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BMJ No 7102 Volume 315 News Saturday 26 July 1997
Two doctors confess to helping patients to dieThe highly charged debate over voluntary euthanasia and physician assisted suicide blew up last week when two British doctors confessed to giving lethal doses of drugs to hasten the deaths of terminally ill patients.Michael Irwin, chairman of the Voluntary Euthanasia Society, told the Sunday Times that he had administered fatal doses to around 50 patients over a 40 year career. Dr Irwin, a retired Sussex GP and former medical director of the United Nations, said that the "double effect principle," whereby doctors may administer large doses of drugs to ease pain and distress even if this shortens the patient's life, was "full of hypocrisy" and called on doctors to be honest about their real motives. David Moor, a GP in Newcastle upon Tyne, claimed to have helped "a large number" of patients to die during his 30 year career, including two in the previous week. Dr Irwin wants to highlight the hypocrisy surrounding euthanasia Doctors involved in mercy killing risk prosecution for murder, punishable by an automatic life sentence, or charges under the Suicide Act, which carry a maximum 14 year prison sentence. But the double effect doctrine means that for a murder conviction the prosecution would have to prove that the doctor intended to kill the patient rather than merely relieve pain. This means that prosecution is extremely unlikely if a standard painkilling drug such as diamorphine is used. Prosecutors would also have to prove that death was caused by the drugs rather than the illness. In 1992 a consultant rheumatologist, Nigel Cox, was convicted of attempted murder for giving two ampoules of potassium chloride to a 70 year old patient in agonising pain from rheumatoid arthritis who had begged him to end her life. He was not charged with murder because the patient's body had already been cremated when police were called in, so the prosecution was unable to prove whether the injection had caused her death. Northumbria Police said that it would "look at the details" of Dr Moor's cases and take advice from the BMA and from other police forces. Sussex Police said that it was not investigating Dr Irwin but was liaising with the Crown Prosecution Service. The BMA overwhelmingly rejected calls to legalise euthanasia at its conference two weeks ago, as did the House of Lords Select Committee on Medical Ethics, which reported in 1994. But a survey of NHS doctors in 1994 found that 32% had acceded to patients' requests to hasten their death, and 46% would consider taking active steps to bring about a patient's death if this were legal (BMJ 1994;308:1332-4).
Clare Dyer,
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