News / Press Releases
01 Jul 2010: BMA issues guidance on patient requests to die, but fails to provide full debate on assisted dying at annual conference
The British Medical Association (BMA) missed an important opportunity to fully debate assisted dying at their Annual Representative Meeting (ARM) today.
Over 20 motions were put forward to discuss assisted dying, representing both sides of the argument, but only one was debated: a motion forwarded by Baroness Finlay, a vocal opponent of assisted dying. The motion which was supported by the conference noted that if able to access good quality end-of-life care, requests for assisted dying are rare. Research by Professor Clive Seale of nearly 3,000 deaths found that in nearly 1 in 10 cases patients requested that their death be hastened, and that this request remains largely persistent. Dignity in Dying acknowledges that the majority of people would be able to have what they consider to be a dignified death if they can access good quality end-of-life care, but the BMA today failed to discuss what should be done to alleviate the suffering of those patients for whom palliative care is not the answer.
Such a debate is urgently needed. The BMA recently issued guidance on responding to a patients request for assistance to die. This guidance, whilst helpful in setting out what doctors cannot do for patients asking for help to die, does not offer practical advice on what doctors can do for patients asking for this assistance; it does not point doctors towards lawful tools which can empower patients to make end-of-life decisions for themselves such as Advance Decisions to refuse treatment or Lasting Powers of Attorney, and it does not reference exploring palliative care options.
Dr Ann McPherson, Patron of Dignity in Dying said:
"I am disappointed for a number of reasons about the way the BMA's conference has unfolded.
"The issue of assisted dying was put forward to the ARM for debate in at least 20 motions, some in favour and some opposed; unfortunately time was only made available to debate a motion by a vocal opponent of assisted dying. There is a need for clear debate on this issue and the BMA needs to allow all of its members the opportunity to make their voices heard.
"In light of this the BMA should follow the RCN's lead and undertake a proper consultation into the views of all of its members. Ultimately I believe there will be sufficient support for this much needed change in the law to provide greater choice and control to patients at the end of their lives, as well as better protecting patients and doctors."
Sarah Wootton, Chief Executive of Dignity in Dying said:
"It is unfortunate that the BMA's conference had time to acknowledge that an assisted dying law would be limited to people who are terminally ill and suffering despite the best palliative care, but it did not find time to discuss what doctors should do for those patients for whom palliative care is not enough. Baroness Illora Finlay, who put forward the motion which was discussed, acknowledges that Palliative Care is not a blanket panacea, what we would like to see now is doctors discussing what can be done for those patients who suffer despite the best end of life care and who want the choice of an assisted death within safeguards.
"Recent guidance from the BMA does helpfully recognise that patients have a legal right to access their medical records, necessary for an assisted death abroad, and advises doctors to do no more than provide these records. The guidance, however, fails to point doctors towards existing and lawful ways in which patients can have choice and take control at the end of their lives. Advance Decisions to refuse treatment are crucial for dying patients who want control over their treatment decisions.
"While doctors will have their own views on issues of conscience such as assisted dying, and absolutely must have the option to refer patient's onto another doctor if they conscientiously object to a patients request, medical bodies like the BMA should be offering practical advice to doctors which promotes patient choice within the boundaries of the law, and which allows doctors to work within the law to compassionately help their patients to have what they consider to be a good death."
Notes to
editor:
About Dignity in Dying:
· Dignity in Dying campaigns for greater choice, control and access to services at the end of life. It advocates providing terminally ill adults with the option of an assisted death, within strict legal safeguards, and for universal access to high quality end-of-life care.
· Dignity in Dying has over 25,000 supporters and receives its funding entirely from donations from the public.
· The
British Social Attitudes Survey 2010 found that 92% of non-religious and 71% of
religious people support assisted dying. This relates to overall support of 82%.
· The
General Medical Council (GMC) defines terminal illness as: "patient's ...
likely to die within the next 12 months. This includes patients whose death is imminent (expected within a few
hours or days) and those with: A) advanced, progressive, incurable conditions.
B) general frailty and co-existing conditions that mean they are expected to
die within 12 months. C) existing conditions if they are at risk of dying from
a sudden acute crisis in their condition. D) life-threatening acute conditions
caused by catastrophic events.
· Seale C (2009) Hastening death in end-of-life care: A survey of doctors Social Science & Medicine69(11): 1659-66
BMA
· Link
to the BMA's ARM page including agenda and motions: http://www.bma.org.uk/whats_on/annual_representative_meeting/index.jsp
· Link to the BMA guidance for doctors on assisted dying requests: http://www.bma.org.uk/whats_on/annual_representative_meeting/index.jsp
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