Both public and politicians have the reasonable expectation that medical professional bodies will offer an overall judgement on the desirability of legislation if it affects medical practice or if doctors have special experience on the issue in question. There is nothing different in principle about professional bodies advising on the desirability of legislation about one issue of practical morality and public policy than any other: whether it’s health service reform, smoking or alcohol policy, assisted death etc. Where a policy is strongly divisive, a responsible organisation will consult, measure and publish its members’ views – as the Royal College of Physicians (RCP) did over the English health reforms recently. An informed public will be interested in the extent of that division as well as an overall judgement. It is for public and ultimately our representatives in parliament to reflect on individual and aggregated opinion from all sources, but especially from those with special experience – as doctors should have in matters affecting medical practice. That’s common sense, not paternalism.

Nobody has ever made the fatuous suggestion that legislation about assisted death (or anything else) is other than for society to decide. But I would certainly hope that the British Economics Association (if such a thing existed) had a greater influence on economic policy than the local cricket club or the best teller of anecdotes.

The problem is that neutrality is not neutral(1) . By withholding any public judgement, proponents of change interpret ‘neutrality’ as acceptance – which is presumably why neutrality (an achievable second best) is the preferred position by those doctors who want change. This was evident (as Tallis seems to have forgotten) when the RCP had a brief dalliance with neutrality on the assisted death issue many years ago, leading to efforts to correct misimpressions. RCP’s current carefully worded position that “it couldn’t support legal change at the present time”, coupled with the data from its consultation (2) offers responsible, principled information to guide interested parties. We owe public and politicians (& perhaps our members too) no less.

1 Saunders J. Ethical Decision Making in Professional Bodies. Clin Med 2006;6:13-15
2 Saunders J. What do physicians think about physician assisted suicide and euthanasia? Clin Med 2008;8:243-5

Competing interests: JS is chair of the Ethical Issues Committee, Royal College of Physicians of London, represented RCP before the HoL Select Committee and had the lead role in the 2006 RCP consultation on assisted death. Views expressed are his own.