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The prognosis of a terminally ill patient can never be determined with precise accuracy. For administrative purposes however the criterion that a doctor would be surprised if a patient remained alive after 6 months has worked well. At present, estimates of prognosis are used very widely when decisions that will shorten life are taken; for example, stopping ventilation or renal dialysis or withholding antibiotics. In general the evidence suggests that patients die earlier than their doctors think they will, so, if mistakes are made they are likely to be in the direction of over-estimating the length of time a patient has to go.
The legislation will ensure that the independent doctors carefully consider the possibility of coercion and take further advice from others who know the family if they are unsure. Great care will be taken to ensure that competence is thoroughly assessed.
Doctors who chose the medical profession solely to cure patients entered the wrong profession. A good doctor will care for patients at all stages of life and at all stages of illness, including terminal illness. The doctor will give primacy to an informed and competent patient’s wishes unless this is clearly inconsistent with the patient’s welfare.
Vice-Chair of Dignity in Dying, steering committee member of Healthcare Professionals for Assisted Dying (HPAD)