Doctors cannot encourage or assist suicide: Official

Almost a year after its consultation closed, the UK General Medical Council issued on 31 January its guidance about what doctors can and cannot do with patients who consult them about assistance with suicide.

Contrary to the spin suggested by Dignity in Dying (the former Voluntary Euthanasia Society) and its satellite, Healthcare Professionals for Assisted Dying, the only clarification which could remotely be seen as a concession is that doctors who respond to a valid request and solely hand over the medical records required by Dignitas for confirmation of diagnosis are unlikely to face sanction by the GMC.

Otherwise, the 6-page guidance for the GMC’s pre-hearing investigators ‘considering allegations about a doctor’s involvement in encouraging or assisting suicide’ upholds the law as it stands and sends no signals at all to suggest the profession endorses assistance with suicide. Although of course the GMC recognises its neutral role and states ‘Nothing… should…be taken to imply that the GMC supports or opposes a change in…law’, the guidance helpfully underlines the law and the profession’s position.

Action concerning a doctor’s fitness to practise is certain when:

•a doctor has been convicted of encouraging or assisting suicide

and probable when

•a doctor has accepted a caution and/or has been the subject of an adverse determination by another regulatory body for encouraging or assisting suicide
•the doctor’s encouragement or assistance depended upon the use of privileges conferred by a licence to practise medicine (such as prescribing) or took place in the context of a doctor-patient relationship
•the doctor knew, or should reasonably have known, that their actions would encourage or assist suicide
•the doctor acted with intent to encourage or assist suicide

Also likely to lead to action are:

•encouraging a person to commit suicide, for example by suggesting it (whether prompted or unprompted) as a ‘treatment’ option in dealing with the person’s disease or condition
•providing practical assistance, for example by helping a person who wishes to commit suicide to travel to the place where they will be assisted to do so
•writing reports knowing, or having reasonable suspicion, that the reports will be used to enable the person to obtain encouragement or assistance in committing suicide
•providing information or advice about other sources of information about assisted suicide
•providing information or advice about methods of committing suicide, and what each method involves from a medical perspective

Guidance follows about ‘realistic prospects’ for proof, and the only ‘Allegations that will not normally give rise to a question of impaired fitness to practise’ because of their lawfulness or their distance from the encouragement or assistance include:

•providing advice or information limited to the doctor’s understanding of the law relating to encouraging or assisting suicide
•providing access to a patient’s records where a subject access request has been made in accordance with the terms of the Data Protection Act 1998
•providing information or evidence in the context of legal proceedings relating to encouraging or assisting suicide

Wisely, the GMC has also released shorter 2-page guidance aimed at patients and those close to them, which summarises the principles and the legal limits detailed for doctors.

Clarifying that ‘respect for a patient’s autonomy cannot justify illegal action’, doctors should ‘limit any advice or information about suicide to an explanation that it is a criminal offence to encourage or assist a person to commit or attempt suicide’.

The position of doctors is now clear to all and does not need changing.

The BMA has welcomed the guidance and the Medical Defence Union (MDU) has not revised its previous warning that doctors who provide medical reports for patients seeking assisted suicide abroad could be prosecuted.

You have read this article Assisted Suicide / bma / GMC with the title bma. You can bookmark this page URL http://celebrityunitedking.blogspot.com/2013/02/doctors-cannot-encourage-or-assist.html. Thanks!

BMA Ethics Debate – Great results on both abortion and euthanasia

This morning the British Medical Association Annual Representative Meeting debated two motions on abortion and one on euthanasia.

Here is a record of the debates as they happened from the BMA blog.

Motion 328 called for the meeting to support the universal availability of non-directive counselling for women considering abortion.

It said that the counselling should be in accordance with NHS standards and independent of the abortion provider if women so wished.

328 Motion by THE AGENDA COMMITTEE (MOTION TO BE PROPOSED BY THE HARROGATE DIVISION):
That this Meeting:-
i) supports the universal availability of neutral counselling for women considering abortion;
ii) believes that any counselling provided for women considering abortion should accord with NHS standards;
iii) believes that women considering abortion should be able to access counselling that is
independent of the abortion provider;
iv) deplores picketing and intimidation around abortion services.

