Is the BMA starting to listen?

By Lloyd Riley

15 Jan

This week the BMA published findings from their ongoing research project into end-of-life care and assisted dying.

The British Medical Association (BMA) have this week published findings from their research project into end-of-life care and assisted dying. The BMA have called on the government to prioritise end-of-life care and encouraged them to address the current unacceptable variations in end-of-life care provision. These are aims which are shared by organisations on both sides of the assisted dying debate and Dignity in Dying adds its voice to this call.

The BMA have historically shown an unwillingness to engage with the issue of assisted dying, having never sought the views of its membership or acknowledged the overwhelming levels of public support for further choice at the end of life. The BMA therefore has no remit to justify its current stance of opposition to assisted dying and nor does it have a remit to repeatedly warn Parliamentarians about the hypothetical dangers of changing the law.

Therefore, it is encouraging that their research project involved events where the public and doctors were invited to voice their opinions.

Unsurprisingly, both members of the public and doctors recognised that changing the law on assisted dying would lead to improved communication and allow doctors to facilitate a ‘good death’.

It is critical the BMA listens to these results.

However, there were also concerns raised in the focus groups around the possible negative impact of changing the law, such as the potential impact on vulnerable people and anxiety around the motivations of doctors. We know these fears can all be addressed by looking at the evidence from jurisdictions that have introduced similar legislation, most notably Oregon, where an assisted dying has worked safely with any such problems for 18 years. The BMA must engage constructively with this evidence.

A particularly troubling aspect of the BMA’s report describes how some people were ‘surprised’ and ‘shocked’ to hear of complications such as ‘nausea and vomiting, seizure or muscle spasms’ in a number of cases of assisted dying in Oregon. However, this needs to be placed in context. The stimulus materials provided to participants said that 23 out of 530 people experienced such complications. This is sensationalist and does not reflect the evidence:

  1. 97% of people who have had an assisted death in Oregon have experience no reported complications.
  2. Whilst there are cases of individuals regurgitating the life-ending medication, data from Oregon shows no record of anyone having a seizure or muscle spasms. To imply that there are known examples of the more serious reactions is misleading.
  3. Participants were not made aware of the fact that additional safeguards have been put in place in the Bills proposed in this country, precisely to address concerns around possible complications.

Without this clarification it is unsurprising that members of the public and doctors expressed ‘emotional reactions’. This goes to illustrate the importance of having an honest, transparent and well-informed debate on this issue. The BMA have started the process, but there is clearly still a long way to go.

We look forward to seeing the BMA’s ‘reflections and recommendations’ when they are published later this year. We also hope BMA members will take into account the voice of their patients when they have the opportunity to debate the BMA’s current policy at this year’s Annual Representative Meeting (ARM).

If you’re a healthcare professional who supports assisted dying – consider joining HPAD.

  • Aileen Cheetham

    I want assistance when I die, please.

  • duncanheenan

    Dying is not a disease, it is the inevitable end we all come to, so I don’t see why doctors’ voices should be any louder than anyone else’s in this debate. Of course they are in the front line in dealing with dying people, but for people who have knowingly chosen the time of their own death and need assistance, why do doctors need to be involved at all, other than to confirm that the person is capable of making their own decision? Properly trained laymen could assist people to die, leaving doctors free to deal with people who want to live, and with no conflict with their consciences.

  • Folkert Veenstra

    At the moment only people who have got money can go to Switzerland to die. Personally I find the right to life should mean that it is humane for the person who is living his/her life. When it isn’t livable for the person anymore they should have to be able to end their own life and when they can’t do it theirselves with help of a professional than should it be possible that a professional does it.

    It should be always a favour from the professional, who needs to be reassured that the person really wants to die. It’s something what you shouldn’t hurry. A professional is a human too and it would be abnormal when they find it difficult.

    People needs to respect eachother. When someone really wants to die, they should have that choice. It would help as well with the amount of dramatic suicides.

  • Angela Coton

    Both my Husband and myself have discussed our dying wishes in detail. We don’t want to be left unattended as my Mother was to die alone with no water no respect. We wish to have assisted death even if not legalised by then, we will assist each other and go together. Assisted death should be left to the Public to vote on not the house of lords or MPs. We have been married 44 years now and are both sound of mind.

  • John Craigie

    why o why did did this not come out before the commons debate last year

  • Adrian Horne

    Receiving a diagnosis of Primary Progressive Multiple Sclerosis in 2009 was perhaps the toughest news possible after an extremely active life. There will be no improvement, and even recent research is finding it impossible to repair/replace myelin.
    Since this I have been diagnosed COPD and have urinary incontinence.
    I am commenting less for myself than on behalf of other people that I’ve met in this journey. I have been amazed how many people are severely distressed by the prospect of death and how many MORE are distressed at the thought of dying – badly !!!
    I am also commenting on the quantity of healthcare professionals that are supportive of Dignity in Dying. Over and over doctors, nurses, consultants and a full spectrum of NHS personnel, indicated their support as, each day, they see people die (or be kept alive) because someone else says so or objects.
    One person is entitled to have a say in this – the patient xx

  • VEforME

    It appears the information given out by the BMA as part of their research into end-of-life care and assisted dying is typical of the scaremongering from those opposing compassionate choice.

    We have a similar problem in Australia with the AMA (Australian Medical Association).

    The most recent Government Report on the Oregon Death with Dignity Act (Year 17) clearly states there have been NO seizures reported in the 17 years. It does state there have been 22 cases of regurgitation during the 17 years out of 859 assisted deaths (not 530 as in BMA info) and 1 complication designated “other”. In at least some of these 22 cases, the patient was already vomiting PRIOR toingestion of the fatal medication.

    There have been NO reports of regurgitation in Oregon in the last 3 years.

    It is useful to compare these very few adverse effects from an assisted death with the adverse effects reported with palliative care. In Australia, the “National Report on Patient Outcomes in Palliative Care”, 2014, covered 12828 deaths in the Terminal Phase of patient’s terminal illness. Of these, 512 patients (4%) reported moderate to severe nausea in the last days of their lives. Perhaps more significantly, 2762 (21.5%) reported moderate to severe pain and 2725 (21.2%) reported moderate to severe breathing problems.

    If assisted dying had been a legal option in Australia, dying patients could have chosen to avoid this futile and unnecessary suffering.

    Ian Wood
    National Coordinator
    Christians Supporting Choice for Voluntary Euthanasia, AUSTRALIA