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UK cautious about 'ending lives' UK cautious about 'ending lives'
(3 days later)
UK doctors are far more cautious about helping terminally ill patients end their lives than colleagues in Europe, a study shows.UK doctors are far more cautious about helping terminally ill patients end their lives than colleagues in Europe, a study shows.
When they do help, most do so only if the patient would be expected to live for less than a week, a poll of 857 doctors revealed.When they do help, most do so only if the patient would be expected to live for less than a week, a poll of 857 doctors revealed.
They are also more likely to discuss the decision with the patient and their relatives and other medical colleagues.They are also more likely to discuss the decision with the patient and their relatives and other medical colleagues.
The research will be published in the Palliative Medicine journal.The research will be published in the Palliative Medicine journal.
UK doctors are very cautious and reluctant to say they have shortened life by any significant amount of time Lead researcher Professor Clive SealeUK doctors are very cautious and reluctant to say they have shortened life by any significant amount of time Lead researcher Professor Clive Seale
Euthanasia and doctor-assisted suicide, whereby the patient is given the means to kill themselves, are both illegal and extremely rare in the UK, but have been legalised in countries such as the Netherlands, Belgium, Switzerland.Euthanasia and doctor-assisted suicide, whereby the patient is given the means to kill themselves, are both illegal and extremely rare in the UK, but have been legalised in countries such as the Netherlands, Belgium, Switzerland.
Earlier work by the report author, Professor Clive Seale, found fewer than 1% of all UK deaths in 2004 were by euthanasia, and few doctors wanted to see euthanasia legalised.Earlier work by the report author, Professor Clive Seale, found fewer than 1% of all UK deaths in 2004 were by euthanasia, and few doctors wanted to see euthanasia legalised.
There are other ways a doctor can help a patient shorten their life - by withdrawing a medical treatment, for example.There are other ways a doctor can help a patient shorten their life - by withdrawing a medical treatment, for example.
Ending lifeEnding life
Professor Seale's latest work compares the attitudes of UK doctors with those of medical colleagues working in the Netherlands, Australia, Belgium, Italy, Denmark, Sweden and Switzerland on such decisions.Professor Seale's latest work compares the attitudes of UK doctors with those of medical colleagues working in the Netherlands, Australia, Belgium, Italy, Denmark, Sweden and Switzerland on such decisions.
Compared with the other countries, UK doctors were more open with colleagues and were likely to discuss "end-of-life issues".Compared with the other countries, UK doctors were more open with colleagues and were likely to discuss "end-of-life issues".
But they were more cautious about taking decisions that significantly shorten life.But they were more cautious about taking decisions that significantly shorten life.
In 88% of cases where there was a death that involved a medical decision, life was shortened by less than one week, data shows.
And in 70% of the cases, the UK doctors had discussed it with the patient, the patient's relatives and their medical and nursing colleagues.
Although this was more frequent than doctors working in other countries where euthanasia or assisted suicide is illegal, it was less than doctors working in countries where it is legal.
FearFear
Professor Seale said: "UK doctors are pretty good about being open about sharing these decisions.Professor Seale said: "UK doctors are pretty good about being open about sharing these decisions.
"But UK doctors are very cautious and reluctant to say they have shortened life by any significant amount of time.""But UK doctors are very cautious and reluctant to say they have shortened life by any significant amount of time."
He said the UK's medical culture of shared decision-making and palliative care might explain why British doctors were so open to discussions.He said the UK's medical culture of shared decision-making and palliative care might explain why British doctors were so open to discussions.
Another explanation might be fear of recrimination.Another explanation might be fear of recrimination.
TYPES OF END-OF-LIFE DECISIONS Voluntary euthanasiaPhysician-assisted suicideEnding life without an explicit request from patientAlleviation of symptoms with possibly life-shortening effectsWithholding or withdrawing treatmentTYPES OF END-OF-LIFE DECISIONS Voluntary euthanasiaPhysician-assisted suicideEnding life without an explicit request from patientAlleviation of symptoms with possibly life-shortening effectsWithholding or withdrawing treatment
"Cases like the Shipman case may have affected things. There might be an element of trying to protect against criticism or prosecution. If you share the decision it is open," he explained."Cases like the Shipman case may have affected things. There might be an element of trying to protect against criticism or prosecution. If you share the decision it is open," he explained.
Deborah Annetts, chief executive of the organisation Dignity in Dying, said the results showed that many patients were not being properly consulted and communicated with about their own lives and deaths.Deborah Annetts, chief executive of the organisation Dignity in Dying, said the results showed that many patients were not being properly consulted and communicated with about their own lives and deaths.
"It is extremely worrying to see that 30% of end-of-life decisions are made by doctors without discussion with the patients or their families.
"This could mean that up to 154,000 patients die each year as of result of end-of-life decisions in which they have played no part."
But Julia Millington, political director of the ProLife Alliance, said: "The results of this study fly in the face of deceptive claims made over the past two years by the pro-euthanasia lobby who allege that doctors are killing thousands of terminally ill patients every year in the UK."But Julia Millington, political director of the ProLife Alliance, said: "The results of this study fly in the face of deceptive claims made over the past two years by the pro-euthanasia lobby who allege that doctors are killing thousands of terminally ill patients every year in the UK."
The Brunel University work will be published on Monday.The Brunel University work will be published on Monday.