Dear Editor
Medicalising assisted dying implies that dying is a treatment that could be prescribed for particular serious illnesses, when at the terminal stage of the illness, but, as Dr.Smith points out correctly (1), it is not in fact possible to predict with any degree of certainty when any particular patient will die.
One important consequence of the present debate is the risk that doctors can easily be drawn into giving an opinion to patients that they should consider assisted dying because of the difficult circumstances of their particular illness, and that therefore, medical textbooks or guidelines will gradually be re-written so as to ‘help’ doctors to give such opinions, by producing lists of circumstances in which recourse to assisted dying is ”indicated”, and this will, in its turn, affect teaching within medical schools.
Such a tendency must be resisted at all costs by the medical profession. Indeed, the opposite is true, because the basic function of medicine is to preserve life, and not to end it. Rather than being available advise how to help end life, doctors need to be able to make it abundantly clear to their patients that, whatever the circumstances, they will always be available to the patients in order to treat conditions which are treatable and alleviate the patient’s suffering to the best of their ability. Any other position by the doctor will inevitably erode the doctor-patient relationship, and which is based on trust between the two (2).
Thus it is important, whatever the outcome of the present discussions in Parliament on the assisted dying bill, that, while a doctor may well, based on his/her experience, be in a position to state that an illness is terminal, he/she should never be placed in a position to prescribe, study, teach, or advocate assisted dying for his patients. Hence any concept of Assisted dying needs to be demedicalised.
References
(1) Smith R. Better to demedicalise rather than further medicalise and bureaucratise death BMJ 2024;387:q2719
(2) Agius M: The medical consultation and the human person. Psychiatr Danub 2014; 26(Suppl. 1):15-8
(3) Wigmore, Steve. What is the essential unit of medical practice? Quoting Sir James Spence
Re: Better to demedicalise rather than further medicalise and bureaucratise death