Dozens of GPs help patients die, study finds

By MARTIN JOHNSTON

In one year, 39 GPs have performed euthanasia or helped a patient commit suicide, a researcher has found.

Both practices are crimes although Parliament will soon debate a bill that would legalise doctor-assisted suicide for terminally ill or incurably ill patients.

The study found that in 225 cases, GPs were in a legal and ethical grey area of stopping or withholding treatment or boosting pain relief, such as morphine, at least partly with the intention of hastening death.

The patients in both groups had been close to death or suffering a terminal illness.

The researcher, Auckland University psychology lecturer Dr Kay Mitchell, said yesterday patients had been expected to survive less than a week, although three might have lived more than six months and were probably suffering from a chronic, degenerative illness.

She did not seek the patients' ages in the anonymous postal survey of GPs, although one doctor disclosed that a patient in the euthanasia/assisted suicide group was a child.

Medical Association chairman Dr John Adams was surprised at the findings and repeated that the association was opposed to the death with dignity bill of New Zealand First MP Peter Brown.

Dr Adams said one of a doctor's primary obligations was to preserve life. The bill would be a "slippery slope" that could lead to pressure to expand the types of people able to be helped to kill themselves.

Euthanasia is legal in Belgium and the Netherlands and doctor-assisted suicide is permitted in the American state of Oregon.

Dr Mitchell said there had been only 91 cases of doctor-assisted suicide in Oregon since its legalisation in 1997. "This idea that the floodgates will open is not being supported by the figures."

The 39 GPs in her study who assisted death were among 2600 she asked about the last patient death they were involved with in the preceding 12 months. They had answered "yes" to the question: "Was death caused by a drug prescribed, supplied or administered with the explicit purpose of hastening the end of life or enabling the patient to end their own life?"

Dr Mitchell said the 225 cases of withheld treatment or increased pain relief were a grey area because the doctors might have been intending to reduce patients' suffering as well as hasten their deaths.

"I should imagine no judge would find them culpable."

There were a further 427 cases in which doctors had withheld treatment, such as tube feeding or oral medication, or increased pain relief. In these cases the doctors said they knew this could hasten death.

"These actions are in accordance with normal medical practice, which does not force treatment on a patient when the treatment has become burdensome," Dr Mitchell said. Voluntary Euthanasia Society of Auckland spokesman Jack Jones said voluntary euthanasia was more widespread than indicated by the study and demand for it would increase as people lived longer.

The study showed patients underwent a "lottery" in terms of their GP's beliefs. "A lot of people would want one of those 39 doctors."

Catholic bio-ethics specialist Father Michael McCabe said the findings could erode trust in the medical profession. In the Netherlands, some elderly people had started carrying tags saying, "please don't kill me should I get ill or have an accident".

Dr Mitchell, who is starting research into end-of-life "palliative" care at rest-homes and private hospitals, said most of the GPs in her study indicated they had access to palliative care.