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MPs will debate assisted dying bill in September

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h3187 (Published 11 June 2015) Cite this as: BMJ 2015;350:h3187

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Re: MPs will debate assisted dying bill in September. Is the BMJ asking the wrong question on doctor assisted dying?

To the Editor:

Is the BMJ asking the wrong question on doctor assisted dying?

Lord Falconer’s assisted dying bill will receive a second reading in The House of Commons on 11 September. Whether the present government will support this private members bill remains uncertain. However, the BMJ has endeavoured to keep this debate alive (in print) via the Observations column for the past 2 years.

In October 2013, the BMJ began a weekly series of interviews with influential figures in UK healthcare. Between 2013 and August 2015, 81 interviews have been published. Those questioned include clinicians, medical academics, health economists, philosophers, NHS managers and civil servants. Some of these individuals are in current employment whilst others are retired or no longer directly involved in healthcare.
Most of the questions are a light-hearted examination of early ambitions, guiltiest pleasures, pet hates, alcohol consumption and career regrets. However, each interviewee has also been asked whether they support doctor-assisted suicide. This is a very topical subject 1, which appears incongruous with the other questions posed.

I decided to examine the responses to this important question to establish if any meaningful conclusions could be drawn from the responses.

3 of the 81 interviews published did not include the question on assisted suicide, leaving 78 interviews with a recorded answer.
34/78 (44%) were in favour of doctor assisted suicide with 26/78 (33%) against. 18/78 (23%) were either undecided, unclear in their response or declined to give a personal view on the matter. Those that declined to answer were mainly heads of professional bodies with an established opposition to assisted suicide.

I am unsure how asking such a heterogeneous group of individuals their views on doctor assisted suicide is helpful to the current debate. Certainly a large proportion of those interviewed have no direct patient contact and are unlikely to ever deal with requests for assisted suicide. Their opinion may be little better informed than the lay public but is likely to be more influential when printed in an established medical journal. Interestingly, several respondents in favour said that they would not like to be directly involved in doctor-assisted suicide. Perhaps this should have been the question asked: If doctor assisted suicide becomes lawful, would you be willing to be directly involved in the process? The answer to this question might prove far more interesting and will be the question all doctors will need to ask themselves if there is change in the present law.

1. Dyer C. MPs will debate assisted dying bill in September. BMJ2015;350:h3187.

Dr Paul Clark
Specialty Doctor in Palliative Care
Rowcroft Hospice, Torquay

Competing interests: No competing interests

11 August 2015
Paul W Clark
Palliative care physician
Rowcroft Hospice
Torquay, Devon