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Assisted dying remains highly topical and debated, both in the public and medical arena. All practising physicians in the UK who care for dying patients should be aware of the proposed legislation and the potential effects on their clinical practice.
Physician assisted death is a legal activity in certain parts of the world but not presently the UK (for example, the state of Oregon following the 1997 Death with Dignity Act and in the Netherlands under the 2001 Termination of Life on Request and Assisted Suicide Act).1 Surveys suggest around 56% of doctors and 82% of the general public favour assisted dying.2,3
If legalised, it is estimated that 13 000 deaths a year may result from physician assisted suicide in the UK.4 The debate regarding physician assisted death is complex involving many legal, ethical, medical, sociocultural, personal, and religious issues.
In this article we describe the important provisions of the proposed Assisted Dying for the Terminally Ill Bill in the UK and summarise the arguments for and against such legislation.
ASSISTED DEATH: DEFINITION OF TERMS
Before elaborating on the Bill and for and against arguments it is necessary to clarify terms relating to assisted death (table 1). “Assisted death” incorporates both physician assisted suicide and voluntary euthanasia, and the current version of the bill only relates to physician assisted suicide.
It is also important to note the legal and ethical “distinction” between physician assisted death and other end of life issues such as withdrawing and withholding life prolonging treatment, do not attempt resuscitation orders, and the appropriate provision of medication to relieve pain that may (but not necessarily) incidentally hastens death (the doctrine of double effect7).1,8 Furthermore, while this distinction is made, it may be argued …
Conflicts of interest: none.
After this editorial went to press the British Medical Association also announced that it was changing its position from one of “neutrality” to “against” the proposed legislation (after a vote of members at its annual conference). The BMA opposes PAS and euthanasia “as alien to the moral focus of medicine”. It argues that legalisation would change the doctor-patient relationship and put pressure on sick people.