MYALGIC ENCEPHALOMYELITIS, also known as CHRONIC FATIGUE SYNDROME (CFS).

In the course of my 30 year career, most of it in a critical care setting, I have never seen anyone admitted to hospital with ME, I have never seen anyone in Intensive Care with ME and I have certainly never seen anyone die of it.
Not until now that is; in a recent court case Kay Gildersdale was acquitted of murder after killing her daughter who suffered from ME. This case is deeply troubling; are we saying that it is okay to kill people with psycho-somatic illnesses?
The Euthanasia lobby have welcomed the outcome of this trial and it sets a very worrying precedent. When people demand physician assisted suicide for the pain they feel are we discussing physical pain (which can be alleviated with opiates if neccesary) or are we talking about existential angst? By which I mean the pain of living in a fallen world?

RCN Consultation on

Assisted Suicide.

The Royal College of Nursing in the UK is presently carrying out a consultation among it members to see what the consensus of professional opinion is about 'assisted suicide'. So if you are a member and have an opinion on this topic you have until 22 May 2009 to send your views into the RCN.

One of the worrying aspects of this so-called "debate" is how the pro-euthanasia lobby frequently misrepresent the issues in the media and not infrequently caricature people who object to euthanasia as motivated by ill-will or sheer ignorance.

For example; the case is often put forward that it is accepted 'custom & practice' for patients to die in pain and that they are subjected to unwanted medical interventions. These commonly accepted fallacies are repeated so often and so authoritatively that the innocent public are unduly influenced by them. It is no surprise that public opinion is moving towards euthanasia but the fact is they are faced with the phoney "false choice" argument ie 'do you want your loved ones to die in agony, yes or no?' Who in their right minds would say anything but 'no!' given that proposition?

I have worked in children's and adult's critical care for more years than I care to remember and I can honestly say that I do not recognise the caricature of our profession.

First up, it is NOT acceptable practice for patients to be in pain - that is not acceptable and there is no excuse for it. If the disease process is such that pain control foreshortens life then so be it - that is not euthanasia or assisted suicide - that is effective pain management. This is exactly the same legal situation as someone dying as a consequence of any other medical treatment aimed at controlling the disease process.

Secondly, everyone has a right to refuse medical treatment. All interventions require informed consent. No one has any intervention "forced" on them - indeed to do so is a criminal offence! (There are some legal exceptions of course - when the mental capacity of the patient may be in doubt - in which case there are legal procedures to be followed). In my experience it is more often the case that family members insist on medical interventions when the professional consensus is that further treatment is futile.

Thirdly, the withdrawal of treatment is not euthanasia or assisted suicide. The purpose of medical treatment is to enable the patient to make a recovery. If the consensus of opinion is that no such recovery is possible then active treatment may be withdrawn and the disease process allowed to take its course.

None of the above are the cause of any ethical or professional dilemma! Okay? Clearly the truth does not suit the pro-euthanasia lobby's arguments which is why they resort to caricature.

When the pro-euthanasia lobby stress the 'pain' people are suffering we must of course exclude physical pain because that can and should be adequately treated. I suspect the 'pain' they refer to is existential pain - the pain we will all have to face at some time in our lives as human beings living in a fractured world. How far do you really want to push the limits of state sanctioned suicide as a cure for this? It is no surprise to me to hear that people who are physically healthy but feeling depressed are being offered suicide at a Swiss clinic. Given everything I have said above about the reality of pain control and informed consent and withdrawal of treatment I do not see where the pro-euthanasia lobby is attempting to take society except down the same route.

Oh! And no I am not motivated by ill-will!!!

ps there is a video about this RCN consultation at http://www.policyreview.tv/embed239/882

Euthanasia and the Arguments
of Straw Men!

From time to time one hears supporters of euthanasia pressing their case in the national media. To judge from the "debate" one would probably conclude that it is the 'accepted custom and practice' for patients to be allowed to die in pain and that health care professionals are solely concerned with employing every conceivable technology to prolong every individuals life to the last uttermost second regardless of the pain involved and the patient's (or their family's) wishes.

I have to tell you in all candour I have NEVER witnessed this scenario in over the twenty five years of my nursing career - the bulk of which has been in critical care. Funny that.

Funny that the commonly accepted "truth'"is that only those who are in favour of euthanasia are motivated by compassion and the rest of us are motivated soley by professional arrogance. There is not a little humbug attached to the argument of the euthanasia lobby.

I qualified as a registered nurse twenty five years ago. I went on to do my paediatric course and subsequently worked on a childrens cancer ward before making a move into Paediatric Intensive Care. I feel that I have earned the right to speak on the subject of euthanasia.

Advocates of euthanasia generally set up a phoney scenario of a patient dying in agony when compassion would demand that we put them out of their misery. As someone who has worked extensively in a variety of critical care settings I can tell you that I find such allegations utterly repugnant and a slur on my
profession. If someone does die in pain that is a matter of professional incompetence not (as euthanasia advocates would have it) accepted 'custom and practice'. And frankly I cannot help but feel that the public is being hoodwinked by their spurious arguments.

There is no excuse for anyone to die in pain. None whatsoever. This is a 'no brainer' as issues go. Period. If you find yourself witnessing such a scenario then I would say that that is clinical mismanagment.There is no excuse for it.

I will give as much pain relief as is required to prevent pain - if their disease process is such that that required analgesia actually foreshortens their life - then so be it. That is NOT euthanasia, that is pain control. As a Christian and a nurse I have no issue with this.... it is a none issue! (It is exactly the same situation as giving any drug with a known side-effect in such circumstances).

Perhaps it is a dated term but no-one seems to mention the principle of "double effect". This is where one carries out one action i.e. to control pain, but which secondarily foreshortens life.

Euthanasia (which is Greek literally meaning 'good death') actually means intentionally terminating a life as the primary purpose.

Now some one will say that this is splitting hairs but I will reply that speaking as someone at the coal-face of these ethical dilemmas this distinction is crystal clear... there is no ambiguity. Killing someone is murder, dying as a consequence of a pathological disorder which professional people are trying but failing to arrest is an entirely different matter.

The real question is why are the advocates of euthanasia pushing a "false choice" argument? Presumably it's simply because the truth will not do.

Another 'straw man' is the implication that patients are having medical treatment "forced" upon them. But the reality is that everyone has the right to refuse treatment, to compel someone to undergo procedures they have declined is assault. (There are some rare instances where perhaps a patients mental state causes medical staff to follow through a legal process to compel a patient (or the parent of a sick child) to have treatment....but that is not the issue in view here). Sadly it is my experience that such legal proceedings that do occur are more often when a parent refuses to let go of a loved child - and insist on futile attempts at resuscitation.... it is heart breaking for all concerned. The purpose of medical treatment is to support a patient through an acute episode of illness to a point where they have recovered sufficiently not to require such support. If the consensus of opinion is that no such recovery is possible, then in my view, the removal of this life support causes no ethical problems - we are merely allowing the pathological process to takes its course. I have been involved in countless such discussions and contrary to the arguments put forward by the pro-euthanasia lobby there are no legal ambiguities about it.

Another 'straw man' is that somehow people like me are in some sort of legal limbo and therefore society should sanction euthanasia. That is yet more codswallop! If I sound irritated - I am. I detest being used as bait to manipulate an unsuspecting public.

The REAL question is this; when so many 'straw men' are being marshalled to emotionally intimidate the innocent onlooker into sanctioning the demise of our fellow human beings where do you think the REAL end point of this argument is?

If anyone wants to take issue with me the comments box is open as always.