What do physicians think about physician assisted suicide and voluntary euthanasia?

In considering the second version of the Assisted Dying for the Terminally Ill Bill, the Royal College of Physicians (RCP) opted for a position of ‘neutrality’,1 changing its earlier opposition to physician assisted suicide (PAS) and voluntary euthanasia (VE).2 ‘Neutrality’ towards this second version of the bill, however, was controversial, being perceived as a change to indifference or tacit support.3 With the publication of a third version of the bill and after deliberation,4,5 the RCP therefore launched a consultation early in 2006. This was conducted online and by post over a four-week period. It was preceded by an article in Clinical Medicine by a former president advocating legal change.6 The consultation format consisted of an introductory letter from the RCP President pointing out the difficulties of framing a question that was free of controversy, but emphasising that the aim was to find out whether legal change was supported. Having maintained a close working relationship with the Royal College of General Practitioners (RCGP), the formal motion passed by that college after its own consultation was then stated. Agreement or not was requested to this. Free text comment was then invited: ‘we would be interested in any other comments you might like to make’. It was then followed by a second question regarding personal participation in PAS/VE in the event of change. A follow-up online survey validated the main survey with a different question. The quantitative results have been reported elsewhere.7,8 In brief, 26.0% thought a change in legislation was needed and 73.2% disagreed (0.8% did not respond); in answer to the second question, regardless of support for change, 18.9% were prepared to personally participate actively in a process to enable a patient to terminate their own life, 59.4% were not and 19.4% were uncertain. The opportunity for free text comment represented an attempt to capture some of the concerns that underlie the variety of views held by physicians – the qualitative dimension. The consultation was anonymous. A summary of these comments is offered here to inform participants and others of physicians’ concerns. All comments were categorised into a number of themes, as suggested elsewhere.9 Out of 5,111 online and paper responses, 2,133 (42%) free text comments were made. Ten letters were also received. Free text comment was not designed as a check on the numerical responses. Nevertheless, it provided further validation of the overall numerical outcome.