Assisted dying would put UK doctors in 'impossible' situation

Amy Proffitt is like the majority of palliative care practitioners in Britain -- she is opposed to changes in the law to allow assisted dying.

In a 2020 survey for the main doctors' union the British Medical Assocation (BMA), three-quarters of palliative care providers were against the move, compared with half of all doctors.

Now, as the issue returns to parliament on Friday, Proffitt said the bill to make the practice legal puts doctors in an impossible situation.

"The safeguards that have been put in place are not robust at all," she told AFP. "We must ensure that this is voluntary.

"But I, as a doctor, cannot determine coercion. I have no legal training whatsoever."

Proffitt, who works at Barts Health NHS Trust in London, said she also opposed the bill because it would be open only to patients with six months to live.

"That's impossible for a doctor to determine," she said.

Focus on end-of-life care

Central to her argument is the state of palliative care in the state-funded National Health Service (NHS) that is creaking due to lack of money and staff.

According to a 2022 parliamentary report, 100,000 people died each year in the UK without having been able to access end-of-life care.

As such, she said, the option of assisted dying was "the very illusion of choice".

"If you can't get palliative care access at all, your only option is to consider this, so it isn't a choice at all," she added.

Proffitt, a former president of the Association for Palliative Medicine, said patients do ask for help dying.

That then prompts questions about the reasons behind the request, including physical pain, psychological distress or social problems.

Palliative medicine is not "just about adjusting a dose of morphine when someone has pain," she said.

Obligated assisted dying

Friday's bill, she added, states that a doctor does not have to recommend assisted dying. But if a patient asks for it, then doctors would have to offer it as a "treatment option", regardless of where they stand on the issue.

"I would be obliged to refer on to another doctor" who would offer the practice, she said.

Proffitt described the accounts of the terminally ill and the families of patients who have taken their own lives as "desperately sad" but maintained there should be more investment in palliative care.

"I think at the moment, until you fix one (palliative care) you can't then legislate for assisted dying," she argued.

"Our workforce needs developing, and the research around what we do needs developing... So, we have to fix one problem before we even consider this in this country."

Other models needed to be considered, she added, urging MPs to reject the bill, calling it "rushed through" with less than three weeks of scrutiny.