Should doctors decide the time to die?

Do you believe doctors have the right to deny treatment to patients without consulting them first?

Cancer patient Jill Baker, 67, discovered doctors had no plans to revive her if she became unconscious by interpreting code written in her medical note.

Age Concern says that Mrs Baker is not alone, and that many elderly patients are written off by doctors who make no attempt to discuss treatment options.

Even the British Medical Association admits that in some cases doctors are too embarrassed to tell patients that, in their opinion, it may not be worth trying to resuscitate them.

Is it right that doctors play god in this way, and have you or your relatives had first-hand experience of such treatment?

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Your reaction

With the best will in the world, a doctor cannot know everything. Deciding for someone else the right time to die is to take on the role of God, and any sane human being ought to back away from such a weighty responsibility. Better to allow a patient to decide for themselves, even though there are intense moral views on that topic also.
Paul R, UK

The arrogance of doctors nowadays is akin to that of politicians and bankers.

James Larkin, Australia

The arrogance of doctors nowadays is akin to that of politicians and bankers. Once they were a trusted cornerstone of society but now like most other previously honourable institutions they are not truly respected. This new generation of doctors reflects a cold business approach to things medical and lacks the kindness and compassion of their previous generations.
James Larkin, Australia

I have to laugh when I hear people complaining about doctors "playing God". It is amazing that the public really do say what suits them: if a doctor makes a decision which the patient doesn't like, s/he is accused of being "God-like", yet as soon as the doctor makes a mistake, the patient (and probably Government) will say that doctors should know better, and should never make mistakes, i.e. be like a God! Hypocrisy reigns!
DH, United Kingdom

I am saddened by the views I have read on this page. You deride doctors although you have little idea of what our work entails. We are scientists, and our treatments are based on something like this: study A shows that patient B will have a C percent chance of recovery from disease D if treated with E. Unfortunately, patient B does not exist - we realise that all patients are different. This is the art of medicine. We are not robots.
Do you really think we would put up with being doctors if it was for some sort of power craze or for the money. We actually do care about our patients and want them to get better, and we also want a better NHS. Please work with us, not against us!
Dr Paul Davison, UK

Doctors should stick to their Hippocratic oath and NOT play God, regardless of what the HMO or the Hospital says. Only the patient or his/her legally designated person can and should authorise medical decisions to resuscitate or not. No matter how euthanasia may seem justifiable in certain cases, it is not a decision for the doctor ALONE, or some HMO or Hospital administrator to make. Even with the patient's permission, euthanasia still is not a legal option in many countries (remember Dr. Kevorkian)!
Dr Riz Rahim, USA

I would not put any faith in a doctor's ability to 'over ride' the desires of his/her NHS managers.

R Williams, UK

No, doctors should not make that decision alone. How do we (the patients) know they are not being pressured to make 'room' in an over stretched NHS. Money talks, it always has and distasteful as it seems I would not put any faith in a doctor's ability to 'over ride' the desires of his/her NHS managers. Any doctor whose inaction or instruction 'allows' a patient to die should be liable to prosecution for murder. Nothing short of that threat will give the public back its confidence in the medical profession.
R Williams, UK

So, who does decide, the Hospital Accountant? Increasingly so lately... And doctors already have a excessively inflated image of themselves, if they have the power of decision to determine who lives, who dies. Seems the patient has no say anymore at all, they are now being told essentially to just put up, pay up and shut up. I say, if the patients are physically able to speak at all, their words should be heeded!
Stephen Kenney, USA

Where I live, it is very simple. There are two people who can put a "do not resuscitate" order in my chart. I can or, if I can no longer give informed consent, the person who has my power of attorney can. By law, the health care provider cannot have my power of attorney, nor can he/she even act as a witness on the document. Under California Probate Code section 4703(a) all generic power of attorney forms must say "...you have the right to make medical and other health care decisions for yourself so long as you can give informed consent...no treatment may be given to you over your objection, and health care necessary to keep you alive may not be stopped or withheld if you object at the time." Respect for basic human dignity demands nothing less.
Mark Allen, California, USA

