Wednesday, June 11, 2008

Encounter with the Bogeyman

I attended a study day today, as part of my teaching role. It was on medical ethics and it was very good - lots of debate from a variety of eminent speakers and interesting clinical cases to mull over.

In the afternoon Jeremy Purvis MSP came to talk and debate about the bill he's attempting to put through the Scottish Parliament on Dying with Dignity [sic]. Clearly that's a euphemism as the bill might better be called the Kill the Dying Bill (except that sounds like a Quentin Tarantino film). I suspect if he were to name it the Killing the Dying Bill it wouldn't attract a lot of support.

What saddened and frightened me was the intellectual poverty of his argument. It went like this:

(1) As a Liberal I like the idea of autonomy and some members of my family committed suicide when I was young. I think that people should have the right to kill themselves.

(2) The slippery slope doesn't really exist.

(3) Harold Shipman changed the face of doctor/patient relationships

(4) It already goes on - ask lots of doctors, they'll tell you. If it's already happening, we should legalise it.

(5) The doctrine of double effect means it's already happening, we should just go ahead and give people big doses of drugs anyway and get it over with.

Now you'll gather I have simplified the thrust of his argument, but believe me, that's what it boiled down to. It's not difficult to counter - it felt like shooting fish in a barrel at the time. He kept saying "I'm not putting this across very well" (You're a politician!That's your job, for heaven's sake!)

(1) Suicide is not illegal but what kind of society encourages it? This is the reason assisting suicide is contrary to Common Law in Scotland. Common Law exists for a reason - the accrued wisdom of ages expressed in case law sees it as wrong. Have human beings changed so much that this is no longer the case?

(2) Slippery slope a figment of the imagination? Easily demolished when one considers the 10-fold rise in abortions from 20,000 in 1968 - the first year after the Abortion Act 1967 - to nearly 200,000 in the UK last year. Interestingly, Mr Purvis worked for David Steel before entering the Scottish Parliament.

(3) Harold Shipman was a serial killer. If he hadn't used a syringe he would have used a clawhammer. A shameless strawman of a argument.

(4) There are lots of stabbings in Glasgow - gonnae legalise that? A crime is a crime is a crime and aiding a suicide is just that. The courts are usually merciful in these circumstances, but the law is there to uphold human life. If it ceases to do that, God help us all.

(5) The doctrine of double effect does not justify killing the vulnerable. It was on this point that Mr Purvis was on his dodgiest ground. He clearly didn't grasp the doctrine (or its origin in the thought of Aquinas). He was also deeply misinformed about how opioids work and the latest work on opioid doses at the end of life.

Mr Purvis seemed like a sincere man (but as Thomas in the bookshop said today "sincerely wrong"). I'm sure he's kind to his cat and polite to old ladies. But if this is the calibre of the argument put forward by our elected representatives, then (1) God help us and (2) I'm underwhelmed.

I'm joining Care Not Killing and I'll keep an eye on the All-Party Parliamentary Group on Dying Well

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12 Comments:

Blogger Mac McLernon said...

Thanks for summarising this so succinctly. We all need to watch out for the arguments of apathy: "It's happening already, so we should just make life easier for ourselves and legalise it" is one of the most pernicious arguments used in today's society.

10:13 PM  
Blogger antonia said...

Tragically it's that kind of "logic" that people buy and that wins in Parliament.

2:46 PM  
Blogger Philip said...

Thanks for the link to "Care not Killing".

Recently, I experienced the "culture of death" first hand. Someone very close to me was "dying" and it was decided that he was so ill, they would remove the noradrenalin and ventilator, so as to let him “die with dignity”. To cut a long story short, there were grave concerns as to the validity of the diagnosis and the opposing opinion was that, with continued care, he would recover. Needless to say, the doctors won out. However, following the removal of the care, he remained alive. His blood pressure dropped a bit, but then levelled and similarly, he maintained his breathing. After two hours, a doctor ordered a nurse to give him a bolus of morphine for his pain (even though he did not appear to be in pain; he was still conscious). Well, you can imagine what happened after the huge dose of morphine was administered.

Following a post mortem, it was shown that the diagnosis was incorrect (what they had been treating him for was not what he had) and that he would have had a much higher chance of survival than the doctors at the time were giving him.

Thinking back even further, to 1992, I had an aunt who was fighting cancer very well, until that is, there was a change of doctor. We left her in her room, sitting up, bright and talking. An hour later, having left to get a drink in the hospital restaurant, we returned to the room to find a nurse leaving it. She said that the new doctor had just told her to “change” my aunt’s medication and that she was now to be denied fluids. We found this once conscious and bright woman now in a drug induced coma. She died within hours.

Oh yes, Mr Purvis, “It already goes on - ask lots of doctors, they'll tell you”.

Thank God for the witness of the Catholic Church!

Jesus, mercy; Mary, help.

11:48 AM  
Blogger Paulinus said...

Philip

That's bizarre and disturbing. Properly administered for the right reasons, morphine kills no-one but does relieve suffering. If Stephen was not in pain, why give morphine? You can ask a conscience patient - it is a very simple question, after all: "Are you in pain? How much pain are you in?"

I'm lost for words. Sometimes my own profession disturbs me profoundly.

2:18 PM  
Blogger Philip said...

If I told you the full story, you'd probably not believe me.

I'll email you if you want, but it's a sorry tale from start to finish. You'd especially like the part where, after being told they were giving up on Stephen, I pointed out that he was a Catholic and as I understood the situation, fluids and food should not be denied. (I mentioned this very politely.) I'll never forget the supercilious sneer of the doctor. You could have replaced his words with, "Where is now thy God?... He trusted in God, let him deliver him".

4:03 PM  
Blogger Paulinus said...

Sadly, Philip, I would. The amil address is lepanto-(at)-hotmail(dot)co(dot)uk

6:05 PM  
Blogger Philip said...

I shall get scribbling. It may take me a couple of days to do, as the recollection is still very painful.

On a happier front, just what fuels your wonderful sense of humour? I find myself visiting Holy Smoke, simply to read your replies to the likes of Old Nick. I was asked a few days ago, who would I most like to invite to a dinner party and I must confess that your name came up as one of the guests. The person who asked me the question did look a little puzzled when I said Paulinus, though! ;-)

6:13 PM  
Blogger Paulinus said...

Those are kind words. My juvenile antics over at Holy Smoke are a cause of shame to me sometimes and no doubt more than a few extra Hail Marys in the confessional.

The IoW is quite a way to come for a dinner party but thanks for the offer....

8:15 PM  
OpenID berenike said...

Hey, I was just asking Man with Catholic Bookshop if he had your email!

Might I write to you also?

I should like to ask you something that you may have some ideas about. (No no, not asking you to do anything, just it's something you will have encountered and would value any suggestions or ruminations)(nor is it a medical question!)

hopefully yours....

9:37 PM  
Blogger Paulinus said...

Berenike

I'm intrigued. Please contact me.

1:13 AM  
Blogger la mamma said...

Would that be Mr. Davey, brother of Elizabeth?

2:17 PM  
Blogger Paulinus said...

La Mamma

Who is Mr Davey? Who is Elizabeth?

2:44 PM  

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