Results: Laws on assisted dying in The Netherlands and Belgium are restricted to doctors. In principle, assisted suicide (but not euthanasia) is not illegal in either Germany or Switzerland, but a doctor’s participation in Germany would violate the code of professional medical conduct and might contravene of a doctor’s legal duty to save life. The Assisted Dying for the Terminally Ill Bill proposed in the UK in 2005 focused on doctors, whereas the Proposal on Assisted Dying of the Norwegian Penal Code Commission minority in 2002 did not. Conclusion: A society moving towards an open approach to assisted dying should carefully identify tasks to assign exclusively to medical doctors, and distinguish those possibly better performed by other professions.
There has been a paradigm shift in terms of thinking about errors. In the aftermath of disasters, the lens of responsibility is being refocused away from people and towards (work) places. Institutions not individuals, processes rather than persons are becoming the focus of investigation. The search for scapegoats is beginning to look crass and ineffective. This is reflected in the formal responses to these events, such as public inquiries, which now routinely focus on system responsibility. Whilst systems analysis has obvious merits it also raises important and unresolved questions. In particular, what are the risks of this shift towards systems thinking? What are the implications for individual professional responsibility? Will the commitment to systems responsibility be meaningful in practice? First, however, we must sketch the contention and connotation of different descriptions of error episodes and appreciate the true toll of the error problem in medicine.
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An out-of-hours doctor who killed a 70-year-old man by injecting him with an overdose of a painkiller could repeat the error, a panel has warned. Nigerian-born Dr Daniel Ubani, 67, injected David Gray, of Manea, Cambridgeshire, with 10 times the recommended dosage of a painkiller. A General Medical Council (GMC) panel is holding a hearing into the case. The panel said Dr Ubani's actions had "brought the profession into disrepute" and questioned his clinical competence.
A retired doctor has been struck off after giving excessively high doses of morphine to 18 dying patients. A disciplinary panel found that former County Durham GP Dr Howard Martin had not acted negligently but had "violated the rights of the terminally ill". He was cleared of murdering three of his patients five years ago. But he has been struck off by the General Medical Council (GMC) for "completely unacceptable" treatment of some patients.
The BMA has long advised doctors - for moral as well as legal reasons - to avoid actions that might be interpreted as assisting, facilitating or encouraging a suicide attempt. This means not giving patients advice on what constitutes a fatal dose or on anti-emetics in relation to a planned overdose, not suggesting the option of suicide abroad nor writing medical reports specifically to facilitate assisted dying abroad, nor on any other aspects of planning a suicide.
Graeme Catto, former president of the UK General Medical Council, has called for parliament to legalise assisted dying "in some shape or form" for a small number of people experiencing unbearable suffering. Professor Catto said he was expressing his personal view and not that of the GMC, which as the United Kingdom’s regulator for doctors had to support the law of the land and therefore could have no position on assisted suicide. Speaking at a conference on the ethics of assisted suicide at the Royal Society of Medicine on 30 June, he said, "I genuinely believe that if there were a change in the law it would pose no insurmountable problems for doctors."
A Dutch doctor who exploited vulnerable people with multiple sclerosis by charging them thousands of pounds for unproven stem cell treatments has been banned from practice in the UK by the General Medical Council. Robert Trossel, 56, who practised in London and Rotterdam, gave “false hope and made unsubstantiated and exaggerated claims to patients suffering from degenerative and devastating illnesses,” said GMC fitness to practise panel chairman Brian Gomes da Costa. The panel held that Dr Trossel’s misconduct was “fundamentally incompatible with being a doctor” and ordered that his name be erased from the UK medical register with immediate effect.
Following the House of Lords' decision in Purdy, the Director of Public Prosecutions issued an interim policy for prosecutors setting out the factors to be considered when deciding whether a prosecution in an assisted suicide case is in the public interest. This paper considers the interim policy, the subsequent public consultation and the resulting final policy. Key aspects of the policy are examined, including the condition of the victim, the decision to commit suicide and the role of organised or professional assistance. The inclusion of assisted suicides which take place within England and Wales makes the informal legal change realised by the policy more significant than was originally anticipated.
A cardiac surgeon with an international reputation has been given a formal warning by the General Medical Council for undertaking an “adventurous” procedure for which he was not adequately trained and for which he did not obtain informed consent.
This End of life guidance covers three main issues: contemporaneous and advance refusal of treatment; withholding and withdrawing life-prolonging medical treatment; assisted dying - euthanasia and assisted suicide.