British Medical Association Requires Doctors to Help Patients Commit Suicide by Self-Starvation

This article was published by National Review online on August 19, 2026.

Wesley Smith

By Wesley J Smith

The subtitle of the revised and updated version of my book criticizing utilitarian bioethics, Culture of Death, is, “The Age of ‘Do Harm’ Medicine.” Helping patients kill themselves by self-starvation and dehydration — known in euthanasia parlance as VSED (for voluntary stopping eating and drinking) — certainly fits that designation.

Two major medical associations now have endorsed doctors assisting in such suicides by palliating the painful symptoms to help patients go all the way to death. The first was the American Academy of Hospice and Palliative Medicine (AAHPM) in 2023. This is especially notable because the organization shamefully went “neutral” on the legalization of assisted suicide, despite that action being the antithesis of the hospice philosophy enunciated by the great medical humanitarian Dame Cecily Saunders. The AAHPM’s journal also published a piece recently endorsing intentionally undernourishing dementia patients under certain conditions (MCF, or “minimal comfort feeding”) — VSED in slow motion, if you will.

Now, another “do harm” shoe has dropped. The British Medical Association has issued an ethical guidance that requires practitioners to participate in VSED when asked to do so by a patient. While the AAHPM guidance assumes that the act will only be done by terminally ill or seriously ill or disabled patients, the BMA guidance notably acknowledges that even those not in ill health can kill themselves in this slow manner — and that doctors must further the suicide palliatively. From the guidance (my emphasis):

We start from a position of understanding that: – patients with capacity are entitled to make decisions about treatment refusals and about their nutrition and hydration, including to voluntarily stop eating and drinking in order to hasten their death;– there is no requirement in the law that a patient needs to be ill or at the end of life to decide to voluntarily stop eating and drinking in order to hasten their death.

All doctors so requested are expected by the BMA to participate in VSED by assessing patients and easing symptoms; indeed, the guidance asserts that it is an ethical duty for doctors to be complicit in such suicides:

When an adult patient has made the decision to elect to VSED, the doctor’s initial responsibility is to assess the patient to check that: (1) the patient has the capacity to make the decision; (2) the patient’s decision is not a symptom of a mental disorder; and (3) the patient’s decision is being made free from coercion.

If the three criteria above are fulfilled, doctors have a professional duty to provide palliative care and symptom relief to their patient. The doctor’s role is not to consider whether the patient’s decision is rational, reasonable, or sensible. It is not for doctors to decide whether the patient should be permitted to end their life in this way. [Emphasis added.]

It’s one thing to say doctors can’t stop a suicidal patient from self-starvation — although one would think that suicide prevention would be on the table of which there is no mention in the guidance. But it is quite another to require doctors’ participation in such suicides.

A stunted conscientious objection clause is endorsed, but it is an essentially meaningless protection, with complicity in the preparation process still required.

Doctors cannot exercise a conscientious objection to seeing or having an initial consultation with their patient. However, some doctors may wish to exercise a conscientious objection to carrying out the detailed assessments (see section 3) and/or providing symptom relief, such as analgesics or palliative sedation (see section 4). Doctors exercising a conscientious objection must follow professional guidance and ensure that there is someone else available to take over the detailed assessments and the patient’s care without delay or detriment to the patient. This means that, with the patient’s consent, doctors must pass on their assessment and care to another doctor who is willing to provide that support. [Emphasis added.]

In other words, forced procurement of another doctor who is willing to help the patient commit suicide. And if the patient says no or another doctor can’t be found? It would seem that the original physician would have no choice but to provide whatever support is required to get the patient dead.

Suicide nihilism is exerting an ever-stronger gravitational pull in the West, with doctors increasingly expected to wield their expertise as so many death order-takers. The AAHPM’s and BMA’s blessing of physician participation in VSED deepens that darkness and strengthens the culture of death.