We must not deprive dying people of the most important protectionBMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g4311 (Published 03 July 2014) Cite this as: BMJ 2014;349:g4311
- Rob George, professor of palliative care, Cicely Saunders Institute, King’s College London, and consultant physician in palliative care, Guy’s & St Thomas’ Hospitals NHS Foundation Trust, London
Legalising medical treatment intended to end life is a momentous step: it alters the very nature of medicine at a stroke. The compelling logic is that once a doctor is mandated to end a life in that person’s best interest, then anyone, as equal before the law, is entitled to make the case for a death, on the basis of notions of best interest, suffering, or a worthwhile life.
In his recent article supporting Charles Falconer’s Assisted Dying Bill, Ray Tallis correctly argued that the chief areas for debate were the position of “assisted dying” in the spectrum of possible lethal interventions, the involvement of doctors, and safeguards against misuse or well intentioned error, but his conclusions were wrong.1
“Assisted dying” is meaningless
Tallis may remember from clinical practice that individual prognostication, even in diseases such as cancer, is at best an estimate. Uncertainty continues even to the last days of life.2 I well recall my dementing father, and currently my mother, being “on the brink of dying” for years. When death came, the clinical indices were no different from the countless “dry runs.”3 Complex studies of comorbidities indicate that survival relates as much to toughness as anything.4 As Tallis said, in US states such as Oregon mentally competent adults …