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Why I’ve changed my views on assisted dying

BMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j3566 (Published 03 August 2017) Cite this as: BMJ 2017;358:j3566

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Re: Why I’ve changed my views on assisted dying

Dr Nicholl has found the courage to publish his thoughts on assisted dying after a very touching experience, losing a close friend after many years of struggle against a rare, incurable diesease. I think most of us after years of practice can easily imagine a situation, in which they for themselves, or for somebody close to them, might take steps to get a good supply of barbiturates. Still, this is a personal decision, not a professional duty or medical treatment. Some countries, we learned, have recently decided to provide euthanasia or assisted suicide within health care.

However, the major cocern that needs to be adressed, at least in Germany with her history of medical mass murder under Nazi rule, is the fear of a slippery slope towards euthanasia as something like a "routine service" (*) provided to anybody requesting it in terminal distress and with some ability to give consent, be it by proxy. There will be many frail, demented, weak, mostly elederly people around in the next decades. Should they too be offered the opportunity to get killed by a doctor, when pain, breathlessness or delirium get out of hand ?

I agree that assisted suicide in exceptional cases should not be prosecuted under criminal law. But to label assisted dying an "option" in terminal care is, in my view, a transgression.

* Madeline Li, M.D., Ph.D., Sarah Watt, Marnie Escaf, H.B.B.A., M.H.A., Michael Gardam, M.D., Ann Heesters, M.A., Gerald O’Leary, M.B., and Gary Rodin, M.D; Medical Assistance in Dying — Implementing a Hospital-Based Program in Canada; N Engl J Med 2017; 376:2082-2088.

Competing interests: Employee of a catholic hospital trust

18 August 2017
Joerg Wiesenfeldt
Staff Grade Neurologist
Verbundkrankenhaus Bernkastel-Wittlich
Koblenzer Str. 91, D 54516 Wittlich, Germany