BMA urged to pledge support for Noel Conway

As the British Medical Association’s Annual Representative Meeting begins in Bournemouth today (Monday 26th June 2017), doctors, campaigners and patients are urging the BMA to pledge support for Noel Conway – a man with terminal motor neurone disease who is mounting a legal challenge to the current ban on assisted dying. The BMA’s official position on assisted dying is opposed, and campaigners are calling for a move to a neutral position in order to allow full and proper debate of the issue.

To coincide with the beginning of the meeting a group of campaigners, among them doctors, local activists and those with a personal connection to the issue, are due to assemble outside the entrance to the Bournemouth International Centre. They will be providing information about Noel Conway’s case and urging delegates to pledge their support to the #ImWithNoel campaign.

The BMA (the trade union and professional body for 170,000 doctors in the UK) is officially opposed to assisted dying, despite never having directly surveyed its members about their views on this issue. Their policy is decided at their annual representative meeting, but is not being debated or voted on this year¹. In polling released by Dignity in Dying last year, just 7% of the British public were found to agree with the BMA’s opposition to assisted dying².

Today demonstrators are urging the BMA and its members to reconsider their position in light of the Noel Conway v Ministry of Justice case, which is due to be heard at the High Court in July. Noel, a 67-year-old retired college lecturer from Shropshire, was diagnosed with amyotrophic lateral sclerosis (ALS), a form of motor neurone disease, in November 2014. His condition is incurable and he is not expected to live beyond the next 12 months. Noel feels that he is prevented from exercising his right to choice and control over his death under the current law and fears that without a change in the law he may be forced to suffer against his wishes. Noel, supported by Dignity in Dying, has instructed law firm Irwin Mitchell to bring this case to fight for his right to have the option of an assisted death when he is in his final six months of life.

Noel Conway explained:

“The UK’s ban on assisted dying has forced me to spend my final months fighting in the courts for my right to have real choice and control over my death. I am not alone in this fight – I have received overwhelming support from other dying people and their loved ones, healthcare professionals and the general public who agree that terminally ill people like me should have the option of assisted dying.

“I am receiving brilliant hospice care and I have been able to make informed choices throughout my treatment, yet I am not allowed a say over this ultimate decision. I know I am going to die, I have accepted that. What I cannot is accept is doctors’ organisations and politicians denying me the right to determine when and how. The BMA must start truly listening to terminally ill people like me – to ignore us is to prolong our suffering and deny us our rights.

“To have the choice of a safe, medically-assisted death in this country would mean the world to me and my family. Knowing that I could determine the time and manner of my death if my suffering became too much would give me back some of the control this illness has stolen from me. I could get on with living now and enjoying my final months with my loved ones, rather than having the constant worry of how much I may suffer at the end or contemplating an expensive and arduous trip to Switzerland.”

BMA member Dr David Nicholl, Consultant Neurologist, said:

“I have no hesitation in supporting Noel in his case, which is fundamentally about recognising the autonomy of the individual – that there are circumstances where someone can have the best palliative care, and it is still not enough. The core of this case is about recognising that Noel, who is terminally ill, should have the right to a dignified death.

“The BMA’s current opposition obstructs proper measured debate of a topic which does have overwhelming support amongst the public³. Rather than avoiding the issue, the BMA should be providing leadership and move to a position of neutrality to enable a more balanced discussion. I would hope that the BMA would be open to such a change of view, as this would enable a more full discussion of the manner in which such legislation could work in the UK, by looking at what other countries have done and properly examining the wishes of dying people here at home. The moral fabric of jurisdictions such as Oregon, California and Canada has not fallen apart from having legislation that enables assisted dying in a limited number of cases.

“Personally, my views on this topic completely reversed after the ‘good’ death of a terminally ill school friend via physician-assisted suicide in Belgium in March of this year, as I described in a letter to The Times in April. I now fully support a safeguarded law for the UK which would allow terminally ill, mentally competent adults in their final months of life to have the option of an assisted death available to them.”

Sarah Wootton, Chief Executive of Dignity in Dying, added:

“The British Medical Association continues to drag its feet on this issue and its opposition remains completely out of step with the wishes of dying people like Noel and their loved ones.

