Professor Wendy Savage is a British obstetrician and gynaecologist and a long-standing campaigner for women’s rights in childbirth and fertility. She is a patron of the assisted dying organisation My Death, My Decision. She has previously served as a member of the General Medical Council and British Medical Association’s Medical Ethics Committee, and is the recipient of the British Medical Journal’s award for an Outstanding Contribution to Health.
This month, the British Medical Association (BMA) launched a landmark survey, asking doctors whether they think the law prohibiting assisted dying needs to change – following a motion from the local Islington Division which I chair. Remarkably, this is the first such survey, given that many doctors come face-to-face with the human suffering caused by current legislation every single day.
Since 2006, the BMA has actively opposed a change in the law on assisted dying, after opposition led by the Christian Medical Fellowship resulted in a decision to overturn a previously neutral stance (which had been achieved after extensive debate in 2005 at the BMA’s annual policymaking meeting). Having spent over 40 years practising as a doctor and campaigning for women’s rights to bodily autonomy, I find this active opposition disturbing.
Of course, individual doctors who oppose legal changes have a right to make their voices heard. But the BMA’s current position silences many of us in the medical community who have a conscientious commitment to respect our patients’ autonomy and exercise compassion to those living in unspeakable pain – such as Paul Lamb, who is paralysed from the neck down and recently launched a legal case to change the law.
Some who oppose a legal, safe and compassionate approach to assisted dying argue legalisation will be a slippery slope and pressure the vulnerable into ending their lives prematurely. But these arguments are not new: I faced the very same objections when campaigning for women’s’ rights to access safe abortions back in the 1970s. They were wrong then, and they are still wrong now.
As it transpires, legalising access to safe abortions has not been a slippery slope. If anything, safeguards around the procedure have become stricter, with the legal time limit for abortions reduced from 28 weeks to 24 in 1990.
Likewise, there is no evidence that legalising medically assisted dying would be any different. Assisted dying is now permitted in Canada, Belgium, Italy, Luxembourg, the Netherlands, Switzerland, and Colombia, as well as parts of the USA and Australia. Nowhere has there been any credible evidence of vulnerable people being coerced. Thanks to sensible safeguards, it simply hasn’t happened.
In fact, Switzerland has 80 years of experience and has managed to avoid any slippery slope. A point brought home to me after I accompanied a friend to die in Switzerland, and saw firsthand their professionalism and respect for human life and patient autonomy.
Over the past ten years, there has also been a massive shift in public opinion that the BMA’s policy has failed to keep up with. A 2019 poll by the campaign group My Death, My Decision found over 90% of the British public regard assisted dying as acceptable in at least some situations. Similarly, various organisations representing medical professionals and the disabled have adopted a neutral stance on the issue, including the Royal College of Physicians, Parkinson’s UK, and the Motor Neurone Disease Association.
Why, then, have the arguments against legalising safe abortions in the 1960s re-emerged in today’s assisted dying debates, despite the overwhelming weight of evidence invalidating them? In one word, money. Only last year, when the Royal College of Physicians sought their members’ views on assisted dying (of which 56.6% in aggregate supported a change in the law or neutral stance) it was revealed campaigns against assisted dying were being funded by the same people who campaign to restrict abortion rights in the USA.
In 1967 the abortion argument fundamentally changed when, as doctors, we realised we could no longer ban abortions – we could only make them unsafe. Before 1967, British women were still having abortions – they were just unsafe, unregulated, and often fatal. The same is true for assisted dying, and British citizens are already finding ways to end their lives in secret.
Assisted dying is happening right now, whether we like it or not. BMA members face a choice. We can remain hostile to a change in the law, thus forcing patients in pain to seek out dangerous, unregulated methods to end their lives; or we can contribute our expertise to the assisted dying debate, and bring compassion to a conversation that too often prizes ideology over the realities of what patients need. I know which way I’m voting.
The British Medical Association’s survey will run from 06 February until 27 February 2020 and is being organised by Kantar.