Stellungnahmen

Eine Konferenz von 50 Delegierten verschiedener Gruppierungen der BMA (British Medical Association) wandte sich in einer eigens dafür einberufenen Konsensus - Tagung gegen Bestrebungen, die eine Veränderung der gegenwärtigen Gesetzeslage zum "physician assisted suicide" (ärztlich assistierten Selbstmord) in Großbritannien zum Ziel haben. Der Wortlaut der Konsensus - Erklärung wurde "Ärzten für das Leben" von der "World Federation of Doctors Who Respect Human Life" (Präsident: Dr. K. Gunning) zur Verfügung gestellt und wird von uns im Originaltext weitergegeben.

BMA consensus conference rejects a move to change the law on physician assisted suicide

The British Medical Association today concluded a two day conference called to promote the development of consensus on physician assisted suicide.

The conference reached consensus on a number of key issues. It rejected moves to promote a change in the law on physician assisted suicide, stating:

"Drawing together a wide range of moral viewpoints and practical considerations, the conference cannot agree to recommend a change in law to allow pgysician assisted suicide"

Commenting on the outcome of the conference, Dr Michael Wilks, Chairman of the BMA s Medical Ethics Committee says:

"This weekend s conference has firmly rejected any move to change the law on physician assisted suicide. That may appear to be a simple reaffirmation of existing law and policy, but behind the decision lies two days of intense and thorough debate. The consensus statement is remarkable for the fact that delegates with fundamentally and diametrically opposing views on end of life issues were able to agree a position with which all feel comfortable".

The conference explored moral, ethical and practical issues in relation to physician assisted suicide. The areas on which consensus was reached included the following:

1. Impact on the relationship between doctors and patients and doctors and society

The conference agreed that if physician assisted suicide were to be practiced it would alter the relationships between doctors and patients, between doctors and those close to the patient, and between the medical profession and society.

2. Patient autonomy

Whilst recognising the importance of patient autonomy and the need for open communication with the patient, the conference agreed that there is a difference between respecting the competent patient s autonomous refusal of treatment and intervention, even if it resuts in the patients death, and acts of omission with the intention of causing death.

The conference agreed that doctors should not be obliged to continue treatment in which the burdens outweigh the benefits for the individual patient.

The conference agreed that although individuals who competently chooose to commit suicide are not legally prohibited from doing so, it does not follow that they have the right to be assisted to do so.

3. Improvements in palliative care

The conference expressed strong consensus support for continuing improvements in the care of the dying. It said that doctors have a duty to promote and mobilise maximum support for patients whose lives would otherwise appear intolerable

4. Practical objections to the introduction of physician assisted suicide

In addition to the major ethical and moral issues, the conference identified a number of practical problems which would have to be addressed if there were to be moves to allow physician assisted suicide. These include:

*It would require a change in the law

*Implementation would require the distribution of drugs not normally used in general medical practice and there would be a danger of dissemination of lethal drugs into the community

*to conduct physician assisted suicide effectively and reliably, drugs would usually need to be delivered by use of the parenteral route (ie:not simply orally). This would therefore increase medical involvement and may be considered as moving towards, or approaching, euthanasia

*number of doctors and other health professionals with conscientious objections to involvement with physician assisted suicide. Their conscientious objection would need to be safeguarded but could have inplications for continuity of care for patients

*There would be considerable difficulties in identifying consistent criteria for deciding which patients could be considered for physician assisted suicide.

5. Background to the conference

The conference was organised in response to a resolution of the 1998 annual representative meeting of he BMA. BMA meetings have debated euthanasia and physician assisted suicide on many occasions.

The BMA has firm policy opposing both

However in recent years, there has been a growing debate about whether there is a moral difference between the two issues and whether, in certain circumstances, it would be legitimate for doctors to respond to the wishes of individual patients and provide them with the means to end their own lives.

The conference was made up of 50 representatives of BMA divisions, selected to reflect the range of specialities within medicine and to ensure a regional spread, assisted by the members of the BMA Medical Ethics Committee and facilitated by the Office for Public Management.

The conference took the form of a series of work shops and plenary sessions with the aims of exploring areas of uncertainty and establishing common ground and consensus where possible.

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