Call for medical bodies to stop opposing assisted dying supported by BMJ

BMJJun 14 2012

The BMJ today supports a call for leading UK medical bodies to stop opposing assisted dying for terminally ill, mentally competent adults.

Healthcare Professionals for Assisted Dying (HPAD), wants the BMA and royal colleges to move their position from opposition to neutrality. The call comes as a new poll commissioned by Dignity in Dying found that, of 1000 GPs, 62% support neutrality. Support for legalisation among the general public is also strong, running at over 80% in successive social attitudes surveys.

The BMA will debate whether to adopt a neutral position on assisted dying at its annual conference later this month.

Fiona Godlee, BMJ Editor-in-Chief, argues that “legalisation is a decision for society not doctors” and draws parallels with abortion reform in the 1960s, which was also resisted by the profession’s representatives until a change in the law was inevitable.

“The same is true for assisted dying,” says Godlee. “A change in the law, with all the necessary safeguards, is an almost inevitable consequence of the societal move towards greater individual autonomy and patient choice.” But, it may take a while, she adds “and it may not happen until we value death as one of life's central events and learn to see bad deaths in the same damning light as botched abortions.”

Raymond Tallis, Emeritus Professor of Geriatric Medicine and HPAD’s Chair supports this view, saying that opposition is inconsistent with the idea of patient centred care and the principle of "no decision about me without me."

The BMA’s main opposition to assisted dying is that it is contrary to the ethos of medicine, he writes, “yet the monstrous cruelty of walking away from a dying patient in unbearable suffering seems more obviously contrary to the ethos of medicine.” Furthermore, international experience has shown that placing assisted dying within the framework of the law would increase, not threaten, patient safety and have an entirely beneficial effect on trust in doctors.

“Given the overwhelming support for assisted dying in society as a whole and given also that there are healthcare professionals of good will, different faiths, and expertise in palliative care, with passionate views on both sides of the debate, we believe that the proper stance of healthcare professional bodies is one of neutrality,” he concludes.

An accompanying article offers a powerful case for a change in the law. Tess McPherson, daughter of Ann McPherson, a GP who was passionate about a change in the law on assisted dying, gives a personal account of watching her mother die slowly and without dignity.

She describes “three weeks of living agony” and being “unable to help in the way that mum wanted.” She says: “It is simple: the law needs to change to allow terminally ill but mentally competent people the right to a more dignified death than my mum was allowed.”

The arguments for and against assisted dying have been rehearsed in the BMJ, says Fiona Godlee. Last month Iona Heath, President of the Royal College of General Practitioners, argued against assisted dying and this week the journal publishes a selection of the mainly critical responses her article received.

"The BMJ supports today’s call and will continue to provide a platform for the debate," concludes Godlee.