'Stop opposing assisted dying' - BMJ

A living will Assisting a suicide is illegal throughout the UK

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The British Medical Journal has called on doctors' organisations to stop opposing assisted dying for terminally ill, mentally competent adults.

In an editorial the BMJ said it wanted the British Medical Association and royal colleges to move their position from opposition to neutrality.

Fiona Godlee, BMJ editor-in-chief, argued that "legalisation is a decision for society not doctors" and drew parallels with abortion legalisation in the 1960s which was initially opposed by medical bodies.

She said: "A change in the law, with all the necessary safeguards, is an almost inevitable consequence of the societal move towards greater individual autonomy and patient choice. But it may take a while, and it may not happen until we properly value death as one of life's central events and learn to see bad deaths in the same damning light as botched abortions."

The BMJ said it backed calls from the campaign group Healthcare Professionals for Assisted Dying (HPAD) which wanted medical bodies to be neutral on the issue.

Iona Heath, president of the Royal College of General Practitioners, wrote in the BMJ last month that the "apparently burgeoning enthusiasm" for assisted dying seemed surprising given recent history. This included "the involvement of doctors in state sponsored killings, personified by Josef Mengele, and the devastating private enterprise of Harold Shipman".

She said it would be impossible to draft a law robust enough to protect the sick and disabled, adding: "A malign government coming into power with legislation supporting assisted dying already in place is a deeply disturbing prospect. As individuals, very few of us act always in the interests of others and, because of this very basic truth, the legalisation of assisted dying, despite the very best of intentions, may render the most vulnerable even more so."

A BMA spokesperson said the organisation was "firmly opposed" to the legalisation of assisted dying adding: "If assisted dying was legalised, effective safeguards could not be implemented without the involvement of doctors. It is therefore appropriate for doctors to voice their views on this issue."

The BMA annual meeting later this month will debate several motions urging neutrality on the issue of assisted dying.

Fergus Walsh Article written by Fergus Walsh Fergus Walsh Medical correspondent

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  • rate this

    Comment number 25.

    Near the end of life, people often endure pointless suffering and a kind and caring society should allow people to choose when they die, including a pre directive of what circumstances they receive a lethal injection. If I were in the advanced stages of dementia, I would want a lethal injection.

  • rate this

    Comment number 24.

    If people who are mentally competent want to end their life to avoid suffering and pain then they should be allowed to do it. Just as doctors should respect living will requests not to resuscitate a person who has died. Whilst life is precious, death will come to us all and when that person wants it we should make their passing as dignified and pain free as possible.

  • rate this

    Comment number 23.

    I'm sure assisted dying will come - I just hope I live long enough to benefit from it.

  • rate this

    Comment number 22.

    Assisted dying?

    What, like 20 Pakistani villagers at a wedding were "assisted to die" by an American drone strike, you mean?

    It's killing. Plain and simple, just like the above.

    However, I'd say it's not always wrong, unlike the example I gave, and I can imagine circumstances when I'd be grateful for someone to finish me off too.

  • rate this

    Comment number 21.

    The best argument against assisted dying is the threat to vulnerable people, i.e. those who would not want the option but choose it because it is available to them.

    However, I believe that with rigorous safeguards and a very small number of procedures it may be viable.

  • rate this

    Comment number 20.

    This doesn't go far enough. I have good health now, but I would not want to continue living if my quality of life significantly drops in the future (eg permanent/constant pain, severe brain damage, severe incontinence, etc). I should be able to express my wishes now and have them carried out should such a situation arise. It's my body and life, not anyone else's.

  • rate this

    Comment number 19.

    I honestly can't fathom why people oppose this still. Why do people treat death like it's something to be constantly fought? It may be ultimate, but if people want to die at home, or quickly rather than slip away slowly in unbearable agony, then honestly, what is more cruel? As someone else said, we put down animals when there's nothing we can do for them, rather than let them linger on in pain.