Dr Mark Pickering, in proposing the motion, said the issue was about extending choice for women, not limiting it.

Professor Wendy Savage responded that she had been the press officer for a woman's choice organisation for 35 years. She said it was 'an absolute insult' to professionals to require so-called independent counselling. She said the pros and cons would be explained in any operation. She said most 'independent' counsellors were not actually independent.

But the meeting supported the provision of non-directive counselling for women considering abortion and also condemned the picketing and intimidation around abortion services.

This is a great result for women facing the crisis of unplanned pregnancy and should encourage parliament to make moves in the direction of independent counselling provision.

Motion 329 called for the meeting to back a call stating that abortion on the grounds of gender alone is unacceptable.

329 Motion by THE AGENDA COMMITTEE (MOTION TO BE PROPOSED BY THE GREENWICH, AND BROMLEY DIVISION):
That this Meeting believes that abortion on the grounds of gender alone is unacceptable and demands that :
i) such practice should cease forthwith;
ii) the law should be changed to make this practice illegal in the UK.

GP Kackie Applebee said the meeting had to be careful about passing any issue that sought to limit abortion. She called on the meeting not to jeopardise a woman's right to choose.

But GP Paddy Glackin maintained that the motion was not a slippery slope. He was cheered as he said the motion was saying that female infanticide was a gross violation of human rights.

However, after a passionate debate the motion was judged ‘not competent’ and was not passed.

Motion 332 called for the BMA to adopt a neutral position on ‘assisted dying’.

It had been brought forward by members of the pressure group ‘Healthcare Professionals for Assisted Dying’(HPAD) in an attempt to neutralise medical opposition to assisted suicide and euthanasia ahead of a new parliamentary bill calling for legalisation. HPAD is closely affiliated to Dignity in Dying, the former Voluntary Euthanasia Society and this motion was part of a carefully orchestrated campaign.

I have previously argued on this blog why I believe that going neutral on assisted suicide would be a very dangerous move indeed.

332 Motion by THE AGENDA COMMITTEE (MOTION TO BE PROPOSED BY THE SHROPSHIRE DIVISION):
That this Meeting:-
i) believes that assisted dying is a matter for society and not for the medical profession;
ii) believes that the BMA should adopt a neutral position on change in the law on assisted dying.

The proposer Professor Raymond Tallis argued that the current situation was 'morally repugnant' and said that the BMA should adopt a policy of studied neutrality on the issue of assisted dying.

Speaking against, Dai Samuel said an 'act of kindness' could lead to 14 years in prison, and added that he was there to care for patients and could not countenance something that he considered akin to murder.

John McGough encouraged doctors to accept that some colleagues do support assisted dying.

Speaking against, medical student Rebecca Briscow said the medical profession cannot be excluded from the decision and that a position of neutrality would be a breach of patient trust. She warns that physician-assisted dying is cheap - and dangerous - and that doctors must be the safeguard.

Farah Jameel responded that keeping a patient alive isn’t always the right answer, and that there was no right or wrong answer for assisted dying. She said a position of neutrality was key.

Also speaking in support, Isky Gordon related an anecdote about a colleague - who went on to be exonerated by the GMC and police - being investigated for the treatment of a terminally ill and mentally competent patient.

Professor Baroness Illora Finlay said that the public would not understand why the BMA won't express a view on the prescription of potentially lethal drugs. 'The safeguards proposed are no more than a checklist.' She believed neutrality would tell parliament that the BMA saw this as acceptable.

Speaking for the motion, Tom Henderson admitted it was 'uncomfortable' to shift away from opposition to assisted dying. He says there were legal and accepted options for some people - those who could fly to Switzerland for example - but others were 'condemned' to suffer. He said neutrality would allow a balanced view of a complex argument.

