Medical Views

The British Medical Association has announced that following a landmark members’ survey on the topic more doctors would prefer for the BMA to actively support assisted dying, than those who oppose or are neutral. My Death, My Decision has welcomed the announcement as a clear signal that the BMA must now drop its opposition to assisted dying. 

More than 29,000 doctors took part in the poll, which found: 

• 40% of doctors think the BMA should actively support a change in the law 
• 21% of doctors think the BMA should adopt a neutral stance 
• 33% of doctors think the BMA should retain its opposition 

Taken together, this means that the most votes cast for any option was for the BMA to actively support assisted dying, and a majority of 61% backed proposals for the BMA to drop its existing opposition. 

In My Death, My Decision’s view the results mean that there is now a clear preference amongst members of the BMA for a shift in the trade union’s policy. 

Since 2006 the BMA has opposed assisted dying. However, the BMA is now expected to change its stance at its next policy-making meeting, expected in June 2021. 

My Death, My Decision’s Chair Trevor Moore said: 

‘Numerous independent polls show that the public is overwhelmingly in favour of an assisted dying law for England and Wales. Therefore today’s revelation by the British Medical Association that a clear majority of members either support, or are neutral, on the introduction of such a law, comes as no surprise. These convincing statistics mean that at its next annual representative meeting the BMA will surely have to shift away from its current opposition to an assisted dying law.’

‘Around 150 million people in different jurisdictions around the world now enjoy the human right to an assisted death, subject to robust safeguards. There is no justification for continuing to deprive the people of England and Wales of that same right. Seeing such a convincing proportion of the medical profession take the stance evidenced by the BMA survey, our politicians must now pick up the baton and take forward a meaningful debate on this key issue. We call on the Justice Secretary to set up a public inquiry without any further delay.’

Two GPs have threatened the Royal College of General Practitioners (RCGP) with legal action after it decided earlier this year to remain opposed to assisted dying, despite a majority of GPs in a prior consultation wanting it to move to be neutral or supportive stance. 

In February 2020 the Royal College of GPs published the results of their 2019 survey of members’ views on the college’s position on changing the law on assisted dying. 41% of the 6,674 GP’s who responded thought the RCGP should support a change in the law; 10% thought the College should be neutral; with 47% believing that the College should retain its opposition. Excluding abstentions, that meant a majority voted for a change in the position to neutral or support. The results also showed a leap in support for assisted dying amongst GPs, as the number of respondents wanting the RCGP to support assisted dying increased by sevenfold, rising from 5% in 2013.  However, despite this, the College’s council chose to remain opposed. This caused outrage amongst many GPs who believe that a neutral stance would be a better reflection of the divided opinions.

Professor Aneez Esmail and Sir Sam Everington, both high-profile members of the RCGP have now mounted a legal challenge to the RGCP council decision. Their press release also reports a new poll of 1,000 GPs who were asked what position the RCGP should take, given the 2019 RCGP poll results. 38% of respondees said the College should now adopt a neutral position on law change, with 20% saying it should support it and only 35% agreeing with the Council’s decision to retain its opposition to legalisation.

My Death, My Decision’s Lead Campaign Commentator, Phil Cheatle, said:

‘The public rightly hold doctors in very high regard, however the same cannot be said of the organisations that claim to represent them. When such organisations disregard the clear wishes of their members and the overwhelming support for assisted dying from the public, they risk undermining trust in their decision-making.  

‘Organisations representing healthcare professionals should be playing an active role in advising on possible UK assisted dying legislation to ensure it is safe, workable and integrated with excellent palliative care, so that it enables people to have the good death they crave when that requires medical assistance to die.’

‘MDMD welcomes the scrutiny being applied to the RCGP decision. We are in full support of those bringing this case.’

Notes:

For any more information or comment please contact Phil Cheatle, My Death, My Decision’s Lead Campaign Commentator at phil.cheatle@mydeath-mydecision.org.uk 

My Death, My Decision is a grassroots non-profit organisation that campaigns for a balanced and compassionate approach to assisted dying in England and Wales. As a growing movement, we are at the forefront of social change: nearly 90% of the public now favours a change in the law to allow adults of sound mind, who are either terminally ill or facing incurable suffering, the option of a peaceful, painless, and dignified death.

Read more about My Death, My Decision’s campaign for an inclusive change in the law: https://www.mydeath-mydecision.org.uk/

A former nurse has opened up about how cruel it feels to refuse patients, who do not want to endure weeks of suffering, the option of a legal assisted death. 

