Author’s replyBMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c4707 (Published 27 August 2010) Cite this as: BMJ 2010;341:c4707
All rapid responses
MacCormick (1) does well to draw attention to the disparity between
the prevention of suicide and assisted dying, exemplified by the case of
Tony Nicklinson. It is imperative that we consider this debate within the
context of wider society.
Anyone who has practiced clinical medicine will have met patients who
live with extreme disability. We remember patients who have, from a young
age, lived with chronic, progressive neurological disease or patients in
advanced years suffering with dementia; patients who are unable to do for
themselves basic tasks which most people take for granted. The vast
majority of these patients who suffer disability are able to live at home
with help from family, friends and state. In only a small number of cases
patients, a considered wish to die is expressed.
Therefore as with any healthcare policy or intervention we must
consider the wider implications. Simply because a change in policy or law
may suit one person, or a group of people, does not mean it is in the best
interest of the whole population. We would not instigate public health
measures based on the desires of a small group but we consider the needs
of the whole population. Expensive anticancer medications are not
recommended, because of the impact on healthcare for the wider population.
Similarly we must consider the wider implications of assisted dying.
We must take a wider objective view; rather than focusing on individual
cases. The state and medicine have an obligation to promote health and
protect life, especially of the vulnerable. Of course there will be cases
to which this arrangement appears inhumane and callous, but the default
position of the state and medicine must be to protect life. We must never
forget the unseen cases in the wider population which this law protects
and should continue to protect.
1. MacCormick IJ. Suicide and euthanasia paradox. BMJ2010;341:c4291.
Competing interests: No competing interests