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
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
Wootton, Chief Executive of Dignity in Dying said:
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.”
About Dignity in Dying:
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.
in Dying has over 25,000 supporters and receives its funding entirely from
donations from the public.
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%.
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
to the BMA’s ARM page including agenda and motions: http://www.bma.org.uk/whats_on/annual_representative_meeting/index.jsp
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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enquiries, please contact Jo Cartwright on 020 7479 7737 / 07725433025 or at firstname.lastname@example.org