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Controversy about UK assisted dying bill
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Older patients with cancer are not more likely to refuse cancer treatment, compared with younger patients, suggests a new study. Commissioned by Macmillan Cancer Support, the study was conducted on 1504 British adults (aged 55 years and over; 1004 with cancer and 500 without cancer) and assessed the attitudes and behaviours of patients and how they could effect cancer therapy and patients’ experience. In the study, about half of the people, of all ages, with or without cancer, agreed that “the side-effects of cancer treatment are often worse than the disease”. However, for people who had cancer, increasing age (57% of working age people compared with 42% of older retired individuals) meant that they were less likely to agree that treatment’s side-effects were worse than the
disease. Previous research suggested that older people are less likely to receive active anticancer treatment, but this study suggested that when offered irrespective of age, people usually opted to receive treatment— only 2% had opted out of any anticancer treatment. According to this study “there is no significant difference by age group or stage of cancer at diagnosis on the likelihood of people to opt out of a certain treatment”, and “15% of people diagnosed with stage 1 or 2 cancer have opted out, vs 12% of stage 3 and 4, for example”. “We know that older people are less likely to get access to cancer treatment for a number of reasons and hoped this would help us unpick one part of this complex puzzle”, said Jagtar Dhanda, head of Inclusion at Macmillan Cancer Support (London, UK). He added, “Surprisingly the
research tells us that older people are no more likely to turn down cancer treatment than younger people, and worries about side-effects of treatment do not make them more likely to opt out of treatment. It also found that whilst older people are confident in pursuing treatment, they are less likely to question decisions about which treatment might be best for them than those aged 55–64.” Shantanu Panja (Apollo Gleneagles Hospital, Kolkata, India) said, “The issues [of older people] require more understanding because they are a set of population with different set of expectations from life and family”. He commented, “this study is a welcome step in that direction which will help us formulate strategies to fight cancer in this vulnerable age group”.
Lea Paterson/Science Photo Library
Older people not likely to refuse cancer treatment
Published Online August 28, 2015 http://dx.doi.org/10.1016/ S1470-2045(15)00273-9 For the report by Macmilian UK see http://www.macmillan.org. uk/Documents/Campaigns/
Sanjeet Bagcchi
Controversy about UK assisted dying bill Leaders of the major religions in the UK have signed a letter urging Members of Parliment to oppose legislation that would legalise assisted suicide. Introduced by Labour’s Rob Marris (Wolverhampton, UK), the bill proposes allowing doctors to prescribe lethal drugs to terminally ill patients, who make the request of their own volition and are judged to have 6 months or less to live. The House of Commons is due to debate the issue on Sep 11, 2015. “A law based on this assisted dying bill would put at risk many more vulnerable people than it seeks to help”, stated the letter, which included among its signatories the Archbishop of Canterbury, the Archbishop of Westminster, the Chief Rabbi, and the Head Imam of Leicester Central Mosque. The authors raised concerns that if the bill becomes law, patients will
www.thelancet.com/oncology Vol 16 October 2015
“feel under pressure within themselves to ‘do the decent thing’”. They added that the 500 000 elderly individuals who are abused each year, mainly by relatives, would be likely to find themselves facing pressure to end their lives. Oxford University’s Julian Savulescu (Oxford, UK) counters that this eventuality has not come to pass in those countries that permit assisted suicide. “At any rate, that’s a separate issue about how to prevent people from being coerced”, he told The Lancet Oncology. The letter was published in the Observer. In an accompanying commentary Justin Welby, the Archbishop of Canterbury, argued that the prospective legislation would “cross a fundamental legal and ethical Rubicon”. He stressed that the letter was not an attempt to enforce
religious principles on UK legislation. “We are asked to sanction doctors participating in individuals taking steps to end their lives”, wrote the Archbishop of Canterbury. “This is a change of monumental proportions both in the law and in the role of doctors; it is little wonder that it is opposed by the medical profession”. Savulescu points out that European laws preventing suicide have their origins in the notion that a body is owned by the King, who might require it for fighting, and by God. “Most people do not hold those views any more”, he said. “People have the fundamental right to choose when and how they die, and they are going to increasingly ask why doesn’t our society offer us these choices?”
