First UK study provokes furore Sarah Boseley, health editor
Wednesday January 18, 2006
The Guardian
Doctors in the UK were responsible for the deaths, through euthanasia, of nearly 3,000 people last year, it was revealed yesterday in the first authoritative study of the decisions they take when faced with terminally-ill patients. More than 170,000 patients, almost a third of all deaths, had treatment withdrawn or withheld which would have hastened their demise.
The figures, extrapolated from the study, show rates of euthanasia and doctor-assisted suicide which are significantly lower than anywhere else in Europe, Australia and New Zealand, where similar studies have been done. The numbers immediately provoked controversy.
"This research proves that some doctors break the law and deliberately help patients die," said Deborah Annetts, chief executive of the Voluntary Euthanasia Society. "This is all done in secret and denied in public. Some of these doctors are acting compassionately on their patients' wishes, but some clearly act without consent. This cannot be safe."
However, Clive Seale, of the school of social science and law at Brunel University, who conducted the research with funds from the Nuffield Foundation, said the proportions of respondents who had been involved in euthanasia were small. "I think doctors in the UK are taking important decisions to alleviate suffering, but not necessarily ones that are illegal," Professor Seale told the Guardian.
He found that only a small proportion of deaths - 0.16% - were attributable to voluntary euthanasia, where patients made a request of their doctor. That suggests that doctors participated in 936 voluntary euthanasia deaths last year.
In a further 0.33% of deaths - 1,930 patients - doctors said they ended life "without an explicit request from the patient", which some call "non-voluntary euthanasia".
Professor Seale, whose research is to be published in the journal Palliative Medicine, said decisions in the latter category appeared to be merciful ones. "Basically a case in this category is often someone who is very close to death - maybe a few hours away - but suffering not in a way that they can communicate. Often doctors think the best solution is to end their lives. Or they can be people who have made the request in the past but are no longer competent," he said.
The study found no cases of physician-assisted suicide, where a patient asks the doctor for the means to kill him or herself, among the 870 doctors who participated.
Euthanasia and doctor-assisted suicide are illegal under British law. Far more deaths were hastened by doctors through the legal means of withholding or withdrawing treatment. For 177,192 terminally-ill patients - nearly a third of all deaths (30.3%) - doctors made such "non-treatment decisions". Professor Seale said: "It seems consistent with a well-developed culture of palliative care and GPs who are rather worried about doing anything that might get them into trouble because of Harold Shipman."
In the wake of the trial of Shipman, who killed hundreds of elderly patients by injecting them with large doses of morphine, some doctors worry about the career consequences of using the pain-relieving opiate drug which can shorten life. The study found in around a third of the deaths last year, (191,811 patients if generalised across the UK) doctors had given treatments such as morphine. The ProLife Alliance said the research showed doctors were involved in far fewer deaths than the "euthanasia lobby would have us believe". "However, we are still talking about the unlawful killing of 2,800 vulnerable people," said Julia Millington, its political director.
http://society.guardian.co.uk/health...688609,00.html 
no crime.. -
19-01-2006, 09:43 AM
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