BMA sets out doctors’ priorities for assisted dying legislation

The national debate on assisted dying took another decisive step last month, as MPs voted to allow the Terminally Ill Adults (End of Life) bill to proceed to committee stage.

Put forward as a private members’ bill by the Labour MP for Spen Valley Kim Leadbeater, the proposed law could eventually see England and Wales adopt a new legal framework, which would enable those terminally ill adults who were expected to die within six months and who wished to end their lives to seek medical assistance in doing so.

By its very nature, the issue of assisted dying is one which often evokes deeply held as well as divided opinions among the public and members of the medical profession. In recognition of the diversity of thought among doctors, the BMA has, since 2021, held a position of neutrality on the issue of whether PAD (physician-assisted dying) should be legalised.

While this position remains unchanged, the association has not stayed silent during the continuing political debate, spelling out in exacting terms what it believes would be the concerns and requirements of doctors should Parliament ultimately seek to change the law.

In a detailed briefing submitted to all MPs, and in constructive dialogue with Ms Leadbeater in advance of the debate, the BMA emphasised that any future model of assisted dying must be explicitly ‘opt-in’ in nature, with doctors able to determine precisely if, when and how they participate in that process. 

For those doctors either opposed to assisted dying or to their personal involvement in it, the bill must enshrine a provision giving doctors a general right to refuse to participate for any reason, which is distinct from the existing conscientious objection clause for procedures such as termination of pregnancies. 

The BMA has also made clear that prospective legislation must also seek to protect doctors and patients. While the association has welcomed a specific provision in the bill making it illegal for employers to subject doctors on either side of the debate to detriment, it wants to see a commitment to creating safe PAD access zones, should the need arise to protect staff and patients from harassment and/or abuse, a feature absent from the bill’s current draft.

The current iteration of the bill would not impose a duty on doctors but rather allow them to use their professional judgement when deciding whether to broach the issue of assisted dying with a terminally ill patient who meets the criteria. While this is welcomed by the BMA, the association has insisted that there must be more clarity on how an assisted dying service might be delivered and funded, areas that the draft law provides little to no detail on.

The BMA has also said should PAD be legalised it would strongly support the creation of an independent and transparent system of oversight and monitoring to regulate it, and a patient information service to be provided by an official, legally accountable body.

More detail on the BMA’s position on PAD and the assisted dying bill