society falls asleep

I was sitting here in the Draughty Old Fen, having a cup of tea with the radio on, when my ears pricked up at the mention of my old home town of Glasgow.

It appears that a GP from the dirty old town has been suspended from practicing for six months, after prescribing sleeping tablets to five patients. Sounds reasonable enough - except the patients didn't have problems sleeping. The conditions the five, four women and a man, suffered from were depression, terminal illness, heart problems and the man had a drink problem.

The official prescribing guide, the BNF, states that the drug prescribed, a barbiturate called Sodium Amytal, is to be prescribed for "severe intractable insomnia only in patients already taking barbiturates" (bold print from the original). The Scottish NHS statistics service concurs: "Overall the prescribing of barbiturates has fallen by 85.8% since 1992/93. Medical opinion is that barbiturates should only be used in the treatment of severe, intractable insomnia in those patients already taking barbiturates and avoided in the elderly."

The reason for this is that barbiturates are extremely addictive, with not much difference between the dose that will provide a therapeutic effect and that which will cause a potentially fatal overdose. Indeed, Drugscope notes the close association of barbiturates with suicide.

The Cautions and Contraindications sections of the BNF entry for Sodium Amytal speak volumes about Iain Kerr's intentions: for one thing, something that concerns all of his unfortunate patients is that the drug is not to be prescribed in cases where "depression and suicidal ideation" are present. It's not to be used in elderly patients - his victims ranged from 61 to 87. Hepatic impairment's out too; I wonder if a liver function test was done on the man who drank problematically. And, of course, there's the contraindication sine qua non - barbiturates are so dangerous that they are not to be prescribed to people who aren't already on them.

One of Kerr's victims had previously told him that she was considering suicide so as not to be a burden on her family. May I shamelessly quote myself in a different context:

The Archbishop of Westminster is one of many people who warned about the shift from the right to die, as enshrined in the advance directive provision of the Mental Capacity Act 2005, to the "duty to die". Older people's inadequate pensions cost too much, they fall over too often, visiting them - or finding excuses not to - uses up time that we might have happily wasted, they are too...old.

The Mental Capacity Act was brought in to see that people who wished to have their treatment terminated should their condition deteriorate to the point where they can no longer communicate their wishes. The thing is, there was already a consensus among medics that what is usually referred to as "heroic measures" was not to be used in the treatment of terminally-ill people; I don't recall pro-life health-workers having a problem with this.

Nowadays, it seems that medics who support euthanasia see themselves as heroic pioneers. I nearly fell off my chair when I read Kerr told police "that his membership of the Euthanasia Society gave patients the choice of discussing end-of-life matters". Patients are free to discuss suicidal thoughts with any GP - being manic-depressive, I've done so myself - but for the GP to then supply materia medica for the purpose is not just going above and beyond the course of duty, it betrays a Malthusian attitude assuming that there are too many people in the world, therefore any help which can be provided to help individuals shuffle off this mortal coil is a service to Gaia, combatting climate change, working for zero population growth and/or whatever is this week's cause célèbre among anxious liberals.

It's less than a century since Dr Crippen was found guilty of the murder of one person - his wife - and hanged. Now a man who is happy to publicise his murderous pastime - he boasted in a 2004 appraisal that he was interested in helping people at the end of their lives - is suspended from his profession for 6 months, but otherwise at liberty. The idea that people who are close to death should be helped - encouraged? - to die as soon as possible is now so entrenched that people who are physically healthy but depressed are being helped on their way. Among the few torch-bearers for sanity is the SPUC group No Less Human, which celebrates the lives of people who are valuable because they are people.

Otherwise, as we approach dystopia a prescription is unneccessary, for a somnambulant society doesn't need sleeping pills.