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Care Not Killing welcomes new doctors' group opposing Assisted Suicide and Euthanasia


Care Not Killing is welcoming the creation of a new doctors' group, which opposes assisted suicide and euthanasia and promotes better palliative care.

The group, 'Our duty of care' , has been set up following the announcement by the leadership of the Royal College of Physicians that they intend to adopt a neutral stance on 'assisted dying' - unless at least 60 per cent of doctors actively vote for the status quo.

The highly unusual move requiring a super-majority has provoked a major backlash from doctors who see this as an attempt by the College to bounce them into a neutral position, which they believe will be seen as a significant softening of the previous position.

An open letter organised by the campaign, in conjunction with other doctors groups has already been signed by nearly 1,500.

Dr Gordon MacDonald, a spokesman for Care Not Killing commented: "We welcome the creation of this new campaign group, which understands the ethical and practical problems of changing the law on assisted suicide and euthanasia. They rightly recognise the dangers of normalising suicide and the pressure that many disabled and terminally ill people are under - the fear whether real or perceived of being a burden. This is what we see in the US and elsewhere. "

In 2017 in the state of Oregon 55.2 per cent of those ending their lives did so not because of their condition, but because they fear being a burden. This compared to just one in five (21 per cent) who were concerned about the possibility of inadequate pain control, or were experiencing discomfort.

In 1998, when the law was first enacted there were just five terminal conditions listed as causes of death of the 27 assisted suicides. By 2017, the conditions listed as the causes of the 143 deaths included arthritis, arteritis, sclerosis, stenosis, kidney failure, and musculoskeletal systems disorders. Endocrine/metabolic diseases (e.g. diabetes) and gastrointestinal disease. Many of these are not considered terminal.

Dr Macdonald continued: "The figures in Washington State were similar with more than half of those ending their lives fearing being a burden. While the range of conditions that meet the criteria to access the lethal cocktail of barbiturates has expanded. Put another way, if an insulin dependent diabetic refused treatment, in both states, they would meet the criteria for assistance in ending their lives.

"At the same time, we have seen cases where those who require expensive medical treatment that is potentially life-saving or simply life-extending being refused this, but offered the assisted suicide."

Care Not Killing has written to Dr Andrew Goddard the head of the RCP raising their concerns about the current RCP poll, which seems to have been designed to produce a specific result.

The letter questions the unfairness of requiring a super-majority of 60 per cent to maintain the College's position of opposition. It also questions why the poll, "deliberately uses the language of those pushing for a change in the law to allow doctors to kill their patients."

CNK argues that the term 'assisted dying' is wholly without meaning - there is either assisted suicide or euthanasia. "Assisted suicide is where one person/s facilitates the death of another by providing them with a poison that they ingest, as happens in Oregon. This is currently prohibited by the Suicide Act 1961. Euthanasia is where one person/s administers poison to another as happens in Holland. It is prohibited by the same laws that cover homicide."

Dr Macdonald continued: "In Holland, which passed their euthanasia law in 2002, it was originally restricted to mentally competent terminally ill adults. This is no longer the case. Deaths from euthanasia have steadily increased from around 1,800 in 2003 to over 6,500 in 2017. This included 169 with dementia; 83 were for people with a psychiatric disorder; and 293 were for people with an accumulation of geriatric pathologies, what we could call old-age. Amongst these deaths was the case of Aurelia Brouwers a 29-year-old Dutch woman. Aurelia suffered from a range of mental-health issues - She was not terminally ill or disabled. In December 2017, her life was ended despite her documented and treatable psychiatric problems. The Dutch law has now gone even further - under the Groningen Protocols it has been extended to include non-mentally competent children."

The letter to Andrew Goddard, goes on to challenge why the poll fails to ask about Physician Assisted Suicide and spell out other impacts on doctors such as 'fundamentally altering the doctor-patient relationship, the problems seen in Holland where palliative care lags behind other countries such as the UK, significantly higher suicide rates in places like Oregon and the difficulties associated with making an accurate psychiatric assessment.

Dr Macdonald concluded: "Those pushing for a change in the law fail to address the issue around treatable clinical depression, which plays an important role for many requesting assisted suicide. Even those who do not suffer from depression can experience from a phenomena known as "demoralisation", which can also trigger suicidal thoughts. This is why those who oppose changing the law and those from the disability rights community talk cogently about the pressure that disabled people and the terminally ill can feel under.

"This is why policymakers in UK parliaments have rejected changing the law more than a dozen times since 2004. Most notably the rejection of the Marris Bill, which was comprehensively rejected by the House of Commons in 2015, by 330 to 118.

"It also explains why every major UK doctors group is opposed to legalising assisted suicide and euthanasia along with the British Medical Association, the Royal College of General Practitioners, the Association for Palliative Medicine and the British Geriatric Society."

Care Not Killing is a UK-based alliance bringing together around 50 organisations - human rights and disability rights organisations, health care and palliative care groups, faith-based organisations groups - and thousands of concerned individuals.

CNK has three key aims: To promote more and better palliative care; To ensure that existing laws against euthanasia and assisted suicide are not weakened or repealed during the lifetime of the current Parliament; To inform public opinion further against any weakening of the law.

The letter by doctors and medics reads:

Open letter to Professor Andrew Goddard, President of the Royal College of Physicians

We, the undersigned, write to express our alarm at the way the Royal College of Physicians seem to have designed the up-coming poll of members' views on assisted suicide. It seems perfectly clear that the survey has been designed to ensure the College drops its long-standing opposition to assisted suicide and move instead to a position of so-called 'neutrality'.

Indeed, at a recent council meeting, a new default position of neutral was adopted prior to the announcement of the new poll, without any involvement of the wider membership. Sadly it seems the council may well be overly influenced by the presence of several prominent campaigners for assisted suicide.

We acknowledge that members may hold different views on this complicated and sensitive issue. But by going neutral, the College is sending a clear signal of support for a law change. Given that the most recent poll of members showed a majority were opposed to assisted suicide, and only a small proportion supported it, the approach the College is taking to a matter of such importance is extraordinary and deeply troubling.

Furthermore, neutrality in this instance is illusory - a myth. By leaning towards a 'neutral' position, the College is effectively stating that it is not formally opposed to doctors prescribing lethal drugs so patients can end their lives. In simple terms, neutrality is a misnomer and nothing more than tacit support for assisted suicide.

We are calling on the College to abandon this survey and instead, if it so desires, to conduct polling in the fair and democratic way it has approached previous polls on this issue.


Read more about Care Not Killing: www.carenotkilling.org.uk

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