BMA’s View on Assisted Dying

With the debate around a proposed assisted dying law on the island heating up, the British Medical Association has outlined its position on some key areas of the proposed Bill.

Dr Alex Allinson wrote to BMA president Prof Philip Banfield (we met him when Dr Ranson won her case v DHSC), with a response being provided by the medical ethics team.

In the letter, the BMA makes clear it does not hold a position on the matter, since 2021 it has taken a position of neutrality on assisted dying and physician assisted dying.

However, it says this does not remove the ‘responsibility to represent the views of our members in discussions on any legislative proposals’.

Having review Dr Allinson’s proposed Private Member’s Bill, the BMA says if the law is changed on the island then it would like to see a change to the opt-out option for doctors, thereby removing the premise that any doctor could be expected to take part in a service unless they have a conscientious objection.

Deputy chair of the BMA’s Medical Ethics Committee Dr Andrew Green said: ‘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).

From the information we have gathered about other jurisdictions, it appears that in practice assisted dying is usually only provided by those who positively choose to participate, even though it is not explicitly presented in this way.

‘Making this explicit in any legislation would provide reassurance to both doctors and patients.’

Dr Green also said that any doctors who do take part would need specialised training, guidance and practical and emotional support.

Right to Refuse

Dr Green’s letter also makes clear that the BMA wants doctors to be able to refuse to carry out any activity related to assisted dying and for any reason.

He said: ‘We are aware (including from responses to our survey) that there are some doctors who do not oppose assisted dying in principle (and so do not have a ‘conscientious’ objection in the way that is normally understood) but who would not personally want to participate in the process. It is important, therefore, that if assisted dying were legalised, doctors should be able to object to taking any part in the process itself, for any reason and, as such, any right to object should not be framed as, or limited to, matters of conscience.’

The BMA also wants to see that doctors are protected from any form of personal or professional discrimination whether they agree or disagree with assisted dying and whether they choose to be involved in the process or not.

It also has called for safe access zones, similar to those created for abortion clinics, to be create to protect patients and staff if the law is changed.

Dr Allinson’s Bill is due to return to Keys next week for its second reading.