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.
Some doctors are set to argue against moves towards an organ donation system of presumed consent in the UK. Under presumed consent all people are assumed to be willing to donate their organs unless they have opted out. No part of the UK has introduced such a system yet, although the Welsh assembly favours the idea. However, delegates at the British Medical Association's annual conference in Cardiff will debate later whether the move could damage trust in doctors. Those in favour of presumed consent, which has been supported by the BMA for the last 10 years, believe it would help boost UK donation rates, which, despite recent improvements, still lag behind many other countries.
The ‘elusive’ concept of ‘impairment’ was introduced into the General Medical Council's Fitness to Practise Procedures in 2002. Its function was ostensibly to bring all forms of fitness to practise allegations against doctors under a unifying concept and thereby reduce procedural complexity. This paper strives to illuminate the application of ‘impairment’ of fitness to practise with reference to a year of fitness to practise decision making by the General Medical Council (GMC). It concludes that impairment has brought with it a redemptive style of resolving matters of
US military medical ethics evolved during its involvement in two recent wars, Gulf War I and the War on Terror. Norms of conduct for military clinicians with regard to the treatment of prisoners of war and the administration of non-therapeutic bioactive agents to soldiers were set aside because of the sense of being in a ‘new kind of war’. Concurrently, the use of radioactive metal in weaponry and the ability to measure the health consequences of trade embargos on vulnerable civilians occasioned new concerns about the health effects of war on soldiers, their offspring, and civilians living on battlefields. Civilian medical societies and medical ethicists fitfully engaged the evolving nature of the medical ethics issues and policy changes during these wars. Medical codes of professionalism have not been substantively updated and procedures for accountability for new kinds of abuses of medical ethics are not established. Looking to the future, medicine and medical ethics have not articul
Doctors could risk losing their licence if they fail to report fitness to practise concerns about their colleagues, MPs have recommended. In its first annual review of the functions of the General Medical Council, the House of Commons Health Committee has called for the regulator to send “a clear signal” to doctors that they are at as much risk of being investigated for failing to report concerns about a fellow doctor as they are from poor practice on their own part. Senior doctors and clinical team leaders in hospitals would be most accountable, but there would be “questions asked of everybody,” said Stephen Dorrell MP, chair of the health committee.
Un médecin du centre hospitalier de la côte basque, à Bayonne (Pyrénées-Atlantiques), soupçonné d'euthanasie active sur au moins quatre patients âgés, a été placé en garde à vue mercredi au commissariat de cette ville. Les faits, qui concernent des décès survenus au cours des cinq derniers mois, dont celui d'une patiente âgée de 92 ans le 3 août, se seraient déroulés dans le service des urgences de l'hôpital. Une information préliminaire a été ouverte pour "homicide volontaire avec préméditation". Tous les cas signalés concernent des personnes âgées ayant été admises aux urgences tout en étant classées "en fin de vie", dans l'attente d'un placement dans un service de soins palliatifs, a-t-il encore indiqué. Les faits ont été signalés par des agents du service des urgences à leur hiérarchie, qui a pris la décision d'alerter la police, selon un communiqué diffusé jeudi par l'hôpital.