In 2009, the Royal College of Nursing voted to adopt a neutral stance on assisted dying reform, and called for a public inquiry to help those who were confused about the law. 

But now, Pauline Carroll, an ex-district nurse, has said that patients can still be unaware that assisted dying is illegal in England and Wales, and that it made her feel ‘more like a bully than a nurse when patients with difficult symptom control requested assisted deaths … [since she] believe[s] it is cruel to force these patients to suffer a protracted death against their wishes’. 

Speaking about her experience of caring for a man suffering from Motor Neurone Disease, who had mistakenly thought an assisted death would be possible, she said knowing the option of an assisted death existed, with appropriate safeguards, would give many people in her patient’s position peace of mind. She added ‘It is incredibly important to respect a patient’s autonomous decision in end-of-life care and the general medical profession is coming round to this view’. 

Her comments follow a submission from My Death, My Decision to the Welsh Parliament that assisted dying and palliative care should be seen as two options on a spectrum of end-of-life care to improve overall choice at the end of life; and a longstanding campaign for the Ministry of Justice to issue an inquiry into the ban against assisted dying. 

Chair of My Death, My Decision Trevor Moore said: 

‘The archaic law on assisted dying in the UK serves only to add to the anguish of those already coping with difficult end of life decisions. Those enduring intolerable and incurable suffering can gain considerable comfort in the knowledge that a dignified death is available, as other more enlightened countries have shown.. Why does the UK continue to deny people the ability to decide how, where, and when they want to die – a right that exists for tens of millions of people in many jurisdictions around the world?  The time for the Government to launch an inquiry into legal, safe, and compassionate assisted dying is long overdue. 

Adults of sound mind, who are either incurably suffering or terminally ill, should have the option of a safeguarded assisted death.’

The Royal College of General Practitioners has maintained its 14-year opposition to assisted dying, despite a majority of GPs voting to support a change in the law or adopt a neutral stance.

The college announced the decision of its executive council, after surveying its 50,000 members on the topic last year.

More than 6000 GPs voted in the online poll:

• 47% of respondents said that the RCGP should oppose a change in the law on assisted dying;
• 40% of respondents said the RCGP should support a change in the law on assisted dying, providing there is a regulatory framework and appropriate safeguarding processes in place;
• 11% of respondents said that the RCGP should have a neutral position and;
• 2% of respondents abstained from answering

The results mean that the College will continue to lobby MPs against changing laws which make assisted dying punishable by up to 14 years in prison, despite a majority preferring to support reform or set out both sides of the argument.

The Royal College of General Practitioners has opposed assisted dying since 2005 and affirmed its opposition in 2014.

In 2013, after a similar survey, 77% of GPs voted to oppose a change in the law, 18% voted to adopt a neutral stance, and only 5% voted to support changing the law.

The news follows after the Royal College of Physicians voted to drop their longstanding opposition to assisted dying in a similar poll last year, and as members of the British Medical Association, the doctors’ trade union body, continue to vote on whether the BMA should change its stance on assisted dying.

The College will now not review the RCGP’s position on assisted dying for at least five years unless there are significant developments.

Trevor Moore chair of the campaign Group My Death, My Decision said: 

‘We are extremely disappointed that the executive council of the RCGP have decided to ignore the preference of a majority of GPs to either support assisted dying or adopt a neutral stance. This seems undemocratic, given that those who voted in support would obviously agree with at least a neutral position’.

‘The overwhelming shift in support for assisted dying among GPS reflects a wider trend across our country, as nearly 90% of the public now support legal, safe, and compassionate assisted dying.

Whilst more countries than ever have now legalised assisted dying, including Canada, and demonstrated that the best way to protect everyone is through an open and robust system of safeguards, it is disheartening that the RCGP has adopted a position which will continue to silence many in the medical community who have a conscientious commitment to respect their patients’ autonomy and exercise compassion for those who are incurably suffering or terminally ill.’

‘The current law on assisted dying simply isn’t working. It forces those who are incurably suffering or terminally ill to suffer, or choose to die abroad – often putting their loved ones at risk of prosecution. There is a better way forward. We will continue to campaign for the adoption of a system akin to that in Canada.’

The UK’s largest medical body, the Royal College of General Practitioners, has launched a consultation on whether to change its policy on assisted dying, which it currently opposes. 

Over 50,000 GPs will now have until 13 December 2019 to respond to the consultation, which is being organised by the independent pollsters ComRes, on whether the College should support, oppose, or be neutral on the topic of the legality of assisted dying. 

