Letters to the Editor Atimetodie

As a retired GP I found the leader in yesterday’s Scotsman on assisted dying interesting. Perhaps the public are not aware that assisted dying happens every day in our NHS.

In intensive care units across the country life support will be ended for those who are brain dead or have no prospect of recovery. It is routine for those admitted to hospital with very serious or end of life illnesses to sign a “do not attempt resuscitation” order. This means those in which resuscitation is very unlikely to succeed, or if successful would leave the person in a significantly disabled condition, can opt out of this procedure. In general practice doctors may, after open discussion with the patient and family, decide not to treat that final chest infection, or to slightly increase the morphine prescription. These actions in themselves will not end the person’s life but will hasten the natural process of dying.

Most experienced healthcare professionals will recognise when a person has only a few days or weeks to live. The patient may be bedbound, semi-conscious, confused, incontinent, in pain or suffering from the many other unpleasant end of life symptoms. At this time, after talking openly with the individual and their family or taking into account the person’s declared wishes, it does not seem unreasonable to help them to die. Doctors need to be better at talking about end of life. We should consider living wills which state in advance what we want to happen to us.

After a life as a GP I often found it distressing watching people die. I can only imagine what this must feel like for families. I believe that as doctors and individuals we need to get away from the idea of preserving life at all costs. Sometimes people just need to die. Although I support helping patients to die within a few days or weeks of end of life I would have reservations about extending this to months or years when outcomes are much less predictable.

Doctors, patients and their families need to be better about open, frank and honest discussions about dying. Only in this way can we take forward assisted dying and be reassured that the concerns about scrutiny can be addressed.

(Dr) Gordon Scott

Edinburgh