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:

Assisted dying is open to Abuse

Dear Editor

If anecdotal reports (1) (2) and statistics showing a positive correlation between midazolam prescriptions and deaths in the over-65s (3) are to be believed, it appears that euthanasia may have already been taking place on an illegal basis, predominantly in care homes.

Since benzodiazepines are contraindicated in Acute Pulmonary Insufficiency, risking Respiratory Depression, particularly with intravenous administration (4), the increased use of midazolam during 2020/2021 is especially concerning.

Would doctors who have not adequately physically examined patients, thereby satisfying themselves that sedation is appropriate in every case, particularly in situations which include pulmonary symptomatology, and have subsequently not adequately monitored such treatment such that respiratory failure has ensued, be guilty of medical negligence? (5)

In the current environment where ‘Telemedicine’ has disrupted doctor-patient interactions (6) yet continues to be encouraged by politicians as reported, for example, by the Telegraph, rushing into legislation authorising Assisted Dying at this point in time would surely be premature and present many opportunities for abuse.

Palliative Care is clearly vitally important. However, relief of distress, whilst sometimes inevitably leading to death, does not have as its primary intention the ending of life.

“First, Do No Harm”, has never encompassed Playing God; it has been resisted by physicians for many years and for very good reason.

Further undermining the trust of an already terrified population at this stage would surely be a step too far?

(1) Fuller A. Care homes accused of using powerful sedatives to make coronavirus victims die more quickly as use rocketed 100%. The Sun 2020 Jul 12.
(2) Interview with Funeral Director, UK: Deaths Jumped 250% When Injections Began: Lindie Naughton Interviews Funeral Director John O'Looney. BitChute 2021 Sep 5.
(3) All cause mortality by age band (65 and over), January 2020 - June 2021, vs National prescriptions issued for midazolam hydrochloride 10 ml/2 mg ampoules for injection, January 2020 - March 2021

Competing interests: No competing interests

14 September 2021
Janet Menage
GP retired
Wales, UK