Medicine and Science from The BMJ

"We see coercion the other way... People cannot let go of their dying family" - assisted dying around the world

26 snips
Feb 14, 2026
Catherine Forrest, a UCSF family medicine clinician with experience delivering assisted dying in California, and James Downer, head of palliative care at the University of Ottawa, discuss international experiences with assisted dying. They compare safeguards and assessment practices. They debate concerns about coercion, disability impacts, palliative care access, oversight and prognosis criteria. They call for evidence-based review.
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INSIGHT

Parliamentary Logjam Threatens Bill

  • The House of Lords tabled 1,277 amendments, many from a few peers, risking procedural delay of the assisted dying bill.
  • This has raised talk of using the Parliament Act to bypass the Lords and provoke constitutional conflict.
INSIGHT

Safeguards And No Detected Coercion

  • Catherine Forrest reports robust safeguards in US states, including private assessments and interpreter access to spot coercion.
  • She notes no recorded cases of coercion in US jurisdictions with long experience.
INSIGHT

Rigorous Assessments Versus Substitute Decisions

  • James Downar explains MAID assessments use duplicative, thorough capacity checks and private questioning.
  • He contrasts this with substitute decision making where family decide for ~30% of people without similar oversight.
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