Proponents of physician-assisted death often argue that its legalisation is vital to ensuring patient choice at the end of life. However, assisted dying laws do not simply give patients a ‘right to die’ but more specifically propose the right to involve someone else in bringing about their death: a physician. Given this, it is significant to fully understand the nature of support and opposition for the legalisation of physician-assisted death from physicians themselves, especially those with first-hand experience caring for patients near the end of life. Doctors would be on the front lines of implementing any assisted dying law and it is vital to attach the appropriate weight to the views of those embedded within the practice of caring for the sick and dying who would be asked to alter the scope of their practice.
1. Most physicians do not support a change in the law to legalise physician-assisted death, especially those with experience caring for terminally ill patients.
- Based on the 2019 survey conducted by the Royal College of Physicians, only 32% of doctors support the legalisation of physician-assisted death.
- Based on the 2019 survey conducted by The Royal College of Radiologists of one-thousand clinical oncologists, only 37% support legalisation.
- 50% of doctors surveyed by the British Medical Association in 2020 supported a change in the law.
- Respondents most likely to support physician-assisted death were those with little experience caring for terminally ill patients, such as medical students and doctors who practiced in the fields of Otolaryngology, Anesthetics, and Emergency medicine.
- Respondents most likely to oppose the legalisation of physician-assisted death were those with significant experience caring for terminally ill individuals and practiced in specialties such as palliative care, geriatric medicine, and clinical oncology.
- 76% of palliative care physicians opposed a change in the law.
- Based on the Royal College of Physicians’ survey, only 5% of palliative care physicians and only 35% of doctors specialising in geriatric medicine supported legalisation.
2. If physician-assisted death were legalised, most physicians who care for terminally ill patients would not be willing to participate in the practice.
- Based on the survey conducted by the RCP, only 24% of doctors are willing to prescribe lethal medication.
- Only 18% of doctors in geriatric medicine, 24% in medical oncology, and 5% in palliative care stated that they were willing to participate.
- Based on The Royal College of Radiologists’ survey of clinical oncologists, only 23% of respondents said they would be willing to prescribe lethal medication.
3. Physicians with experience caring for terminally ill patients have several concerns, and they should be taken seriously.
- In the BMA’s 2020 survey, many doctors who opposed physician-assisted death offered their reasons for opposing a change in the law based on their experiences caring for terminally ill patients. The most common responses were:
- Assisted dying goes against their medical ethical belief regarding the role of doctors and their oath to ‘do no harm’.
- Legalisation poses a risk to vulnerable patients, especially those who may feel like a burden to their families.
- The quality of palliative care provision could worsen.
- Negative impacts on the physician-patient relationship.
- Legal risks to physicians.
4. Professional medical associations continue to withhold their support for changing the law, and stances of neutrality should not be viewed as indifference or endorsement.
- The British Medical Association, Royal College of General Practitioners and Association for Palliative Medicine remain opposed to the legalisation of physician-assisted death.
- The BMA states, “In full, our policy states that the BMA: believes that the ongoing improvement in palliative care allows patients to die with dignity, and insists that physician-assisted suicide should not be made legal in the UK”.
- Other organisations, like the Royal College of Physicians, have recently adopted stances of “neutrality”. Positions of neutrality, however, should not be interpreted as indifference or supportive of a change in the law, but rather as a testament that although there are a diverse range of opinions expressed by physicians toward the legalisation of physician-assisted death, it remains clear that those who care for the terminally ill oppose a change in the law.
To clarify its position, the Royal College and Physicians stated recently, “So that there can be no doubt, the RCP clarifies that it does not support a change in the law to permit assisted dying at the present time.”
Author: Ana Worthington