Hyperventilating Headline

Bookdrunk does a first rate job of pulling to pieces the gross abuse of statistics behind the Daily Mail’s latest hyperventilating headline which claims that:

Doctors ‘help’ 2 in 3 to die

Which is, of course, a complete load of bollocks.

Euthanasia is a difficult and emotive subject and one which must routinely task the consciences of those doctors who routinely find themselves responsible for the care of terminally ill patients. However one tries to look at it, it is an issue that is loaded with difficult moral and ethical choices – how does one reconcile the desire to save and preserve life with the feeling that must come to all doctors when dealing with patients in their final days/hours that the end, whenever it comes, will be a merciful release for the individual in question, from which it is but a small step to the conclusion that speeding them gently on their way is but an act of mercy.

One of the points the Mail makes in its coverage, in particular, needs to the picked up and challenged:

The study also revealed that an estimated one third of people who died in the year – 192,000 patients – had their deaths accelerated by doctors using pain relief, the so-called “double effect”.

All of which sound horrific on face value, but like everything else in the Mails’ report is actually a very long way from the truth.

By pain relief what the Mail are referring to is morphine – a very powerful and effective pain-killer/sedative which can often be the only effective means of providing a patient with any effective respite from excruciating pain. However, as can be the case with many drugs, the benefits of morphine come at a price.

Morphine relieves pain. It also depresses respiratory function, which when it comes to very ill or weak patients makes its use a matter of a very delicate balancing act: too little and any benefits to the patient in terms of pain relief may be marginal and very short-lived, too much – and we’re a long way from admistering a lethal dose here – may tip a particular patient over the edge and inadvertantly hasten their end. Factor in a capacity of the human body for developing a tolerance for some drugs which, over time, reduces their effectiveness and its doesn’t take a genius to figure out the equation that all too easily comes into operation.

For patients who experience the kind of protracted and severe chronic pain due to illness, and not always terminal illness, for which morphine offers the only effective pain relief, there is inevitably a point of equillibrium on the horizon beyond which their need for pain relief will tip the past the point at which the drug they’re given – morphine – acts to accelerate their death – the sole alternative to this scenario being to leave them to live in a near permanant state of chronic and often dehumanising pain.

To state simply that morphine accelerated the deaths of 192,000 patients is merely to state that for those people, morphine was the lesser of two ‘evils’ and nothing more.

This, in turn, calls into question the statistics which purport to show that in an estimated 1930 cases – remember these figures are extrapolated from an anonymous survey and are not, therefore, definitive – doctors took matters into their own hands and engaged in non-volutary euthanasia.

They is a distinct grey area in such a definition – how do you define, precisely, non-voluntary euthanasia? Does such a definition apply only where a doctor knowingly administered an overdose to a patient to bring about their end, or does this definition also encompass situations in which a doctor administers a clinically correct dosage, but does so in the knowledge that the patient’s condition is such that such a dosage will prove lethal?

The truth, as ever in reporting medical matters, is rather more complex and less clear-cut than newspaper reports suggest and blatant scare stories, such as this, are not only irresponsible but doing nothing whatsoever to contribute to what should be a clear and carefully reasoned moral and ethical debate on the complex issue of euthanasia.

In fact like so many other stories in which the media consciously stirs up a moral panic in a purely venal attempt to sell a few more copies, stories such as this serve only to cloud the issues and mitigate against reasoned argument and debate to the detriment of us all.

Or to put it another way, the journalist who wrote this sorry excuse for a scare story and, of course, the editor who approved its publication, deserve nothing more than to be handcuffed, tarred and feathered before being deposited, naked, in Hyde Park and then soundly whipped through the streets of London by the massed ranks of the medical profession, armed with rolled-up copies of ‘The Lancet’, until they expire from exhaustion or take the honourable way out and self-euthenase by throwing themselves bodily into the Thames from the nearest available bridge, or under a speeding Hackney Carriage, whichever they encounter first.