Vulnerable groups are not at higher risk of physician-assi...( Claims that vulnerable groups such a...),Health

Claims that vulnerable groups, such as the elderly and people with physical or mental disabilities, are at an increased risk of physician assisted death are not supported by evidence, says an expert in this weeks BMJ.

Physician assisted death (both voluntary active euthanasia and physician assisted suicide) has been openly practiced in the Netherlands for more than 25 years and was formally legalised in 2002. Physician assisted suicide was also legalised in Oregon in 1997, writes Professor Timothy Quill of the University of Rochester, USA.

Many concerns still surround the practice, but evidence now exists to answer questions about the risks and benefits of legalisation.

For example, a study published in this weeks Journal of Medical Ethics analysed data from Oregon and the Netherlands and found no increased incidence of physician assisted death in elderly people, women, people with low socioeconomic status, minors, people with physical disabilities or mental illness.

These findings call into question the claim that the risks associated with legalisation will fall most heavily on potentially vulnerable populations, says Quill.

Further evidence dispels the concern that these practices become more common over time. In Oregon, physician assisted death accounts for around one in 1000 deaths each year, with no significant change in frequency over nine years. The Dutch practices of physician assisted death have also remained stable over the duration of four studies, and hospice and palliative care have become more prevalent in recent years.

Evidence from the US also shows higher rates of assisted death in areas where these practices are prohibited than in Oregon after legalisation. Although the data are not directly comparable, none the less, it raises the possibility that legalisation and regulation with safeguards may protect rather than facilitate the practice, says Quill.

The argument that legalisatio
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