Author: Catherine Burns

12 hours agoShareSaveCatherine BurnsHealth correspondentVicki LoaderHealth producerShareSaveBBCIf you ask these three doctors about being GPs, their answers are remarkably similar.”It can be the best job in the world,” one tells me. It’s “a privilege” another says. They all talk about how they love getting to know their patients and their families.But all three have different views on assisted dying.Right now, the law here is clear: medics cannot help patients to take their own lives. But that could change.The Terminally Ill Adults (End of Life) Bill is being debated in Parliament. And if it goes through, it will give some terminally ill patients in England and Wales the option of an assisted death.Here, three doctors – Abdul Farooq, Susi Caesar and Gurpreet Khaira, who all have a different view on assisted dying – tell us how they feel about the proposals. The three were among more than 1,000 GPs to respond to a BBC questionnaire on assisted dying.’A red line I would never cross’Dr Abdul Farooq is 28 and relatively new to his career as a GP.We meet at his home in east London. He gives his baby daughter a bottle of milk before heading around the corner to pray in his local mosque.His religion is absolutely key to his views on assisted dying.”I believe in the sanctity of life. As a Muslim, I believe that life is a gift from God, and that no one has the right to take that away,” he says.Dr Farooq feels taking your own life is wrong, and so, he says, it would be “sinful” for him to be involved in that process – even indirectly.If this law passed – and a patient came to him asking for help to die – he would refer them to another doctor.He says anything beyond that would be “a red line I would never cross”.Dr Farooq’s objections are also informed by his professional experience, particularly his time working in a hospital.He describes seeing “undignified deaths” – people passing away on busy wards – and says the health system is not getting the basics right in end-of-life care.”There is so much we can do to make patients comfortable, if we have the right resources available,” he tells me.”We have a whole field of medicine called palliative medicine that is there to help people towards the end of their life. So why are we not throwing all our resources and money into that and actually making the process of death less scary?”He’s also concerned about specific parts of the proposed law. Doctors would have to assess if terminally ill patients are expected to die within six months before they are approved for an assisted death.Dr Farooq sees this as problematic. The final day or so is easy to predict, he says, but adds that some patients he’s expected to die within six months can still be alive a year later.Is there anything that could change his mind on assisted dying?”No,” Dr Farooq says without hesitation. “I’m strongly against it. Personally and professionally, I think it’s the wrong thing to do for patients.”‘I’ll be at the front of the queue to help’Dr Susi Caesar has been a GP for 30 years and thinks she probably wouldn’t have previously been so vocal in her support of assisted dying.Now, she says she is ready to “stick her head above the parapet”.Recently she lost her beloved dad, Henning. We meet at a lake near Cirencester because being near water reminds her of him.”My father was the most amazing person and this is so evocative of everything he loved,” she says. “The outdoors, walks, sailing, boats, kayaking, swimming.”She thinks Henning would be proud of her for talking to us about her views because he was a long-term believer in assisted dying.When he was diagnosed with a terminal illness, Dr Caesar says he became “terribly scared about the manner of his dying”.”My father was a very proud man, and the thing that was unbearable to him was the idea that he would lose control at the end of his life – of his bodily functions, of his mind, of his ability to be the person that he was.”By the end, Dr Caesar says her father’s “medication never quite kept up with his symptoms.” For her, the argument over assisted dying comes down to patient choice.”Everybody is going to die. Every individual deserves the comfort of choice about how they die. I would want it for myself,” she tells me.She acknowledges that many of her colleagues have “very, very reasonable concerns” about assisted dying. But she says “we have the wisdom to set up systems that will work and get over some of these hurdles.”I ask if Dr Caesar’s support for assisted dying would translate into her working in this area.”I will be at the front of the queue to help people to have the death that they wanted,” she says. “I think that’s the core joy of my job – being with people to the very end of their health journey.”‘A very guilty place’Dr Gurpreet Khaira doesn’t have any of the certainty of Dr Farooq and Dr Caesar.She describes herself as “pretty conflicted about the whole subject” of assisted dying.Dr Khaira is a GP in Birmingham but also has first-hand experience as a patient.In 2017, she was diagnosed with breast cancer. She found chemotherapy gruelling and says if the cancer ever came back, she wouldn’t want to go through it again.”I remember feeling very passionate that I should have the choice of whether I go through this kind of treatment, or to say ‘that’s enough now’,” she says.She says it felt very important for her to have a choice about the end of her life.Now, she’s a picture of health, striding along a hillside with ease.As a GP with decades of experience, she worries that vulnerable patients might opt for assisted dying rather than be a burden to their loved ones. Or that some families might coerce vulnerable patients into it.”That is one of my biggest areas of personal conflict. I know that there are lots of plans to put safeguards in.”You can be the best doctor or advocate in the world, but you may not pick up where someone is being controlled or manipulated.”For her, there’s a fundamental conflict between her personal and professional experiences.But, she adds: “As a doctor, I’d be very reluctant to be handing over a syringe for a patient to make that choice.”Balancing up these two sides leaves her “in a very guilty place”, she says, but adds that it’s not a weakness to be open minded. For her, making this decision is an “evolving process”.Personal experience shaping opinionsIt’s striking when talking to Dr Farooq, Dr Caesar and Dr Khaira, how much their views on assisted dying reflect their core belief systems.In that respect, GPs are possibly much like the rest of us.If this bill does pass into law, doctors will have to consider whether they are willing to work in the area of assisted dying, or not. They could be asked to be involved in the process – whether that’s holding preliminary discussions with patients who want to die, to prescribing a substance for someone to end their own life.If they don’t want to, no-one will force them.They will have time to think about it. If MPs do vote in favour of this next month, it could still take years to come into effect.

