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End of life decisions

Views of the BMA
July 2006

The British Medical Association has several publications dealing in detail with aspects of end-of-life decisions. These include chapters in its general textbook, Medical Ethics Today (2nd edition 2004), Withdrawing and Withholding Life Prolonging Medical Treatment (3rd edition available 2007), and Advance Statements about Medical Treatment (1994 currently under revision).

This guideline summarises the BMA's views on three main issues:

• Contemporaneous and advance refusal of treatment
• Withholding and withdrawing life-prolonging medical treatment
• Assisted dying: euthanasia and assisted suicide

Background to BMA policies
The British Medical Association is a professional association for doctors. Its policies are formulated at its annual representative meeting where motions submitted by the BMA membership are debated. If approved, they become BMA policy.

End-of-life issues are frequently a matter of such debate, including concerns about the availability of good quality palliative care. In its policies, the BMA distinguishes between the right that every person has to be supported and cared for during the process of dying and requests that patients sometimes make that the doctor should deliberately hasten their death. The Association emphasises patients' clear and indisputable right to care and assistance while dying but does not believe that patients have a right to assistance to end their lives.

Many doctors worry that high profile media interest in other aspects of end of life treatment may detract attention from issues such as palliative care provision. In 2005, a House of Lords Select Committee criticised the gaps in palliative care provision. It said services were inadequately resourced and unevenly spread. BMA members echoed this point. In 2006, the Government acknowledged that more investment was needed and pledged to double funds for palliative care services. Nevertheless, a continuing matter of concern for the Association remains the uneven availability of good quality palliative care for patients who want it.

See also
- Medical Ethics Today
- Withdrawing and Withholding Life Prolonging Medical Treatment