Impact on doctor/patient relationship
It will surely involve major changes in the law, which could have serious consequences for the doctor/patient relationship. ‘First do no harm’, is frequently bandied about and whatever the origin, it is a maxim that means patients can hold us to the highest and most transparent of motives.
Death is an emotional time for families and it is essential that the trust of the patient and their carers is never eroded but there are also the wider implications. How do we deal with those in particularly vulnerable groups, the psychologically unwell, those unable to express intention? How do we discern if choice is free and informed
End-of-life care raises difficult legal and political questions.
Thanks to the legacy of the formalised hospice movement started in the UK, palliative care is centred on addressing all of the patient’s and family’s needs from physical to the emotional and spiritual. Dying patients are not dictated to by doctors and nurses but are encouraged to articulate their wishes through empowering patient centred initiatives, such as advance care planning and the ReSPECT process.
The approach to assisted dying in much popular journalism tends to be superficial and simplistic. The reality is not so.
Reports from countries, such as Holland and Belgium, which have adopted legislation for assisted death, indicate that the much-maligned ‘slippery slope’ argument against it is, in fact, supported by emerging evidence. It is well nigh impossible to maintain an approach to assisted dying which keeps it within strict guidelines and firm control.
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