BBC: bringing Dignity to a death near you

Quick fisk of a BBC news article, a pastime which I’m sure could provide full-time employment for whosoever might be inclined, this time on its reporting of recent research findings that, shock, faith plays a role in shaping the beliefs and decision-making of its adherents (and, specifically in this case, that of doctors). Whilst the general public will no doubt shake their heads, confirmed in their suspicion that academics exist solely to point out the blindingly obvious or else to refute it, nonetheless the way the BBC reports this newest leap forward for the progress of humankind is worth a little scrutiny.

The article starts with the subheading;

Doctors with religious beliefs are less likely to take decisions which could hasten the death of those who are terminally ill, a study suggests.

Good, one might think, a mildly positive report, religious people are less likely to decide for themselves whether someone else’s life is worth living, and choose  to ‘hasten the death’ of their terminally ill patient accordingly. Oh, but wait…

The survey of nearly 4,000 doctors found those with a strong faith were also less likely to discuss end-of-life treatment options with their patient.

Seems I spoke to soon: it would appear doctors let their religious beliefs trump their duty of care to patients – although, for the time being at least, precisely what is meant by ‘end-of-life treatment options’ remains unclear.

Doctors and campaigners described the findings as “concerning”.

Generic statement, with the obvious intention of trying to generate legitimacy for what follows, which will no doubt include some of those doctors and campaigners earnestly putting their own beliefs before their duty of care to their patients – let’s just wait and see who pops up, shall we? Moving on…

The General Medical Council, which regulates the profession, says that while doctors should start from the assumption that life should be prolonged, this should not be at any cost.

Slap on the wrist for those religious types. I’ll jiggle about with the order of the next couple of paragraphs, to highlight the theme that is developing (though take particular note of the language used);

While it is illegal to give drugs with the deliberate intention of ending someone’s life, doctors may administer morphine or other medication to relieve pain or distress which may have the effect of shortening life – so-called deep sedation

…

Those who described themselves as very or extremely non-religious were about 40% more likely to sedate than religious doctors, the study in the Journal of Medical Ethics reported.

So you see, those ‘very or extremely non-religious’ types (is that even coherent?) are clearly much more benign than their religious counterparts, since they’re generally much more eager to reach for the sinister sounding, and death inducing, ‘deep sedation’.

The GMC also advises that discussions surrounding end-of-life care, including issues such as tube-feeding, hydration and resuscitation, which can all cause avoidable distress, be started with those who are terminally ill well in advance of their dying days.

…

Being very or extremely religious was also associated with significantly fewer discussions of decisions with patients around treatment at the end of life.

With the obvious implication that religious folk are for some reason hostile to end-of-life care, here highlighted as including such evidently benign procedures as tube-feeding, hydration and resuscitation, though quite why they would be hostile to such procedures is left unstated, primarily because it is patently ridiculous (though I reckon there might be a few ‘very or extremely non-religious’ doctors that might judge such procedures a waste of time and reach for the sedation syringe instead). Clearly, it would be much truer to say that religious people are not generally as willing to take measures to ‘hasten the death’ of their patients, probably because they rather reasonably think that that would be a pretty lousy definition of ‘end-of-life care’ – but the complete lack of nuance is instructive.

More than 12% of the doctors surveyed described themselves as very or extremely religious, compared with just over 6% of the UK general population – as documented in the last national survey of attitudes.

However one in five described themselves as very or extremely non-religious, slightly higher than the general population.

The merest glance at that social attitudes survey is enough to suggest that the question of religiosity is not so black and white as that statement would appear to suggest.

The survey showed that specialists in the care of the elderly were more likely to be Hindu or Muslim than other doctors, while palliative care doctors were slightly more likely to be white and Christian.

Gosh, how terribly inconvenient. That doesn’t fit in with the narrative at all. I know, let’s just ignore it and quickly move on.

The British Medical Association said: “Decisions about end-of-life care need to be taken on the basis of an assessment of the individual patient’s circumstances – incorporating discussions with the patient and close family members where possible and appropriate. The religious beliefs of doctors should not be allowed to influence objective, patient-centred decision-making. End-of-life decisions must always be made in the best interests of patients.”

One gets the distinct impression that that comment is not aimed at the 20% of ‘very or extremely non-religious’ doctors who are 40% more likely to ‘deep sedate’, or to ‘hasten the death’, of their patients. Funny that.

Dr Ann McPherson of the charity Dignity in Dying…

Neutral commenter, then…

added that while there was growing awareness of the need to put patients’ wishes first…

Well, that and the small matter of the law, and such terribly inconvenient things as, y’know, medical ethics and stuff.

…the fact that some doctors are not discussing possible options at the end of life with their patients…

is killing them really a possible option?

… on account of their religious beliefs is deeply troubling.

The fact that some doctors, on account of their ‘very or extremely non-religious’ beliefs, appear to be rather more trigger happy with the ‘deep sedation’ drugs (‘which may have the effect of shortening life’, natch), is rather more deeply troubling.

“Whilst entitled to their beliefs, doctors should not let them come in the way of providing patient-centred care at the end of life.”

Hear Hear!, Ann ‘let doctors kill their patients’ McPherson. And right back at you.

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