Physician-assisted dying

The BMA adopted a neutral position on PAD (physician-assisted dying) at the annual meeting in September 2021. Read more about what PAD is, the law across the world, the survey we did and the BMA's position.

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BMA position on physician-assisted dying

We represent doctors and medical students who, like the wider public, hold a wide range of views on physician-assisted dying.

On 14 September 2021 our policy-making body (the representative body) voted in favour of a motion changing the BMA’s policy from opposition to a change in the law on assisted dying, to a position of neutrality.

This means we will neither support nor oppose attempts to change the law. We will not be silent on this issue, however. We have a responsibility to represent our members’ interests and concerns in any future legislative proposals and will continue to engage with our members to determine their views.

The debate at our annual meeting was informed by the results of a survey of our members in 2020. This survey was not a policy-making exercise but was one of a number of factors that representatives took into account when making their decision. 

Representatives also reiterated their call for robust protection for conscientious objection should the law change in the future.

Read more about how BMA policy is formed.

 

Protecting and representing BMA members

Over the last year, we have been considering how we can best protect and represent our members in the event of future legislative proposals to permit assisted dying. We have done this by identifying those issues that would significantly impact on doctors, if the law were to change, and considering what position the BMA should take on them.

In reaching a position on these issues, the BMA has sought to consider and balance three sets of interests:

  • BMA members who would be willing to provide assisted dying if it were legalised;
  • BMA members who, for whatever reasons, would not be willing to participate in assisted dying; and
  • patients who may wish to access a lawful assisted dying service.

The views arising from this work formed the basis of a letter to Dr Alex Allinson, a member of the House of Keys (the lower House of the Isle of Man Parliament) in response to his request for views on his Assisted Dying Bill, which had its Second Reading on 31 October 2023. By providing these comments, we are not giving support for a change in the law – the BMA is neutral on whether or not the law should change. We are, however, seeking to ensure that our members are protected and represented in the event of any future change in the law to permit physician-assisted dying.

 

BMA views

If assisted dying were to be legalised in any part of the United Kingdom or the Crown Dependencies (Jersey, Guernsey and Isle of Man), the BMA would want to see legislation that gives doctors genuine choice about whether, and if so to what extent, they are willing to participate, and protection from discrimination and abuse. In particular, the BMA would want to see:

  • An opt-in model of delivery

The BMA believes that any legislation to permit physician-assisted dying should be based on an ‘opt-in’ model, so that only those doctors who positively choose to participate are able to do so. Doctors who opt in to provide the service should also be able to choose which parts of the service they are willing to provide (eg assessing eligibility and/or prescribing and/or administering drugs to eligible patients).

  • A right to refuse to carry out activities directly related to assisted dying for any reason

Any legislation on assisted dying should not include a standard conscientious objection clause as found in legislation on abortion and assisted reproduction. The BMA believes that, if assisted dying were legalised, doctors should be able to refuse to carry out any activities that are directly related to assisted dying (such as assessing capacity, or determining life-expectancy, specifically to assess eligibility for assisted dying) for any reason. Therefore, there should be a general right to object which does not need to be based on matters of conscience.

  • Statutory protection from discrimination

If assisted dying were to be legalised, the BMA would want to see specific provisions in the legislation making it unlawful to discriminate against, or cause detriment to, any doctor on the basis of their decision to either participate, or not participate, in assisted dying.

  • Provision for safe access zones

The BMA believes that any Bill to legalise assisted dying should include provision for safe access zones that could be invoked should the need arise, to protect staff and patients from harassment and/or abuse.

 

What physician-assisted dying is

Physician-assisted dying refers to doctors’ involvement in measures intentionally designed to end a patient’s life, covering the situations below. 

  1. Where doctors would prescribe lethal drugs at the voluntary request of an adult patient with capacity, who meets defined eligibility criteria, to enable that patient to self-administer the drugs to end their own life. This is sometimes referred to as physician-assisted dying or physician-assisted suicide.
  2. Where doctors would administer lethal drugs at the voluntary request of an adult patient with capacity, who meets defined eligibility criteria, with the intention of ending that patient’s life. This is often referred to as voluntary euthanasia.​

Eligibility

Eligibility for physician-assisted dying would be set out in any piece of legislation brought forward in the future.

In our 2020 member survey, however, we assumed the criteria would fall within the following boundaries, to cover patients who:

  • are adults
  • have the mental capacity to make the decision
  • have made a voluntary request and
  • have either a terminal illness or serious physical illness causing intolerable suffering that cannot be relieved.
Video cover of the physician assisted dying presentation by Dr John Chisholm
Watch: BMA medical ethics committee chair, John Chisholm, summarises the key findings from the BMA member survey