Ethics Chairman Tony Calland argued that we must approach this with a logical head and not an emotional heart. If the law changed the medical profession would be involved so it was important that we stayed engaged in the debate.

BMA Chairman Hamish Meldrum said a position of neutrality would exclude doctors from the debate and urged the meeting to reject the motion.

Both parts of the motion were lost.

In rejecting this move the BMA has sent out a strong message that doctors must play a leading role in this debate which could otherwise be far too easily swayed by celebrity endorsement and media outlets who have consistently acted as the cheerleaders for assisted suicide and euthanasia.

Majority medical opinion remains opposed to assisted dying and this vote is a victory for common sense. I hope that the BMA will now continue its valuable work in campaigning for high quality compassionate care for patients at the end of life.

You have read this article Abortion / bma / Euthanasia with the title bma. You can bookmark this page URL http://celebrityunitedking.blogspot.com/2012/06/bma-ethics-debate-great-results-on-both.html. Thanks!

Why the BMA should not go neutral on assisted suicide and euthanasia

This Wednesday, 27 June, the British Medical Association Annual Representative Meeting (ARM) will vote on a motion to go neutral on assisted suicide and euthanasia.

The BMA, the trade union for doctors, has been opposed to a change in the law for all but one year of its 180 year history.

But those proposing the motion will claim that this is an issue on which doctors are divided and where most members of the public favour a change in the law. Furthermore, they will argue that the British Medical Journal favours a neutral stance and that a poll published last week has shown that 62% of doctors agree.

The motion reads as follows:

* 332 Motion by THE AGENDA COMMITTEE (MOTION TO BE PROPOSED BY THE SHROPSHIRE DIVISION):
That this Meeting:-
i) believes that assisted dying is a matter for society and not for the medical profession;
ii) believes that the BMA should adopt a neutral position on change in the law on assisted dying.

So why not support it? Ten reasons:

1. If the BMA chooses to go neutral on this particular issue, it will be giving the issue a status that no other issue enjoys. Doctors, quite understandably, are strongly opinionated and also have a responsibility to lead. The BMA is a democratic body which takes clear positions on a whole variety of issues on the basis of a majority vote. This week the association will vote on issues as broadly ranging as Syria, torture, tobacco and the future of the NHS. Why should assisted suicide and euthanasia enjoy a position which no other issue shares, especially when doctors will actually be the ones carrying it out?

2. It will further damage doctors’ public profile. The industrial action over pensions has not been well received by all sections of the community, and however justifiable we regard it, it will not look good for doctors to take a strong position on their own financial interests but to have no position at all over whether doctors, to put it bluntly, should have the power, in some circumstances, to kill their patients.

3. This motion is part of a campaign led by a small pressure group with a particular political agenda. Healthcare Professionals for Assisted Dying (HPAD), which is strongly affiliated to the pressure group ‘Dignity in Dying’ (formerly the Voluntary Euthanasia Society) has 520 supporters, representing fewer than 0.25% of Britain’s 240,000 doctors. But they have flooded this year’s ARM with no less than nine motions calling for the association to go neutral. This is in line with HPAD’s and DID’s clearly stated campaign objectives to legalise ‘assisted dying’ and is aimed at neutralising medical opposition ahead of a new bill being introduced to parliament over the next year. DID is planning a mass lobby of parliament to support such a bill next week on 4 July. A neutral vote will be a vote for the success of this campaign.

4. The 62% support figure from DID/HPAD of doctors favouring a switch to neutrality is based on a questionable poll. Although widely trumpeted by the British Medical Journal, the poll was based on an unbalanced question which is currently the subject of a formal complaint to the Market Research Society. It was asked over a month ago without any clear definition of key terms such as ‘assisted dying’ and ‘terminally ill’ and was framed in an unbalanced way with a stem aimed at priming respondents. An on-line poll run last week by the BMJ after HPAD and DID had launched their campaign ran 82% against neutrality.

