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

The 20th Rapid Response on this subject published on 14.06.12 by Clive Seale balances the ‘for’s and against’s’ in this polarised debate, ending with a question rather than a firm opinion that concedes nothing to the other side.
I salute Iona Heath’s courageous stand in putting forward her arguments against the legalisation of assisted dying. To speak out against the growing tendency of some professionals, as demonstrated in this correspondence, to seek the legitimisation of euthanasia is indeed a brave thing to do. Although those who argue for the law to be changed do so on the grounds of enhancing patient autonomy, the driving force is often a wish to protect the doctors who carry out the procedure.
The paramount professional intention must be to relieve distress but any action that the physician takes is constrained by the law and may make achieving relief of suffering difficult. No one will argue that control of distress is what is required by doctor, patient and family. If the patient succumbs during well intentioned efforts to mitigate intractable symptoms, it will be a death that is incidental rather than the planned objective of treatment. Intention is everything. It is always a difficult and unsettling judgement to make in the face of the law as it presently exists because the doctor has to constantly question whether the action taken can be justified in a court of law. The law stands as an unseen guardian of the vulnerable patient in their last few days or hours of life. If the law is weakened, the power of the doctor to act according to his or her conscience is greater and the moral code of the doctor inevitably becomes the more decisive authority. Different doctors have different codes and although I would use neither Mengele nor Shipman as examples of doctors with any moral code such evil individuals or indeed regimes, will seek succour in the softening of current legislation.
Difficult decisions are by their very nature difficult and to make them easier may not necessarily make them better or right.

Competing interests: No competing interests

15 June 2012
Simon A P Jenkins
GP retired
81 Ringley Road, Whitefield Manchester M456 7LH