“We are constantly told that the medical profession is moving towards a more patient-centred approach, putting the individual at the heart of decisions about their care rather than perpetuating a culture of ‘doctor-knows-best’ paternalism. But end-of-life care cannot be truly patient-centred until there is real choice and control for dying people; until we legislate to allow assisted dying as an option for terminally ill, mentally competent adults in their final months, alongside the world-class palliative care we already have.

“The BMA must face up to this reality. It needs to fully acknowledge the views of patients, the public and the diverse opinions of its own members⁴. It needs to properly consider the evidence from overseas, which shows that compassionate, safeguarded laws can be implemented with effective protections for the vulnerable. It needs to accept that even the best palliative care cannot relieve all suffering for everyone. The BMA adopting a neutral position on assisted dying would allow the debate to move on from the current stalemate and allow parties from all sides to start having constructive conversations about how we can provide true choice and control at the end of life. Change is coming – it is up to the BMA whether they help lead the way or are left behind.”

***ENDS***

For further information, photos and interviews, please contact davina.hehir@dignityindying.org.uk / 07725 433 025 / 0207 479 7737 or thomas.davies@dignityindying.org.uk / 0207 479 7734

Photo call: Demonstrators will be gathered from 8.30am-9.30am outside the Bournemouth International Centre, Exeter Road, Bournemouth, BH2 5BH.

Notes to Editor
¹ Last year the delegates at the BMA’s ARM chose to remain opposed following a half-hour debate, which took place after an earlier motion not to even debate the issue of assisted dying was narrowly defeated.
² YouGov Plc. Total sample size was 1,764 adults. Fieldwork was undertaken between 19th – 20th May 2016. The survey was carried out online. The figures have been weighted and are representative of all GB adults (aged 18+).
³ Populus interviewed 5,018 adults aged 18+ online between March 11th & 19th 2015. Interviews were conducted throughout Great Britain and the data weighted to be fully representative of all GB adults. A 5,000 sample nationally representative poll carries a margin of error of +/- 1.4% at 95% confidence.
⁴ A poll of 1000 GPs in England and Wales commissioned by Dignity in Dying and conducted by medeConnect in May 2015 showed that doctors are split on this issue. It found that 34% of GPs are supportive of a change in the law on assisted dying and 20% are neutral, and that 56% of GPs think that representative bodies such as the BMA should adopt a neutral position on assisted dying.

About the Noel Conway vs Ministry of Justice case
Noel Conway, 67, from Shrewsbury, was diagnosed with amyotrophic lateral sclerosis (ALS), a form of motor neurone disease, in November 2014. His condition is incurable and terminal – he is not expected to live beyond the next 12 months.

Noel feels that he is prevented from exercising his right to choice and control over his death under the current law. He fears that without a change in the law he may be forced to suffer against his wishes. Noel is bringing this case against the Ministry of Justice to fight for his right to have the option of an assisted death when he is in his final six months of life.

Noel attended the High Court on March 21st to request permission to bring a legal case. On Thursday 30th March 2017, a decision was handed down denying permission for the case to proceed. Noel Conway’s legal team successfully appealed this decision on Tuesday 11th April 2017, meaning the case will proceed to a full hearing at the High Court.

A directions hearing on Monday 22nd May 2017 determined the procedural arrangements for the High Court hearing, namely that it will take place in the week commencing the 17th of July 2017 over five days, heard by three judges. The courts close for summer on Monday 31st July, and reopen on Monday 2nd October. It is anticipated that a decision will be published on the Conway case after the summer recess.

Also on the morning of Monday 22nd May, the court considered the case of Omid T, a separate legal case to that of Noel Conway. Omid T does not have a terminal diagnosis and is calling for assisted suicide to be made available to anyone who is suffering unbearably, not just those who are dying. His case was granted permission to proceed but it will not be joined with Noel Conway’s.

About Dignity in Dying
Dignity in Dying campaigns for greater choice, control and access to services at the end of life. It advocates providing terminally ill adults with the option of an assisted death, within strict legal safeguards, and for universal access to high quality end-of-life care.