot.ca/2013/05/suicide-rate-in-oregon-continues-to.html

Winston said...

Suicide isn't illegal. The publication of Derek Humphrey's Final Exit did not cause the suicide rate to increase.

The only thing that changed was how people committed suicide. Violent methods were replaced, slightly, by pills.

The "increase" in Oregon's suicide rate is not statistically significant. The time span is also too short to be meaningful. Moreover, you did not compare suicide rates among age groups.

Alex Schadenberg said...

Winston:

All of your points are false and misleading.

Winston said...

And yet you did not bother to present any sources or arguments to refute them. You've lost.

Alex Schadenberg said...

Dear Winston:

Read my earlier comments.

Your comments are old and false.

Any reader of this blog will notice all of your insane comments and wonder why I bother to publish them.

Winston said...

If you say so.

I note that you think all sex is rape and taking life in self-defense is indistinguishable from murder in cold blood in the progress of a robbery.

From your ivory tower free from suffering, you condescend and infantilise everyone who wants true choice and compassion at the end of life.

Alex Schadenberg said...

Thank you for your comments Winston because they simply prove that your insane.

Winston said...

And your basis for making that judgement is... my disagreements with you?

What college degrees do you hold, Alex? Are any of them in psychology or psychiatry?

Alex Schadenberg said...

Dear Winston:

Your comments are very concerning and very dangerous.

Your comments were crazy when you stated:
I note that you think all sex is rape and taking life in self-defense is indistinguishable from murder in cold blood in the progress of a robbery.

From your ivory tower free from suffering, you condescend and infantilise everyone who wants true choice and compassion at the end of life.

Winston said...

Alex, when you hold informed consent in such low esteem, I have no other way to interpret your statements.

If consent matters not, then no choices we make have any validity.

I know you lost your daughter to suicide. That's tragic. I couldn't begin to imagine your grief.

But have you ever seen palliative care fail?

Alex Schadenberg said...

Dear Winston:

Thank you for your kind words.
It was my wife's sister who committed suicide in a tragic manner.

Alex

Winston said...

My apologies for getting the facts wrong.

If you want to reduce the suicide rate, the first step is to listen. I told my story back in 2011 (it's a very brief call):

https://www.youtube.com/watch?feature=player_detailpage&v=f1WFYFmcOs4#t=120s

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