Intended for healthcare professionals

Assisted dying

The BMJ has provided a platform for debate on assisted dying (or assisted suicide, according to some opponents of the option) for two decades. The issue provokes strong feelings, among doctors as well as the public worldwide. Proponents of physician assisted dying, including The BMJ, claim that access to the option gives dying people choice and control over their death and can prevent intolerable and intractable suffering. But opponents fear consequences for vulnerable people, for society, and for the medical profession when doctors are permitted actively to induce death. The BMJ thinks it likely to be more a question of when, not if, assisted dying is legalised in the UK, and that all doctors should now engage with the debate.

The BMJ continues to strive to represent all voices in the debate.

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Definitions under dispute

Proponents and opponents of assisted dying do not all agree on the terminology used to describe the process.

Assisted dying—Proponents of the Assisted Dying Bill 2015 in England and Wales argue that this term best describes prescribing life ending drugs for terminally ill, mentally competent adults to administer themselves after meeting strict legal safeguards. Assisted dying, as defined like this, is legal and regulated in the US states of California, Colorado, Hawaii, Montana, Oregon, Vermont, and Washington, and in Washington, DC. In 2017, similar legislation was passed in Victoria, Australia.

Assisted suicide—This term is often intended to describe giving assistance to die to people with long term progressive conditions and other people who are not dying, in addition to patients with a terminal illness. The drugs are self administered. Some opponents of assisted dying do not accept that it is different from assisted suicide. Assisted suicide, as defined like this, is permitted in Switzerland.

Voluntary euthanasia—This term describes a doctor directly administering life ending drugs to a patient who has given consent. Voluntary euthanasia is permitted in Belgium, Luxembourg, and the Netherlands. In 2016, Canada legalised both voluntary euthanasia and assisted dying for people whose death is “reasonably foreseeable,” in what it calls “medical assistance in dying.”

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