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BMA should drop its opposition to assisting dying, say members in landmark poll

BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3936 (Published 09 October 2020) Cite this as: BMJ 2020;371:m3936
  1. Ingrid Torjesen
  1. London

The BMA should drop its stance against changing the law on assisting dying, say a majority of members voting in an historic poll.

The poll, the first ever by the BMA on its members’ views on assisted dying, found that a third (33%) of those responding supported its current position of opposing a change in the law to allow physician assisted death or physician assisted suicide (table 1). Forty per cent of respondents said the BMA should support a law change that would permit doctors to prescribe drugs to eligible patients for self-administration to bring on death, 21% said it should take a neutral stance, and 6% were undecided.

Table 1

Should the BMA support a change in the law to permit doctors to prescribe drugs for eligible patients to self-administer to end their own life?

View this table:

John Chisholm, chair of the BMA’s medical ethics committee, emphasised that the results would not automatically change BMA policy to oppose assisted dying in all its forms. “That will only change should members at the BMA’s annual representative meeting (ARM) vote to do so,” he said in a blog.1 “The next meeting is scheduled to take place in June 2021; the results will play an important role in informing that discussion.”

The anonymous poll, conducted in February by Kantar, is one of the largest ever surveys of doctors’ views on assisted dying. Sent to 152 004 BMA members, it generated 28 986 responses (a 19.4% response rate).2

Half of the respondents (50%) said that they were personally in favour of a law change, although many of these considered it better for the BMA to take a neutral position. Those personally opposed to a change in the law accounted for 39% of respondents, and 11% were undecided. And when it came to their willingness to prescribe life ending drugs themselves, 36% were prepared to do so, 45% were not, and 19% were undecided.

Commenting on the findings, Jacky Davis, chair of Healthcare Professionals for Assisted Dying, said, “We now know what we’ve suspected for many years: that there is a wide range of views among doctors, and support for law change is growing year by year. For too long the medical establishment has opposed assisted dying without listening to the opinions of the profession as a whole.”

But she added, “The BMA should be commended for conducting a very thorough and fair survey and for securing a huge turnout of members.”

Sarah Wootton, chief executive of Dignity in Dying, agreed, describing the poll as an “historic vote” that showed that the BMA’s official opposition to assisted dying was “completely unrepresentative of its members.”

She said, “We look forward to the BMA reviewing its position so it can truly claim to represent the range of opinions of its members.”

Within the last two years the Royal College of General Practitioners and Royal College of Physicians have both surveyed members on assisted dying, and the results showed that 51% and 57%, respectively, wanted their colleges to stop opposing a change in the law on assisted death. The RCGP decided that the result did not support a change in its view, but the RCP changed its position and now adopts a neutral stance.34

Gordon Macdonald, chief executive of Care Not Killing, said that in all of these surveys the strongest opposition to changing the law came from doctors who worked most closely with terminally ill, elderly, and disabled patients in palliative care, geriatric medicine and general practice.

“These doctors are concerned about the discriminatory message that singling out terminally ill and disabled people would send,” he said. “Many active medics have repeatedly rejected the mendacious claims made by those pushing for this change, namely that legalising assisted suicide and euthanasia can be done with safeguards and would not put pressure, real or perceived, on vulnerable people to end their lives prematurely.”

The results of the BMA poll also show that non-practising doctors, such as students, the retired, and those who do not hold a licence to practise, are more supportive of change in the law on assisted dying than practising doctors and that doctors in Northern Ireland are less supportive than those in other UK nations.

While there was overwhelming support for a change in the BMA’s stance on assisted dying, far fewer doctors were supportive of a change in the BMA’s position on voluntary euthanasia. Only 30% of respondents believed the BMA should support a change in the law to permit doctors to administer drugs to end a patient’s life, while 40% said it should continue to oppose voluntary euthanasia, 23% said it should take a neutral stance, and 7% were undecided.

Almost half of the respondents (46%) were personally opposed to a change in the law on voluntary euthanasia, 37% supported a change, and 17% were undecided. More than half of doctors responding (54%) would not want to administer life ending drugs themselves, only 26% said they would be willing to do so, and 20% were undecided.

References

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