Doctors call for greater say in assisted dying law

A group of doctors on the Isle of Man have called for greater involvement in developing safeguards for assisted dying after legislation received Royal Assent.

The Isle of Man Medical Society said almost three-quarters of its members opposed the practice - raising concerns about the eligibility criteria, its implementation and the potential for patients to be coerced.

The law will allow adults who have lived on the island for at least five years, who have a terminal illness with a life expectancy of 12 months or less, to request an assisted death.

The island becomes the second place in the British Isles to make assisted dying law, after a similar bill in Jersey was given Royal Assent in July.

The legislation received Royal Assent on consultation radiologist Vanina Finocchi's first day as president of The Isle of Man Medical Society.

She said while engagement had been weak previously, there was "still time" for meaningful engagement with the medical profession before the service was introduced.

The IOMMS has about 150 members- including both general practitioners and hospital doctors.

Finocchi said the society felt it had not been sufficiently involved in the process leading to the law's approval.

'We are subject experts on this and I think the communication and discussion were not really what they should have been,' she said.

'The decisions and pathway were made without our engagement, which is very sad.'

She said future discussions should address the concerns of both supporters and opponents of assisted dying, adding that experiences in other countries showed eligibility criteria could change over time.

She added the legislation 'would change a lot of approaches in healthcare' and required careful consideration of its potential consequences.

'Patients have to come first. Their safeguarding has to come first,' she said.

'We have to advocate for those who cannot, for vulnerable people and for all the aspects that a normal person might not think of.'

Martin Rankin, who recently retired as president of the society, said one of the main concerns was the potential for vulnerable people to feel pressured into requesting an assisted death.

He gave the example of an older person paying substantial fees for long-term care who might worry about the financial impact on their family.

Rankin also questioned how reliably doctors could determine whether a patient had 12 months or less to live, as required under the legislation.

"You may have an idea of prognosis being measured in months to years, but often it's not much clearer than that," he said.

He said the uncertainty created challenges for clinicians assessing eligibility, particularly when patients could still enjoy a good quality of life.

Both doctors stressed the importance of maintaining and strengthening palliative care services alongside preparations for assisted dying.

Finocchi said: 'We need to make sure that our palliative care is robust, funded, strong and accessible.'

Rankin said he had been involved in palliative care throughout his career and suggested good care could relieve severe symptoms for patients approaching the end of life.

He said opposition to assisted dying should not be interpreted as a lack of compassion for people experiencing suffering.

The government said the law would not come into force until the necessary practical, clinical and safeguarding arrangements had been agreed.

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