New research reveals that UK doctors are strongly opposed to legalisation of euthanasia or physician-assisted dying, in stark contrast to the majority of patients who are in favour.
And a separate study by the same author, Prof Clive Seale from the Centre for Health Sciences, Queen Mary University of London, reveals that UK doctors rarely administer drugs to people who are terminally ill with the explicit intent of speeding death.
Prof Seale carried out a postal survey of 3733 UK medical practitioners comparing their attitudes to euthanasia with the general public. Only a third (34%) said they are in favour of the legalisation of euthanasia and 35% in favour of assisted suicide. That contrasts with 82% and 62% respectively of the general public who were asked exactly the same questions in the survey.
Both studies are published today in the journal Palliative Medicine. Prof Seale found that palliative medicine specialists are particularly opposed and a strong religious belief is independently associated with opposition to assisted dying.
“Frequency of treating patients who die is not independently associated with attitudes. Many doctors supporting legalisation also express reservations and advocate safeguards; many doctors opposing legalisation believe and accept that treatment and non-treatment decisions may shorten life. It is hoped that future debates about legalisation can proceed with this evidence in mind.”
Last week former Health Secretary Patricia Hewitt called for a change in the law so that desperate people need not go to Dignitas in Switzerland to die and put their families at risk of prosecution for helping them.
The fundamental difference of opinion between doctors and the public is important, says Seale, because governments who have passed laws to enable assisted dying have only done so with the support of the medical profession, as happened in the Netherlands.
"The Dutch medical association in the late 1980s and 90s was moving towards the view that euthanasia was an acceptable way of dealing with certain forms of suffering," he said. "Dutch medical opinion was influential with the government."
He also sent a questionnaire to 8857 UK medical practitioners, of whom 3733 (42%) replied, with 2869 having attended a person who died in the previous year.
Approximately one in 200 doctors said they explicitly used medication to end a life. Where doctors have helped a patient to a faster escape from their pain or distress, by taking non-treatment decisions or double effect measure, most say they have not shortened life by more than 24 hours and nine out of 10 say their actions hastened death by less than a week. Doctors who admit to it say they had the full collaboration of the patient and family.
The survey revealed, however, that in 16.5% of cases, doctors used continuous deep sedation – heavy sedation which can result in the patient effectively being in a coma. The figure is higher than in other countries. In the Netherlands, doctors who were asked a similar question in 2005 said they employed it in 8.5% of cases, and in Belgium in 2001 the figure was 8.3%.
"The results show that deaths in the UK are particularly likely to involve continuous deep sedation," said the paper. "This may be a cause for concern if interpretations of this as 'slow euthanasia' are to be avoided. A better understanding of the context in which these decisions are taken is needed to assess this."
The studies were commissioned by the National Council for Palliative Care, Age Concern, Help the Hospices, Macmillan Cancer Support, the MND Association, the MS Society and Sue Ryder Care, all of which are campaigning for better end of life care.