5. If the BMA goes neutral this week it will lead inevitably to a new attempt to change the law at parliamentary level over the next twelve months. In the only previous year in which the BMA took a neutral position (2005/6) we saw huge pressure to change the law by way of the Joffe Bill. Throughout that crucial debate, which had the potential of changing the shape of medicine in this country, the BMA was forced to remain silent and took no part in the debate. The same scenario would arise again. Doctors would have no collective voice.

6. The motion itself is broadly and vaguely worded. Were it to go through, this would not be simply a vote for ‘assisted suicide for mentally competent adults with less than twelve months to live’ as sought by DID and other campaigners. The motion simply talks about ‘assisted dying’, a term which is variously defined and which has no meaning in law. So it is not at all clear what doctors would actually be signing up to be neutral on. Does it include assisted suicide or euthanasia or both, and for which categories of patients?

7. The majority of doctors are opposed to a change in the law. Opinion polls show an average of 65% doctors opposing the legalisation of assisted suicide and/or euthanasia with the remainder undecided or in favour. Palliative Medicine Physicians are 95% opposed and the Royal Colleges of General Practitioners and Physicians (RCGP and RCP) are both opposed. Why choose to go neutral on an issue where there is such a strong majority amongst doctors?

8. Assisted suicide and euthanasia are contrary to all historic codes of medical ethics, including the Hippocratic Oath, the Declaration of Geneva, the International Code of Medical Ethics and the Statement of Marbella. Neutrality would be a quantum change for the profession and against the international tide.

9. To drop medical opposition to the legalisation of assisted suicide and euthanasia at a time of economic recession could be highly dangerous. Many families and the NHS itself are under huge financial strain and the pressure vulnerable people might face to end their lives so as not to be a financial (or emotional) burden on others is potentially immense.

10. Were the BMA To drop its opposition, and as a consequence a law were to be passed, it would leave the medical profession hugely divided at a time when, perhaps, more than any other time in British history, we need to be united as advocates for our patients and for the highest priorities in a struggling health service.

For the BMA to go neutral on assisted suicide and euthanasia would be inappropriate, undemocratic and potentially highly dangerous. It would also be playing into the hands of a small unrepresentative pressure group and giving an advantage to only one side of the debate. Furthermore it would communicate confused messages to the public at a critical time and divide the profession at a time when a united doctors’ voice is needed more than ever.

Let’s resist it!

You have read this article Assisted Suicide / bma / Euthanasia with the title bma. You can bookmark this page URL http://celebrityunitedking.blogspot.com/2012/06/why-bma-should-not-go-neutral-on.html. Thanks!

Why is the editor of the BMJ making such a strong case for the BMA going neutral on ‘assisted dying’ on such shaky evidence?

The British Medical Journal this week published three articles aimed at neutralising medical opposition to euthanasia.

There was nothing surprising about this. The BMJ’s record of editorial bias on euthanasia and assisted suicide has been noted before and the deputy editor Tony Delamothe, who has previously written passionately on the subject is a named supporter of the pressure group ‘Healthcare Professionals for Assisted Dying’ (HPAD).

HPAD were responsible for penning two of this week’s articles. Not bad coverage for a group representing fewer than 0.25% of Britain’s 240,000 doctors!

One of these was a comment piece from Ray Tallis, HPAD chairman, which called for the BMA and Royal Medical Colleges to take a position of ‘studied neutrality’ on ‘assisted dying’.

The second was an emotive plea for a change in the law from the daughter of HPAD’s founder who died of pancreatic cancer.

But the third article was an editorial by Fiona Godlee (pictured), the journal’s editor in chief saying that the BMJ ‘supports’ HPAD’s call. Godlee has hinted at her support for assisted dying before, but has never gone quite this far.

The significance of this move is that the British Medical Association is about to debate a motion calling for the doctors’ trade union to take a neutral position on the issue. HPAD, which operates under the auspices of Dignity in Dying, the former Voluntary Euthanasia Society, flooded the BMA this year with no less than nine almost identical motions calling for neutrality.

DID in turn are planning a mass lobby of parliament a week later on 4 July in support of a new bill seeking to decriminalise assisted suicide.