With regard to the comments made by Dr.S, UK. What can I say? I am thoroughly disgusted that any member of the medical profession has the absolute cheek to think that he or she has the authority to put a 'worth' on the life of another human being. "the patient should stick to what they do best" what kind of comment is that? Surely if a patient could do this at all times they wouldn't be in hospital at all! I only hope that Dr. S is confronted by enough hindrances to make him/her realise that they are in the wrong line of work. How about a little human feeling?
Emma, Wales

As a physician in the US specialising in intensive care medicine, I am familiar with both the frequent futility of heroic efforts to preserve the quality of life even after the body is kept alive as well as the inability of doctors to always know the outcome. Let the patient, the family and the doctor talk through all the options so that whatever can be done will be done to preserve the patient's life as she or he chooses to live it. Each one of us should have this conversation well before we are whisked through the hospital's doors.
Jack Kilcullen, USA

All this hysteria about the NFR comment being like playing God is a little bizarre. It is an acceptance by the doctor that God is ultimately going to win.

Dr Chris Baddon, UK

All this hysteria about the NFR comment being like playing God is a little bizarre. It is an acceptance by the doctor that God is ultimately going to win and that trying to prolong the game IN THIS CASE is only going to lead to prolonging suffering.
Resuscitation sometimes causes trauma to the body: broken ribs from cardiac massage, electrical damage to heart muscle, not to mention feeling like every muscle in your body has been pulled (after the convulsive jolt of the electric paddles made them all contract at once). A frail patient who is terminally ill or suffering a poor quality of life does not stand to benefit from the hammering a resuscitation requires.
While I broadly agree with Mr Walker's comments, I would caution him not to mistake arrogance for bearing the burden of a clinical decision as to when it is kindest to give up and what subjects to broach in the doctor patient relationship. In my experience "NFR" status DOESN'T mean halting any available treatment for the condition, DOESN'T mean "we don't care" and is reviewed daily anyway.
Dr Chris Baddon, UK

Many of the comments in this section, talk of a dignified death and the 'right' for someone to decide they want to die. Surely there is no dignity whatsoever in being overdosed with morphine - isn't this the same as suicide? Personally I am all for pain relief - but there is a very wide range in pain relief - and this is surely being abused!
Kenny, Scotland

I'd agree with doctor S if I believed that doctors were as well educated as they used to be. Unfortunately, it has become very easy to obtain ones doctorate and as such the people in the profession cannot be trusted to make the correct decisions. I would suggest that the public take what their doctor says with a very large pinch of salt.
Dr . T, UK

There seems to be some confusion as to what "do not resuscitate" means. It means if the patient dies, do not try and bring them back to life.

Chris, UK

There seems to be some confusion as to what "do not resuscitate" means. It means if the patient dies, do not try and bring them back to life. Most patients noted for "do not resuscitate" are still marked "full active treatment" which means that if their condition deteriorates or they are uncomfortable and in pain, they should receive all possible treatment. The "do not resuscitate" literally means only that; when the patient is dying, don't have their last moments involve having needles pushed in to them, electric shocks applied etc. Programs like Casualty and ER have given the public the false impression that everyone who goes into re-sus will miraculously be saved and walk out of the hospital at the end of the episode. In reality, very few patients live more than a week after being resuscitated. Most people do not seem to appreciate the reality of what resuscitation involves or the likelihood of it doing anything other than prolonging suffering. I am not a doctor, but I felt it was important I find out a bit more about this subject before commenting.
Chris, UK

Last paragraph - DR. S. U K; I beg to differ, if I had an incurable illness and really suffering with no hope, I would definitely would want to go. So Dr s. I feel you are a little arrogant in your attitude and life.
Sheila, South Africa

So someone is not worth reviving at 66? What does a junior doctor in his/her early 20s consider "Elderly"? What is the medical cut off date for letting people die? I'd like to know because I'm currently 53 and if I go into hospital I'd like some idea of whether I'm likely to be coming out again.
Keith Chamberlain, UK

We live in a world that is losing its ethics, and compassion.

