GP at centre of suicide row suspended

CAMPAIGNERS yesterday called for a change in the law to allow patients to ask for help to end their lives, after a Scottish GP was suspended for prescribing sleeping pills to an elderly woman so she could kill herself.

Dr Iain Kerr, a family doctor in Glasgow, was found guilty of misconduct after prescribing the pills to an elderly patient with osteoporosis, who went on kill herself using other drugs.

Yesterday, the General Medical Council (GMC) suspended the 61-year-old from practising medicine for six months after a two-week hearing in Manchester.

Campaigners said the case highlighted the "moral ambiguity" surrounding cases where a patient asks for help to end their life.

But the medical profession stood firm, saying the role of doctors is to protect the vulnerable and give all patients as good a quality of life as is possible, rather than helping them to die.

Dr Kerr prescribed 30 sodium amytal sleeping pills to the former businesswoman in 1998 after she told him she had considered suicide.

His actions go against the Hippocratic Oath, the classical principles to which doctors should adhere in their treatment of patients, which includes the statement: "I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect."

The GMC found that the Glasgow GP's fitness to practise was impaired and branded his actions "inappropriate, irresponsible, liable to bring the profession into disrepute and not in your patient's best interest".

Dignity in Dying, which campaigns for better access to palliative care and a change in the law to allow mentally competent terminally ill adults in unbearable suffering to have the option of an assisted death, expressed concerns about Dr Kerr's case. Its spokesman, James Harris, said: "We do not condone anybody taking the law into their own hands and we are greatly saddened by this case."

Scottish group Friends at the End (FATE) also campaigns for a change in the law to allow doctor-assisted suicide so that patients who wish to can end their own lives with dignity. Yesterday, they expressed sympathy for the position in which Dr Kerr found himself. Spokeswoman Sheila Duffy said: "It is sad to witness an obviously well- respected and compassionate GP being dragged in front of the panel to justify his actions towards an 87-year-old patient who plainly knew her own mind and wished to end her life."

Margo MacDonald, the MSP who suffers from Parkinson's disease and joined the debate on assisted suicide when she told the Scottish Parliament she wanted the right to end her own life, welcomed the news that Dr Kerr had not been struck off the medical register completely.

Suzanne Goddard, QC, counsel for the GMC, said that what Dr Kerr did was "akin to handing her a noose with which to hang herself at a time of her choosing".

The woman, who was identified only as Patient A, later disposed of the sleeping tablets that Dr Kerr gave her because she did not want to get the GP into trouble after learning he was being investigated by health chiefs for his views on assisted suicide.

Police took no action against Dr Kerr after finding there was "insufficient evidence".

Speaking after the hearing, an emotional Dr Kerr thanked family, friends and his wife for supporting him.

FACT BOX

• At present, there is no legislation in Scotland covering suicide. Anyone who assists another person in a successful suicide or a suicide attempt is usually charged with culpable homicide.

• In England and Wales, such an action would be covered by the Suicide Act 1961, which prohibits assisting suicide.

• The British Medical Association (BMA) is clear in its opposition to such actions. Dr George Fernie, a member of the BMA's Scottish Council, said: "In 2006, the BMA voted against legalising physician-assisted suicide and euthanasia. The primary goal of medicine is to promote welfare, protect the vulnerable and give all patients as good a quality of life as is possible."

PROFILE: Caring family GP who 'handed woman a noose'

TWO differing pictures of Dr Iain Kerr have been painted during the past two weeks.

On the one hand he has been described as an amazing GP, caring and professional in his dealings with patients.

On the other, his actions in prescribing sleeping pills to a suicidal patient were described as "akin to handing her a noose".

Dr Kerr graduated from Edinburgh University in 1969. The father of three has a practice at the Williamwood Medical Centre in Clarkston, Glasgow. During the GMC hearing, there were several testimonies from colleagues in praise of Dr Kerr.

One consultant, who had known the GP for 28 years, said he would be delighted if Dr Kerr cared for one of his relatives.

And even the son of the patient to whom he was found to have wrongly prescribed sleeping pills said his mother had held Dr Kerr in high regard. The woman's carer said she had considered him "a great doctor".

But the GMC hearing revealed the doctor's interest in assisted dying. Dr Kerr informed police he had lied to patients about being a member of the Euthanasia Society.

He also told police: "In Holland and Sweden, I think, you can legally commit suicide and I would find it difficult to say their attitude is completely wrong."

Dr Kerr told officers that during his NHS appraisal in May 2004 he had admitted he was "in favour of assisted suicide and had some experience of it."

ANALYSIS: Balancing act between duty of the medical profession and patient need

ASSISTED suicide is where another person provides the means for an individual to end his or her life, such as a doctor providing a prescription for a large amount of painkilling drugs.

There is much debate about the extent to which patients should have the right to ask for help to die when their suffering has reached such a degree that life becomes unbearable for them, or where they feel that their life has reached such a poor quality that it is unacceptable to them.

Many people believe that we should respect the requests of people who are dying to ensure that their dignity is maintained at the end of their life. However, doctors are placed in a difficult position if they are asked by a patient to assist in their death. This goes against all the principles they have been taught about the sanctity of life and their role in preserving life.

There have been attempts to challenge the law to allow some form of assisted dying. Dianne Pretty, who had motor neurone disease, wanted her husband to assist her death without the fear of prosecution. However, the courts found that she did not have a right to choose the manner of her death. In 2006, Lord Joffe's Assisted Dying for the Terminally Ill Bill was rejected by the House of Lords.

One major concern about a change in the law on assisted dying and euthanasia is that it could lead to a slippery slope – the circumstances in which they could be allowed would be extended beyond what was originally envisaged. If you start from the premise that assisted dying is allowed for those who are terminally ill, is there the danger this will be extended to those with unbearable physical or even mental suffering and how are these terms to be defined?

This issue will continue to be debated in the UK, but no change in the law will be a simple process. The recognition given to patient autonomy at the end of life must be balanced with the need to respect vulnerable patients and the professional duties of doctors.

• Carolyn Johnston is adviser in medical law and ethics at King's College London, School of Medicine.

THE HIPPOCRATIC OATH

I swear by Apollo Physician and Asclepios and Hygeia and Panacea and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant:

To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine...

I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.

I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art...

Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.

What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.

If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.