If doctors withhold useless treatments, that is not ‘assisted death’ | Letter

I am writing in response to the letter from Dr. Jagat Aulakh (A form of assisted dying already occurs in hospitals, May 8). It must be made clear that withholding or discontinuing futile treatments is not and never has been an aid in dying. Stopping – or not starting – treatments that are unwanted, don’t work or aren’t worth it is good medicine and the law of the land. While “assisted dying” is the modern euphemism for physician-assisted suicide and euthanasia, both forms of medicalized killing.

The General Medical Council Good medical practice The guidelines state: “Patients should be able to trust medical professionals with their lives and health. To justify that trust, (physicians) must make patient care (their) primary concern.” Assisted suicide and euthanasia are incompatible with such a duty. How can patients trust professionals who facilitate their murder?

Elsewhere, the GMC outlines that high quality care involves balancing the benefits, burdens and risks of treatments; that life-prolonging treatment can lawfully be withheld or withdrawn from a patient who is unable to initiate or continue treatment if this is not in his or her best interests; that there is no obligation to provide treatment that is useless or burdensome; and that decisions about potentially life-prolonging treatments should not be motivated by the desire to bring about the patient’s death.

Intentions matter. When I withhold or stop life-prolonging treatment, it is because I fear that the balance has shifted and that the burdens outweigh the benefits; my patient is now irreversibly dying, and it is time to “let nature take its course” with dignity and care. Physician-assisted suicide is a completely different phenomenon. It is an independent causal act intended to prematurely end a patient’s life. I hope, especially for the vulnerable patients under my care, that this will never be permitted within these shores.
Dr. James Haslam
Consultant in Intensive Care Medicine and Anaesthesia, Salisbury