Sheila Hollins et al: The BMA is right to reject a neutral position on assisted dying

The BMA’s annual representative meeting was right to reject a policy of neutrality on “assisted dying.” The “do no harm” principle lies at the centre of clinical practice and underpins everything we do as doctors. For the BMA to fold its arms and tell the world that it has no policy on whether doctors should be licensed by law to supply lethal drugs to some of their patients would be absurd.

And it would send the misleading message that the association had changed its mind. As one speaker put it, the headline wouldn’t be that doctors had decided to be neutral in the debate: instead it would be spun with a headline “Doctors drop opposition to assisted dying.”

That is simply not the case – a survey of 1,000 GPs last year found that only 1 in 7 of them would be prepared to assess a patient for legalised assisted suicide.

Of course there are doctors who disagree with this view, and some are undecided. Differences of opinion are normal in any profession. Some believe that “assisted dying” is working without problems overseas. One speaker told the ARM that a law like Oregon’s would result in around 1,200 deaths a year from assisted suicide in Britain if we had a similar law here. The latest published data show otherwise. There has been a surge in such deaths since 2013: the comparable UK figure is now 2,000 – and rising. And we have no way of knowing with what care these cases are being handled, because there is no audit system in place.

So why is there this persistent pressure on the BMA to go neutral? It’s because the lobbyists know that, in the few jurisdictions which have gone down the “assisted dying” road, the first step has been to muzzle the medical profession. They know that medical neutrality is a stepping-stone to legalisation. The motivation behind these calls is political, not medical.

The lobbyists have tried to spin neutrality as a position which would “recognise and respect diversity” and “encourage open discussion”. The BMA’s existing policy does just that. It does not preclude any individual doctor from taking a different view. And its exhaustive 15-month-long study into ‘End of Life Care and Physician Assisted Dying’ (ELCPAD), on which both supporters and opponents of “assisted dying” were represented, has resulted in a balanced and extensive report on the subject.

What the lobbyists propose isn’t just assisted suicide but physician-assisted suicide. It’s only right that, if doctors are seen as the people who would have to engage in such practices, their representative body must be allowed to take a view. The majority of doctors who took part in the ELCPAD study’s extensive consultations did not regard involvement with such practices as compatible with their role. The BMA’s policy reflects this.

Sheila Baroness Hollins FRCPsych, FRCP (hon), St George’s University of London.
Heather Davis, BA Hons (cantab), Medical Student.
Sarah Johnson, Medical Student, Cardiff University.
Kevin O’Kane, FRCP, St Thomas Hospital, London.
Mark Pickering, MRCGP, Yorkshire.
William Sapwell, MBChB, F2 rotation, Sheffield.
Gary Wannan, MBChB, Bsc(Med Sci), DCH, MRCPsych, DipFT, Parkside Clinic, London.

Competing interests: SH is a patron of Living and Dying Well. HD, SJ, KO’K, MP, WS, GW: None declared.