Dave Adams, USA

No doctor has the right to decide when any person should die. We are slowly moving towards legalised murder. We see it in capitol punishment or the death penalty. We see it in legal abortions. Now, we are going to see it for people who are old or not able to contribute much toward society. We are a society without a soul. And, perhaps, that is why kids are killing kids, handguns are out of control, and nations make bio-chemical weapons and missiles to send them to their targets. We live in a world that is losing its ethics, and compassion.
Dave Adams, USA

Doctors are not God. The right to life must be pursued in all circumstances. Everybody has the right to have life, resuscitation should be mandatory. Nobody should die as a result of a doctor deciding they should. And for any doctor that terminates treatment for any reason other than the patient has died, they should look hard at themselves and think they have broken one of their oaths as doctors: that of maintaining and enhancing life.
Rameen John Ghobadian, UK

We find it difficult to accept that death is inevitable and sometimes a relief.

Vinod Dawda, UK

We find it difficult to accept that death is inevitable and sometimes a relief. Just as we like to think man has no right to take life why can't we think man has no right to prolong life when all that is left is a shell without any dignity? We seem to be quite happy to kill a horse with a broken leg if it does not serve any purpose. Ask the elderly who have very rare and brief visits from their 'loved ones' and ask the 'loved ones' who rarely visit their elderly what they feel.
Vinod Dawda, UK

By forsaking the Hippocratic oath, doctors appear to be swearing by a different oath altogether - the Hypocritical Oath.
Ed Bayley, USA (English)

The fact that we have the technology, medicine and skills to intervene when nature would dictate that we should die, means that society should accept that the medical profession is already playing God.
Peter Casey, England

Now I know why some doctors go into medicine; they're too heartless, arrogant, and selfish to make it as a veterinarian.
Charlene, Canada

Thank goodness for the honest doctors who are still around.

Geraint, UK

Dr S clearly feels he IS God!! Poor soul. I have spent many sad, distressing hours with my wife who has been suffering with Malignant Melanoma for 22 years. Over this time we have repeatedly discussed the issue of death, and have spectated as doctors have agonised over what to say to us. Thank goodness for the honest doctors who are still around.
The bottom line is that no doctor has the right to play God, without the full knowledge of those people involved. It is the duty of the doctor to relieve suffering, but this should only be done when the patient and close relatives have been involved in frank, but often painful discussions. Most patients want to die with some dignity, and with some modicum of control over their own destiny.
Geraint, UK

If a fully qualified doctor can substantiate that the quality of the patients life is beyond recall, then I believe the use of euthanasia (because that is what we are talking about) can be administered, but only with the patient's and the patient's family's consent. Both my mother and father in their final hours had lethal doses of morphine administered, in order to die with dignity and relief of incredible pain.
Derek, ex-pat, Brazil

The hospital and the Doctors pre-decided that my mother had reached the "right age" and reduced their care and attention accordingly.

Ian, UK/USA

My mother died in an English hospital a couple of years ago. She was 81 (many would say a good age). Like many, older people, she had some medical issues but was suddenly rushed to hospital because she had a respiratory problem. My relatives called me, in America, to inform me and I asked a question about what the Doctor had to say. Their answer, Ian what Doctor? We have only seen nurses.... BR> Over the next 24 hours, before I could get to the UK, my mother suddenly got worse and died. During all this time my relatives continued to get "information" at the hospital from nurses and NEVER saw a Doctor. Without a doubt, the hospital and the Doctors pre-decided that my mother had reached the "right age" and reduced their care and attention accordingly. It also was clear this was such a widespread behaviour pattern that even relatives expected never to see a Doctor or have one involved directly in the care of an elderly patient despite the gravity of the situation.
Ian, UK/USA

I would say it is arrogant for patients and relatives to assume that they are in the best position to make educated decisions in subjects about which they have the faintest understanding.

