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In their Forum post, Downar and Ahmedzai use unusual logic in their defence of assisted dying (BMJ Blog, 30 May 2025).1 The basis of their argument is that, because palliative care is not 100% perfect, you cannot expect assisted dying to be perfect. This might be acceptable if there were detailed studies of assisted deaths, but such studies are remarkable by their scarcity, as the authors admit. No assisted dying drug, doses or combinations have ever been studied or approved by any drug regulatory authority anywhere in the world. At least the practice of palliative care has been closely examined for over 50 years.