The British Medical Association prepares to revisit its opposition to assisted dying

FOR doctors, the idea of helping a patient to die—even a terminally ill one—is fraught. The Hippocratic Oath, the first attempt to provide an ethical framework for the profession, starts with an injunction to “do no harm”; many feel the discussion need go no further. But a survey for The Economist last year showed that seven in ten Britons thought doctors should be allowed to help patients end their lives, subject to safeguards. So what is a doctor to do?

The stance of the British Medical Association (BMA) is clear: doctor-assisted dying should not be made legal. But the organisation’s policy was drawn up a decade ago, and the wider discussion has moved on since then. Two assisted-dying bills were brought before parliament last year alone, though neither was successful. The topic has been debated at seven of the BMA’s 13 annual meetings since 2003.

So the medical union has set about investigating doctor-assisted dying in the broader context of end-of-life care. The first two instalments of its findings were released in January, and a final report last month. Two day-long gatherings focused on “moving the debate forward” were held in the last week of May. And the issue is once more on the agenda of its annual meeting, which will be held on June 23rd.

But none of this should be taken as a sign that change is imminent, says Sam Dick of Dignity in Dying, a pro-legalisation campaign group. The reports, and the debates, tuck doctor-assisted dying away inside a broader discussion of end-of-life care. The language is cautious, sometimes tortuously so. “[W]e are pleased that this project, and some of the associated activities, have begun to move debate beyond over-simplistic for/against positioning to consider some of the complex issues surrounding physician-assisted dying,” writes Ian Wilson, who chaired the BMA working group, in his foreword to its most recent publication.

The various reports and debates are a sign that the BMA feels it must respond to outside shifts, rather than an indication of a change of heart within. A survey by MedeConnect, a market-research firm, in England and Wales in 2014 found that six in ten family doctors wanted the BMA to take a neutral stance on doctor-assisted dying. Though only one in seven said they would be willing to conduct full assessments of those seeking help in dying, half said they would be willing to play some role. So the BMA’s flat opposition is some way from the opinions of those it is supposed to represent.

Doctors are the people who would have to put any new law into practice. And those who draft legislation look to the BMA as the voice of the profession. Its opposition was a big part of why the bills brought before parliament last year did not pass, reckons Dignity in Dying. Its Californian counterpart’s decision to shift from opposition to neutrality was probably essential in the state governor’s decision to sign an assisted-dying law last October. A shift is unlikely next month. Campaigners believe, though, that it will happen eventually, as it has elsewhere.