The ongoing debate around physician-assisted dying is one of the most divisive issues facing medical ethicists in the UK, although the disparate views expressed are sincerely held and passionately argued. The BMA’s current policy, opposing assisted dying in all forms, dates back to 2006 – a policy position reaffirmed in 2016 – and it remains the same today.
Numerous studies have been published into the views of both clinicians and the public, including the BMA’s major research project carried out in 2015, into the views of members and the public concerning their experiences and perceptions of end-of-life care and physician-assisted dying.
In February this year we followed this up with one of the biggest surveys of medical opinion on the issue that has ever been undertaken, with 28,986 BMA members responding. It is important to be clear from the outset that the survey was not a policy-forming exercise. The BMA’s policy remains opposed to assisted dying in all its forms. That will only change should members at the BMA’s annual representative meeting (ARM) vote to do so. The next meeting is scheduled to take place in June 2021; the results will play an important role in informing that discussion.
Published in full today, the results provide us with members’ views on both prescribing life-ending drugs for self-administration by eligible patients and doctors administering drugs to end the life of an eligible patient.
On the issue of prescribing drugs for self-administration by eligible patients, 40% of those who responded believe the BMA’s position should be one of support; 21% believe it should be neutral; 33% believe it should be opposed; and 6% were undecided. When asked for their personal view, 50% were supportive, 39% opposed and 11% undecided. As for their ‘willingness to actively participate in any way in the process’, 36% said yes, they would be, 45% said no and 19% were undecided.
There were differences in the answers when it comes to opinion on doctors administering drugs to end the life of an eligible patient, where 30% believe the BMA’s position should be supportive; 23% believe it should be neutral; 40% believe it should be opposed, and 7% were undecided. When asked for their personal view, 37% were supportive, 46% opposed and 17% undecided. And finally, on their willingness to actively participate, 26% said yes to being willing to actively participate in some way in the process, 54% said no and 20% were undecided.
As these results are designed to inform, and not set, BMA policy, it is not for me to provide an interpretation of what they mean or what should happen next. They do, however, provide some interesting trends, which are clearly set out in the full results. For example, when all of the questions were assessed, doctors in some specialties such as anaesthetics, emergency medicine, intensive care and obstetrics & gynaecology tended to be generally more supportive, whereas those in specialties including clinical oncology, general practice, geriatric medicine and palliative care tended to be generally more opposed.
There are also some differences in opinion geographically, across branches of practice and between those with and without a licence to practise in the UK.
All of this will make for an absorbing and important debate on the future of the BMA’s policy when the time comes, and the members of the representative body make their decision. Until then the BMA’s policy remains opposed to assisted dying in all its forms.
Finally, I want to thank the thousands of members who took the time to take part in the survey and to provide us with their invaluable insights.
John Chisholm is chair of the BMA medical ethics committee