Friday, July 2, 2010

Reporting that Distorts EOL Care

Ah, it's The Economist's turn; shoddy reporting that does the "he said, she said" deal but reveals little about how we die. Where are the statistics on how many nurses and doctors do issue fatal doses of morphine to end suffering at the end of life? Why make Howard Martin a pariah - without a discussion of why he and other doctors DO give overdoses?? Where's the discussion of futile care and over-treatment, the prolonging of death that takes place in every modern hospital the world over because of pursuit of ineffective treatments? The statistics on how many elders have medical proxies, end of life care plans, or living wills? Or advocacy for these? And the doctors and nurses who would rather overdose in silence than face the warped and hypocritical wrath of a sentimental public? We live in an age where society, the media, and the medical profession pretend that more and more treatment is the best way to approach death, despite the extraordinary pain that such treatments bring to elder and terminal patients.

From the negligent article that is so typical of our preference for sentimental and factless reporting about death:

THE argument over the ethics of assisting the terminally ill to die is sharpening, as two recent cases concentrate minds. On June 25th Keir Starmer, the director of public prosecutions, said that Michael Irwin and Alan Cutkelvin Rees would not be prosecuted for helping Raymond Cutkelvin, who had pancreatic cancer, die at a Swiss clinic in 2007. Prosecuting would not be in the public interest, he held: Mr Rees was motivated by compassion; Mr Irwin, a former doctor, was an elderly man; and neither had profited from the death.

In another, very different, case, the General Medical Council struck Howard Martin off the medical register on June 18th. Mr Martin admitted to hastening the death of a number of patients and said that he had not always sought consent from sufferers or their families before doing so. In 2005 he was acquitted of murdering three patients through overdoses of morphine. The police may reopen that investigation.

At issue is whether it should be legal to help a sufferer who wants to take his own life, or whether this might put pressure on the sick, the disabled and the elderly to call it quits early. In February the Crown Prosecution Service (CPS) issued new guidelines on when someone might expect to be prosecuted for assisting suicide. Debbie Purdy, who has multiple sclerosis, had asked the courts to clarify whether her husband would be prosecuted if the couple travelled to Dignitas, a clinic in Switzerland, to end her life. Mr Starmer stressed that the guidelines did not decriminalise assisting someone to die or “open the door to euthanasia”, and that no case was absolutely prosecution-proof. But all sides welcomed the new stress on a suspect’s motivation.

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