Medical opinion has been polarised after revelations yesterday by a former GP who admitted to helping dozens of his patients to die. The police are considering whether there is scope for fresh charges against Dr Howard Martin, who was struck off the medical register last week after he was found guilty of giving unjustifiably high doses of powerful painkillers to 18 patients.
The former GP broke a long silence to admit that, despite being cleared of three murders in 2005, he did deliberately hasten those patients' deaths, as well as countless others. Dr Martin, 75, claimed he was motivated by "Christian compassion" rather than any malice or desire to "play God".
Two eminent medical experts who gave evidence at Dr Martin's murder trial were divided yesterday as to whether his actions were medically justified or simply unlawful.
Professor Robert Forrest, a toxicologist who has been involved in six murder trials involving health professionals, said it was clear at the time that Dr Martin had given inappropriately high doses of morphine and he was aware of the consequences of his actions. "This is now, and was then, murder, and he should face another trial," Professor Forrest said last night.
Professor Karol Sikora, an oncologist who was a medical expert for the defence, however, remains convinced that Dr Martin is "no Harold Shipman", but merely "heavy handed", an "old doctor out of kilter with advances in science, ethics and technology which got him into trouble". Professor Sikora believes that a new trial would be a "waste of time and money".
Professor Sikora's views will no doubt anger relatives of some of Dr Martin's deceased patients whose lives were deliberately shortened by a GP apparently practising euthanasia throughout much of his career.
Professor Forrest joined the son of Harry Gittin, 74, who died after receiving a injection of diamorphine from Dr Martin in 2004, in urging Durham Police and the Crown Prosecution Service to reopen the investigation on account of Dr Martin's own admissions and, in particular, his motivation and intent to hasten death. Dr Martin could even face a retrial after the double jeopardy law was revoked in 2005.
The doctor's frank but startling admission has also reignited the political debate surrounding assisted suicide. The campaign group Dignity in Dying urged the Government yesterday to reconsider legalising assisted suicide to protect vulnerable patients. An open and transparent assisted dying law would enable people to make their own choice rather than being helped to die or kept alive against their wishes, said Jo Cartwright, a spokeswoman for the group.
Meanwhile, patient safety campaigners are calling for tighter checks for doctors and nurses giving patients powerful painkillers. Peter Walsh, chief executive of Action Against Medical Accidents (AvMA), said while it was impossible to have a fool-proof system, it is essential that at least two professionals were involved every time a decision was made to begin palliative care. New GMC guidance which recommends that doctors discuss and record all decisions about end-of-life care for terminally ill patients does not go far enough, Mr Walsh said.
Professor Forrest is adamant the jury in the 2005 trial were sympathetic to Dr Martin's actions because they also felt euthanasia is acceptable. He said: "I think juries are quite happy that doctors and nurses end people's lives in some circumstances as there is still the perception among people that dying in pain is inevitable. This is murder. In Dr Martin's case I'm sure he had only one motive. He admitted to murder in that interview and so I hope the police and CPS will take proper notice because he should face another trial. There are a lot of doctors who think that they are above the law."
But Professor Sikora said: "Howard Martin is no murderer. He just used old-fashioned pain-control practices which were common when I was a student. Despite the Shipman hysteria at the time, he was no murderer, just heavy handed. At the time of the criminal case I felt he was close to the edge of law, but I think he did the right thing for his patients, who were all dying and in pain. His weakness was to do everything on his own. What would be the point of another trial? It's not going to bring those people back; he's already lost his licence; he is 75. It doesn't matter now: we can't hang him."
Dr Martin, a former army doctor and police surgeon, was arrested in May 2004 at one of his three surgeries in Co Durham after relatives of an elderly cancer patient raised concerns with police after his death. He was suspended by the GMC and charged with three murders after nearly 20 bodies were exhumed. He was cleared at Teesside Crown Court of murdering Mr Gittin, Frank Moss, 59, and Stanley Weldon, 74, after the jury was unconvinced about his intentions.
Dr Martin, who lives in Penmaenmawr, North Wales, said he felt no guilt or remorse; he gave his son Paul, 31, a lethal injection of morphine when he was dying from cancer in 1988. "On Judgment Day I will have to answer to God, and my answer will be this: that I did my best for my patients," he told The Daily Telegraph.
In a statement, Superintendent Paul Unsworth from Durham Constabulary said: "We are aware of comments Dr Martin is said to have made to the media in the wake of the GMC hearing... A decision will have to be made on whether there are any new grounds to reopen the investigation and any such decision will be taken following consultation with the CPS."
Dr Martin was unavailable for further comment.
Doctors in the dock
Daniel Ubani: convicted 2010
Came to Cambridgeshire from Germany in 2008. On his first, and only, shift in Britain he killed David Gray, 70, by administering a massive overdose of diamorphine. Ubani, 67, was convicted in Germany of death by negligence and was last week, struck off the UK medical register.
Harold Shipman: Convicted 2000
One of the most prolific serial killers in history with 215 murders ascribed to him over 23 years. In 2000 a jury found Shipman, above, guilty of 15 murders and sentenced him to life in prison. In 2004 he hanged himself in his cell in Wakefield prison, West Yorkshire.
David Moor: Acquitted 1999
The Northumberland GP was accused of murdering George Liddell, an 85-year-old terminally ill cancer patient with a fatal dose of the painkiller diamorphine. But a landmark verdict cleared him and established that doctors who administer drugs to relieve pain act within the law, whether or not the patient dies.
Nigel Cox: convicted 1992
The consultant rheumatologist believed he shortened Lillian Boyes' life by "between 15 minutes and one hour" by injecting potassium chloride to stop her heart. He was convicted him of attempted murder of the 70-year-old and received a 12-month suspended sentence in 1992. But a year later he returned to his former job under supervision.