By Dr. Peter Saunders
Editor’s note. Dr. Saunders is a former general surgeon and CEO of Christian Medical Fellowship, a UK-based organization with 4,500 UK doctors and 1,000 medical students as members.
The news broke last week that more than 5,000 cancer patients will be denied life-extending drugs under plans which charities say are a ‘dreadful’ step backwards for the NHS.
If, in addition, assisted suicide is legalized in Britain – and Rob Marris’s Assisted Dying (No 2) Bill is to be debated this coming Friday – then it would also leave vulnerable cancer patients being steered toward suicide as a cheaper ‘treatment option’.
The Cancer Drugs Fund was launched in 2011, following a manifesto pledge by David Cameron, who said patients should no longer be denied drugs on cost grounds.
Since its launch four years ago it has benefitted more than 50,000 patients, who received treatment which NHS rationing bodies had refused to pay for.
But now the fund’s budget is massively overspent.
Health officials have just announced sweeping restrictions on treatment, which will mean patients with breast, bowel, skin and pancreatic cancer will no longer be able to receive drugs funded by the NHS.
In total, 17 cancer drugs for 25 different indications will no longer be paid for in future.
The decision means that in total, two thirds of all treatments which were paid for by the scheme will no longer be paid for by the NHS.
Drugs which will no longer be funded include Kadcyla for advanced breast cancer, Avastin for many bowel and breast cancer patients, Revlimid and Imnovid for multiple myeloma, and Abraxane, the first treatment for pancreatic cancer in 17 years.
Note that these are drugs with proven therapeutic effectiveness.
Mark Flannagan, Chief Executive of the charity Beating Bowel Cancer, said
Nothing has changed in terms of the clinical effectiveness of these treatments. They remain as clinically effective now as they were when they were added to the list of funded drugs.
There is also a much darker side to this move as we learn from the experience of the state of Oregon, where assisted suicide was legalized in 1997.
Barbara Wagner had recurrent lung cancer and Randy Stroup had prostate cancer. Both were on Medicaid, the state’s health insurance plan for the poor that, like some NHS services, is rationed.
The state denied both treatment, but told them it would pay for their assisted suicide , although they had not even considered the latter and did not ask for it.
‘It dropped my chin to the floor,’ Stroup told the media. ‘[How could they] not pay for medication that would help my life, and yet offer to pay to end my life? ’(Wagner eventually received free medication from the drug manufacturer. She has since died. The denial of chemotherapy to Stroup was reversed on appeal after his story hit the media.)
Despite Wagner and Stroup’s cases, advocates continue to insist that Oregon proves assisted suicide can be legalized with no abuses. But the more one learns about the actual experience, the shakier such assurances become.
If AS [assisted suicide] were to be legalized in the UK end-of-life care would be likely to worsen under financial pressures because it costs on average £3,000 to £4,000 a week to provide in-patient hospice care, but just pounds to pay for the drugs which would help a person commit suicide.
Cancer treatments like chemotherapy, radiotherapy or surgery cost much more. Do we really wish to place that temptation before families, NHS managers and Health Secretaries in cash-strapped Britain?
Because if we pass this law this is exactly what will happen. Assisted suicide will be costed just like any other ‘treatment’ and will be assessed alongside other ‘options’ for ‘cost-effectiveness’. And vulnerable cancer patients will be steered toward suicide.
Doctors will then be left in the terrible position of having to present assisted suicide as an affordable ‘treatment option’.
‘I’m afraid you have breast cancer. There is a drug called Kadcyla, which we used to prescribe to around 800 women a year. It has been shown to extend life by an average of six months, with fewer side effectives than any alternatives. But this drug is sadly no longer funded. We can however pay for your assisted suicide as it is so much cheaper.’
This is just one of the consequences of legalizing assisted suicide.
You will find much more information on why we should not change the law in a paper published this week by Care Not Killing: ‘Don’t Make Oregon’s mistake: Ten reasons why England and Wales should not follow suit and legalize assisted suicide’.
This appeared at pjsaunders.blogspot.com.