Intended for healthcare professionals

Rapid response to:

Editor's Choice

Assisted dying: your vote counts

BMJ 2020; 368 doi: (Published 20 February 2020) Cite this as: BMJ 2020;368:m646

Rapid Response:

Do not medicalize assisted dying – say no!

Dear Editor,

The BMA is currently polling members on whether it should change its opposition to doctor assisted dying.

On BMJ Opinion the doctors Iona Heath and Ole Hartling write that patients might feel “abandoned” by doctors if assisted dying were legal and that “Humanity’s response to unbearable suffering must be more than simply eliminating the sufferer,” they insist. We would like to stress that the key concept in the debate “humanity’s response” has not been clearly argued.

We physicians are not trained in delivering painless death. Nor should we be so trained. Humanity’s insistence on lassoing physicians into the debate and eventually into becoming the executioners for assisted killing is a massive denial and distancing from the process of dying. Medicalization of assisted killing is not the way forward. If we are to respect humanity’s response to unbearable suffering we should allow compassionate killing to occur in one’s family with intimately involved members carrying out the procedure. This can easily be accomplished without physicians’ involvement. Ten years ago Ogden and colleagues demonstrated that, for example, the dying process of oxygen deprivation with helium is potentially quick and appears painless. It also bypasses the prescribing role of physicians, effectively demedicalising assisted killing [1].

In the great majority of countries where euthanasia is legalised, there have been extensions of its criteria [2]. We suggest that this dynamic can be halted by international agreements of medical societies to reject involvement in assisted killing.

1. Ogden RD, Hamilton WK, Whitcher C. Assisted suicide by oxygen deprivation with helium at a Swiss right-to-die organisation. Journal of medical ethics 2010;36(3):174-9. doi: 10.1136/jme.2009.032490 [published Online First: 2010/03/10]
2. Gale C, Barak Y. Euthanasia, medically assisted dying or assisted suicide: time for psychiatrists to say no. Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists 2019:1039856219878645. doi: 10.1177/1039856219878645 [published Online First: 2019/10/02]

Competing interests: No competing interests

26 February 2020
Yoram Barak
Dr C Gale
Dunedin School of Medicine, University of Otago, New Zealand