As a doctor, I am trained to preserve life, not to end it | Letters
As a doctor, I find it challenging to reconcile the idea of authorizing or consenting to life-ending medication, even when legally justified (Cabinet Minister Liz Kendall says she will vote in favor of assisted dying, November 14). My entire training was focused on saving lives. During the ongoing deliberations, decision makers should carefully consider a number of critical points.
First, advances in medicine have allowed patients with serious diseases to live longer, often through supportive and definitive therapies that slow disease progression, prioritizing preserving life over hastening death.
Second, physicians receive extensive training to save lives and should never be coerced—whether by outside pressure or professional obligation—to participate in or make decisions about assisted dying. If society deems assisted dying necessary, it could train individuals specifically for that purpose in a relatively short time, without the intervention of physicians, whose primary role is to heal.
Furthermore, the UK healthcare system operates on a shared decision-making model. Patients are fully informed of the risks and benefits of their treatment options and have the right to agree to or refuse therapies. An individual who is mentally capable of requesting assisted dying may also choose to decline life-prolonging treatments and instead opt for comfort care, allowing the disease to run its course. In this context, involving physicians in taking life-ending measures is contradictory and ethically problematic.
A do-not-resuscitate order (DNR) is a valid option for patients who do not wish to undergo life-sustaining interventions. If patients cannot make such decisions, their relatives can apply for a DNR order.
Finally, it is essential to note that “terminal illness” is not an absolute definition. There are numerous documented cases where patients who were considered dying unexpectedly recovered. This underlines the uncertainty inherent in prognostic labeling and emphasizes the potential for recovery even in seemingly hopeless situations.
Chula Goonasekera
Preston, Lancashire
I support the proposal that, subject to conditions, a patient who is expected to die within six months should have the right to request an assisted death (The assisted dying bill: what it means for patients in England and Wales, 11 November). But I fear that the process of making a terminal prognosis, which may well take place at an earlier stage, will not be sufficiently rigorous.
After the cancer recurred, I was advised to undergo palliative treatment, aimed at prolonging life rather than seeking a possible cure. The surgeon told me that although another operation was an option, he felt that this was not the better approach, although this was not clear. I asked for a second opinion, from another hospital, which he supported. The second and third opinions favored an operation that was successfully performed at the original hospital more than two years ago. Although the risk remains, it is decreasing, and my quality of life in the intervening period has been excellent.
I was bold enough to get a second opinion, but medical friends tell me that’s unusual. I therefore suggest that any terminal prognosis should be subject to a second opinion by a suitably qualified doctor in another hospital. The mere right to a second opinion is not sufficient. If that were to happen, it seems likely that other patients would be assigned to a treatment pathway that would not inevitably lead to the proposed right to an assisted death.
Jonathan Haydn-Williams
Richmond, London
I have my second cancer and this one is really terminal. My colon cancer from 12 years ago turned out not to be terminal. This is located in the spine and has been controlled by regular chemotherapy since its discovery about three years ago. This time the words ‘cancer’ and ‘terminal’ no longer shocked us as they did twelve years ago.
Some days are good, some are bad. There are times when I happily go to sleep and think: wouldn’t it be nice not to wake up? But then within an hour I can change my mood – probably because of all the drugs I’m taking – and decide that life is worth living.
I am reasonably intelligent and composed, but my mood swings make serious decisions, such as assisted dying, unreliable.
Eric Foxley
Nottingham