BMA moves to neutral stance on assisted dying

Press release | 14th September 2021

Doctors’ body to follow Royal College of Physicians and Royal College of Nursing in adopting neutral position to represent range of members’ views on topic
Majority of doctors disagree with BMA’s longstanding opposition to assisted dying and half personally support law change, 2020 survey found
Decision comes as House of Lords prepares to debate Assisted Dying Bill next month, with consultation on Assisted Dying Bill in Scotland and debate on citizen’s jury recommendations in Jersey due in coming weeks

The British Medical Association (BMA) will move to a position of neutrality on a change in the law on assisted dying, following a vote at its Annual Representative Meeting today (Tuesday 14 September 2021). The debate follows the largest ever survey of medical opinion on assisted dying last year, which found a majority (61%) of members disagreed with the BMA’s longstanding opposition to law change on assisted dying. The BMA will now join the Royal College of Physicians, the Royal College of Nursing and other medical bodies in adopting a position of neutrality.

The decision comes as the House of Lords prepares to debate prospective assisted dying legislation next month (22 October 2021) for the first time in six years. The Assisted Dying Bill, brought by Chair of Dignity in Dying Baroness Meacher, would enable terminally ill, mentally competent adults to request assistance to die in a manner, timing and place of their choosing, subject to approval by two independent doctors and a High Court judge – a change supported by 84% of the British public. A consultation is also due to begin on an Assisted Dying Bill in Scotland in the coming weeks and the States of Jersey is set to debate recommendations for law change by a citizen’s jury later this year.

In 2019 Dr Jacky Davis, Chair of Healthcare Professionals for Assisted Dying, proposed a successful motion calling on the BMA to survey its members for their views on assisted dying – something it had never done despite holding an official policy of opposition to law change for several years. It followed the Royal College of Physician’s decision in 2019 to adopt a neutral position after a survey of its own members views found a split in opinion.

As a result, in February 2020 BMA members were asked, among other questions on the topic, what the organisation’s position should be regarding a change in the law on assisted dying to allow doctors to prescribe drugs for patients to self-administer in order to end their own life. 40% said the BMA should support a change in the law, 21% said the BMA should take a neutral position and just 33% thought the BMA should maintain its opposition. When asked for their personal views on law change, 50% of doctors were in favour of law change on assisted dying with 39% opposed and 11% undecided.

Today a motion to move the BMA to a neutral stance “in order to represent the diversity of opinion” on assisted dying was passed at the BMA’s Annual Representative Meeting, after 49% of the Representative Body (members who are elected or appointed to attend the Annual Meeting and vote on BMA policy) voted in favour, with 48% voting against and 3% abstaining (of 302 total votes).

Dr Jacky Davis, Chair of Healthcare Professionals for Assisted Dying, said:

“The BMA should be commended for listening to its members and for adopting a position which now represents the range of views on assisted dying among doctors fairly and accurately. A neutral position promotes inclusion, respects diversity of thought and gives the BMA a seat at the table in this historic debate. It will enable our profession to contribute constructively to future legislation to help ensure it works for doctors, works for dying people and works for society as a whole.”

Alison Pickard, 64 from Nottinghamshire, a grandmother of 3 and nurse for more than 40 years, was diagnosed with motor neurone disease in 2012. She said:

“As a former healthcare professional now living with a terminal illness, I am delighted that the BMA is taking a more balanced view on assisted dying. Personally, it would give me great reassurance and peace of mind to know that the excellent support I receive from my medical team could extend to allowing me to determine how, when and where I die. It is terminally ill people and their families who should be leading this discussion and it is right that medical organisations contribute constructively without actively blocking a change that so many patients desperately want.”

Sarah Wootton, Chief Executive of Dignity in Dying, said:

“This is an historic decision and a victory for common-sense. It brings the BMA in line with a growing number of medical bodies in the UK and around the world that truly represent the range of views that healthcare professionals hold on assisted dying.

“With the House of Lords, Holyrood and the States of Jersey due to debate assisted dying proposals in the coming weeks and months, it is essential that discussions are conducted fairly and based on facts. Last year’s BMA survey, the largest ever of medical opinion on assisted dying, proved that its stance of opposition was unrepresentative and undemocratic, silencing great swathes of its membership. It also revealed that more doctors now personally support law change than opposite it.

“By adopting a position of engaged neutrality the BMA can now proudly and accurately advocate on behalf of its members, while sending a message to Parliament that assisted dying is, rightly, an issue for society, where the views of dying people and their loved ones should be heard loud and clear.”

*ENDS*

For more information or interview requests, please contact Ellie Ball at ellie.ball@dignityindying.org.uk or 07725 433 025.

Notes to Editor

Dignity in Dying

Dignity in Dying campaigns for greater choice, control and access to services at the end of life. It campaigns within the law to change the law, to allow assisted dying as an option for terminally ill, mentally competent adults with six months or less to live – something supported by 84% of the public (Populus, 2019).

Assisted dying is prohibited in England and Wales under the Suicide Act (1961), and in Northern Ireland under the Criminal Justice Act (1966) which states that anyone who “encourages or assists a suicide” is liable to up to 14 years in prison. There is no specific crime of assisting a suicide in Scotland, but it is possible that helping a person to die could lead to prosecution for culpable homicide.

