Copperfield on the bill for assisted dying

That with assisted dying the debate is that it’s just not fun. Which is a shame, as I generally like to introduce a tone of self-defeating levity into these blogs, as my regular reader knows.

Perhaps there is some potential in the issue of waiting lists for euthanasia. Supply and demand for this new service can mean such endless queues that by the time you are seen, you may be… you know…

There are also the slippery slope concept. It amuses me. According to the naysayers, one minute we will euthanize the terminally ill, the next it will be those with TATT or lists. Come again. There is a big difference between what we secretly think and what we would actually do. Also, there would be something called the law.

And that’s it. Assisted dying into easy blog does not work. So I have no choice but to be completely serious from this point. Two points, actually.

1. LDL cholesterol. Bear with me. I had an epiphany recently when I was plowing through a QOF out-of-target list and found myself considering whether to recall a patient with an LDL of 2.01 for statin intensification. What I realized is this: medicine has lost its way. Its obsession with prevention, targets and arbitrary disease labels means we have completely forgotten what to do. We are so preoccupied with biochemical micromanaging that we overlook the fact that there is a person attached to every number.

And this leads to a completely perverse situation: doctors are only too happy to repeatedly intervene and impose on people’s lives for marginal benefit when they are not sick, yet are unwilling or too weak to intervene with gracious, compassionate and effective intervention when these lives are coming to an end. Is it cowardice, stupidity or moral blindness? Or maybe all three?

2. I do not buy the argument that palliative care, properly performed and adequately resourced, can solve all end-of-life problems. It can certainly help, but I’ve seen enough palliative horror shows to know it’s no panacea. A case in point: a man whose mental anguish was so great that he lost all control of body, comfort and fate that he cried when he awoke from his opioid sleep due to the simple fact that he was still alive and did not want to be. Where is the “management of psychological pain” section in the BNF palliative care chapter?

So you can see which mast my colors are nailed to. And if my arguments don’t convince you, try some clichés the next time you’re thinking about an LDL. Like treating the patient, not the blood result. And cure sometimes, relieve often, comfort always. And above all, whose death is it really?

No, it’s not funny. But with the right care, I can die laughing.

Dr. Tony Copperfield is a GP in Essex.