Exit International is the world's leading Voluntary Euthanasia & Assisted Suicide information and advocacy organisation. A registered non-profit organisation, Exit was founded in 1997 by Philip Nitschke. In 1996, Dr Nitschke became the first physician to administer a legal, lethal voluntary injection, under the world's first right to die law - the Rights of the Terminally Ill Act of the Northern Territory of Australia.
The aim of this guideline is to inform health and social care professionals on how best to manage advance care planning (ACP) in clinical practice. At the core of current health and social care are efforts to maximise individuals’ autonomy, promote patient-centred care, offer choice and the right to decide one’s own treatment or care. This can be difficult to achieve when an individual has lost capacity – the ability to make their own, informed decision. ACP is one method of enhancing autonomy, not only where an individual has lost capacity, but also by focussing discussion on the individual’s values and preferences throughout the time they are in contact with health or social care professionals. Whilst ACP has been used for some time in North America, there has been relatively little experience in the use of ACP in the UK. This set of concise evidence-based guidelines has therefore been prepared to guide practitioners.
Aims: This guidance relating to the management of the birth of extremely preterm babies (at less than 26 weeks of gestation) is aimed at both parents and healthcare professionals. It addresses communication before delivery, management recommendations, neonatal resuscitation and ethical considerations. Intended audience: Obstetricians, healthcare professionals working in maternity settings, parents of preterm babies. Publication history information: Published online 06 October 2008.
Subsequent to an intensive three-year period of reflection, the CMQ is revealing its perspective and conclusions today regarding end-of-life care and euthanasia. The CMQ embraces the point of view of the patient who is confronting imminent and inevitable death. In such a situation, the patient looks to their physician and generally requests that they be able to die without undue suffering and with dignity. Neither surveys, nor attorneys, nor politicians can properly advise the physician and the patient facing this situation. In the majority of cases, the patient and their doctor find the appropriate analgesia that respects the ethical obligation of physicians not to preserve life at any cost, but rather, when the death of a patient appears to be inevitable, to act so that it occurs with dignity and to ensure that the patient obtains the appropriate support and relief.
The British Medical Association and the General Medical Council have already made it abundantly clear that they want no part in voluntary euthanasia becoming a clinical practice. Now the estimable Royal College of Physicians, the professional body representing over 20,000 physicians that “aims to improve the quality of patient care by continually raising medical standards”, has weighed in with a strongly worded letter to the DPP. “We would go so far as to say”, writes the College’s Registrar, Dr Rodney Burnham, “that any clinician who has been part, in any way, of assisting a suicide death should be subject to prosecution.” Dr Burnham continues: “The trust afforded doctors and nurses in particular gives their views considerable weight with their patients and the public. Clinicians’ duties of care entail active pursuit of alternative solutions to assisted suicide, not its facilitation.”
Guideline for Palliative Sedation Royal Dutch Medical Association (KNMG) Committee on National Guideline for Palliative Sedation Utrecht, The Netherlands Januari 2009
A leading doctors’ organisation has today warned that doctors face a greater risk of prosecution for assisting a patient’s suicide following the publication of the DPP’s final Policy for Prosecutors in Respect of Cases of Encouraging or Assisting Suicide. The Medical Protection Society (MPS) – which provides indemnity, legal and professional support to around half of all doctors in the UK – said that the new policy sends a clear signal that prosecutions are more likely to be brought against healthcare professionals in circumstances where they might have assisted a patient’s suicide. The organisation warned doctors to be extremely cautious when providing help or advice to patients who are considering assisted suicide.
The MDU has grave concerns about how the new policy* on whether or not to prosecute the offence of assisted suicide, will be applied to doctors. “The MDU’s advice to its members remains that doctors approached by patients for advice about suicide should not engage in discussion which assists the patient to that end. Members who are faced with requests for help from patients, including for example the provision of medical reports, should contact us for advice.”
The GMC has responded to the consultation documents from the Directors of Public Prosecution for England and Wales and for Northern Ireland, explaining why the GMC does not take a position on assisted suicide.
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.
The Society for Old Age Rational Suicide was established in Brighton and Hove, by several right-to-die activists and humanists, in 2009. Presently, the main objective of SOARS is to begin a campaign to get the law eventually changed in the UK so that very elderly, mentally competent individuals, who are suffering unbearably from various health problems (although none of them is “terminal”) are allowed to receive a doctor’s assistance to die, if this is their persistent choice. Surely the decision to decide, at an advanced age, that enough is enough and, avoiding further suffering, to have a dignified death is the ultimate human right for a very elderly person. Although there is much public support for this to become lawful in the UK, it is unlikely that Parliament (either at Westminster or in Edinburgh) will change the law, to help those who are terminally ill, for at least five to ten years.
In February 2010 the NVVE, Right-to-Die Netherlands, supported by other social organizations, started the campaign Completed Life. Interrupting this societal debate again shouldn’t be allowed. The NVVE is of the opinion that the elderly should be allowed to make a well thought-through choice at the end of their lives and that such a choice will be entirely up to them. Of course, people are not forced to make use of assisted suicide, but they should be at liberty to resort to such, if they wish to. When human suffering can be avoided, the NVVE is of the opinion that access to assistance shouldn’t be withheld. Obviously, under all circumstances all forms of due-care should be practiced.