Legalise assisted suicide because 'choice’ the most important principle in medicine – says BMJ

Legalise assisted suicide because 'choice’ the most important principle in medicine – says BMJ

Assisted dying should be legalised because respecting “choice” is now more important than preserving life, the influential British Medical Journal argues today.


Breaking ranks with the medical establishment, it has issued an outspoken editorial backing a bill tabled by the former Lord Chancellor Lord Falconer which would open the way for a form of assisted suicide in the UK. It argues that “respect for autonomy” – rather than the ideas of the Hippocratic Oath – is now the “cardinal principle” in medical ethics amid a “patient revolution”. The journal accuses professional bodies – including its owner, the British Medical Association – and the royal colleges, which oppose relaxing the euthanasia laws, of going to “extraordinary contortions” to avoid consulting their members on the issue.


“Ultimately, however, this is ultimately “a matter for Parliament, not doctors to decide,” it remarks.


It challenges MPs and peers to back the bill, describing them as “our timid lawmakers”. Supporters of the bill welcomed the intervention, saying it was recognition that a “growing number” of doctors and other medical staff support a change in the law. But the BMA insisted that the journal did not represent its views or those of the wider medical profession.


In just over two weeks Lord Falconer’s bill, which would enable doctors to prescribe lethal doses of drugs to terminally ill patients with a “settled intention” to end their lives, will have its first full parliamentary airing with a second reading debate in the House of Lords. Members of both houses are to be given a free vote on the issue and ministers, including Norman Lamb, the care minister, have already signalled they would support it.


Last week the President of the Supreme Court, Lord Neuberger, publicly challenged Parliament to review the law on assisted suicide or face intervention by the courts. The court turned down a challenge involving the family of Tony Nicklinson, the “locked-in syndrome” sufferer who fought a long campaign for assisted suicide, but signalled it could be prepared to declare the ban on helping someone to take their own life as “incompatible” with human rights if Parliament did not act.


“Let us hope that our timid lawmakers will rise to the [court’s] challenge,” the editorial remarks.


It goes on: People should be able to exercise choice over their own lives which should include how and when they die, when death is imminent.


“In recent decades, respect for autonomy has emerged as the cardinal principle in medical ethics and underpins developments in informed consent, patient confidentiality, and advance directives.”


Recognition of an individual’s right to determine his or her best interests lies at the heart of this journal’s strategy to advance the patient revolution in health care.


“It would be perverse to suspend our advocacy at the moment a person’s days were numbered.”


Dr Peter Saunders, campaign director of the Care Not Killing Alliance, said: “While autonomy is important it has to be balanced against other principles including public safety.


“None of us believes autonomy is absolute, if we did we would have to say that there was no place for law because every single law restricts personal autonomy.”


Sarah Wootton, Chief Executive of Dignity in Dying said: “We are delighted that the British Medical Journal has backed Lord Falconer’s Assisted Dying Bill.”


“The recognition by the leading medical journal of the importance of safeguarded patient choice in end of life care is to be welcomed, and comes at a time when a growing number of leading health care professionals are supporting such choice.”


Dr Mark Porter, chair of the BMA Council, said: "There are strongly held views within the medical profession on both sides of this complex and emotive issue.


"The BMA remains firmly opposed to legalising assisted dying.


"This issue has been regularly debated at the BMA’s policy forming annual conference and recent calls for a change in the law have persistently been rejected.


"The BMJ is a wholly owned subsidiary of the BMA, and quite rightly has editorial independence.


"Its position on assisted dying is an editorial decision and does not reflect the views of the BMA or the medical profession.


"Our focus must be on making sure every patient can access the very best of palliative care, which empowers patients to make decisions over their care."

By John Bingham,

The Telegraph, Thursday 03 July 2014

View this article