Ethics

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Physician-assisted dying

BMA policy

All forms of assisted dying are illegal in the UK, but it remains a hotly-debated topic. 

We are often asked for our views on assisted dying and how we have reached them. This page explains:

  • the BMA policy on assisted dying;
  • the key reasons for it; and
  • how BMA policy is agreed.

What is assisted dying?

We recognise that the terminology around assisted dying is not straightforward, and that different people have preferences for different definitions.

In the context of BMA policy and guidance, we use physician-assisted dying as an overarching term to describe physician-involvement in measures intentionally designed to terminate a patient’s life. This may include knowingly and intentionally providing a person with the knowledge and/or means required to end his or her life, including counselling about lethal doses of drugs, and prescribing or supplying them.

Administration of the drug may be by the individual him or herself (physician-assisted suicide) or by the physician or another person (euthanasia).

What is the BMA’s position on assisted dying?

We represent doctors and medical students from across the UK who hold a wide range of views on the issue of assisted dying. Our policy position since 2006 has been to oppose assisted dying in all its forms, and to support the current legal framework, which allows for compassionate and ethical care for dying patients.

In full, our policy states that the BMA:

  • believes that the ongoing improvement in palliative care allows patients to die with dignity;
  • insists that physician-assisted suicide should not be made legal in the UK;
  • insists that voluntary euthanasia should not be made legal in the UK;
  • insists that non-voluntary euthanasia should not be made legal in the UK; and
  • insists that if euthanasia were legalised, there should be a clear demarcation between those doctors who would be involved in it and those who would not. 

Prior to 2006, we had policy dating back to 1950 which opposed euthanasia. Later policy statements continued to do so, but moved away from focusing solely on euthanasia (where a third party carries out the final act) to also include assisted suicide (where the patient carries out the final act themselves). 

In 2005, the BMA became briefly neutral on the issue of assisted dying, before reverting to the current policy position the following year.  

This policy was reaffirmed in 2016 when the Representative Body (the BMA’s main policy-making body) voted to reject a motion calling for the BMA to adopt a neutral position. This debate and vote followed a project on end-of-life care and physician-assisted dying, through which we engaged with over 500 BMA members and members of the public in a number of dialogue events around the UK. 

The findings from this research, which helped inform the debate, can be found in Volume 2 of the final report.

What are the arguments for the BMA’s opposition to assisted dying?

While we recognise that some individuals facing terminal or other incurable illnesses would like to be able to choose the time and circumstances of their death, we are concerned about the consequences of giving people a legal right to end their lives with physician assistance – even where that assistance is limited to assessment, verification, or prescribing. 

Our policy opposing assisted dying is based on the following key concerns raised by our members:

  • Medical involvement in assisted dying could fundamentally alter the ethos within which medical care is provided. The principal purpose of medicine is to improve patients’ quality of life, not to foreshorten it.
  • Permitting assisted dying for some could put vulnerable people at risk of harm, by altering society’s attitudes towards the elderly or disabled, or by making assisted dying an option people feel under pressure to consider. 
  • Assisted dying could have a negative impact on the doctor-patient relationship, by causing some to fear doctors and medical settings (particularly for more vulnerable individuals, such as the elderly, disabled or those who see themselves as a burden). It may also change the way in which the general public perceives the medical profession as a whole. 
  • We believe that, for most patients, effective and high-quality palliative care can effectively alleviate distressing symptoms associated with the dying process. 

If you would like to find out more about some of the evidence on how assisted dying operates in jurisdictions where it is permitted, you should read Chapter 4 of Volume One of our final report on our end-of-life care and physician-assisted dying. 

If you are interested in exploring some of our own findings about the potential impact of legalising assisted dying on the doctor-patient relationship, you should look at Chapter 7 of Volume Two of our final report. 

What is the BMA policy on end-of-life care?

End-of-life care refers to the total care of a person with an advanced incurable illness and does not just equate with dying. The end-of-life care phase may last for days, weeks, months or even longer. It is defined as care that helps those with advanced progressive, incurable illness to live as well as possible until they die. It includes the prevention and relief of suffering through the assessment and treatment of pain and other problems, whether physical, psychosocial, or spiritual. 

We have longstanding policy that supports the provision of high-quality and comprehensive end-of-life care, and for the public to be better informed about what it can achieve. 

We recognise, however, that such care isn’t always universally available, and that some groups continue to have poor access to it. We have continually called for increased investment in palliative care services and support for staff to deliver the highest quality end-of-life care. 

As part of our research project on medical and public attitudes to and perceptions of end-of-life care and physician-assisted dying, we made a series of recommendations on end-of-life care. Download a factsheet of our recommendations and read Volume 3 of the report.

How is BMA policy made?

BMA policy is made through well-established democratic processes, where members debate motions at our annual representative meetings (ARMs) and vote on them after hearing the arguments on both sides. Motions are submitted ahead of time through various routes, including grassroots divisions, regional councils, and negotiating and professional committees. 

There are 560 seats available at the ARM to which members are elected: half of these are allocated to local BMA divisions, and the other half to branches of practice. This ensures that the make-up of those who attend (the Representative Body) is characteristic of the medical profession across the UK as a whole. We believe that this process ensures that we capture a representative picture of members’ views.

If you are a BMA member, and would like to know more about how you can get involved in discussion and debate, find out more.

Why don’t you survey members?

We know that various other medical and health bodies have surveyed the whole of their membership to inform their policy position. We do not use, and have never used, polls of members as a way of deciding policy positions. Our main policy-making mechanism is through the Representative Body (see above). 

We are concerned that balloting on the issue would enable and encourage campaign groups at either end of the spectrum of opinion to organise swing voting in their direction, and so fail to capture genuine differences of opinion amongst members.  

Assisted dying is not a binary issue. It is a complex and emotive topic which does not lend itself easily to simple yes or no survey-type questions, including rudimentary polling. We believe our current method of setting policy ensures that decisions are reached through informed and considered debate.

Why don’t you have a neutral position?

The Representative Body decides BMA policy. It has voted to oppose assisted dying and has repeatedly rejected motions which called for the BMA to adopt a neutral position – most recently in 2016. 

We adopted a neutral position in 2005, after the Representative Body approved a motion which called for this. This was overturned the following year, when our current position of opposition was agreed.