Where there’s life, there’s hope: debating the Saatchi Bill

Br J Cardiol 2015;22:(1) 1 Comment
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Opinion from the world of cardiology

Editors’ introduction: The Medical Innovation Bill proposed by Lord Maurice Saatchi, which would have allowed doctors to treat terminally ill patients with new and experimental treatments instead of having to stick to standard procedures, has given rise to heated debate across the medical community. Recently vetoed by the Liberal Democrats, who now promise a full examination of the issue, it is even more important for healthcare professionals to voice their opinions. We present one view below on the Bill’s ambitions and implications, which we hope will stimulate debate. Have your say now in the comments section at the end of the article.

We believe we live in a world of choice. We believe that we choose our futures. We believe that the power of choice makes us invincible. Yet, we seem to have forgotten what makes us truly human: one day, our brief, precious lives will end. Society today still cowers at the spectre of death − but why? It is because the thought of being deprived of choice has become such an alien concept to us. We cannot choose the way in which we leave this world, so we fear death. But what if, when the time came, you were given the choice to try and cheat death? Even if it were risky, wouldn’t you grasp for one more chance at life? The Saatchi Bill, which would allow doctors to treat terminally ill patients with new and innovative treatments instead of having to stick to failed standard procedures, supports the most fundamental human instinct: the will to survive.

Superficially, we have become indifferent to the endless parade of distressing photographs and reports about the Ebola outbreak in Africa. Beyond that initial insensitivity, we start to feel pity for helpless victims of the virus. Temporary medical facilities in crisis zones are rapidly overwhelmed by its ruthless nature. Therefore it is astonishing to learn that the Ebola sufferers in Liberia have better access to innovative treatments than the people of Britain. For example, in Britain today, the death toll of cancer is 100 times higher than that of Ebola globally, and access to such groundbreaking treatments is non-existent, even for those desperate patients whose needs have far extended the capacities of current medicine. 150,000 Britons will die of cancer this year. How can we stand and watch our loved ones lose the fight, knowing that we could arm them with a cure?

It is understandable why some fear this potentially radical leap forward in medical standards. Firstly, patients fear that the Bill will strip them of their protection against bad practice. This is false. The Bill will not result in patients being treated like laboratory mice, nor will it invite reckless experimentation: instead, it will marshal in bold, but responsible, innovation. New treatments administered under the Saatchi Bill would not only require the consent of the patient (or the patient’s representative) but also the doctor would have to be supported by at least one other qualified doctor, carry out a full risk assessment, and obtain any other consents required by law. Freedom of choice, respect for the patient and preservation of dignity are thoroughly preserved. Secondly, critics state the Bill is simply unnecessary because of our steady success in fighting cancer and other diseases throughout the decades. However, this is only half the story. There is not nearly enough research funding for less common diseases because there are not enough patients to run the trials and the potential profit for the drug companies is small so does not provide enough of an incentive. Cancer research, for example, is focused around the most substantial killers; breast, lung, prostate and bowel. Nevertheless, one in six of us will die from a rarer cancer. By giving doctors the opportunity to explore new avenues of medical practice, everyone will be equally accounted for.

Polio, tetanus, rabies, yellow fever…we have conquered so many afflictions with the weapons of modern medicine. But how did we achieve it? The process has to begin with a first trial. Although the treatment may not be perfect at the outset, doctors are given the opportunity to learn and improve. Then, one day, after trials and perseverance, success comes about. The story is true for every disease; cancer, multiple sclerosis, motor-neurone disease — there will never be a cure for any of these debilitating conditions unless “real doctors with real patients in real hospitals can be given the opportunity to innovate”. When people are dying, they want their suffering to mean something. By monotonously trotting out our tired, futile procedures, we are devaluing their deaths. They become another line in the tally carved on death’s door.

It is not too late to change our ways. We have come so far and, together, we have pushed the boundaries of medicine to extraordinary limits. As Stephen Hawking said: “Where there is life, there is hope”. Therefore I exhort you to join us in facing the forces that fight the passage of the Saatchi Bill, for the sake of the hope which can save lives today, the lives of those we love and the lives of so many generations to come.

India Fox
Aswan Heart Centre, Aswan, Egypt

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