More openness needed in palliative care

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7128.390a (Published 31 January 1998) Cite this as: BMJ 1998;316:390

Deliberate shortening of life has no part in ethical medical practice

  1. Anthony M Smith, Medical directora
  1. a Pilgrims Hospices, Canterbury CT2 8JA
  2. b St Christopher's Hospice, London SE26 6DZ
  3. c Trinity Hospice, London SW4 0RN

    Editor—Corner's contribution to the euthanasia debate, in her Personal View, concerns me.1 Surely palliative care physicians are—and need to be—perfectly clear in their response to requests for symptom control and euthanasia as to what is legally permissible and what they are attempting to do. A recent letter in the Times makes the position clear, and there is no intention or desire for “greyness” or obfuscation.2

    The role of medicine in the care of patients whose disease is beyond the possibility of cure is to improve quality of life as far as medically possible (and to facilitate nursing, social, and spiritual support through involvement of the relevant professionals); it is not to deliberately shorten life or to drag out the dying process.3 To that end we are able to prescribe or advise appropriate analgesics, including morphine, diamorphine, and other opioids; we can escalate the dose to the level that will control pain or add coanalgesics and other drugs to maximise this control.4 By this means we are able to remove pain in the vast majority of patients and to relieve or reduce it to acceptable levels in the remainder. Our practice is …

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