Any law which would allow physician-assisted suicide would put vulnerable patients at risk, a leading British 
medical expert has said.
Writing in the British Medical Journal (BMJ), Dr Bill Noble, a senior lecturer in palliative medicine at the University of Sheffield, warned that if assisted suicide was legalised “society’s neglect of older people, poverty, and the lack of home care services will drive up demand for assisted suicide”.
He said that doctors should speak out against proposals being made in the UK House of Lords to legalise assisted suicide.
Dr Noble said that while he had no religious objections to such legislation, he recoiled “from the vision of a society where death is a therapeutic option; the idea that there are two categories of suicidal people, those deserving and those undeserving of death; and the idea that doctors should do the sorting and the killing”.
And he said that while he agreed “that society and not the medical profession should determine the law” doctors must not step back during the debate over assisted suicide, or they would risk abrogating “responsibility for our patients and the next generation of doctors”.
He said: “Doctors worry about the idea that ending your life before you lose dignity will become a new cultural norm. The US state of Oregon is the new model; but why should we take a moral lead on personal rights from a country without gun control, unwilling to ensure adequate healthcare for all its citizens?
Dr Noble acknowledged that palliative care “cannot remove every kind of distress”.
He said: “Some patients suffer to the extent that they wish to be dead, but few attempt suicide or ask that we end their lives. Much more common is the relative who wants to see an end to the suffering.
“Wishing for death is not a purely individual decision, uninfluenced by family and society. Nor should the retention of dignity become a social prerequisite to continued existence.
“I see vulnerable patients under pressure. Older people, who are already ejected from our NHS funded and governed care, acquiesce to be nursed in commercial institutions of variable and uncertain quality.
“Their wish not to be a burden on family is powerful, and I have seen patients reject treatments to shorten survival to make it easier for their family.”
Dr Noble warned: “If assisted dying is legalised, I fear that our society’s neglect of older people, poverty, and the lack of home care services will drive up demand for assisted suicide.
He said that politicians “should ask who is asking for assisted dying; and why now”.
He continued: “It is widely assumed that baby boomers are pushing for a change. Apart from a few widely publicised exceptions, it’s not baby boomers who are dying, it’s their parents.
“I wonder whether the loudening call for institutionalised suicide is born of the experience of witnessing distressing deaths rather than the prospect of our own.
Most members of the main medical representative groups opposed the legalisation, he said.
The public should be informed as to why these groups were not neutral, he added.
Dr Noble said: “If professional organisations fail to join the argument, the debate will be poorer for it. The public has a legitimate interest in understanding what the profession has to say on the subject.
“The argument that doctors should not influence legislation on this subject seems rather thin if we end up with a system in which doctors have to decide whose distress is bad enough and whose capacity is good enough to receive assistance to commit suicide.”
Any society that chooses legalised assisted suicide “should at least own up to the process being a social and legal intervention rather than a medical one,” he said.
“If society is seeking the blessing of the medical profession for a system of assisted dying, we should be clear and open about our views both individually and collectively, no matter how diverse or inconvenient for the legislators,” Dr Noble concluded.