In other words, this is all part of a carefully orchestrated campaign.

Godlee and Delamothe are of course entitled to their individual opinions, provided of course that they remain transparent about their ideological vested interests.

But we do expect Britain’s highest circulation medical journal, which many regard as the mouthpiece of the medical profession in Britain, to deal with controversial subjects in an even-handed and evidence-based way.

Earlier this week the BMJ issued a press release about the articles in an attempt to bring them to international attention. I was asked to comment at the time and was interested to see how it presented the story.

The press release bore the provocative title, ‘BMJ supports call for medical bodies to stop opposing assisted dying’ and the first three paragraphs read as follows:

‘The BMJ today supports a call for leading UK medical bodies to stop opposing assisted dying for terminally ill, mentally competent adults. Healthcare Professionals for Assisted Dying (HPAD), wants the BMA and royal colleges to move their position from opposition to neutrality. The call comes as a new poll commissioned by Dignity in Dying found that, of 1000 GPs, 62% support neutrality.’

I thought that the prominence given in the press release to the BMJ’s call for neutrality and the 62% figure were particularly telling, given that in Godlee’s editorial they featured only in the very final paragraph.

Clearly the BMJ, and Godlee as editor, wanted to give the call and the survey a huge level of publicity.

According to the BMJ Godlee qualified as a doctor in 1985 and in 1994 spent a year at Harvard University as a Harkness Fellow, evaluating efforts to bridge the gap between medical research and practice.

On returning to the UK, she led the development of BMJ Clinical Evidence, which evaluates the best available evidence on the benefits and harms of treatments and is now provided worldwide to over a million clinicians in 9 languages.

So she is a person who is both well qualified to judge evidence and also a stickler for claims in peer-reviewed journals being soundly evidence-based.

So I was most interested to see the strength of the evidence for this 62% figure. This was referenced in footnote 17 of her article, but this footnote merely provided a link to the HPAD website events page.

From there was a further link to PJ Online which could only be viewed by paid-up subscribers.

I thought this was rather odd and so pointed it out both on this blog and in a rapid response to the BMJ website.

Sometime within the next 24 hours (one can imagine anxious phone calls to HPAD from BMJ editorial staff – perhaps Godlee or Delamothe themselves) HPAD posted the link and one can now access both a joint press release from DID and HPAD and a copy of the poll results.

I wonder whether Godlee herself had seen these before she wrote her article (and if so why she did not link to them directly) or whether she simply took HPAD’s say so (through ‘personal communication’?) as unadulterated truth. My guess is that we might never know.

As it turned out the poll was conducted by medeConnect Healthcare Insight (the research arm of Doctors.Net.UK) between 16 and 22 May 2012 who asked 1004 GPs an online question.

So what was the question DID actually asked which elicited this 62% response? You have to go to the 2nd footnote of the press release to find out but it read as follows:

‘Opinion polls indicate that doctors are divided on the issue of assisted dying for the terminally ill, with approximately 60% opposed to change. Do you agree or disagree that medical bodies (RCGP, BMA) should adopt a position of studied neutrality* on the issue of assisted dying for terminally ill, competent adults.*A position of studied neutrality indicates that a medical organisation is neither supportive of, nor opposed to a change in the law on assisted dying. A neutral position recognises and respects the diversity of personal and religious views of its members and their patients, and encourages open discussion.’

To this 12% voted ‘strongly agree’, 50% ‘agree’, 7% ‘don’t know’, 21% ‘disagree’ and 11% ‘strongly disagree’. 12% plus 50% equals 62%.

Of course, the value of polls such as this depends both on the reputability of the polling agency (and medeConnect is highly regarded) and also on the quality of the question.

Some observations:

1.The term ‘assisted dying’ is not defined in the question and has no meaning in law. It was actually a term invented by the pro-euthanasia lobby and is generally used as a euphemism for both euthanasia and assisted suicide. However different groups define it in very different ways. But what did the respondents actually understand by it?

