Intended for healthcare professionals

Rapid Response:

Our reply to Brewer: Respect is not fear

Has it come to the point that those pushing for physician assisted suicide (PAS) believe their only recourse is to claim that palliative medicine physicians are too frightened to speak up in support of PAS? These are the same doctors who for half a century have been fighting tooth and nail for more resources and developed UK palliative medicine into a speciality that is a key element of teams caring for 200,000 individuals of all ages, every year, in any setting. Brewer’s view of palliative care physicians should not be surprising after he and Michael Irwin wrote in 2015 that our ‘ ....doctrinaire views make them, in some very important respects, unfit—or at any rate, much less than ideal.....’(1)

Brewer is right that we have been too quiet. We have been too respectful and considerate of the views of others, but that is neither cowardice nor a fear of remarkable individuals such as Cicely Saunders. Indeed, a decade after she died the Association for Palliative Medicine polled its members and 92% were against legalising assisted suicide. It is time for us to stand up and be counted, but Brewer will not like our answer.

(1)Brewer C, Irwin M. In support of assisted dying. Palliative care: the promise and the reality. BMJ 2015; 350. doi:

Competing interests: No competing interests

05 February 2019
Claud Regnard
Honarary Consultant in Palliative Care Medicine
Carol Davis, Consultant in Palliative Medicine and Clinical End of Life Care Lead, University Hospital Southampton NHS Foundation Trust; Rob George, Medical Director St Christopher's Hospice, Professor of Palliative Care Kings College London and Consultant Palliative Care Guys and St. Thomas’ NHS Trust; Prof. David Oliver, University of Kent; Retired Consultant in Palliative Medicine; Rosemarie Anthony-Pillai, Consultant in Palliative Care, Peace Hospice, Watford; Amy Proffitt, Consultant in Palliative Medicine, Barts Health NHS Trust.
St. Oswald's Hospice
Regent Avenue, Newcastle-upon-Tyne, NE3 1EE