Manx Herald Isle of Man News

The next public meeting of Positive Action Group (P A G) is on Monday 1st November 2010 and will consider the provision of N H S dental care.

Speaking will be Colin Partington, former Chair of the Isle of Man Dental Association, who has some controversial views about NHS dental provision here. He is convinced that the system is currently an expensive nonsense and that it could be vastly improved for half the current cost.

Health Minister, David Anderson, has announced consultation for a new ‘Oral Health Strategy’ which aims to set the direction for the next five years in terms of preventing tooth decay. It also focuses on modernizing primary care dental services.

As usual P A G encourages members to respond to such consultations and believes that presenting an alternative view may assist in providing a more balanced perspective.

Many will remember the controversy over government's ill fated fluoridation proposals so the chance to exert an influence on the proposed Oral Health Strategy is welcome.

Those people who have heard Mr Partington on local radio will know that he presents his ideas in a forthright manner which will ensure a lively debate.

Roger Tomlinson of P A G stated: “Government claims that the proposed Oral Health Strategy is a vision for a patient led and accessible Island dental service. With his committed views on NHS provision Colin Partington will put the strategy under severe scrutiny. We want to encourage the public to make informed submissions to the consultation process. After all, if adopted, it will be in place for the next 5 years. Let’s make sure it is people-centred. Fluoridation of our water, as a means of reducing tooth decay in children was a hot political topic only 2 years ago and the public rejected it. With the publication of a new Strategy we all can contribute to framing something that will be more acceptable. Practising dentist Colin Partington’s wise words will help us decide I’m sure”.

As ever this P A G Public Meeting - in the Manx Legion Club, Market Hill, Douglas, starting at 7.30 pm, Monday 1st November 2010 - is open to everyone and all are welcome.

Link: www.positiveactiongroup.org

Normal 0 MicrosoftInternetExplorer4 st1\:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman";}

The Positive Action Group’s first event of the new political season (Monday 27^th September 2010) was as expected a lively affair with a clear split in the views of the two guest speakers and the large audience of well over 100 people.

Jo Cartwright, Campaigns and Press Officer for the organization Dignity in Dying, made an impassioned speech in favour of a change to the existing law, citing both personal and well documented cases - including the Diane Purdy case - in support of her stance.

She pointed out it is feasible to make it possible for people to choose the time of their death and to obtain the help they need without the ‘assisting’ person being prosecuted.

She dismissed arguments a change would lead to a massive increase in assisted deaths and onto the slippery slope of people being pressurized into dying for the convenience of others.

She pointed, among others, to the experience of Oregon, in the USA, where the practise is permitted, and the small number of people actually going through with the process relative to the number who express an initial interest in ending their lives at a time of their choosing.

Responding to Ms Cartwright’s presentation, Peter Murcott, a retired lecturer in law and Methodist lay preacher, said having listened to Ms Cartwright he more confused then ever. He surmised Ms Cartwright was proposing either the repeal or amendment to the Suicide Act to allow an intention to kill or, at its basest level, murder; and he just couldn’t see this being allowable.

He pointed out the Queen is required to uphold the law and takes an oath to up hold the Laws of God; and, therefore, no legislature could present to her an act for Royal Assent that would conflict with the word of God.

He said he wasn’t interested in arguments from people who say they do not believe in god as it is not an issue of who has more votes it is a more fundamental issue than that.

Mr Murcott went on to say it would not be possible to meddle with the law and frame any proposed legislation that would not, in time, “run out of control” - as has been the experience with other originally good intentioned legislation.

He pointed out in the previous Manx Bill a clause had even been weakened by removing the word ‘unbearably’ before suffering in the wording.

He referred to the German experience in the 1930’s and 1940’s when initially very desperate cases were put forward for euthanasia but eventually it snowballed and ran out of control.

As a further example to support the premise the situation would run out of control he stated that as a result of the legalization of abortion the equivalent of the population of Ireland has now been “disposed of”; and the ‘victims’ of this law hadn’t even had a choice or a chance to live.

In his opinion a further unintended consequence of a change to the legislation would be a loss of trust in the medical profession, with groups of people becoming fearful of visiting a doctor.

Emphasizing his strong religious beliefs and principles he said you cannot get people into heaven by breaking the word of God. He recounted a recent experience of someone he visited dying in Hospice, who he said he was able to reassure spiritually, of being able to die in peace.

Therefore, in finishing he said he rejected the act of ‘dying in disobedience’ but believed in ‘dying with assurance’.

P A G’s Roger Tomlinson then opened the debate to the floor for comments and questions.

Tristram Llewellyn-Jones stated he was against the idea of “state regulated death” but wondered about the potentially contrary position in human rights regarding the ‘right to choose’ and the ‘right to life’ and asked what the current legal position is.

Ms Cartwright said a judgement had been made in the Purdy case but it was not an argument her organization is using. She pointed out people are already attempting suicide alone and their proposal would allow them to consult with a medical team; and perhaps they could help the person find an alternative to suicide.

