Intended for healthcare professionals

Rapid response to:


Assisted dying: a question of when, not if

BMJ 2021; 374 doi: (Published 09 September 2021) Cite this as: BMJ 2021;374:n2128

Read our coverage of the assisted dying debate

Rapid Response:

Mercy Killing - Malice of intent

Dear Editor

The articles in the present BMJ promoting the killing of patients (under all its methods) confounds the issue and confuses people. There is a real difference between palliative care - which is motivated to make a person's last days as comfortable and bearable as possible - and mercy killing - which is motivated to actively and consciously terminate a life. Both sets of proponents could be classed as caring people who want what they see as best for their patients. A palliative care doctor may hasten death by administering opiates to relieve pain but the intent is not to kill but to comfort. A similar scenario may (and does) play out with a euthanasia doctor but the intent here may also be to reduce suffering but with the intention to kill. The palliative care doctor does not have malice of intent.

It seems that the crucial issue is around quality control (are some lives more sacred than others and who can decide when a life "is not worth living?"). The elderly, frail, disabled and vulnerable are at high risk from such evaluations and the most valuable foundation of human society is violated - the right to have one's freedom and life protected and respected.

Competing interests: No competing interests

14 September 2021
Eugene Breen
Psychiatrist, Associate Clinical Professor
Mater Misericordiae University Hospital Dublin, University College Dublin
62/63 Eccles St Dublin 7