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:
- 97% of people who have had an assisted death in Oregon have experience no reported complications.
- 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.
- 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).