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Assisted dying: a question of when, not if

BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n2128 (Published 09 September 2021) Cite this as: BMJ 2021;374:n2128

Read our coverage of the assisted dying debate

Rapid Response:

Re: Assisted dying: a question of when, not if

Dear Editor,
The legalisation of assisted suicide would not only be the death knell for many of our vulnerable patients, but also for freedom for the medical profession, due to a toxic mixture with the campaign for restrictions on conscientious objection.
Respect for others' freedom was reflected in the recent BMA poll on assisted dying as, even though 50% supported a change in the law to permit assisted dying, only 36% of those polled would be personally willing to prescribe lethal drugs [1]. The results were more disparate for Euthanasia, with 37% supporting a change in the law, but only 26% willing to participate in any way in the process of administering drugs with the intention of ending an eligible patient's life. This infers that although some BMA members would support a legal framework, the majority (74%) would not be prepared to harm their patients, even if this were legal. They value freedom of opinion and so would tolerate others' views, but also expect their personal choice to be respected, even if there be a change in law.
Many health care practitioners would find referral complicit and an unacceptable degree of involvement in assisted dying. However, they would not restrict the freedom of others, so would be prepared to 'signpost', to let them know where they can go for another opinion. This would be in line with the current GMC position [2].

There is a subtle but real difference between referral and signposting and it works well for abortion [3]. It should be maintained in the name of freedom.

[1] BMA Physician-assisted dying survey Thursday 8 October 2020
Physician-assisted dying survey (bma.org.uk) https://www.bma.org.uk/advice-and-support/ethics/end-of-life/physician-a...
[2] General Medical Council. Good medical practice. London: GMC, 2019 Paragraph 52. Personal beliefs and medical practice
[3] Glasgow GPs do not need refer at all these days, only point to the Sandyford open access service.

Competing interests: No competing interests

12 September 2021
Anne Williams
GP Partner
Scottish Council on Human Bioethics
52 First Gardens