Mr Murcott said it was never intended that Human Rights would introduce a ‘right to death’. He pointed out the Director of Public Prosecutions has no right to over rule the law, and has not done so, but he has laid out the procedure used when contemplating a case. He explained in every case a decision has to be taken whether the law has been broken but thereafter discretion is allowable as to whether a prosecution is in the public interest, which is the issue in question, he said; and some guidance has been issued on this.

David Talbot was concerned about the law of unintended consequences and feared a change in the law would move the focus to what the family wanted rather than the patient.

Henry Ramage suggested people are already being killed by the medical profession through the withholding of treatment, particularly cancer drugs.

Along similar lines, the Manx Herald has been contacted by many people concerned about the use of the controversial ‘Liverpool Care Pathway’ in the Island, and has also received a number of allegations regarding the neglect of patients needs which could or may have contributed to ‘premature’ deaths; a subject which the Manx Herald will return to in future reports.

Mr Murcott said he would have to consider the matters raised by Mr Ramage further as he had insufficient knowledge of the facts to comment. However, from what he had heard he didn’t think the law, as it stands now, is being infringed.

Andrew Dixon introduced another aspect into the equation, that of economics. He said there is an economic issue involved in the end of life – the get rid of granny argument he added – as the number of elderly people grows. However, he said, who should be the person who is empowered to make that end of life decision. “You”, was his response, as only you would know if you wanted to live or die. He went on to emphasize the economic issue will boil to down not having the drugs, the cash, the will to extend life indefinitely.

Another audience member said his wife is a Christian and believes in a compassionate Lord and doesn’t believe if she chooses to die she would be denied entry into heaven. I any case the situation now is much different to that appertaining at the time of Nazi Germany.

Reverend Frear told the audience he is the Chaplin at NoblesHospital and wished to reassure the audience all patients at NoblesHospital are treated properly and with kindness and understanding. He also saw considerable merit in the argument a change in the law will lead to the ‘slippery slope’ scenario and thus urged caution in how the matter is progressed.

Ms Cartwright responded by quoting the experience of Oregon where it is has proved not to be a slippery slope and in any case she said a ‘sunset clause’ could be added to any legislation to give an opportunity to reassess the situation. She reiterated that she couldn’t see why people should be denied the chance to decide.

The issue of people changing their mind was raised by a contribution from the audience; to which Ms Cartwright replied it was up to the individual to decide whether to make an ‘advance decision’ and this was probably the bigger issue rather than the small chance of someone wanting to change their mind. However, safeguards would be built in, including cooling off periods.

Mr Murcott referred to a case where someone had effectively changed their mind by blinking an eye, so in his view this is an issue that can not be ignored.

Colin Bendall said there is a third side to the issue that had probably been overlooked so far that of the people who carry out the procedure. He pointed out doctor’s already suffer the third highest suicide rate and, they are there to look after life not extinguish it. Therefore, is it fair to put further pressure on doctors if there is no member of the family to do it, he asked.

Ms Cartwright responded by saying assisted dying is about the patient taking medication not someone else administering it. The only participation of a doctor would be to issue the prescription; and any legislation would include an opt out clause for doctors not wishing to participate.

Mr Murcott was not persuaded by this argument and said he was very interested in this ‘conscience’ clause; but stated it was “worthless”.

He went on to explain his reasoning as a doctor opting out would have to refer the ‘patient’ to another doctor; thus becoming a statutory procurer and ultimately, even by best endeavour, implicated in any resulting death. Refusal to refer could lead, he said, to referral to a disciplinary panel and even loss of their job; and so the clause would “not be worth the paper it was written on.”

A possibly tongue-in-cheek retort from the floor suggested doctors could, if necessary, be removed from the issue by allowing lawyers or even undertakers to issue the prescription.

The final contribution from the audience commented on the point raised earlier about the elderly and infirm being made to feel unwanted and a burden on the family; and if that is the case what does it say about the society we have.

Mr Tomlinson, before asking Dr Garland to close the meeting with a few words, reminded the audience previous P A G public debates had acted as a catalyst for the formation of new organisations such as TravelWatch IOM. He said he was aware of group of individuals that were keen to keep this issue moving forward and anybody interested in attending a meeting was welcome to get in touch with him for further details.

(During the evening Rushen MHK, Quintin Gill informed the audience the subject is still on his political radar, and some of his colleagues, and the matter would be resurfacing in some form or other in due course.)

Dr Garland, wearing his heart on his sleeve, was quite humorously scathing of some of the religious dogma he had heard during the evening and his time at the hospital; although he acknowledged that the views were genuinely expressed. Whilst clearly dismissive of the thought you have to wait for god to be ready for you, he thanked the two speakers, and the audience, for their attendance and their contribution to the debate.

A copy of the powerpoint presentation made by Ms Cartwright can be viewed on the P A G website www.positiveactiongroup.org