Why neutrality on assisted dying is not an option for doctors’ professional organisations

The two issues in assisted dying should be kept separate. Firstly , there is the basic one as to whether an individual – particularly one who is dying - can have a degree of suffering that makes death a preferable alternative. Compare this to abortion – should Society allow abortion in certain circumstances ? This is not primarily one for a collective medical response , particularly when the basis for that response is so unsound. It would be remarkable if our profession held views at such variance with the rest of the population – and so contrary to what has been part of medical practice until relatively recently. Until we are clearer on this point , the BMA should remain neutral . Secondly there is the issue – both for assisted dying and abortion – on their delivery as part of medical care. That is where the Colleges and other professional organisations should be involved.
Various polls have used simple – and usually prejudiced - questions . Delamothe highlights the problems with the recent BMJ poll (1). Pressure groups opposing assisted dying have greater numbers and resources than those supporting change but both are only a small part of the whole. We need to know the opinion of the middle ground – those who do not necessarily object to the principle but have concerns about the practice. The poll held by the RCGP seemed designed to produce an answer wanted by a chairman with a strong commitment to conventional palliative care. The RCP made a reasonable attempt at consultation , but it is the College with strong representation from those in conventional palliative care. The ARM of the BMA is a very flawed means for deciding policy of this type and if members of pressure groups feel they have to use the system to attend and influence policy , that could have an adverse effect on the voting on other agenda items. The past 30-40 years have been a period of a fairly remorseless drive to prolong existence at all costs with a few press worthy steps in the other direction. The former excuse of “double effect” opiate use for the terminally ill is no longer valid. Although not supporting assisted dying , the editorial by Ranaan Gillon emphasises where this trend has reached (2)
The problem with the present hostility to assisted dying is that it is being left to case law without adequate discussion of the underlying issues involved and without attempting to see how these might be resolved
1 Tony Delamothe Editorial note on results of assisted dying poll BMJ 2012 ; 345: e4582
2 Editorial Sanctity of life law has gone too far BMJ 2012;345:e4637