Sajid, UK

I have to agree with Dr S. I'm not a doctor or in any way medically qualified but the public in the UK is in general very ignorant on medical matters. I would say it is arrogant for patients and relatives to assume that they are in the best position to make educated decisions in subjects about which they have the faintest understanding.
This level of scientific ignorance cannot be dispelled in a few minutes by even the best of doctors. People should either realise their limitations or stop wasting their lives on soap opera's and sport and start reading about medicine and science!
Sajid, UK

My mother died seven months ago after slipping into coma. Doctors took her off oxygen and told us to take her home where she will die in a few days time.
Driven by nagging from nurses that they do not want to take care of a comatose patient, doctors drove her to death.
New rules have been drawn by the new generation of doctors. The doctors have forgotten their oath.
Most of the time doctors are just guessing to save a patient's life. How can they be sure that a patient is going to die and therefore must help him/her die ?
Rajan, Canada

If we allow doctors to have a free reign, without sufficient safeguards, then we might be on a slippery slope to allowing doctors to make judgements on the value of life for their patients.

David Fetteroll, UK

There is an important principle about the value of life and the importance of the elderly in this issue. If we allow doctors to have a free reign, without sufficient safeguards, then we might be on a slippery slope to allowing doctors to make judgements on the value of life for their patients. This would be against the interests of not just the old but of all those who are ill.
David Fetteroll, UK

Not doctors, I think the patients should decide if they must die or not. What is the meaning of let the person suffer for even months when he or she can make all the moral and biological pain vanish in only a few seconds?
Juliana Albuquerque, Brazil

I have written into my medical folder the following: No heroics; do not resuscitate. When it is time to go, GO.
Geald W. West, U.S. of A

Stress, overwork and 72 hour shifts are no excuse for denying someone's right to life.

Jim, UK

In relation to Dave's comments on not prolonging his own suffering should - God forbid - that ever occur, I agree entirely and have been asked by older members of my own family to ensure as painless as possible a passing when the time goes.
But the point here is that Doctors are not giving patients that choice, and for that they must be condemned utterly. Stress, overwork and 72 hour shifts are no excuse for denying someone's right to life.
Jim, UK

I think that being allowed to die with dignity is a wonderful thing. I know I would prefer this option to losing all quality of life because of illness.
Neil, UK

My family and I were treated very sympathetically by the doctors at the hospital to which my 78-year-old father was admitted.

Colin Smith, UK

In response to many of the negative comments here, I would just like to say that my family and I were treated very sympathetically by the doctors at the hospital to which my 78-year-old father was admitted.
When things became difficult for him we were fully consulted about the resuscitation process and given all the options. It was something we had discussed with him beforehand and although he pulled through, we were fully prepared for the question.
Quite simply it is the inability of any given doctor to deal with the family that prevents them from consulting. I would not like to do the job myself, but then that is why I would never seek to become a doctor myself.
Colin Smith, UK

Even Dr. S will eventually become old and sick. Under those circumstances I wonder which doctor will know best? Dr. S's attitude to patients may reflect a much more common detachment amongst medical practitioners in the UK.
Malcolm McCandless, Scotland

The duty of a doctor lies in communicating as clearly as possible to those involved what the prognosis is and in language that can more easily be understood by the ordinary person.

Graham Walker, UK

The comments from Dr S (presumably the full name is omitted as he hopefully is too ashamed to own up to his comments) certainly reinforce the idea that doctors are far too arrogant in their dealings with patients. Clearly there can be a case made against resuscitation in many cases but the final decision must rest with the patient or those close to them if the patient is not in position to express an opinion. The duty of a doctor lies in communicating as clearly as possible to those involved what the prognosis is and in language that can more easily be understood by the ordinary person. In that way, the decision can be made on the basis of sound information. The worth of any particular life is not defined in any medical text book. Whether an individual wishes to continue living, for however short a time, and however physically compromised they may be, is for them (and, some would say, God) to decide. I suggest Dr S reflect on the content of his Hippocratic oath before letting himself loose on his unsuspecting patients again.
Graham Walker, UK

