Reply to Farsides's editorial: palliative care--a euthanasia-free zone.

Dr Farsides entitles her editorial Palliative care-a euthanasia-free zone.' This is a misleading title in view of the fact that the whole of medicine and nursing in the United Kingdom and most of the rest of the world are currently euthanasia-free zones, for not only is it currently illegal in those areas, but also the professional organisations (for example the British Medical Association and the Royal College of Nursing) are universally opposed to the legalisation of euthanasia. Nevertheless, let us look at what she has to say about palliative care in particular. Her first thesis is that practitioners working in specialist palliative care in the United Kingdom uniformly believe that "euthanasia is morally wrong and ought not to be legally accept-able". She then wonders whether the appearance of uniformity is an illusion. Her first thesis really contains two different points: firstly that palliative care practitioners believe that "euthanasia is morally wrong", and secondly that "it ought not to be legally acceptable". I do not think we have sufficient evidence to state that there is uniformity about the first view. Professional bodies such as the Association for Palliative Medicine and the National Council for Hospice and Specialist Palliative Care Services (NCHSPCS) have not made any statement that "euthanasia is morally wrong" on behalf of their members. Many palliative care specialists (and other health care professionals) may well consider euthanasia to be morally wrong but without public statements about moral wrongness we cannot infer this view on their behalf. On the other hand we know more about the second view-that euthanasia ought not to be legalised-since most debate centres round this important question of public policy. Here there is evidence that the appearance of uniformity among this group in terms of opposition to the legalisa-tion of euthanasia is not an illusion. In 1993 pal-liative care practitioners were asked to send in views regarding this issue to the House of Lords Select Committee on Medical Ethics, and all who wrote in opposed legalisation of euthanasia. In 1997 the Association for Palliative Medicine asked members to comment if they did not agree with a circulated statement (prepared with the assistance of Dr Farsides) which opposed the legalisation of euthanasia, and to give justifications for their views. Only five out of 584 members said they could not endorse the statement, which was subsequently published by the NCHSPCS, which is a representative body. Dr Farsides seeks …