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.
Bienvenue sur le site du Conseil national et des Conseils provinciaux de l'Ordre des médecins Welkom op de website van de Nationale Raad en de provinciale raden van de Orde van geneesheren
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.
A man who is almost completely paralysed is taking legal action in a bid to end his life. His solicitors have told the BBC that they believe his case could have major implications for the way prosecutors in England, Wales and Northern Ireland deal with assisted suicides.
Most senior doctors in England and Wales feel that rational suicide is possible. There was no association with specialty. Strong religious belief was associated with disagreement, although levels of agreement were still high in people reporting the strongest religious belief. Most doctors who were opposed to physician assisted suicide believed that rational suicide was possible, suggesting that some medical opposition is best explained by other factors such as concerns of assessment and protection of vulnerable patients.
A man who was virtually paralysed by a stroke has won the first step in his legal bid to pursue his right-to-die. Known only as Martin, he would require professionals to help as his wife has said she will not assist him. But current guidance suggests they may be prosecuted, where loved ones would not, and Martin's case is this discriminates against him. This High Court judgement means lawyers and doctors can discuss assisted dying with him, but only to prepare his case.
The Commission on Assisted Dying, set up in September 2010 and chaired by former Lord Chancellor Charles Falconer, has issued its monumental report on assisted dying in England and Wales. The Commission was funded by two supporters of assisted suicide, author Terry Pratchett and businessman Bernard Lewis, and despite reassurances that the running and outcome of the Commission were independent, some individuals and groups opposed to the practice regrettably refused to give evidence to the Commission. Still, the range and quantity of the evidence, which included evidence gathered from international research visits, qualitative interviews and focus groups, commissioned papers, and seminars, is impressive and can be read and watched here.
When faced with a terminal illness, medical professionals, who know the limits of modern medicine, often opt out of life-prolonging treatment. An American doctor explains why the best death can be the least medicated – and the art of dying peacefully, at home
This report documents changes since the ODT 2008 report. It records significant improvements that have been made to infrastructure and projected 34% increase in donation rates over 4 yrs to April 2012. The report notes, however, that even if Taskforce’s target of a 50% increase in donation rates by 2013 is achieved, people will still be dying unnecessarily while waiting for an organ. We believe that we now need to decide whether we should be satisfied that we have done all we can or whether we should seek to build on what has already been achieved by shifting our attention to additional ways of increasing number of organ donors. The report examines a range of options that have been suggested for increasing the number of donors including a system of mandated choice, reciprocity, a regulated market or paying the funeral expenses of those who sign up to the ODR and subsequently donate organs. The report also explains why we remain convinced that an opt-out system with safeguards is best.
Guidance for the Investigation Committee and case examiners when considering allegations about a doctor’s involvement in encouraging or assisting suicide. Draft for consultation Start: Feb 6, 2012 End: May 4, 2012 Results Published: Jul 31, 2012
The General Medical Council is launching its first ever guidelines on assisted suicide. The new guidelines will help the GMC decide if doctors should face a disciplinary panel if they are alleged to have encouraged or assisted suicide. A draft version is to be subject to a three month public consultation period. The GMC's chief executive, Niall Dickson said "the main message is that assisting suicide is illegal and doctors should have no part of it". The GMC, which is the regulatory authority for doctors, decided to produce the guidelines after the case of a severely paralysed man, which was highlighted by the BBC last summer. The man, given the pseudonym "Martin", told the PM Programme that he wanted to end his life and was taking legal action to try to get advice and help to do so.
In circumstances where life-sustaining treatment appears merely to be drawing out the inevitable, it is usual practice for the healthcare team to withdraw aggressive life-sustaining measures, once agreement is reached with the patient and their family. Common law gives doctors several defences to allegations of criminality or malpractice in taking the key actions that withdraw treatment and result in the patient's death; however, the legal defensibility of nurses undertaking this role has not been explored. In the absence of a specific body of law related to nurses taking the actions that withdraw life-sustaining treatment, I discuss the probable legal response by consideri
The Medical Practitioners Tribunal Service is the new adjudication service for UK doctors. This site contains information and advice on the role of the MPTS, including the schedule of forthcoming hearings and recent decisions by the panels.
Our angst is not limited to cases of assisted-suicide. It is rather that engaging in it alters the mission of medicine. It strikes at the very core of our beings as healers. It would leave an indelible imprint on dialogues with all patients. Our worry is anchored in the deep recognition of the vulnerability of sick persons and the power differential that exists in the doctor-patient relationship.
The first-hand experiences of physicians from coast to coast vividly illuminated a paucity of available palliative care, a simmering health-care crisis in Canada as the baby boomer generation enters old age. The association's members had come together on Tuesday to debate whether to revise the current CMA policy on euthanasia and assisted death. The session ended with an overwhelming vote — 90 per cent — in favour of an advisory resolution that supports "the right of all physicians, within the bonds of existing legislation, to follow their conscience when deciding whether to provide so-called medical aid in dying." The CMA defines "medical aid in dying" as, essentially, euthanasia or physician-assisted suicide.