Sorry, Dr S, but, yes, you do sound extremely arrogant and self-righteous and, unfortunately, represent exactly the worst of the NHS about which everyone is moaning. Of course no one but the patient and his or her family can make a judgement on their quality of life. Your job as a doctor is merely to advise what you feel the outcome of any situation is likely to be and, even then, you might be wrong. The case which came up today, anyway, refers to a woman who was 'written off' by a doctor who had never even seen her! Clumping an age group into the same category is a big mistake. I'm over 50, but I have a very positive view of live, am told I look a lot younger, work out every day and am married to a man 20 years younger, and he would be outraged if he felt that my age mitigated against my receiving the best treatment - and yet, that happens even to people in my age group. Live and let live - precisely!
C O'Neill, UK

How can Doctors know best when they are pressurised by nursing staff to take quick decisions and without consultation with patient or relatives. This is plainly immoral. It is disturbing that such a culture has become institutionalised within the NHS and with the full knowledge of the General Medical Council. Whistle blowers within the service have simply been silenced in a cloak of secrecy. Its high time the guidelines that exist are implemented and all patients treated with equality.
John Nevitt, England

Surely if God decides the day and time of death, resuscitating them would be going against the wishes of God.

Simon, England

Germaine Bonnet contradicts herself - surely if God decides the day and time of death, resuscitating them would be going against the wishes of God. We already have an ageing population, their lives supported by ever advancing medicines and drugs. If nature takes their life, maybe we shouldn't be trying to prolong it... If this were to happen to someone I know, I'm sure I'd be singing a different tune though.
Simon, England

Clearly people of any age should not be allowed to die to save money. Equally, we have to remember that dignity in dying is very important, and that it may not always be appropriate to use the whole gamut of medical technology to increase quantity of life at the expense of quality. Such a decision should rest with the patient primarily, but there may be occasions when it rests with the doctor in charge of the patient's care. We have to have some remaining faith in the professionalism of our doctors.
Robin P, UK

Aren't doctors supposed to be saving lives? They should not trouble themselves to decide who dies when! Let nature take its course. We should attempt to minimise the pain and suffering, but not take away a life to eliminate it. Life is short, and we should be left to experience both joy and pain. It's part and parcel of life!
Ho Jin Cheng, Singapore

This may sound heartless but to all those who have said that only God can decide to let people die, what if God has decided that these people should die by means of not being resuscitated? On a similar point, what if god has chosen that some people should die before birth, and the means of their death is to be abortion? But back to the point in question, it should not be up to a doctor, or even a whole collection of them, to simply dismiss a patient's life. Unless the patient has told the doctors otherwise, all attempts should be made to keep him or her alive, until there really is no more that can be done.
Matt, UK

She said "hang on, because there's something written here: 'do not resuscitate'. What does this mean? Are they going to let me die?"

Germaine Bonett, Malta

My sister was in her last few months of fighting cancer, in America. My heart bleeds when I remember I called her one day and found she had been admitted to hospital, so I called her there, right at her bedside.
She said "hang on, because there's something written here: 'do not resuscitate'. What does this mean? Are they going to let me die?" She was referring to the tablet hung on her bed.
Nobody, I repeat, nobody has any right to let go of a patient like that, let alone write it down. God alone determines the day and time of death and it is so hurtful to both patient and loved ones to think that nobody cares enough to give you the treatment necessary to keep you alive.
I hope I'll never go through that experience again.
Germaine Bonett, Malta

Start with training the doctors and nurses to respect the humanity of their elderly patients.

Tony White, UK

The standard of care for the elderly in our hospitals is appalling. Unfortunately, in my family's experience some private hospitals are hardly any better. I lost my mother to cancer 18 months ago, and the treatment she received in an NHS hospital and its private "offshoot" was disgusting: Cold food, meals missed due to treatment, and no food supplied afterwards to make amends, indifference from staff, and more, towards an elderly woman of 68 suffering from Ovarian Cancer, who deserved some comfort and love in her final days rather than to be treated as an object.
The only time my mother was treated well was in BUPA's own hospitals, but that was before her money ran out. The whole system disgusts me and is well over due for a shake-up. Start with training the doctors and nurses to respect the humanity of their elderly patients. And guess what? This doesn't even cost money!
Tony White, UK

This sends out a horrible message to retired or older people in that a doctor might think that your life is no longer worth living (saving NHS money).
Colin, Netherlands

I would rather be allowed to die. I would not like to be a burden on anyone especially my family.

