The editors of the BMJ recently put the prestige of their publication squarely behind “voluntary assisted dying”. In a long editorial with 30 footnotes, “Assisted dying: a question of when, not if”, they argued that Oregon’s model has worked smoothly and that “there is no evidence that palliative care deteriorates if assisted dying is available”.

They conclude that: “No professional should be obliged to participate in assisted dying. But doctors who oppose it should not stand in the way of colleagues who find it ethically justifiable to assist a dying patient’s death. Nor should they stand in the way of terminally ill patients who reasonably ask for doctors’ help to end their life.”

The editorial only attracted 13 comments, but the interesting thing is that all of them opposed the proposal. It’s obvious that Britain’s doctors are deeply divided on the issue.

Some of the comments are worth reporting:

‘Assisted dying’ is not widespread. The number of people with access to an assisted death is 2% of the world’s population. To put this in perspective, 41 states in the US do not allow assisted deaths, many have laws against it and the US has a federal law against euthanasia. (Claud Regnard, Retired Consultant in Palliative Care Medicine)

The claim that legislatures such as Oregon are ‘strictly monitored’ is a caricature; little data is collected, the decision-process is not monitored, and any documents are destroyed after one year.(6) Other legislatures collect even less data. (Claud Regnard, Retired Consultant in Palliative Care Medicine)

Once trust is lost it will be almost impossible to restore. With most doctors [in the UK] being employed by the state, the next step will be to bring doctor participation in this activity up to a standard of care. (Anthony M Brooks, Retired consultant anaesthetist)

This reflects a response to the significantly partisan stance of the BMJ, which is not proportionately representative of Membership views. (John E Etherton GP)

There is a real difference between palliative care — which is motivated to make a person’s last days as comfortable and bearable as possible — and mercy killing — which is motivated to actively and consciously terminate a life. (Eugene Breen, Psychiatrist)

In Oregon, official data document progressive increases in both the number and proportion of patients who receive a medically assisted death because of concerns about being a burden on others. (H Lucy Thomas. Consultant in public health and specialty doctor in palliative care)

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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