The topic of assisted dying is a contentious issue among family doctors in England, as shown by recent BBC research. This study provides a detailed look into the perspectives of general practitioners (GPs) regarding the proposed legislation that aims to legalize assisted dying for certain terminally ill individuals in England and Wales. The research sheds light on the strong feelings and diverse opinions within the medical community, influenced by personal beliefs and experiences.
The BBC conducted a survey, sending questionnaires to over 5,000 GPs to gauge their stance on the proposed law change. Of the more than 1,000 responses received, around 500 GPs expressed opposition to the law, while about 400 were in favor. Those opposed to the law described it using terms such as "appalling" and "highly dangerous," with one GP commenting, "We are doctors, not murderers." In contrast, supporters of the legislation deemed it "long overdue" and a "basic human right," arguing that the current practices often prolong suffering unnecessarily. "We are keeping human bodies alive in the most inhumane manner," one supporter noted, questioning the ethical justification for extending suffering.
The representative nature of the respondents is uncertain, as the survey does not necessarily reflect the views of all family doctors. The timing of this research is significant as Members of Parliament are set to debate the bill, with a parliamentary vote expected soon. Should the bill pass, it would mark a transformative change in societal norms regarding end-of-life care in England and Wales.
Currently, laws prohibit medical professionals from assisting patients who wish to die. The Terminally Ill Adults (End of Life) Bill proposes allowing doctors to participate in assisted dying, a role that GPs have taken in countries where the practice is legal. Meanwhile, a similar bill in Scotland recently passed an initial vote, highlighting the broader context of this debate within the UK.
A major concern among the nine out of ten GPs against legalizing assisted dying is the potential for terminally ill patients to feel pressured into choosing death due to a sense of guilt about being a burden. One GP summarized this concern, stating, "The right to die becomes a duty to die for those who feel a burden on family." Additionally, there are fears about potential coercion, with some GPs sharing experiences of treating elderly patients whose family members appeared more interested in inheritance than the well-being of their relatives.
Religious beliefs also play a significant role in the opposition, with over half of those against the law citing spiritual reasons, describing life as "sacred" and labeling assisted dying as "sinful." Some opponents referred to the commandment "thou shalt not kill" as a moral foundation for their stance. Others argued that resources should be directed toward enhancing end-of-life care, criticizing the current reliance on charity-funded hospices.
The Royal College of Psychiatrists recently stated that while it remains neutral on assisted dying as a principle, it cannot support the current bill. Dr. Lade Smith, the college's president, highlighted the lack of provisions for addressing patients' unmet needs, including pain management, financial difficulties, and social isolation. Dr. Gordon Macdonald, CEO of Care Not Killing, echoed these concerns, emphasizing the need for improved palliative care instead of legalizing assisted dying.
Conversely, more than 400 GPs who supported the law change reported feeling "traumatized" by witnessing patients die in severe pain or distress. Over 90% of these GPs believed that the legislation could offer patients a dignified death. Many shared personal stories of family members losing dignity or pleading for death, with one GP recounting their spouse's nightly prayer not to wake up in the morning. Supporters argued that allowing patients to choose how they die respects their autonomy and is not patronizing.
For those in favor, the option of an assisted death is seen as a personal comfort, with some expressing resentment toward those opposing this choice. If passed, the law would apply to terminally ill patients expected to die within six months. However, more than a quarter of the GPs surveyed expressed doubts about accurately predicting such a timeframe, citing the unpredictability of terminal illnesses.
The proposed legislation does not obligate doctors to participate in assisted dying. Of the GPs surveyed, over 500 indicated a willingness to discuss the option with patients, nearly 300 would assess eligibility, and 161 would prepare the necessary substances for patients to self-administer.
Professor Kamila Hawthorne, chair of