Education and debate

Taking the final step: changing the law on euthanasia and physician assisted suicide

Legalised euthanasia will violate the rights of vulnerable patients

BMJ 2005; 331 doi: 10.1136/bmj.331.7518.684 (Published 22 September 2005)
Cite this as: BMJ 2005;331:684

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  1. R J D George, senior lecturer (rob@palliativecare.org.uk)1,
  2. I G Finlay, baroness2,
  3. David Jeffrey, chair of ethics committee3
  1. 1Centre for Bioethics and Philosophy of Medicine, University College London UB1 3HW
  2. 2House of Lords, London SW1A 0PW
  3. 3Association for Palliative Medicine of Great Britain and Ireland, Southampton SO17 1DL
  1. Correspondence to: R J D George
  • Accepted 18 July 2005

Doctors in the United Kingdom can accompany their patients every step of the way, up until the last. The law stops them helping their patients take the final step, even if that is the patient's fervent wish. Next month's debate in the House of Lords could begin the process of changing the law. To help doctors decide where they stand we publish a range of opinions

Introduction

The chameleon of euthanasia continues to change, and the current shade is physician assisted suicide. The politically correct position for clinicians is “studied neutrality” since doctors will not really be involved in assisted suicide. Thus the issue has slipped past the BMA,1 and the recent House of Lords' report on assisted dying suggests that euthanasia and assisted suicide are different.2 This cannot be. What doctor prescribing for assisted suicide would refuse to complete it with euthanasia? In the Netherlands just under one in five physician assisted suicides ends in lethal injection.3 Were physician assisted suicide legalised, doctors would have the new duty of therapeutic killing,4 even if they planned only to prescribe lethal medication. Both are killings justified as treatment, hence we use the term therapeutic killing simply because it describes precisely what is done. Medicine cannot escape; quite aside from patient safety, legalising physician assisted suicide will have a profound and ubiquitous effect on clinical codes, duties, and practice.w1-w15


Embedded Image

Dutch protests in 2001 as parliament debated legislation and euthanasia

Credit: SERGE LIGTENBERG/AP/EMPICS

Change is unjustified

Autonomy and suffering are the usual justifications for change. The autonomy argument is thin. In all legislatures, the final decision …

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