Dr. Richard Lamerton, Medical Director, Hospice of the Valleys, South Wales

If you give someone rights, it means someone else has a duty. A right to die means someone has a duty to kill. If doctors do this:

1. As in Holland, doctors would lose their patients' trust.
2. As the habit of killing catches on, the voluntary element is lost. Patients in Holland are having to carry cards saying "Please, doctor, DON'T kill me.."
3. The ways open to doctors for killing are not always effective. To be paralysed but still conscious, or not to die as expected, are distinct risks - all drugs sometimes fail.

When the question was being debated in the House of Lords a doctor, knowing these limitations, asked a Dutch doctor giving evidence "What you do when the patient doesn't die first time?" The gruesome details in the reply were a major factor in deciding the committee against euthanasia. Don't be dazzled by the words "death with dignity".

What would be much kinder, quicker and surer would be a bullet in the head. Doctors should be left out of this altogether. Policemen could do the killings, or undertakers, or social workers.

I have considerable sympathy for Mrs. Pretty - Motor Neurone Disease is awful. But having looked after dozens of people with the condition, I would hate to endorse Mrs. Pretty's message of despair. Some patients despair, but most do not. Most find new depths in relationships, new meanings in life, and enough reasons to go on living. But they do need skilled care - I hope Mrs. Pretty is getting help from a good Hospice with experience in this kind of care.

But if we make it legal to kill her, some very dangerous consequences would follow.

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Just to restate the principles

• Futile treatment should be discontinued. Chemotherapy and life-support are overused in the USA, sometimes with financial motives, and can give people awful deaths.
• Hydration and food like glucose to keep a body ticking over, however administered, should not be classed as medical treatment. They should never be discontinued or denied with the intention of ending a patient’s life.
• When someone is definitely dying, artificial hydration pushes them into heart failure, makes them wet the bed, drool on the pillow and get a death rattle which is awful for relatives. Hospice doctors and geriatricians have a horror of a law which would oblige them to do this.
• The solution is to record in the patient’s notes that hydration is being stopped because the patient is now dying. The Profession should be told to prepare clear guidelines to help doctors decide when that time has arrived. Of course there will be mistaken decisions occasionally. Of course an element of trust in the Profession has to be present. Of course ill-will will occasionally produce a doctor who abuses the trust.
• Clearly a person with a possibly-reversible coma is not to be classed as dying. Professional guidelines are well-known, and try to make the most accurate prediction possible. Equally clearly, anyone who is at all responsive must be given fluid to avoid suffering, by mouth if possible.
• We need a definite statement of good-will from the Government which says that measures intended to hasten a patient’s death are never acceptable, and shortage of resources can simply never be cited as a reason for such decisions.

10th March 2005

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Let's just remind ourselves what Lord Joffe said when answering Question 89 on THURSDAY 16 SEPTEMBER 2004. Lord Joffe:

"I have been criticised by many people who have supported the principle of assisted dying over the fact that in their view the Bill does not go far enough, that it should go a great deal further, and that many of the safeguards are not necessary. I feel, however, that we are starting off; this is a first stage

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