AS reported by Alistair Thompson on TCW yesterday the Royal College of Physicians (RCP) is to poll its 35,000 members to ask whether ‘they would help a terminally ill patient to die and whether the law should be changed to allow assisted dying’.
It is hard to see why, despite polling all its members only a few years ago with the same question, it has decided it needs to ask them again. The worry is whether this could be the start of a deliberate attempt to go officially ‘neutral’ on ‘assisted dying’ and from there, actively to support it.
The term ‘assisted dying’ is a euphemism. It has no meaning in law but in practice means supplying lethal drugs to the terminally ill with the purpose of helping them to commit suicide. At the moment, the RCP opposes it. And rightly so for the reality is that ‘assisted dying’ is just another definition of euthanasia.
The RCP says it wants to find out if its members and fellows support a change in the law to permit ‘assisted dying’ or not, and whether it should become officially ‘neutral’ on the issue.
In its last poll of members, five years ago, 58 per cent said they would not participate in ‘assisted dying’, showing little change from the proportion expressing this view in a 2006 survey.
With a majority likely still to be opposed to a change in the law, how are those in the RCP desirous of change to get around this opposition?
In what looks to be a clever move the RCP now says it will go officially neutral on the law unless a full two thirds of members oppose it. ‘The RCP will adopt a neutral position until two thirds of respondents say that it should be in favour or opposed to a change in the law.’ (my emphasis).
This means that if 58 per cent of the RCP’s members still oppose going neutral, as they did last time, they will simply be ignored. The college will go ‘neutral’. A supermajority of at least 66 per cent of members opposing a change is required for them to be listened to. As well as being democratically questionable, it is a very unusual procedure and highly unlikely to be achieved, which is why ‘neutrality’ seems inevitable now.
It prompts the question of why have the RCP decided that a full two thirds of members are needed to oppose ‘neutrality’? Is it of any relevance that two representatives from the lobby group Dignity in Dying (DiD, formerly the Voluntary Euthanasia Society), patrons of DiD and active campaigners for legalising euthanasia, are on the RCP Council? One, Raymond Tallis, is a campaigner, speaker and writer for assisted suicide and euthanasia, and the other, the famous journalist and campaigner Nick Ross.
These connections seem remarkably coincidental, and concerning.
So what is my worry about the idea of doctors going ‘neutral’? It suggests that doctors can just sit on a fence and not dictate to others what they should or should not do, neither supporting nor opposing ‘assisted dying’. That might on the surface seem perfectly reasonable in this age of individualism and personal choice. However neutrality is a murky concept. In this case, declaring oneself ‘neutral’ on the subject is equivalent to watching and standing by while someone jumps off a bridge or under a train. Logically, neutrality implies that ‘we are no longer opposed’. Rather than saying ‘I’ll help you kill yourself’, ‘neutrality’ from a doctor signals that ‘I don’t care if you kill yourself’.
It is impossible to be neutral about doctor-assisted suicide, as Daniel Sulmasy and Baroness Finlay argued cogently last year in the Journal of General Internal Medicine. The political effect would be to give it a green light. It would send the signal that there is no serious problem with doctors prescribing lethal drugs so their patients can kill themselves. Yet doctors have no business pretending to be ‘neutral’ about matters of life and death. This is at the heart of their profession. It is not an issue for indifference. They have to take a stand and if they do not oppose assisted ‘dying’, they in effect support it.
Michael Cook warns that ‘the call for “neutrality” is a clever way to breach the defences of opponents of assisted suicide and euthanasia. In the lead-up to World War II, Denmark, Norway, Belgium, the Netherlands, Luxembourg, Lithuania, Latvia and Estonia were all neutral. And then, suddenly, they weren’t.’
Moreover, if ‘neutral’, doctors would not only be abdicating moral responsibility for their own patients but they would have to stand by and have no influence in any public debates: ‘Neutral’ means the RCP neither supports nor opposes a change in the law and can reflect the differing views of its members and fellows in discussions with government and others’. The RCP will be forced to remain silent and take no part in any debate. Physicians will have no collective voice.
The RCP represents doctors from across a spectrum of thirty specialities and is the oldest and one of the largest and most influential medical colleges in the world. Their influence on this matter should not be underestimated. A position taken by such a leading College will have political and social consequences that will reverberate far beyond its own members.
By tipping the scales in favour of so-called ‘neutrality’ the RCP’s position has itself become far from neutral. And it is moving away from the fundamental duty that doctors should always care and never kill.l