Ramblings of a Scottish Student

I was asked by a medic friend of mine what my views on Physician Assisted Suicide are.  This was sparked off by a debate that the Medical School he attends was holding on the subject with speakers coming from a variety of areas within and out with Medicine.  It gave me the idea to write about this subject, so, here are my views on the matter.  Feel free to challenge me if you do not agree with what I am saying.

The bottom line is that I do not agree with any form of assisted suicide, regardless of whether it is a friend, relative or doctor.  Just for your information,  I don’t want this to turn into a post or debate about this particular subject, but I am also against abortion.

End of Life care has been changing in the developed world.  As our understanding of medicine has grown we have been able to better understand how to use medication and other techniques to ensure that those whose life is knowingly coming to an end through illness and disease are as comfortable, pain free and dignified as possible.

It is my belief that rather than debating euthanasia we should be focusing our efforts on further developing the palliative care system.  Systems such as the Liverpool Care Pathway are the way forward when dealing with the terminally ill and we should never be satisfied with the system we have.  We should always be striving to improve them and to better understand how to treat people in the last months, weeks and days of their life.

Sadly, not a huge amount of research or funding goes into End of Life Care.  I suspect this has something to do with the fact that End of Life Care is usually associated with older people.  While a large proportion of the NHS budget (around half) goes on treating elderly patients, the levels of research into and funding for the research is minuscule compared to the funding and research into other health issues.  If we continue to keep funding levels where they are then we will never be able to have the advances that may be possible in this area.

Often when discussing or debating this issue I am asked about the withdrawal of medication by medics and it is often put to me that such actions are tantamount to physician assisted suicide.  These are points that are fairly easy to refute.

Firstly, medicine’s first priority is often curing.  This means that more often than not the medication that patients are on when the decision to withdraw is taken is there to prolong life and o try and cure any illnesses.  The withdrawal of the medication is simply allowing nature to take its course.  Euthanasia is a deliberate act to bring about a person’s death by administering lethal doses of medicine.

The same applies to the switching off of life support.  When such a decision is taken it is often the case that the body had died long ago and the vital organs are simply being kept alive by machines; in other words preventing nature from taking its course.

It’s a really complicated issue and I could keep writing on it for hours, but such a lengthy piece wouldn’t be suited to a blog entry.  I feel that what I have written tells you my stance on it and points to why I have adopted that stance on the issues.

Feel free to challenge me on any of the above or to ask me questions should you wish to know more about where I stand on these matters.

I have just watched the Dispatches programme broadcast on Channel 4 yesterday.  I must say, I was getting a little fed up with Dispatches and felt it was moving in an undesirable direction over its content, but I found this programme of a reasonably good quality and addressed many of the key issues that I would have expected any balanced documentary to have done on this issue.

The programme was based on the way in which police deal with public order at large protests in the wake of the G20 disaster at the start of the year.  The senior Metropolitan Police officer who took part in the programme and described G20 as a policing success must be living in an ivory tower:  a man dies after officers act in a way which appears to be totally disproportionate, an officer facing potential criminal charges and widespread condemnation from the public, academics and the police watchdog cannot in anyway be viewed as a successful policing operation!

Returning to Dispatches, those interviewed who were not employed by the Metropolitan Police did speak a lot of sense.  Protests in this country have largely moved to peaceful ones and where violence does happen it appears that more often than not a major contributing factor is the police tactics.

The gear that police being deployed in public order situations is very much disproportionate.  I have no issues with police dressed like “Robocop” where it is needed for their safety, but deploying them in that kit from the start of the protest is a major fail.  I would imagine that having that kit on changes the way an officer thinks, it also changes the attitudes of those in attendance to one that is much less compliant than it may otherwise have been:  the police go ready for confrontation and appear to be seeking it out.

The focus of public order policing in the UK is very much, from what I’ve seen, more about policing civil unrest and public disorder than it is about actually keeping the peace in the first place.

The job of the police, in my opinion, at such events is two fold.  First and foremost it is about keeping those who attend the protest safe and secondly to ensure that people and property around the protest is also kept safe.

I liked the community policing style adopted at the Climate Camp in August – it seemed very appropriate.  You have a large number of people in an area for a number of days who are all gathered together for a common purpose:  they are essentially a community; so why not police them like a community.  Officers patrolling in normal, day-to-day police with officers on standby should trouble break out (just like they are when policing the “normal” communities”).  It’s not an overnight fix, and there will always be individuals who will cause trouble:  this is a problem with society generally and not just protests.

UK public order policing has been developed based on the riots that were common place in the 70s and 80s; modes of protest have changed and have largely become peaceful and as such the police must change their tactics in order to ensure that the police response is appropriate and moves with the times.  Yes, officers need to be trained to deal with the rare situations and need to be able to handle them, but does their training need to focus solely on the extreme to the detriment of covering the norm?  If the extreme is taught to the police as the norm; then officers on the ground are going to treat the norm as the extreme, after all they’ve been trained to deal with nothing else.

Frankly I found the comments of Comdr. Bob Broadhurst (Metropolitan Police) regarding the latest policing tactics in Northern Ireland dismissive and poor.  As was pointed out by others in the programme the level of violence seen in Belfast and Londonderry far outstrips what happens in the towns and cities of mainland Britain.  Yes, we have seen some violence on par with that of Northern Ireland, but PSNI have had to deal with a lot more incidents on that scale than the Met or any other force in the UK has had to deal with.  The tactics clearly worked when they were employed by the Met – Climate Camp in August went by peacefully when tactics from PSNI were used.

Tactics such as containment can only lead to one thing:  Violence.  It’s very basic human behaviour that is displayed in situations such as this.  When you have a large group of people in a small space, a space which is becoming smaller as the police advance forward and push the public back, then anger levels rise to points where it overflows and violence happens.

Sadly, there will always be a small number who break the rules and the police should deal with them appropriately, and by appropriately I also mean proportionately.  However, policing public order has to move away from having disorder at the forefront to a model which is more at home with the way protesting has been progressing.

Dispatches:  Ready for a riot was broadcast on Channel 4 on Monday 19 October 2009 at 20:00.  The programme is available on 4OD to be watched at anytime for 30 days following its original broadcast.  4OD can be found at http://www.channel4.com/4od