Following Harold Shipman’s conviction in 2004 for murdering patients, an investigating committee stated there was not enough monitoring and safeguarding of doctors’ decisions.
Subsequent attempts to correct matters concerning end-of-life care have suffered from confused thinking, the consequence of conflating different issues requiring different management.
One of these issues concerns the movement of controlled drugs. It was the suspicion of funeral directors which led to the prosecution of Shipman, though a re-write of the computer programme governing GPs’ use of drugs would have identified much earlier a pattern of prescribing suggestive of criminality. Another issue concerns doctors’ case management. Doctors will make mistakes – everyone does – but doctors very rarely make mistakes intentionally.
Where their management stands to be questioned, a complaints machinery already exists.
Among the most sensitive issues are matters of life and death which require absolute respect for the confidentiality of the doctor/patient relationship.
Terminal care in the community is presently the final responsibility of GPs and they work under the guiding principle of “First do no harm” and their motto: “Compassion with knowledge”. As things now stand, Parliament has been unable to pass legislation in support of patients who would like the right to manage the end of their lives.
There seems to be a message – that we have been misled over the past decade by the collective response to Shipman, with a subsequent loss of public confidence in the integrity of GPs.
GPs do care and perhaps we could turn now from trying to legislate assisted dying to focus on how best to assure the primacy of the confidential doctor/patient relationship and the patients’ end of life wishes within that.
(Dr) PG Gaskell MD FRCGPe
What is the point of Holyrood? The purpose of a democratic parliament is surely to promote and protect the rights (and the reciprocal responsibilities) of the citizens.
This is not accomplished by curtailing debate on issues that apparently have the support of the majority (69 per cent?) of those citizens, as happened last week when further discussion on Margo MacDonald’s bill was prevented.
Such negative behaviour reinforces the views of those who believe that since most of us are at least as well educated and informed as the MSPs we no longer require elected persons to do our thinking and decision making for us.
It seems to me that the Irish referendum, bypassing their parliament as it did, has shown the future by instituting the novelty of actual, as opposed to seeming, democracy.
Holyrood should now reconsider its recent decision and work out a method of enabling “dying with dignity”, including attendant safeguards against abuse, to become law.
This formula should then be the subject of an informed Yes/No referendum. A novel idea perhaps, but whatever the outcome at least Holyrood would have grown a grown-up purpose.