Doctors with most relevant experience oppose assisted suicide and euthanasia

9 October 2020

Paul Huxley, Communications Manager, comments on a recent survey by the BMA, which suggests the majority of doctors working in palliative care and with terminally ill patients oppose euthanasia and assisted suicide.

The British Medical Association has released the results of a recent poll of its members on whether doctors should be allowed to prescribe or administer life-ending drugs.

The survey, designed to inform the debate at its next annual representative meeting (likely in 2021), suggests a slender majority of doctors (40% vs 33%) favour allowing doctors to give patients drugs to end their lives – even though most would not be happy to do so themselves.

However, on closer examination, the strongest support for assisted suicide and euthanasia comes from doctors with little practical experience in this area of medicine: medical students and those working in emergency medicine, intensive care, anaesthetics and obstetrics & gynaecology.

By contrast those with the most relevant qualifications – those who deal with long term illnesses and elderly patients – were most strongly opposed: doctors in clinical oncology, general practice, geriatric medicine and palliative care.

Dr Gordon MacDonald, CEO of Care Not Killing commented on this trend:

“Once again there appears to be a difference between practising and non-practising doctors. The largest percentage of those doctors at the coal face of caring for the elderly and terminally ill, who work in Palliative Care, Geriatric Medicine and General Practice continue to oppose assisted suicide and euthanasia, whereas retired doctors and those who have never practiced medicine because they are students or do not hold a license to practice, remain more supportive. Indeed, 70% of Palliative Care doctors opposed the BMA supporting a change in the law to allow physician assisted suicide and 44% of geriatricians were opposed to the BMA supporting assisted suicide whilst only 27% were in favour. Some 40% of GPs opposed BMA support for physician assisted suicide whilst only 34% were in favour of it.

“Moreover, the survey shows that the largest group of doctors opposes the BMA supporting the legalisation of euthanasia. Of those who responded to the survey, 40% want to oppose, whilst only 30% voted for support, in relation to the BMA’s stance on euthanasia.”

Listen to the experts?

In debates over Covid-19 and lockdown policies, we are consistently told in the public discourse only to listen to experts with the most relevant experience in public health and immunology. Even though our response to the novel coronavirus touches on all aspects of our lives, the opinions of those with anything short of impeccable credentials are brushed aside.

End of life issues are far more limited in scope. But if we’re going to be remotely consistent, we need to give greater weight to the views of those with relevant expertise than a twenty-something going through med school.

It is relatively easy to scare someone with little experience of end of life situations into believing that they are typically excruciating and undignified – and that refusing to end people’s lives is a failure of compassion. In fact, this is the assisted suicide lobby’s standard tactic. But palliative care doctors are much harder to fool – and many of them raised concerns in the survey that assisted suicide would lead to less funding for their critical work.

Doctors aren’t the only experts

In reality, it’s not just doctors who have relevant, informed opinions on artificially hastening people’s lives.

As Gordon MacDonald writes:

“The current laws on assisted suicide and euthanasia exist to protect those who are sick, elderly, depressed or disabled from feeling obliged to end their lives. They protect those who have no voice against exploitation and coercion and those who care for them who might come under pressure to conserve scarce resources. They do not need changing.”

I’ve rallied outside parliament many times with disability rights campaigners who know full well the message assisted suicide sends: that some lives aren’t worth living. Give up. People already facing serious physical health conditions, who may already feel a burden on others, are implicitly told that ending it all is at least a morally neutral, viable plan.

But it strikes me as an even more dangerous attitude towards those with long term mental health conditions. Anyone who has been through or supported someone through a mental health crisis will know how utterly debilitating it can be. How difficult is to persuade someone that their life is worth living.

For example, when someone has been through severe trauma, or the loss of a job or relationship and wants to end it all – they may well face the prospect of much greater hardship than someone in a potentially painful end of life experience. What message do we send to them if we say it’s rational for others to want to end their life?

For the good of all, we must consistently uphold that it is always irrational to want to end your life.

Killing really is a slippery slope

On moral matters, minor, restrictive changes in the law never stay that way. The extreme liberalisation of abortion practice in the 52 years of the Abortion Act are a case in point. What was meant to make abortions safe, legal and rare opened the floodgates to women calling up to get pills for unsafe home abortions, never being seen by a clinician and never even speaking to a doctor. Without even substantively changing the law!

Some people love to point fingers and claim that people like me are guilty of slippery slope fallacies but even if assisted suicide were a good idea, the idea that it could be restricted to extreme cases is ludicrous and goes against all the available evidence.

Again, Dr MacDonald puts it well:

“They have seen what happens in the small number of jurisdictions that have gone down this dangerous path – places like Oregon and Washington. These two US states are held up as the model to copy, but in both, a majority of those opting to end their lives cite fear of being a burden as among their key reasons, and others talk about financial concerns. While the list of conditions that qualify for the lethal cocktail of barbiturates continues to grow, some experts have warned that allowing assisted dying might also be normalising suicide in the general population. Suicide rates are, after all, a third higher in Oregon than the US average.

“In Canada, last year a Court struck down the requirement that a person be terminally ill before they qualify for euthanasia. This followed the case of Alan Nichols, a former school caretaker who was physically healthy, but struggled with depression. His life was ended by lethal injection in July. Roger Foley, meanwhile, was repeatedly offered the drugs to kill himself, while being denied the social care to live a dignified life, due to the cost.

“Closer to home, we see how laws introduced in the Netherlands or Belgium, which were supposed to be limited to mentally competent terminally ill adults, have been extended to non-mentally competent adults and children, profoundly disabled people, and even those with treatable psychiatric problems such as depression and anorexia.”

‘Mercy’ killing isn’t

These are just some of the practical reasons assisted suicide or euthanasia is a bad idea. But there are even more fundamental reasons Christians should strongly oppose the practice.

Our booklet on euthanasia and assisted suicide goes into the issue in detail, surveying the Biblical data as well as looking in detail at what has happened when other jurisdictions have allowed this kind of killing.

Simply put, the intentional taking of human life is strictly forbidden by God (Genesis 9:5-6) except in cases where God demands or allows civil rulers to administer justice. Theologians and philosophers may debate exactly what those circumstances are, but so-called ‘mercy killing’ – of oneself or another – is never tolerated and is utterly foreign to a Christian worldview.

Well-meaning Christians, who want to be compassionate and empathetic with others are too easily suckered into supporting assisted suicide or euthanasia. Even former archbishops.

We’re under no moral obligation to throw all of our resources into prolonging life indefinitely. We can give medicines with the intent and effect of treating pain that have a possible side effect of hastening death. But Christians should know that death is an enemy.

When he died and rose, Jesus punched a hole through death; and will one day defeat it forever. Let’s not be duped into treating death as a friend.

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