13 hours agoShareSaveCatherine BurnsHealth correspondentHarriet AgerholmData journalistShareSaveBBCFamily doctors in England are deeply divided on the issue of assisted dying, BBC research on plans to legalise the practice suggests.The findings give a unique insight into how strongly many GPs feel about the proposed new law – and highlight how personal beliefs and experiences are shaping doctors’ views on the issue.BBC News sent more than 5,000 GPs a questionnaire asking whether they agreed with changing the law to allow assisted dying for certain terminally ill people in England and Wales.More than 1,000 GPs replied, with about 500 telling us they were against an assisted dying law and about 400 saying they were in favour.Some of the 500 GPs who told us they were against the law change called the bill “appalling”, “highly dangerous”, and “cruel”. “We are doctors, not murderers,” one said.Of the 400 who said they supported assisted dying, some described the bill as “long overdue” and “a basic human right”.”We are keeping human bodies alive in the most inhumane manner,” one said. They asked: “How do we ethically justify forcing these bodies to continue to exist in decrepitude?”We cannot know whether the GPs who responded to the BBC are representative of all family doctors.It comes as MPs will this week again debate proposed changes to the controversial bill, with a vote in parliament expected on whether to pass or block it next month.If assisted dying does become legal in England and Wales, it would be a historic change for society.Current laws prevent medics from helping any patient to carry out their wish to die. The Terminally Ill Adults (End of Life) Bill would allow any doctor to be involved in assisted dying, but GPs are often a large part of the practice in other countries. On Tuesday, a separate bill to legalise assisted dying in Scotland passed an initial vote.The BBC’s research, carried out over a few weeks in March and April, is the first in-depth look at how GPs in England feel about the proposed new law.Nine out of 10 GPs who said they were against legalising assisted dying worried terminally ill patients would consider it because they felt guilty about being a burden on their loved ones or the health service.”The right to die becomes a duty to die for those who feel a burden on family,” said one GP.Another common concern was patients might be coerced. Some told us they had treated elderly people with family members they suspected of being more focussed on their inheritance than their relatives.More than half of the group who opposed a law change said it would be against their religious beliefs.They spoke about life being “sacred” and called assisted dying “sinful”. Some referred to the commandment “thou shalt not kill”.Another argument from those who said they were against assisted dying was the health system should instead focus on improving end-of-life care.One GP said creating an assisted dying law was “scandalous” when hospices were largely funded by charities rather than by the state.Separately, on Tuesday the Royal College of Psychiatrists said that while the group “remains neutral” on the principle of assisted dying, it “just cannot support this bill”.In an interview with BBC’s Newsnight, the college’s president Dr Lade Smith cited a lack of requirements concerning the “unmet needs” of patients, and a shortage of psychiatrists to process requests.”We’re concerned that there isn’t a requirement to think about any unmet needs a person might have. A person with a terminal illness… they may be in pain, they have difficulty with their housing, their finances because they haven’t been able to work, they might feel lonely, isolated,” Dr Smith said.Dr Gordon Macdonald, CEO of Care Not Killing said there was a “black hole” in the hospice budget and “we need better care not killing”.Dying with dignityMore than 400 GPs told us they supported a law change, with some describing feeling “traumatised” and “haunted” by watching people die in “severe pain or distress”.Of those who said they were in favour, more than nine in 10 respondents believed it could allow patients to have a dignified death.Some shared personal experiences: telling us about watching their parents losing dignity or begging to die. One said their sick wife prayed every evening to not wake up in the morning.Those who backed assisted dying often spoke about patient choice, arguing it was patronising not to let people decide how they wanted to die.Wanting the option of an assisted death for themselves or their loved ones was another common reason for supporting the law.”Personally, I would find this a comfort and I resent those who take this choice away from me,” one told us.’Unpredictable’ timeframeIf assisted dying does become law in England and Wales, it would apply to certain terminally ill patients who were reasonably expected to die within six months.But more than a quarter of all the GPs who responded told us they would rarely, or never be confident assessing if a patient was expected to die in that time frame.”It’s unpredictable even in the severely frail,” one said.No doctor would be obliged to work in assisted dying. Of the 1,000 GP respondents, more than 500 told us they would be willing to discuss assisted dying with a patient.Nearly 300 would assess if a patient was eligible and 161 said they would prepare a substance for a patient to take to end their own life.Legal risksProf Kamila Hawthorne, chair of the Royal College of GPs, said the BBC’s research showed GPs had “real concerns about the practical and legal implications of a change in the law on assisted dying”.”These must be acknowledged and addressed, so that any legislation is watertight,” she said.Sarah Wootton, chief executive of Dignity in Dying, said GPs and other medics will “rightly be considering how they will navigate” the proposed law.She said evidence from assisted dying laws in Australia and the US showed it could be carried out “safely and effectively, with far reaching benefits for end-of-life care and robust protections for both patients and doctors”.Additional reporting by Vicki Loader, Elena Bailey, Natalie Wright and Hannah Karpel