Select Committee on Assisted Dying for the Terminally Ill Bill Minutes of Evidence


Examination of Witnesses (Questions 260 - 262)

THURSDAY 14 OCTOBER 2004

PROFESSOR RAYMOND TALLIS, PROFESSOR JOHN SAUNDERS and DR IVAN COX

  Q260  Baroness Finlay of Llandaff: From a specialist service or from the service that Ivan Cox outlined, which is generalist education?

  Professor Tallis: Within our own service we have some very good palliative care nurses, who are involved very early on in our wards and connect with the wider palliative care services.

  Q261  Baroness Finlay of Llandaff: Do you have a specialist consultant service?

  Professor Tallis: We have access to it through the palliative care nurses and we are able to access the full palliative care service, so we are very fortunate in that sense.

  Q262  Baroness Finlay of Llandaff: Professor Saunders, do you have a comment?

  Professor Saunders: No, only to say that we have discussed this issue within the College. Yes, we have no view on it and that reflects the divisions within the College. Again, I do not particularly want to go off message and give you a personal opinion but I do not see that there is any logical objection to the idea of a separate service. I do not think this has been adequately evaluated anywhere. I just make that as a statement of fact. There are those who feel that it is the physician's job to accompany their patient on the journey as far as they can, and that may mean to the end literally. There are others who feel that this in some way contaminates medicine. I do not think we have any empirical data from other jurisdictions that would inform whether such authorised assistance in suicide or active killing should be done by another profession—as I said in my submission, obviously not a funeral director, but perhaps pharmacists and nurses and so on. In all seriousness, there may be a role for other professional groups.

  Dr Cox: If I could come in and also make a comment, I do not think we have any definite evidence that there are doctors who would want to be the doctor that carries out the assisted dying. In some respects we have got ourselves mixed up with two different entities here. One is discussion of what used to be called assisted suicide. It seemed to mean that the doctor left a prescription for some tablets for the patient to take as and when they wanted to. We now are talking about the doctor deliberately killing the patient in the same way, almost with a contagious element to it, as someone carrying out an execution. We do need to address the difference between those two because it does have emotive issues although they are one and the same thing. As I say, we have not got any evidence as to how many doctors in this country would want to participate in this as far as I am aware, and no doubt the committee will achieve this at some stage or other. There was a paper in the BMJ not long ago which had asked the question of about 400 or 500 New Zealand GPs whether they actively participated in assisted suicide. Remember, of course, that in New Zealand assisted suicide is not legally available. Roughly 50 per cent of the GPs who were asked said that in the terms of their definition they had in fact carried out assisted suicide. When you talk to GPs in this country they will say that they have assisted patients in dying but this may be what some of us would call a double effect; in other words just raising the dose of morphine in already dying patients simply to make quite sure that they do not suffer and it is almost a coincidence that they die as a result of an excessive dose of morphine. Again, it all relates to definitions. I hope that Baroness Finlay understands where we as GPs come from.

  Chairman: Thank you very much indeed. We have been much helped by your submissions both in writing and orally.





 
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