could you give me something, doctor?

It had to happen eventually. Mrs M, whom I wrote about in my very first post, isn’t doing too well. When I visited today, she had taken to bed. I had been called out as she thought she might have a chest infection, and I couldn’t rule it out. She looked dehydrated, and she was a little tachycardic, but I couldn’t see much else. She clearly couldn’t look after herself, as she wasn’t eating or drinking, so I arranged admission. While I packed away my things, we chatted about her mood. Then the tears came. Then The Question. “Could you give me a little something, doctor, just something to end it all? Being old is so terrible. It just not worth it without John.”

Euthanasia is such an ethical dilemma for me personally. I’m very liberal in politics and in ethics. A bit fluffy round the edges, and drawn to the sufferers in life. My duties as a doctor seem fairly straightforward but on closer reading you can see quite easily where conflicts arise. I must respect human life, of course. I must make the care of the patient my first concern, but I must also respect my patients’ right to make decisions about their own care. I must not abuse the public’s trust in my profession, but I must also listen to patients and respond to their preferences.

I am glad I live in the UK, as I feel happy that I can say “no” in cases like this, knowing that the law is clear. Although in some circumstances, legal euthanasia feels to me like the “right thing” ethically, I know I’d find it difficult if I were the one who had to administer it. I’m glad I don’t have to make that decision.

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9 Comments

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9 responses to “could you give me something, doctor?

  1. Such a difficult problem. I absolutely understand where your patient is coming from.

  2. no one

    dont worry when the hospital docs think its her time to go they will just sedate her and withdraw fluids, the legal form of killing in the nhs

    quite how its morally different i have no idea

    and considering the numbers of perfectly viable lifes the nhs doesnt bother to treat, prostate cancer patients et al, i dont see any moral difference between not treating a prostate cancer patient and putting a gun to his head

    so you think your morals are sweet?

  3. I agree with you. Glad we live in the UK where we don’t have a “choice”.

    “No-one” I think the oncologists specialising in prostse cancer would probably disagreee with you about their lack of teratment as well as my many prostate Ca patients who have survived 10 years or more of intermittent chemotherapy etc. On the sedation/withdrawing fluids etc I think that that is a justifiable way to treat someone who is actively dying; it’s very different from choosing to kill someone who no longer wants to live but is not dying….

  4. no one

    specialists in the prostrate cancer field treat SOME of the patients, many others are left to die even when diagnosed nice and early, they die many years before they would in other western nations, to a large extent because the specialists are measured on the shortness of their lists not the accuracy of the potential patients added to the list, they and their managers can look a lot better in the official stats by simply failing to put folk on the lists, and of course for the lucky bunch put on the lists the treatment options are significantly behind the rest of the western world

    i think sedation/death by dehydration is significantly over used in the uk, and many folk die a lot earlier than they would in other countries, of course the death certificate never lists this as cause of death so the practise goes un analysed, “justifiable way to treat someone who is actively dying” we disagree – i know a few folk dying and this would be out of order in all cases, you can kill anyone by sedating them and letting them dehydrate

    all in all the nhs is not in a good place

  5. Petra Huijts

    Hi nice lady doctor,

    Being old can be very tough. Is there any possible help you can give this lady after her (possible) lung infection has been treated? Anything like sending some volunteer to her to talk to her and go out with her to have a nice cup of tea somewhere; or perhaps find out if she is not only old and realistic about her life, but maybe also depressed, unrealistically negative and therefore her mood might lift with medication?

    Good luck anyway,

    Petra

  6. For all its tenacity and ability to cling for the morrow, life can get fatigued from time to time.

    Above all, it’s a question really of companionship that gives strength to living.

  7. I understand your dilemma and it is a very difficult issue. We have to find our own solutions, the law of course must say NO for the fear of its misuse. Thanks. Vivek
    PS: I have added you to my favourite blog list hope it is okay.

  8. I guess No One thinks all patients should die via a full code.

    *Shudder*

  9. dutchdoctor

    I don’t think there are a lot of countries where euthansia is allowed under certeain circumstances, where euthanasia would be possible with your patient. Swiss might be the only country, that is why people from other countries go there.

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