2.‘Terminally ill’ is similarly a term with a range of meaning to different people. DID define it as having less than twelve months to live, although they are unclear if this means with or without treatment. This is the definition they will be using when they use these figures to campaign, but is this what the respondents will have understood?

3.The clear intent of DID and HPAD was to use this figure to campaign for the BMA to take a neutral position on ‘assisted dying’ in order to neutralise opposition for a new private member’s bill in parliament during the next year. Might respondents have voted differently if they had known this? I wonder.

4.The question states that about ‘60% of doctors are opposed to change’ but does not say what change. If this was meant to mean ‘opposed to a change in the law to allow assisted suicide and euthanasia to be legalised’ then why did it not say so? And where did the ‘60%’ figure come from given that Godlee herself quotes the 2009 Seale study’s figure of 65%.

5.The most important question from a pollster’s point of view, however, is why DID chose to insert the information they did in the first sentence of the question. Because the giving of this information, that seems to have been intended to influence the result, thereby makes this group not representative of all GPs who might be asked. The context has changed. In short, this group has been primed.

Pollsters know that the way a question is asked can have a strong bearing on the responses received. That is why there are strict codes about the phrasing of questions. It will be interesting to see if this question actually breaches the national research society code.

But to labour the point let me illustrate how the introductory sentence in the question might have been worded in other ways that may have achieved a different result:

'Opinion polls indicate that 95% of specialists in palliative medicine are opposed to a change in the law to allow assisted suicide or euthanasia for terminally ill patients. Do you agree or disagree that medical bodies (RCGP, BMA) should adopt a position of studied neutrality* on the issue of assisted dying for terminally ill, competent adults.'

Or perhaps:

'A small group of doctors called HPAD, representing less 0.25% of all doctors in the UK and closely affiliated to the former voluntary euthanasia society, is intending to introduce a motion to the BMA annual meeting in order to move the BMA to a neutral position on assisted dying, thereby neutralising medical opposition to a new private members bill to be introduced very soon. Do you agree or disagree that medical bodies (RCGP, BMA) should adopt a position of studied neutrality* on the issue of assisted dying for terminally ill, competent adults.'

I was interested to see that Godlee had also quoted another study from DID to support the following statement in her article.

‘When asked in a poll on doctors.net whether they would want the option of assisted dying for themselves, a third of the 1000 general practitioners surveyed said they would, a third said they would not, and the remainder were unsure’

The reference again was to a webpage, interestingly this time on DID’s website.

This time background information about the question on the site was not available so I emailed DID for a copy of the poll itself (I wonder if Godlee went this far or simply gave the web reference possibly supplied to her by HPAD/DID? ) To DID’s credit they sent the information to me within the hour.

The question read as follows:

‘If you were terminally ill and suffering unbearably at the end of life with only months or weeks to live, and palliative care options had been explored, would you personally want the choice of legalised medical help to die so you could control the time of your death?’

Well that is not how Godlee has presented it, but then I am assuming that she did not actually read the question. It is noteworthy that only 33% of 1,001 GPs said yes to a question worded this way but it demonstrates powerfully the strong opposition there is to a change in the law within the medical profession at large.

Is Godlee just being sloppy in her use of this data? Or does she have an agenda that she is pursuing with such passion that she has inadvertently let her usual high standards for seeking strong evidence slip?

As someone who helps pay her salary through my BMA subscription, I would like to know. I suspect I am not alone in this.

You have read this article Assisted Suicide / bma / bmj / Euthanasia with the title bma. You can bookmark this page URL http://celebrityunitedking.blogspot.com/2012/06/why-is-editor-of-bmj-making-such-strong.html. Thanks!

British Medical Journal adopts campaigning stance on euthanasia

The British Medical Journal this week contains three articles aimed at neutralising medical opposition to euthanasia.

The BMJ, which remains editorially independent from the British Medical Association, but is sent to all members, has a long track record of backing liberal causes, amongst them the legalisation of assisted suicide and euthanasia.

