MORE than a year ago Dr Patrick Leahy sparked media headlines when he claimed he had given a lethal injection, at the patient's request, to an elderly man with chronic arthritis.
The man had allegedly asked Dr Leahy "to promise not to let him suffer if life became intolerable". Following a stroke, the man, in his 70s, asked Dr Leahy to "keep his mise" and, after a discussion with the man's wife, Dr Leahy was reported to have administered a lethal injection.
He was also reported as claiming as aware he had probably committed a criminal offence. But the incident is supposed to have happened more than 50 years ago. In an interview published in The Irish Times last year, Dr Leahy claimed to have performed as many as 50 acts euthanasia during his years in practice. He also claimed he knew of any other Irish doctors who had been practising "sensible euthanasia" but who would not admit this publicly.
Again, this week, Dr Leahy secured headlines by claiming he gets one call a week from people seeking his help to die. Examples which he gives to justify his attitude are always dramatic. For example, he has cited the situation of a woman who was vomiting faecal matter as a complication of cancer and also describes the unrelieved massive pain, suffering and torment that may occur with certain diseases.
Modern surgery and techniques in pain relief ensure that no one need suffer in this manner. Before making such claims, Dr Leahy might be well advised to update himself on current medical practice, and he might very well be pleasantly surprised. Most surgeons, physicians, oncologists, pain and palliative care specialists would be only too happy to oblige.
Dr Leahy says if he found himself wheelchair bound or incontinent of urine and faeces, the quality of his life would be so affected that he would know what to do to himself. This is very forthright but leaves a large question mark, in my mind over his judgment.
THIS week, Dr Leahy is quoted as saying: "I am not prepared to say what I did, but nothing falls on a deaf ear." That statement is unreal when placed beside his published remarks of a year ago which caused me to refer his claims to the Director of Public Prosecutions and to the Medical Council for investigation.
When contacted by the gardai in Harcourt Square, I withdrew my complaint because of Dr Leahy's venerable age and because I was sceptical about some of his claims.
Dr Leahy is no stranger to controversy: for example, in 1992 he admitted in Hot Press magazine to have taken five teenage girls to England for an abortion, including one girl of 13, part of whose expenses he personally paid.
The Medical Council was asked to investigate Dr Leahy's claims that euthanasia is a "regular practice" in Ireland and that he had participated in up to 50 such acts. He had also claimed that abortions disguised as "dilatation and curettage" were conducted on wealthy patients in Dublin by private practitioners.
The Medical Council informed me by letter three weeks ago that these matters, which had formed the basis for my complaints against Dr Leahy, did not come within its rem it. It defined "professional misconduct" as "conduct which doctors of experience, competence and good repute consider disgraceful or dishonourable".
The Medical Council's guide to ethics states: "Euthanasia, which involves deliberately causing the death of a patient, is professional misconduct and is illegal in Ireland."
I find it difficult to understand how the Fitness to Practise Committee could conclude there was no case to answer. An explanation from the council would be interesting.
Strangely, Dr Leahy is reported as being angry at the Medical Council's decision not to proceed with an investigation, and is quoted as claiming that he "could give hundreds of cases of people whose lives were terminated by me".
Frankly, I find Dr Leahy's claims outside the bounds of credibility. If he wished to get involved in a serious debate on the pros and cons of euthanasia, the columns of the Lancet or the British Medical Journal would have been open to him.
THE practice of euthanasia is controversial in medicine and it has its advocates In 1990, the majority view of a working party of the Institute of Medical Ethics stated that euthanasia was ethical in certain circumstances. In 1994, a survey of 300 doctors, published in the British Medical Journal, found that almost half had been asked by their patients to take active steps to end their lives, and of those asked, about 30 per cent had complied. However the British Medical Association disagreed and considers euthanasia unethical. I agree with this view.
In New South Wales, Australia, a survey of 1,200 doctors in 1994 found that more than a quarter had agreed with patients' requests to hasten their deaths. The British House of Lords ruled in 1994 that it should remain a crime for a doctor to kill a patient intentionally even when the patient requested it. This was because there would be no way of ensuring that all such acts were truly voluntary and some people might feel under pressure, to request early death. There is a danger that a right to die could become a duty to die.
A review of euthanasia in the Netherlands reported that in more than 1,000 cases per year (0.8 per cent of all deaths), doctors shortened patients lives as a primary intentional without their explicit consent. In 41 per cent of these cases, there was no information available about the patients' wishes.
In the Remmelink Report of 1991, also from the Netherlands there were 2,300 cases annually of voluntary euthanasia and a further 1,000 patients whose lives were ended without their explicit request or consent. In my view, euthanasia has been used in the Netherlands to clear hospital beds. This places euthanasia in its true context.