  • rate this

    Comment number 18.

    Neutrality is the best position
    The subject matter is even less contentious than abortion, since the life has awareness and choice

    Not a pretty subject though, a brutal reality

    In it's defence, older people are far more acutely aware of the value of life because we have a lot less of it left

    When I was young I was going to live forever. Now I know I can't

  • rate this

    Comment number 17.

    I made a bucket list about 8 years ago, last thing on it is my wish to die free falling from a plane into the ocean, its an odd wish granted but if I'm ever walking up the path to deaths door I want the chance to face it my way. I hate that I don't have that right at the moment, we all die, I want to enjoy my death as much as I've enjoyed my life.

  • rate this

    Comment number 16.

    When my dog reaches the end of his life and I can see that he is distressed, I shall take him to the vet and he will be put to sleep. My wish is that I should be able to have that service available to me because the thought of a slow painful end fills me with horror. There is nobody alive on this earth that has the right to tell me how I should make my exit.

  • rate this

    Comment number 15.

    True story:- One Doctor decided to allow terminally ill person to slip away,Religious do gooder called in second Doctor who stopped decline, Resulting in untimely death of overstressed carer, followed by death of patient. We DO need a proper plan for death as it approaches, not religious dreams, and interfering do-gooders. Your beliefs have nothing to do with my Death

  • rate this

    Comment number 14.

    I stood by my father's hospital bed and asked my son to stand on the tubes or pull the plugs if I ever got like my dad. I doubt very much if my emotive request will ever be acted upon but I would hope that if I was suffering a protracted and distressing end, those charged with my care would veer strongly towards pain relief and nothing to prolong life rather than intervention for no real purpose.

  • rate this

    Comment number 13.

    It should be the individuals right to decide if they wish to die or not, religion and modern medicine should have nothing to do with the matter. I have seen enough people with terminal illness suffer the indignity of having to be cared for by others and lose control of their faculties and bodily functions to know that this is not something we should be aspiring to.

  • rate this

    Comment number 12.

    As things stand, I'd rather be treated by a vet if I contract a terminal illness.
    I'd be treated while I had some quality of life, and allowed to die with dignity instead of being forced to continue to suffer because some irrelevant religious organisation refuses to see that causing someone to endure intense suffering does not enhance the greater glory of their god.

  • rate this

    Comment number 11.

    Each person should have the right to determine the manner and timing of their own death. The problem is, once you reach the stage where you need to consider it, you are often in a position where you can't easily articulate your wishes.

    I think it is important that we all think about what treatment we would or wouldn't want should we ever reach the point where we cant make decisions for ourself.

  • rate this

    Comment number 10.

    Nothing's ever black and white; but the BMJ has the right idea in suggesting a position of neutrality.

    Keeping someone alive in a state of terminal suffering is not a kindness - its inhuman. I know I'd rather die than suffer in the knowledge I'd never get any better.

    Yes, safeguards are vital and more discussion is needed, but at least unconditional opposition is rightly being questioned.

  • rate this

    Comment number 9.

    Well if we start to talk openly then progress can be made. My main concern is that Doctors may continue to take it upon themselves to ignore my living will. If this happens to me and I survive with enough faculty left then I would sue if I could. Let us use the same compassion we use for pet dogs!!!

  • rate this

    Comment number 8.

    Why prolong life beyond all reason? If someone terminally ill gets pneumonia, it is absurd to administer antibiotics - instead death should be eased. Is that assisted dying? In similar circumstances, should the attempt be made to treat stroke or heart attack - is that assisted dying? Doctors really should not "err on the side of caution" in such cases but on that of humanity,

  • rate this

    Comment number 7.

    With the drugs doctors prescribe killing 25,000 - 50,000 people a year in the UK, this is just another way to get some of those deaths recorded as 'assisted suicide' rather than killed by medications.

  • rate this

    Comment number 6.

    we should start by talking about death and dying more.


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