Dave, UK

If I was dying and there was no cure, or a protracted illness where there would be a good chance I would die I would rather be allowed to die. I would not like to be a burden on anyone especially my family. I would feel the same if very badly disabled as well.
Dave, UK

Only god has the right to decide when people die (Genesis chapter 9). The doctors who lost my father a year ago at least made a show of trying to save him. I don't think we'll ever know in this life whether they were genuine or just good actors, but it was hard enough losing him without the suspicion that the medics had written him off.
Phil, UK

I think that some responsibility must lie with doctors who too often are treated with kid gloves.

Andy Shaw, UK

My Grandma died in hospital just about 18 months ago and I have to say that I was absolutely appalled at the treatment she received when she was under NHS care.
While it may be "ludicrous" to suggest the NHS is directly and wholly responsible for her death, I certainly did not see them making the best effort to care for her in her time of greatest need. Rather she was fed disgusting food, often by staff that couldn't speak good English and we were never given a proper explanation of her illness, why she died and the reasons for the treatment given to her.
I think that some responsibility must lie with doctors who too often are treated with kid gloves, as though they were above reproach. We put great faith in our doctors and fully respect their skills and position. But the culture of denial that exists is going to erode their standing and the trust people place in them.
Andy Shaw, UK

I think I ought to be feeling very worried about the way things will be when I get into my old age.

Mike, UK

The bottom line here is that every person in this country should be given the best chance of life - young and old. It is totally wrong for a doctor to decide whether somebody is "worth" reviving or not. The elderly in this country are given such a bad deal anyway and I think this course of action really is immoral.
I can just imagine somebody finding out that an elderly relative was allowed to die just to save a few quid here and there. Would you be happy about it? I certainly know that I would not be! Suddenly, at the age of 29, I think I ought to be feeling very worried about the way things will be when I get into my old age.
Mike, UK

It seems for some time doctors have seen fit to play at being God. We have machines that extend a person's physical life way past the point at which Nature calls time. It's hardly surprising they've now taken this next step and decided not to make any attempt to assist someone. Funny thing is, euthanasia is still supposed to be illegal on the grounds that it isn't for Man to play God.
John B, UK

Euthanasia is supposedly illegal, but it seems doctors can practise it when they think it is in the patient's best interest, regardless of the patient's wishes.

Jenni, UK

How dare doctors decide to let some patients die whilst others, who wish to die with dignity, are forced to suffer pain, humiliation and unhappiness? Euthanasia is supposedly illegal, but it seems doctors can practise it when they think it is in the patient's best interest, regardless of the patient's wishes.
My father-in-law spent his last two months in hospital, 90% paralysed from a stroke, and was resuscitated 11 times. Every time we visited him he cried and asked to be allowed to die in peace but the doctors insisted it was their obligation to prolong his life.
Jenni, UK

How about this for an amazing idea: That doctors actually ask the patients what course of action they would like taken on their behalf, then respect that wish!
I think there is a standard assumption made by many doctors in this country, that they know best. I'm sorry to disappoint any doctors reading this, but you don't know best. You are there to care for your patient, and that means respecting their wishes to either be kept alive at any cost...or to die if their quality of life is likely to be seriously compromised.
Phil Saum, UK

If, in the doctor's opinion, the patient isn't worth reviving then there must be good reasons for this.

Dr. S, UK

Surely the doctor knows what is best for the patient and his staff? Of course he does. If, in the doctor's opinion, the patient isn't worth reviving then there must be good reasons for this.
Without wishing to sound arrogant, I think the patient should stick to what they do best and allow the doctor to perform his duties without hindrance.
Dr. S, UK