Dear Editor,
Downar and colleagues state that “over 300 million people across the world already have access to the option” of assisted dying. Unfortunately I believe this to be an incorrect statement. The combined populations of the countries and states where some form of assisted dying option or similar is available may be some 300 million but only a very small proportion of people in those regions will actually be eligible for this option. It would instead be more informative for the reader to know the numbers of people from within this population who have been eligible and the proportion who have availed themselves of assisted dying.
The legal availability and the idea of normalising assisted dying raises another point. It is not uncommon for patients with very severe and difficult to manage conditions (whether terminal or not) and prolonged and complicated hospital stays to at some point lose hope of recovery and request their life-sustaining treatment to cease or even for staff to help hasten their death. At present, staff can feel confident in encouraging such patients not to seek to end their lives prematurely. However, if assisted dying were a legally available option, such requests would have to be considered more formally, potentially involving considerable amounts of staff time, effort and bureaucracy. Clinicians may even become reluctant to challenge their patients’ perceived wishes, in case this were seen as obstruction of their legal rights and thereby a criminal offence. Furthermore, clinicians’ views on whether an individual patient’s condition is recoverable or terminal will naturally vary. In borderline cases, it will likely be possible for a patient to make sure they can find two doctors who can agree to sign the required form. It is therefore highly likely that passage of the Assisted Dying Bill would lead to instances where it would be used beyond its intended scope.
Yours faithfully,
Dr Andrew G. L. Douglas
Assisted dying – not 300 million people