Intended for healthcare professionals

Rapid response to:

Observations Life and Death

What’s wrong with assisted dying

BMJ 2012; 344 doi: (Published 29 May 2012) Cite this as: BMJ 2012;344:e3755

Rapid Response:

Re: What’s wrong with assisted dying

Iona Heath argued that to protect vulnerable patients from abuses of assisted-dying rights, we must deny all patients the possibility of an assisted suicide. With political dysfunction currently causing misery on both sides of the Atlantic, it can be difficult to maintain much faith in our ruling class. Nevertheless, I feel Dr Heath's assertion that 'it will be impossible to draft a law robust enough to protect the vulnerable' from assisted dying is too pessimistic. We already rely on legislation to identify and protect vulnerable people in society; safeguarding vulnerable patients from an abuse of assisted-dying rights would be no different. Certainly, robust safeguards would be required, but none beyond the bounds of possibility.

What strikes me as incoherent is Dr Heath's later suggestion that avoiding over-aggressive treatment and allowing patients to die 'provides the body with a way out.' Consequentially, allowing a patient to die when treatment could have extended their life is no different to providing assisted suicide. The difference is that, whereas assisted suicide is at the patient's request, planned and painless, waiting to be struck down by an aspiration pneumonia is sudden, unpredictable and distressing for the patient and family. That 'the affected body could be said to be meant to die' is likely to be cold comfort in such circumstances.

Dr Heath rightly points out that 'Aristotle's golden mean applies to healthcare as much as any other human endeavour.' The same could be said of assisted dying. Authorising it in every request is indeed likely to sanction abuses of vulnerable patients. But denying it to every patient who desires it is to hold patients hostage to their inability to end their own life. It is an infraction of their autonomy and a source of much misery.

Competing interests: No competing interests

06 June 2012
Richard Bagshaw
Medical Student
University of Birmingham
Edgbaston, Birmingham