Sunday, 27 July 2008

Life, and other kinds of existence

A very old woman in failing health, with nothing to look forward to, became tired of lingering. She asked her doctor, a Glasgow GP, for strong sleeping pills. He prescribed them to her. She used them to commit suicide.

The Independent of 24th July reports that the British General Medical Council suspended the GP for six months for
actions "inappropriate, irresponsible, liable to bring the profession into disrepute and not in your patient's best interest".

They found he prescribed the retired businesswoman, known as Patient A, with sodium amytal "solely for the purpose of ending her life" and practised poor clinical management after she took an overdose of a different drug.

The panel also found he prescribed sodium amytal without adequate reason and contrary to guidance, and that he failed to make adequate notes.

Dr Kerr said he gave Patient A the sleeping pills as an "insurance policy".

He told the hearing in Manchester: "She said 'Give me something that I can take if things get too bad' and I said yes."

Suzanne Goddard QC, counsel for the GMC, said what Dr Kerr did was "akin to handing her a noose with which to hang herself at a time of her choosing".

Patient A later disposed of the sleeping tablets because she did not want to get him into trouble after learning he was being investigated by health chiefs for his views on assisted suicide.

Patient A was an osteoporosis sufferer who loved playing bridge and attending family events but feared becoming a burden upon her family, the GMC heard.

Her son told the GMC she was strong-minded and had a high regard for Dr Kerr.

He said she was aghast at witnessing the deterioration and death of her sister from bone cancer.

Dr Kerr said Patient A had "firm views about how she wanted her life to end" and wanted to maintain control over what happened to her.

She made an advance statement in which she expressed her desire not to be resuscitated if she became gravely ill, the GMC heard.

Patient A killed herself in December 2005, aged 87, using a cocktail of Temazepam, antihistamines and painkillers.

The GMC heard she made a failed suicide attempt two weeks earlier using Temazepam but was not referred to hospital by Dr Kerr.

His decision to prescribe her more Temazepam three days later was branded "illogical" by John Donnelly, chairman of the GMC Fitness to Practise Panel.

The panel found Dr Kerr had not failed to take adequate measures to dissuade her from suicide.[my emphasis]

Mr Donnelly said: "Patient A was an elderly lady who made her end-of-life wishes quite clear, in that she did not want to become a burden upon her family. The panel found that she was determined to end her own life."

[Dr Kerr] told the GMC: "I think when dealing with someone holding a rational view of the circumstances in which they want to end their life, it was my duty to at least consider whether he or she had a reasonable opinion and that it was my duty to assist if I thought I agreed with that patient's assessment."

He also said his concern was for the wellbeing of his patients who had placed their trust in him.

Lives are individual. Individuals who choose not to continue a painful existence have more respect for life than those who would deny them the right to assisted suicide. As philosopher Tara Smith says in her book Viable Values:
[T]he reason that suicide can be morally allowed is that life is not intrinsically valuable. Life is not to be maintained at any cost, like it or not. A life-based code is not a sentence to live, saddling people with the obligation to endure, however painful the circumstances. Life is the standard of value and source of moral obligation if it is a person's goal but it is up to the individual whether to embrace the goal.

Who in the world has the right to tell Patient A whether to value her life or not? And, if she didn't, what was she supposed to have done instead of seeking help from someone she trusted? Leapt off the Forth Bridge? Dragged herself through another few hateful months or years of increasing dependence as her health continued to deteriorate? For whose sake should she have done it? The religious have an answer: for God's Sake. For God's sake!


  1. I agree with you. I'm not able to contemplate what it would take for someone like "Patient A" to say that non-existence is better than living under those conditions, but that's exactly the reason why I -- and groups like the GMC -- need to be kept out of the matter. Only one individual had to suffer through the circumstances that Patient A had to endure, and that's she. On what grounds can another person interfere with her decision to stop living under those circumstances? Not someone who respects Patient A's right to her life.

    When the GMC said that the doctor was acting in the patient's "best interests," what exactly was her best interest? To suffer in agony? To be forced to take more risky methods to do what she's going to do anyway? I don't know Patient A, but I'm willing to bet that if there was another alternative to end the pain she would have chosen it.

    I think that the way the GMC is punishing this doctor is a horrible, back-handed way for them to dictate to others how they should live their lives. Apparently they have a problem with the right of a patient to end their lives, but they can't make suicide illegal. And even if they could, there would be no way to enforce it. So instead, the GMC punishes a doctor for holding a contrary position than theirs. They point to his role in the suicide, but that's just an excuse to punish him -- not a reason to punish him. They'll let their arbitrary rules on doctors and let the effects trickle-down to the patients.

  2. Thanks for your comment. I'm glad you made that point about the way the GMC treated Dr Kerr, because the predicament of doctors who truly do have their patients' best interests at heart upsets me just as much as that of people like Patient A.