This article appears in the May 2004 edition of the Catholic Medical Quarterly

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Assisted Dying for the Terminally Ill Bill

Second Reading 10 March - Summary of the BMA Views

The Bill seeks to legalise assisted suicide and also purports to make provision for terminally ill individuals to receive pain-relieving medication. In respect of the first part of that aim, the BMA has consistently opposed euthanasia and physician assisted suicide for the following reasons

In 2000, the BMA held a two day conference to promote the development of consensus on physician assisted suicide. Overwhelmingly, BMA members, from a wide range of moral viewpoints, agreed that they could not recommend a change in the law to allow voluntary euthanasia and physician assisted suicide. Part of the reason for this consensus concerned the high risks if assisted suicide came to be accepted as a viable option for people not specifically mentioned in this Bill but who would inevitably be affected by it: vulnerable, dependent or very impressionable sick people.

Although views in society differ about the legitimate or appropriate uses of medical skills, the primary goal of medicine is still seen as promoting welfare, protecting the vulnerable and giving all patients as good a quality of life as is possible. In the BMA's view, permitting euthanasia or physician assisted suicide would irrevocably undermine this primary goal of medicine, impacting on how doctors relate to their own role and to their patients. The BMA recognises that patients are not only benefited by physical and clinical improvements but are also benefited by having their own values respected and being enabled to achieve their personal goals. Nevertheless, we believe that in the case of euthanasia and assisted suicide, benefit for an individual, in terms of having their wishes respected, is only achievable at too high a cost in terms of potential harm to society at large.

The Bill's second proposition is that there needs to be legal provision for pain relief. In the BMA's view, this plays on unjustified public fears about the possibility of intolerable or unrelieved pain at the end of life. In fact, the law and ethical position are already clear on the right of patients to receive the most effective pain relief available. This right - and doctors' ability to prescribe appropriately - is not compromised by the fact that effective medication might have the side effect of shortening some patients' lifespan. Control of pain, or other symptoms, and of psychological, social and spiritual problems, is paramount. The goal of care in terminal illness is achievement of the best quality of whatever life remains for patients and their families.