This morning, the Commission on Assisted Dying headed by the former Lord Chancellor Charlie Falconer recommended that terminally ill patients should be offered the choice of assisted dying in certain circumstances, sparking a heated debate in this morning’s media.

The Times carried opinion pieces for both sides of the debate. Arguing in favour of a change to the law, Raymond Tallis, the Chair of Health Professionals for Assisted Dying (HPAD), claimed that the experience of countries where assisted dying was legal allayed many of the fears raised by its opponents.

Mr Tallis claimed “Nor would [legalised assisted dying] damage trust (the Netherlands has the highest level of trust between doctors and patients).”

In the Netherlands assisted dying has been legal in specific circumstances since 2002. So does the Dutch example show that legalisation has no damage on doctor-patient trust?

The claim made by Mr Tallis also crops up in HPAD’s submission to the Commission, which argues that: “Some fear that assisted dying will erode the trust between doctors and patients. HPAD believes that properly implemented assisted dying using good communication skills will enhance the relationship. This is supported by a survey of seven European countries, which found trust between patients and doctors was highest in the Netherlands (where assisted dying is permitted).”

HPAD source this claim to an article in the British Medical Journal, which does indeed note that “of all the countries we found surveys for, it was Dutch patients who found it hardest to fault their doctors.”

However there are a couple of reasons to be cautious about drawing too many conclusions from this article when it comes to assisted dying.

The first problem is that the BMJ article itself dates from 2002, the year that assisted dying was legalised in the Netherlands. It is therefore difficult to trace the impact of the change in the law on patient-doctor trust from this study.

It is worth noting that the Dutch example is complicated as assisted dying had been tolerated in case law in some circumstances since the 1970s. What cannot be read from the BMJ piece however is what impact, if any, the 2002 legalisation had on levels of trust.

A second problem emerges when we dig into the methodology of the BMJ article. As the report’s author told Full Fact, the data was compiled from separate polls and surveys from each country, and may not therefore be comparable.

She stressed: “This was not a scientifically robust study. I asked our correspondents from the countries we quote to send in results of surveys which are regularly performed nationally about how the public regards different professions and compiled the article from these findings. So the original sources were national polls of public opinion of a range of professions.”

For example, while the BMJ article focuses on Dutch studies measuring “confidence” in GPs specifically, the Australian surveys seems to rank “doctors” more generally into rating of very high, high etc.

Given this, it is difficult to conclude with any certainty on this basis that the Netherlands “has the highest levels of trust” among all those countries covered by the BMJ piece, even though on a national level reported levels of confidence in medical staff seems high.

We have put these points to the Healthcare Professionals for Assisted Dying, and will of course update with any response we receive.