Doctors admit helping terminal patients to die

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The fragile consensus within the medical profession that mercy- killing is wrong burst apart yesterday as two doctors publicly declared that they had helped patients to die.

The British Medical Association (BMA) called for an investigation into the activities of Dr Michael Irwin, a former medical director of the United Nations and the World Bank, who was reported to have ended the lives of at least 50 terminally ill patients. Dr Irwin, who is also chairman of the Voluntary Euthanasia Society, said he was speaking out because the time had come to confront the issue of euthanasia.

He said he had helped two patients die in the past six months, one by prescribing 20 times the normal dose of a sedative, then placing a large plastic "exit" bag with an adhesive neck seal over the patient's head. "The bag is big enough so it doesn't get sucked on to the face. You then wait until they have stopped breathing or the body starts to go cold. They feel no discomfort and just gradually use up the oxygen," he said.

His stand was backed by Dr David Moor, a GP from Newcastle upon Tyne, who said he had helped two patients to die in the past week by giving them lethal doses of morphine.

"I went to their homes, assessed the patients and decided they were in pain, anguish and distress. I then discussed giving a lethal overdose with relatives, they agreed it was the best thing to do, and I gave the injection."

He said he would not personally use a plastic bag to suffocate patients but insisted this was a humane way to die. "I aggressively support what Dr Irwin is doing. It would be morally wrong if he were arrested. I invite people against euthanasia to join me and witness the pain, anguish and distress, not only for the dying patient but also for the relatives. Then and only then can they have the temerity to come to me and argue the case against euthanasia."

The British Medical Association said Dr Irwin had clearly broken the law and would have to face the consequences in the courts and before the General Medical Council, the doctors' disciplinary body. "It is effectively an execution," the association said.

Dr Vivienne Nathanson, Head of Science at the BMA, said that rather than finding new ways to kill patients, doctors should be seeking better ways to control their symptoms so they could face their final weeks with peace of mind. "Vulnerable people with a terminal illness should be able to turn to their doctor in trust without fearing that the doctor could put pressure on them to end their lives."

Dr Moor's position is less clear-cut because it is acceptable to give as large a dose of morphine to a dying patient as is necessary to relieve their pain, even if that means hastening death. The key principle is that the intention should be to relieve suffering, not to kill.

Signs of tension within the profession over euthanasia emerged at the BMA's annual meeting earlier this month. Doctors voted overwhelmingly to oppose moves to legalise euthanasia but agreed by a narrow majority to include the words "for the time being", signalling their intention to return to the issue in the future.