A comment piece from Ray Tallis (pictured), chairman of the pressure group ‘Healthcare Professionals for Assisted Dying’ (HPAD) calls for the BMA and Royal Medical Colleges to take a position of ‘studied neutrality’ on euthanasia.

An emotive ‘personal view’ by Tess McPherson, relates the story of the death of her mother Ann, an Oxfordshire GP who died from cancer of the pancreas last year and was the founder of HPAD.

Finally the journal’s editorial by Fiona Godlee, ‘supports’ HPAD’s call.

The BMJ sought wide exposure for the articles by sending out an embargoed press release yesterday ensuring that the story would get prominent media coverage (See Daily Mail, Daily Express, Daily Telegraph, Press Association and Evening Standard).

Godlee acknowledges in her editorial that 65% of doctors are opposed to a change in the law but makes much of a ‘poll of 1,000 GPs’ commissioned by the pressure group Dignity in Dying last year which allegedly showed that ‘62% supported neutrality’.

The poll is referenced to the HPAD website events page but the link from there to PJ Online can only be viewed by paid up subscribers meaning that is difficult to ascertain what question was actually asked and of whom. How convenient! (I see they have now finally posted the link - I will blog on this very soon)

Healthcare Professionals for Assisted Dying backed by Dignity in Dying, the former Voluntary Euthanasia Society, have flooded this year’s BMA annual meeting with motions calling for doctors to take a neutral stance on assisted suicide and euthanasia.

This is a carefully orchestrated move by a small minority of doctors with extreme views aimed at neutralising medical opposition and softening up public and parliamentary opinion in advance of new pressure to change the law. HPAD has just 520 supporters, representing less than 0.25% of the medical profession.

It has been carefully engineered to coincide with two high profile cases being heard in the high court next week, plans for a new private members bill and a mass lobby of parliament by the pro-euthanasia lobby on 4 July.

The majority of doctors and the major medical royal colleges (RCGP, RCP and Association for Palliative Medicine) however remain strongly opposed to a change in the law and British parliaments have three times in last six years, twice in the House of Lords and once in Scotland, voted against the legalisation of assisted suicide.

The BBC this morning reports a BMA spokesperson saying that the organisation is 'firmly opposed' to the legalisation of assisted dying adding: 'If assisted dying was legalised, effective safeguards could not be implemented without the involvement of doctors. It is therefore appropriate for doctors to voice their views on this issue.'

A powerful article in last week’s BMJ by Iona Heath, president of the Royal College of General Practitioners, argued strongly against a change in the law and is well worth studying.

Heath eloquently voiced her ‘deep concern that it will be impossible to draft a law robust enough to protect the vulnerable’ and expressed her discomfort ‘that medicine seems once again to be preparing to offer a technical solution to an existential problem’.

‘One of the huge challenges of human life’, she argues, ‘is to find ways of living a meaningful life within the limits of a finite lifespan that will always involve loss of love and the inevitability of grief. Doctors have a regrettable tendency to ignore this reality and to persist in active and invasive treatment beyond the point at which it has become futile and even cruel.’

She acknowledged that some of the drive to legalise assisted suicide and euthanasia is driven by fears about inappropriate invasive treatment but insisted that the right answer is not changing the law, but rather better care that recognises the limits of medicine.

She concludes:

‘When doctors fail to recognise and acknowledge existential suffering in the dying and take refuge in excessive technological interventions, patients become frightened and, no longer able to trust their doctors, may request assisted dying. But two technological wrongs do not make an existential right. I don’t want assisted dying, but I also don’t want a PEG tube.’

Any change in the law on assisted suicide and euthanasia would place pressure on vulnerable sick, elderly and disabled people to end their lives for fear of being a financial or emotional burden on loved ones.

This is the very last thing we need at a time when many families and the health service itself are already under considerable financial pressure.

Doctors should see this latest move for what it is and firmly reject it.

You have read this article Assisted Suicide / bma / bmj / Euthanasia with the title bma. You can bookmark this page URL http://celebrityunitedking.blogspot.com/2012/06/british-medical-journal-adopts.html. Thanks!

