Letters Assisted dying debate

What of virtue and integrity?

BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d467 (Published 25 January 2011) Cite this as: BMJ 2011;342:d467
  1. Rhona A Knight, portfolio GP1
  1. 1Leicester, UK
  1. rk89{at}le.ac.uk

The arguments for and against assisted dying continue.1 Deontological and utilitarian arguments abound, but what of virtue and integrity? How many doctors are going to be happy actively helping to end the life of a patient? And what will be the impact for those who are not happy but feel duty bound to follow a change in the law?

Lifton’s comprehensive book examining the stories and experiences of Nazi doctors details what happens when doctors have to do things that compromise their integrity as healers and become killers.2 Few of these doctors took pleasure in their “work,” most developing strategies to cope with their compromised integrity.

It behoves us as a profession to look to the lessons of history and explore what happens when integrity is compromised. In our increasingly utilitarian evidence based healthcare service, we need to research the impact on the mental, physical, and emotional health of doctors who assist people to die in jurisdictions where this is legal.

This research should be extended to look at the impact on the relatives of those whose family member has been assisted to die. Assisting someone to die is seen by many as killing. What is the impact on doctors, patients, and society when carer becomes killer? Good ethics begin with good facts. Let us as a profession ensure that we have these essential facts on which to base our arguments.


Cite this as: BMJ 2011;342:d467


  • Competing interests: RAK is opposed to euthanasia, and hence assisted suicide.


View Abstract

Sign in

Log in through your institution

Free trial

Register for a free trial to thebmj.com to receive unlimited access to all content on thebmj.com for 14 days.
Sign up for a free trial