Wednesday, April 01, 2009

From the coal face

Baroness Finlay of Llandaff, a member of the House of Lords, and Professor of Palliative Medicine at Cardiff University has penned an important contribution to the "right to assisted suicide" debate presently bubbling away in the United Kingdom.

She writes as a doctor at the "coal face": her article in The Times is firmly grounded in practice and reality.

"Assisted suicide is fine in a perfect world. We don't live (or die) in one

A doctor's job is to treat the sick and relieve pain. That cannot be squared with helping the terminally ill to end their lives

When I was a junior doctor, patients who were dying were often abandoned in side wards, without effective pain and symptom control; terrible deaths were commonplace. In those days euthanasia seemed a temptingly humane solution.

That is not the situation today.

Palliative medicine has come of age; and the modern hospice movement has grown from the foundations laid by the late Dame Cicely Saunders, who pioneered the treatment of “total pain” - of mind and soul as well as body. I have been privileged to play a part in this revolution.

I have learnt - from patients, their families and colleagues - that care of the dying is far more than diagnosing and treating the physical aspects of terminal illness. That is an important part of the task, and advances in palliative medicine have revolutionised the science of pain and symptom control.

Care is also about addressing the wider suffering of incurably ill patients - their anguish at losing personal control of their lives, their failing strength, loss of self-worth and feelings of dependence on others. That is what the discipline of palliative care is about - bringing patient-centred care to the most vulnerable.

Experience of treating many patients over 30 years has convinced me that doctors must accept death as a natural end to life and avoid inappropriate interventions, but that legalising euthanasia, whether indirectly, in the form of assisted suicide, or directly, via lethal injection, is a dangerous step too far."