Intended for healthcare professionals

Letters Denial in assisted dying

So, farewell then, doctrine of double effect

BMJ 2011; 343 doi: (Published 02 August 2011) Cite this as: BMJ 2011;343:d4512
  1. Claud Regnard, consultant in palliative care medicine1,
  2. Rob George, consultant physician, palliative care2,
  3. Ellie Grogan, consultant in palliative medicine3,
  4. Tim Harlow, consultant in palliative care4,
  5. Stephen Hutchison, consultant physician in palliative care5,
  6. Jeremy Keen, consultant physician in palliative care5,
  7. Sheila McGettrick, consultant in palliative medicine6,
  8. Celia Manson, nurse adviser in pain and palliative care7,
  9. Scott A Murray, St Columba’s Hospice chair of primary palliative care8,
  10. Vicky Robinson, palliative care nurse consultant2,
  11. Patrick Stone, Macmillan reader in palliative medicine9,
  12. Carole Tallon, consultant in palliative medicine and medical director10
  1. 1Newcastle Hospitals Foundation NHS Trust, Newcastle upon Tyne NE7 7DN, UK
  2. 2Guys and St Thomas’s NHS Foundation Trust, London, UK
  3. 3Northumbria Healthcare NHS Trust, North Tyneside General Hospital, North Shields, UK
  4. 4Hospicecare, Exeter, UK
  5. 5Highland Hospice, Inverness, UK
  6. 6Prince and Princess of Wales Hospice, Glasgow, UK
  7. 7Sevenoaks, UK
  8. 8Centre for Population Health Sciences, University of Edinburgh Medical School, Edinburgh, UK
  9. 9St George’s, University of London, London, UK
  10. 10Myton Hospices, Warwick, UK
  1. claudregnard{at}

Spence offers the cases for and against assisted suicide in a balanced way that is often lacking in such debates.1 He then raises the issue of double effect as a result of strong opioids. This is important because, if this effect exists, many doctors stand …

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