The Committee stage of Kim Leadbeater’s deadly assisted suicide bill is proving to be utterly shambolic. The committee is biased and Ms Leadbeater is making some extraordinary decisions. On day one, MPs on the Committee voted not to hear from psychiatrists who have expertise to add to discussions about assessing a patient’s capacity to choose assisted suicide. Only after a public outcry did a sudden U-turn take place, and then psychiatrists were let in.
Shocking
It was shocking that Kim Leadbeater thought that psychiatrists had nothing to contribute to the debate, considering that the Terminally Ill (Adults) End of Life bill requires two doctors to agree that, as well as having only six months to live, a patient is mentally capable of making the decision and is not being coerced.
Doctors are not good at accurately predicting how long a patient will live. Doctors are even more challenged in making an accurate assessment of a patient’s mental state. A major flaw in the assisted suicide bill is that it fails to take into account the complex relationship between serious physical illness, a depressed mental state and suicidal ideation.
Senior psychiatrists told MPs in the Committee that doctors did not have the “knowledge, expertise and experience” to assess whether a patient was making an informed decision in choosing to end their life by assisted suicide.
In response to a survey of its members, 65% of members of the Royal College of Psychiatrists, believe that consent is not an adequate “safeguard” against patients being coerced into making the decision. Over half (58%) of respondents said they would not be willing to participate as a medical professional in an assisted dying service.
Limited value
Research shows that reliance on a doctor’s impression of a patient’s state of mind is of limited value. Studies on the relationship between depression and the wish for a hastened death show that doctors often fail to recognise depression in very ill patients. Treatment for depression can alleviate the desire for death even in terminally ill patients.
A 2017 study of psychiatric patients seeking euthanasia in Belgium found that significant suffering for these patients resulted from serious disruptions to important relationships, social isolation and loss, poor socioeconomic circumstances, agonising over questions of meaning and the perception of being a burden on society. A humane society should be offering such patients the professional care they require to overcome these huge problems. However, once a culture embraces assisted suicide and euthanasia, vulnerable people will look to these options to end their suffering.
Depressed mood
It seems fairly obvious that severely ill people struggling in difficult and unhappy circumstances will choose assisted suicide if it is legal to do so. Yet in a 2005 study, researchers were surprised to find that the risk of a euthanasia request for patients with a depressed mood was 4.1 times higher than that of patients without a depressed mood. They reported: “We thought the patients requesting euthanasia were more accepting [of] their impending death and we therefore expected them to be less depressed. To our surprise, we found that a depressed mood was associated with more requests.”
One researcher sounded a warning note following Lord Joffe’s 2005 attempt to legalise assisted suicide: “The UK is likely to face significant clinical problems arising from physician-assisted suicide if it is legalized. Terminally ill patients with mental illness, especially depression, are particularly vulnerable to the misapplication of physician-assisted suicide despite guidelines and safeguards.” Ten years on, this is a warning we should heed.
Hippocratic oath
For 2,500 years the wisdom of the Hippocratic Oath has been the foundation of medical ethics. If Kim Leadbeater’s assisted suicide bill is passed it will overturn the principle: “I will neither give a deadly drug to anybody if asked for it nor will I make a suggestion to this effect.” This is the only true safeguard for vulnerable patients. There is nothing “safe” about doctors helping sick, disabled and dying people to kill themselves.
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