Published Online September 11, 2015 http://dx.doi.org/10.1016/ S1470-2045(15)00313-7 For the faith leaders’ letter see http://www.theguardian.com/ theobserver/2015/sep/05/ assisted-dying-bill-leaders-faithcommunities-letter-against For Justin Welby’s accompanying commentary see http://www.theguardian. com/commentisfree/2015/ sep/05/assisted-dying-suicidebill-justin-welby-archbishopcanterbury
Talha Khan Burki
e483
Older patients with cancer are not more likely to refuse cancer treatment, compared with younger patients, suggests a new study. Commissioned by Macmillan Cancer Support, the study was conducted on 1504 British adults (aged 55 years and over; 1004 with cancer and 500 without cancer) and assessed the attitudes and behaviours of patients and how they could effect cancer therapy and patients’ experience. In the study, about half of the people, of all ages, with or without cancer, agreed that “the side-effects of cancer treatment are often worse than the disease”. However, for people who had cancer, increasing age (57% of working age people compared with 42% of older retired individuals) meant that they were less likely to agree that treatment’s side-effects were worse than the
disease. Previous research suggested that older people are less likely to receive active anticancer treatment, but this study suggested that when offered irrespective of age, people usually opted to receive treatment— only 2% had opted out of any anticancer treatment. According to this study “there is no significant difference by age group or stage of cancer at diagnosis on the likelihood of people to opt out of a certain treatment”, and “15% of people diagnosed with stage 1 or 2 cancer have opted out, vs 12% of stage 3 and 4, for example”. “We know that older people are less likely to get access to cancer treatment for a number of reasons and hoped this would help us unpick one part of this complex puzzle”, said Jagtar Dhanda, head of Inclusion at Macmillan Cancer Support (London, UK). He added, “Surprisingly the
research tells us that older people are no more likely to turn down cancer treatment than younger people, and worries about side-effects of treatment do not make them more likely to opt out of treatment. It also found that whilst older people are confident in pursuing treatment, they are less likely to question decisions about which treatment might be best for them than those aged 55–64.” Shantanu Panja (Apollo Gleneagles Hospital, Kolkata, India) said, “The issues [of older people] require more understanding because they are a set of population with different set of expectations from life and family”. He commented, “this study is a welcome step in that direction which will help us formulate strategies to fight cancer in this vulnerable age group”.
Lea Paterson/Science Photo Library
Older people not likely to refuse cancer treatment
Published Online August 28, 2015 http://dx.doi.org/10.1016/ S1470-2045(15)00273-9 For the report by Macmilian UK see http://www.macmillan.org. uk/Documents/Campaigns/
Sanjeet Bagcchi
Controversy about UK assisted dying bill Leaders of the major religions in the UK have signed a letter urging Members of Parliment to oppose legislation that would legalise assisted suicide. Introduced by Labour’s Rob Marris (Wolverhampton, UK), the bill proposes allowing doctors to prescribe lethal drugs to terminally ill patients, who make the request of their own volition and are judged to have 6 months or less to live. The House of Commons is due to debate the issue on Sep 11, 2015. “A law based on this assisted dying bill would put at risk many more vulnerable people than it seeks to help”, stated the letter, which included among its signatories the Archbishop of Canterbury, the Archbishop of Westminster, the Chief Rabbi, and the Head Imam of Leicester Central Mosque. The authors raised concerns that if the bill becomes law, patients will
www.thelancet.com/oncology Vol 16 October 2015
“feel under pressure within themselves to ‘do the decent thing’”. They added that the 500 000 elderly individuals who are abused each year, mainly by relatives, would be likely to find themselves facing pressure to end their lives. Oxford University’s Julian Savulescu (Oxford, UK) counters that this eventuality has not come to pass in those countries that permit assisted suicide. “At any rate, that’s a separate issue about how to prevent people from being coerced”, he told The Lancet Oncology. The letter was published in the Observer. In an accompanying commentary Justin Welby, the Archbishop of Canterbury, argued that the prospective legislation would “cross a fundamental legal and ethical Rubicon”. He stressed that the letter was not an attempt to enforce
religious principles on UK legislation. “We are asked to sanction doctors participating in individuals taking steps to end their lives”, wrote the Archbishop of Canterbury. “This is a change of monumental proportions both in the law and in the role of doctors; it is little wonder that it is opposed by the medical profession”. Savulescu points out that European laws preventing suicide have their origins in the notion that a body is owned by the King, who might require it for fighting, and by God. “Most people do not hold those views any more”, he said. “People have the fundamental right to choose when and how they die, and they are going to increasingly ask why doesn’t our society offer us these choices?”
Published Online September 11, 2015 http://dx.doi.org/10.1016/ S1470-2045(15)00313-7 For the faith leaders’ letter see http://www.theguardian.com/ theobserver/2015/sep/05/ assisted-dying-bill-leaders-faithcommunities-letter-against For Justin Welby’s accompanying commentary see http://www.theguardian. com/commentisfree/2015/ sep/05/assisted-dying-suicidebill-justin-welby-archbishopcanterbury
Talha Khan Burki
e483