Helping the terminally ill to die

Euthanasia is illegal in the UK

This weekend sees the Liberal Democrats grapple with the thorny issue of medically-assisted suicide.

Delegates at the party's spring conference will debate whether medical staff should be allowed to actively help terminally ill patients to die.

As the politicians gear up to discuss this controversial issue, BBC News Online examines why most doctors and nurses are firmly against it.

Most Britons believe terminally-ill people should be allowed to ask for medical help to die.

A string of opinion polls over the past 20 years suggest as many as 81% would support a change in the law to make medically assisted dying legal.

But it is a road politicians and successive governments appear reluctant to go down.

Under British law, medical staff are allowed to withhold treatment from patients if they believe it will cause more harm than good.

The RCN is against euthanasia and assisted suicide Beverly Malone, Royal College of Nursing

Patients are also entitled to refuse any treatment they do not want.

But what is not allowed is for doctors or nurses to actively help patients to kill themselves.

There have been numerous attempts to change the law. A Bill, which would make assisted dying legal, is currently going through the House of Lords.

It is destined to fail, not least because it does not have government support. In fact, none of the political parties like the idea.

The Lib Dems concede that even if conference delegates back calls for it to become legal, it will not become official party policy.

"It is something we can't have a party policy about because people have such different views on it," says a spokesman.

It is a move many doctors and nurses would agree with.

Medical opposition

While the public appears to be firmly in favour of medically assisted suicide, the medical professions are strongly against.

A survey by Nursing Times magazine, published last year, found just one in three nurses wanted to be allowed to help terminally ill patients to commit suicide.

A survey suggested some nurses want the law changed

A poll of doctors by the anti-euthanasia group Right to Life, also published last year, found just one in four backed such a policy.

"It goes against their ethical code," says Dr Kenneth Boyd of the Institute of Medical Ethics at the University of Edinburgh.

He said: "Quite a number would be prepared to do it but others would be very reluctant for ethical and psychological reasons.

"They would be afraid it would become a slippery slope."

The medical establishment is adamant that the status quo should remain.

The Royal College of Nursing, the British Medical Association and the medical royal colleges are all opposed to making medically-assisted dying legal.

Last year, a senior member of the RCN sparked a furore when she suggested the law should be changed.

The RCN quickly distanced itself from her comments.

Speaking at the time, Beverly Malone, its general secretary, said: "The RCN is against euthanasia and assisted suicide. Euthanasia is illegal and the RCN does not condone it."

The BMA and other medical organisations have been equally unequivocal. The BMA, for its part, has been openly opposed to euthanasia for decades.

Four years ago, senior members met to review its position on the issue. They backed the status quo and reiterated their opposition to any change in the law.

Firm policy

There appears to be little demand for that policy to be reviewed.

"We have a firm policy on euthanasia," says a BMA spokeswoman.

Over 80% of the public support the right to choose to die Spokeswoman, Voluntary Euthanasia Society

"We believe it would adversely affect the doctor-patient relationship.

"Our position hasn't changed and we are not receiving any calls from members to change it."

The Royal College of Physicians and the Royal College of GPs set up a working group to examine the issue in 1998.

It too concluded that there was no case for the law to be changed. They do not appear to have plans to re-open the debate.

"There has been little change in medical opinion on euthanasia or physician assisted suicide," says Dr Anthony Cole of the Medical Ethics Alliance, an anti-euthanasia group.

"The fact is it would undermine the basic ethos of a caring profession and it would lead to a deterioration in the doctor-patient relationship. There is little support for it."

Nevertheless, surveys suggest that given the right circumstances some medical staff may be prepared to help terminally ill patients to die.

A survey carried out by The Sunday Times six years ago suggested 15% of doctors had helped patients to end their life.

Another poll for a medical magazine, published a year earlier, indicated that almost half of GPs "eased a patient's death in some way".

With public support for a change in the law to enable medical staff to do this legally, this is an issue that will run and run.

The medical establishment like politicians will face continued calls to change their views on medically-assisted suicide.

"They need to keep it under review," says a spokeswoman for the Voluntary Euthanasia Society.

"Over 80% of the public support the right to choose to die. It is about patient choice."