U.K.: Treating doctors like murder suspects

The trial of Dr Howard Martin shows how the process of dying is becoming a sordid battleground

The trial of Dr Howard Martin, found not guilty of murdering his patients, shows the atmosphere of suspicion engendered by today's spotlight on the final hours of life. Both those who advocate and those who oppose a change in the law on assisted suicide have helped to create a climate where all general practitioners (GPs) are seen as potential Harold Shipmans - the GP jailed for murdering his patients. The constant calls for a tightening of the law on assisted suicide have made doctors, who most people used to trust with their own lives and the lives of their loved ones, into murder suspects.

In this climate of fear, it is perhaps not surprising that relatives of three men who died shortly after a visit by Dr Martin initiated a prosecution against him. Dr. Martin was accused of killing Harry Gittins, 74, Stanley Weldon, 74, and Frank Moss, 59, all patients at his surgery in Newton Aycliffe in Country Durham. The prosecution alleged that the GP had administered huge doses of powerful painkilling drugs with the intention of killing them. The implication was that, corrupted by his own power, Dr Martin killed these patients long before it was their time to die. As the prosecution said in court, he 'determined the lives' of the three men. Family members testified that Mr. Weldon looked 'jolly and happy' just days before dying.

However, the defence pointed out that all three were in the final stages of dying. It argued that the prosecution had failed to prove that the doses of morphine and diamorphine had killed the three men. One of the most important witnesses, Karol Sikora, a professor of cancer medicine at the Imperial College School of Medicine, told the court that in similar circumstances he might have done the same thing. Professor Sikora told the court that he felt that Harry Gittins had less than 24 hours left to live even without the morphine. Home Office pathologist Nathaniel Carey noted that it was impossible to conclude that morphine was the cause of the death of Frank Moss. 'It would not be appropriate to include morphine as a cause of death, otherwise we would have to include it for any people that died in a hospice.'

If cases like this become more common, it is the dying who will suffer. It seems that ambulance-chasing lawyers are being distracted by passing hearses. Adverts now offer: 'Did your loved ones dies as a result of a doctor's actions? Call this freephone number..' It's likely that more remains will be exhumed, and fear and suspicion will further increase. Doctors will be wary of administering the necessary dose of a 'double effect' - pain killers that may also hasten death - forcing patients to suffer more during their last few hours. Who would place a loved one in a hospice - or indeed choose to work in a hospice - when it could be portrayed in court as akin to a gas chamber?

In a somewhat sinister press release, Deborah Annets, chief executive of the Voluntary Euthanasia Society, argued that: 'The sooner we move to a patient-based system of regulation that allows a patient's wishes to be respected with proper safeguards the better protected all patients will be.' Protected against doctors who have been declared innocent in a court of law, presumably? Or against all the doctors who spent their lives caring for patients and who took brave decisions in their interests?

Assisted suicide advocates often accuse their opponents of scare mongering by using the 'slippery slope' argument. But the Voluntary Euthanasia Society has turned the slippery slope innuendo into an artform. Why is there an assumption that doctors and patients want different things? When did doctors transform from kindly helpers to budding Mengeles out to 'determine the lives' of helpless patients? The twisted logic of the Voluntary Euthanasia Society is that the only way for a dying person to take control is if they force the doctor to kill them at a time of their choosing.

The problem is that dying renders a human being entirely helpless. Often there is no possibility of making meaningful choices and the dying individual can only trust those around them to act in their interest. Anything that jeopardises that essential trust can only hurt the vulnerable, not protect them. Cases like this create a dismal spiral of distrust, chaos and fear at the end of life

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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