Keep Assisted Dying Out of Healthcare
If you are a healthcare professional and,
whatever your views on assisted dying,
please consider these 5 questions
1. Well over half of practising UK doctors do not want to be involved in assisted dying.
Could this create conflicts and damage working relationships in your team?
Fact: of those expressing an opinion, 58% of practising BMA doctors do not want to prescribe drugs for assisted suicide and 70% do not want to prescribe euthanasia drugs.
[Sources: BMA Survey 2020; Pressures on GPs providing assisted dying; Burden of paticipating in AD]
Between 30-50% of doctors describe an emotional burden or discomfort about participation in assisted dying.
2. Canada, Oregon, Belgium and the Netherlands have all expanded their criteria for assisted dying.
Are UK doctors ready to discuss assisted dying, regardless of the prognosis?
3. Healthcare professionals are already struggling to cope with safeguarding legislation.
Could assisted dying safeguards cause similar difficulties?
Fact: the 2005 Mental Capacity Act was a milestone in protecting decisions made by individuals with capacity and on behalf of those lacking capacity.
[Sources: House of Lords select committee; CIPOLD inquiry; Action on Elder Abuse]
More than a decade later, healthcare professionals are still finding it difficult to comply with its legal safeguards. Abuse continues of older people and people with a learning disability.
4. Assisted dying is cheaper than providing care
Is it right that assisted dying would be funded in an NHS which has to ration treatment or care?
Fact: According to a health economic assessment published by Scottish health economists in 2020, the authors claimed that “the benefits to the individual patients who choose assisted dying may in fact be outweighed by the broader benefits to society through reduced resource use and the improved potential for organ donation.”
[Source: p69 in Clinical Ethics]
Canada estimates that assisted dying will save nearly 87 million Canadian Dollars (over £50 million) in 2021.[Source: Cost estimate for Bill C-7]
5. Individual patient choice and autonomy are important, but involving doctors to decide on assisted dying sacrifices that autonomy.
How confident do you feel at detecting subtle signs of coercion or fluctuating capacity?
Fact: Doctors do not make ‘life or death’ decisions- they advise on treatments by sharing decisions with patients. Judges, such as those in the Court of Protection, are trained in making objective and accountable assessments about an individual's request to have their life ended. In addition, judges are trained to correct legal errors.[Source: Role of doctors in assisted dying; Court of Protection; Whistle blowers]
Keep Assisted Dying Out of Healthcare
Is committed to achieve, for all:
Real and transparent separation of healthcare and assisted dying
Professionals caring for your health will only influence that aspect of care.
Decisions made with you about assisted dying will be the remit of the legal system
A real NHS
Real pressure to achieve better access to palliative care support and care
Real dignity and compassion
Individuals can continue to choose their preferred place of care
Fair treatment for those who do not have their own voice
Respecting individuals’ wishes in a compassionate and considered way
Is there an alternative?
If assisted dying is allowed the answer is:
Court Authorised Assisted Dying
1) Have decisions made by the courts (who would order the required drugs)
2) Make the UK the first in the world to provide scrutiny during the decision-making process.
3) Be outside mainstream clinical care
4) Ensure medical reports are only about the patient's medical condition
5) Enable healthcare professionals to opt-in as opposed to having to opt-out
Assisted dying should not be part of mainstream
Medically assisted dying frames assisted death as a straightforward medical solution to a medical problem, a solution that promotes compassion and autonomy and has no ill effects for individual patients or society. However, with medical criteria for what constitutes an acceptable reason for ending life, and with doctors as the arbiters and administrators, it extends medical authority rather than enhancing patient autonomy, with deeply damaging unintended consequences. Moving outside the medical frame brings the fundamental ethical and practical dilemmas into focus, facilitating serious discussion about how society should respond to people with mental capacity and a consistent desire to end their life prematurely.