Why administration of lethal drugs should not be the role of the doctor.

The suitability of doctors as agents of assisting dying remains debated, although it is common in many jurisdictions, and forms part of the proposed assisted dying legislation for England and Wales.We examine the established philosophical and legal role of doctors in England and Wales and compare it to the active role required of doctors under proposed assisted dying legislation. For clarity, we refer to the latter role as 'assisted dying practitioner' (ADP). We interrogate two common claims: that (a) the role of doctors and ADPs holds normative conceptual analogy by virtue of shared goals to uphold autonomy and reduce suffering and (b) the practical skills required of ADPs are specific and exclusive to a doctor's training. Examination reveals that neither claim is justified and, despite both roles prioritising patient welfare, identifies significant conflict between their primary goals. The role of an ADP is philosophically and legally singular. To add a duty to the role of the doctor which is antithetical to their overall goal of cure and disease prevention disrupts the defining characteristic of being a doctor: this may have repercussions on who applies to medicine, how doctors are trained, interact with patients and are regulated. We do not advocate for or against assisted dying but propose that if it is to be taken forward in England and Wales, society would be more appropriately served by considering the role of an ADP as a novel profession whose goals, competencies, research base and regulation can be established independently.