Abortion and Euthanasia dominate ethics agenda at BMA annual meeting

Abortion and euthanasia are to be debated at a major BMA meeting later this month.

The British Medical Association (BMA) holds its annual representative meeting, where it sets policy for the next year, in Bournemouth in the last week of June.

An almost unprecedented number of motions on abortion and euthanasia are listed on the agenda for the section on medical ethics on Wednesday 27 June.

In total 45 motions on ethics have been listed for the 95 minute session which is scheduled from 1000am to 1135am and no less than 33 deal with either abortion or euthanasia.

13 motions deal with abortion, with the majority either calling for women considering abortion to receive access to ‘neutral counselling’ which is ‘independent of the abortion provider’ or for abortion on the grounds of gender alone to be made illegal.

20 motions deal with euthanasia or assisted suicide with 14 supporting a relaxation of the BMA’s position and 6 supporting the status quo of opposition to a change in the law.

Nine of the 14 motions supporting relaxation call for the BMA to adopt a neutral position on ‘assisted dying’ and use almost identical wording despite coming through five different BMA divisions – Shropshire, North West Regional Council, Retired Members Forum, Islington and Suffolk.

The language of all these motions is that of the campaigning group Dignity in Dying (formerly the Voluntary Euthanasia Society) and without doubt they represent a carefully orchestrated ploy by the pressure group Healthcare Professionals for Assisted Dying (HPAD), which operates under the DID umbrella, to soften up medical and public opinion in advance of a new assault on the law.

This latest move is part of a larger campaign that Dignity in Dying is running over the next month leading up to a celebrity-endorsed lobby on parliament on 4 July.

HPAD originally registered as Healthcare Professionals for Change in October 2010 but has since changed its name.

It contains a number of well-recognised campaigners for the legalisation of various forms of euthanasia including former Liberal Democrat MP Dr Evan Harris. Overall it has 520 supporters listed on its website.

Being a trade union, the BMA is particularly susceptible to moves by small pressure groups.

Motions at the ARM are always prioritised and it is therefore virtually certain that only two abortion motions and one euthanasia motion (328, 329 and 332) will be debated (see below).

The other 30 motions on these two issues are very unlikely to be reached.

It is interesting that whilst the two abortion motions are seeking to tighten BMA policy the one euthanasia motion is seeking to loosen it.

The BMA has supported Britain’s abortion policy, which allows over 200,000 abortions annually for many years.

But the union has always been opposed to any change of the law to allow euthanasia or assisted suicide apart from one year of its history (2005-2006) when it was briefly neutral.

The wording of these three motions is below.

The motions set to be debated

* 328 Motion by THE AGENDA COMMITTEE (MOTION TO BE PROPOSED BY THE HARROGATE DIVISION):
That this Meeting:-
i) supports the universal availability of neutral counselling for women considering abortion;
ii) believes that any counselling provided for women considering abortion should accord with NHS standards;
iii) believes that women considering abortion should be able to access counselling that is
independent of the abortion provider;
iv) deplores picketing and intimidation around abortion services.

* 329 Motion by THE AGENDA COMMITTEE (MOTION TO BE PROPOSED BY THE GREENWICH, AND BROMLEY DIVISION):
That this Meeting believes that abortion on the grounds of gender alone is unacceptable and demands that :-
i) such practice should cease forthwith;
ii) the law should be changed to make this practice illegal in the UK.

* 332 Motion by THE AGENDA COMMITTEE (MOTION TO BE PROPOSED BY THE SHROPSHIRE DIVISION):
That this Meeting:-
i) believes that assisted dying is a matter for society and not for the medical profession;
ii) believes that the BMA should adopt a neutral position on change in the law on assisted dying.

You have read this article Abortion / bma / Euthanasia with the title bma. You can bookmark this page URL http://celebrityunitedking.blogspot.com/2012/06/abortion-and-euthanasia-dominate-ethics.html. Thanks!