Intended for healthcare professionals

Head To Head

Should doctor assisted dying be legal?

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k562 (Published 07 February 2018) Cite this as: BMJ 2018;360:k562

Re: Should doctor assisted dying be legal?

I am a UK-trained physician now practising in British Columbia (BC), Canada. I have provided over 20 medical assisted deaths for my own patients and those referred by other physicians. In my experience, one of the most remarkable consequences of the change of the law in Canada in June 2106 has been the immense anxiolytic effect that patients and their loved ones get from the knowledge that they, the patient, are in charge of when their suffering ends. Not the disease, not the doctor: the patient. This is powerful stuff and the medical profession in the UK should not stand in the way of what is one of the most significant improvements in the options available to patients suffering intolerably and irremediably, especially at the end of life.

I accept there are concerns amongst those opposed to medical assistance in dying (MAID). There are scare stories about slippery slopes; the evidence is pretty clear that there isn’t one. There are fears that physicians will be seen as encouraging suicide; actually MAID is very different from suicide resulting from mental illness and there is no evidence that it does anything of the sort. There is the belief that patients will distrust their physicians because we are supposed only to help prolong life; in fact, most patients are pleased to learn that we are more interested in their well-being and their autonomy than in our own rather narrow view of the role of the physician at the end of life. I get thanked on a weekly basis for being involved in providing MAID.

MAID is supported by Canadians. 87% of people in BC support it. On Vancouver Island, a part of BC with a population of nearly 800,000, where I practise, currently 4-5% of those who die choose to do so via MAID. Given that the hallmark of MAID is the peacefulness of the patient’s death, I would be rather surprised if the numbers were wildly different in the United Kingdom should MAID be made legal there.

I am confident that MAID will come to all modern, liberal democracies in due course. I am thankful that my Canadian patients have the choice already.

Competing interests: I am a Board member of Dying With Dignity Canada and the Chair of its Physicians Advisory Council I am a Board member of the Canadian Association of MAID Assessors and Providers

13 February 2018
Jonathan G Reggler
Family physician
Comox, BC