Healthcare professionals

The British Medical Association (BMA) has today (Tuesday 14 September 2021) voted to drop its official opposition to a change in the law on assisted dying in favour of neutrality, following a debate at its Annual Representative Meeting.

The largest ever poll of British doctors on assisted dying, conducted by the BMA in February 2020, results of which were released in October 2020, found overwhelming support for a change to the BMA’s current stance of opposition to an assisted dying law (61%), and that half of doctors personally support a change in the law (50%).

In March 2019, the Royal College of Physicians (RCP) dropped its longstanding opposition to assisted dying in favour of neutrality following a member survey.

The Royal Society of Medicine, Royal College of Nursing (and Royal College of Nursing Scotland), the Royal College of Psychiatrists and the Royal Pharmaceutical Society all also hold neutral positions on assisted dying.

The Academy of Medical Royal Colleges, Association of British Neurologists, General Medical Council, General Pharmaceutical Council, Royal College of Anaesthetists, Royal College of Obstetricians and Gynaecologists, Royal College of Ophthalmologists, Royal College of Paediatrics and Child Health, Royal College of Pathologists, Royal College of Physicians of Edinburgh, Royal College of Radiologists and Royal College of Surgeons of Edinburgh have no stated position on a change in the law on assisted dying.

In September 2020, Eminent GPs Prof Aneez Esmail and Sir Sam Everington launched a legal challenge to the Royal College of GPs (RCGP) alongside the Good Law Project and Dignity in Dying over RCGP Council’s decision to maintain opposition to assisted dying despite its own survey showing a dramatic shift in GP opinion. The Association for Palliative Medicine and the Royal College of Surgeons of England also hold a stance of opposition to a change in the law on assisted dying.

Assisted Dying Bill

Baroness Meacher’s Assisted Dying Bill was selected seventh in the House of Lords private members ballot in May and received its First Reading on Wednesday 26th May 2021. It will receive its Second Reading on Friday 22 October 2021. The full text can be found here: https://bills.parliament.uk/bills/2875. It is based on a bill introduced by Lord Falconer in 2014. Rob Marris MP introduced a similar bill in 2015 which was defeated in the Commons.

The functioning of the current law on assisted dying was the subject of a Backbench Business Committee Debate in July 2019 and a Westminster Hall debate in January 2020, at which a majority of MPs speaking called for a review of present legislation.

In April 2021, the then Health Secretary announced to the All Party Parliamentary Group on Choice at the End of Life that he had requested data from the Office for National Statistics on suicides by terminally ill people and assisted deaths in Switzerland of British nationals. This followed comments Mr Hancock made in the House of Commons in November 2021 and January 2021 highlighting the Government’s role in obtaining a fuller understanding of the functioning of current assisted dying laws and stressing the importance of suicide prevention and patient safety measures.

Assisted Dying Scotland Bill

Liam McArthur, Lib Dem MSP for Orkney, lodged the ‘Assisted Dying Scotland’ Members Bill proposal with the Non-Government Bill Unit (NGBU) of the Scottish Parliament in June 2021. A Consultation on the contents of the bill is planned to take place in the autumn.

The proposal seeks to introduce the right to choose an assisted death for terminally ill, mentally competent adults in Scotland.

Jersey’s citizen’s jury on assisted dying

Since March 2021 a citizen’s jury in Jersey has met to hear expert and personal testimony on assisted dying and to consider a change in the law on the island. The jury published its initial recommendations in June, calling for islanders who are terminally ill and unbearably suffering to be able to request medical assistance to end their own life.

Over the coming months the States of Jersey will develop policy proposals and the jury will publish a final report before a debate in the States Assembly by the end of this year.

International developments

In the US, assisted dying as an option for terminally ill, mentally competent adults in their final months of life is legal in 11 jurisdictions: Oregon (1997), Washington, Vermont, Montana, the District of Columbia, California, Colorado, Hawaii, New Jersey, Maine and New Mexico (legislation approved April 2021).

In Australia, assisted dying is a legal choice for terminally ill citizens in Victoria (June 2019), Western Australia, Tasmania and South Australia (legislation approved June 2021). A bill is currently being debated in Queensland.

New Zealand is set to implement an assisted dying law allowing this option for terminally ill, mentally competent citizens by November 2021, following a public referendum on the End of Life Choice Act in October 2020.

Spain passed a law allowing assisted dying in March 2021 to be implemented later this year.

In Ireland, assisted dying is set to be examined by a Special Oireachtas Committee, as recommended by the Justice Committee in July 2021.

Austria’s Supreme Court ruled in December 2020 that its blanket ban on assisted dying is unconstitutional and the practice will be decriminalised in limited circumstances by 2022.

Germany began considering potential assisted dying legalisation in January 2021 after its Constitutional Court struck down the ban in 2020.

Canada introduced assisted dying legislation in 2016.

Assisted dying is permitted in Switzerland, including for foreign nationals, and broader right-to-die laws are in place in Belgium, the Netherlands and Luxembourg.