When the body’s members were last consulted in 2014, a majority said that the college should remain opposed to reform. But, only a fraction of the college’s members participated in the consultation. 

A poll of more than 1000 GPs in January, found that a majority of GPs are now either neutral or support changing the law on assisted dying, whereas only 33% oppose law reform. 

The news comes after the British Medical Association announced its intention to hold a similar poll and after the Royal College of Physicians dropped its opposition earlier in the year after consulting its members. 

Assisted dying is now permitted for terminally ill and incurably suffering people in Canada, Belgium, Italy, Luxembourg, and the Netherlands. It is also permitted specifically for specifically terminally ill people in Colombia, ten US jurisdictions, and the Australian state of Victoria. 

To help ensure everyone has a right to choose how they die, My Death, My Decision and its Assisted Dying Coalition partners, are encouraging their members and supporters to write to their GP and ask them to support legal, compassionate, and safeguarded assisted dying. 

Commenting on the announcement My Death, My Decision’s Chair, Trevor Moore, said:

‘There has been a seachange in evidence since GPs were last given an opportunity to express their views on assisted dying, and we welcome the Royal College of General Practitioners’ commitment to engaging with its members, in light of these changes. 

Now more than ever, as progressively more countries, including Canada, empower their citizens with the right to choose the manner and timing of their death, the nature of our country’s inexcusably callous law against assisted dying has become clearer. More than one person a week from the UK is now forced to end their life in Switzerland, and public opinion has reached a watershed moment – nearly 90% now agree that adults of sound mind, who are either terminally ill or incurably suffering, deserve the right to a peaceful, painless, and dignified deaths.

When voting in this consultation, doctors will represent not only their own interests, but also those of their patients. They will represent the patients forced to conceal plans because they fear a doctor’s duty to prevent them from travelling abroad;  the patients unable to alleviate pain and who face years of unbearable suffering; the patients who want an open and honest conversation about dying but are unable to under the current law. 

We believe as the majority of doctors do, that the best way to protect the doctor-patient relationship is a reformed the law, which balances respect for autonomy alongside robust safeguards. It is time for the law to change.’

NOTES

For further comment or information or requests for interviews, please contact My Death, My Decision’s Campaigns and Communications Manager Keiron McCabe at keiron.mccabe@mydeath-mydecision.org.uk or phone 020 7324 3001. 

Details of the Consultation

On 1 November 2019, the Royal College of General Practitioners released a non-binding consultation its 50,000 members. The consultation is being run through the independent pollsters Comres and will be open until December 13 2019. The consultation asks whether the College should support, oppose, or be neutral on the topic of the legality of assisted dying. In addition, it provides an opportunity for members to indicate, through a list of non-exhaustive options and a free text box, why they have voted in a particular manner. The final decision will then be taken by the Royal College of General Practitioners Council in the new year. 

In February 2014, 77% of respondents voted to oppose assisted dying reform, 18% of respondents voted to adopt a neutral stance, and 5% of respondents voted to support a change in the law on assisted dying. 234 individual members submitted an individual response online, and 1,479 people participated through 28 devolved regional and faculty discussions. 

The law on assisted dying in the UK

Under section 2(1) and 2(2A) of the 1961 Suicide Act, it is unlawful in England and Wales to encourage or assist someone to end their life. Anyone found guilty of an act ‘capable of encouraging or assisting the suicide or attempted suicide of another’ can face up to 14 years’ imprisonment. 

Following Debbie Purdy’s case, the then Director of Public Prosecutions, Sir Keir Starmer MP, issued guidance on factors indicating when a prosecution will and will not be brought for assisting another to die. One factor tending against prosecution is when a ‘suspect was wholly motivated by compassion’. Consequently, between April 2009 and January 2019, there have been 148 cases of assisted dying referred to the Crown Prosecution Service (CPS) by the police, but only 2 successful prosecutions. 

In 2014, Jane Nicklinson, the widow of locked-in sufferer Tony Nicklinson, and Paul Lamb, who is paralysed from the neck down, challenged the law on assisted dying in the Supreme Court. The court held that Parliament should be afforded the opportunity to debate the issue before the courts would rule on whether the law is incompatible with the rights of those who are both terminally ill and facing incurable suffering. 

In 2015, parliament rejected by 330 against to 118 in favour, Rob Marris’ private members’ bill to legalise assistance for those who were terminally ill and likely to die within 6 months. 

Under Section 1(2) of the 1982 Forfeiture Act, an individual who assists a loved one to end their life abroad can have their inheritance withheld, even if the CPS deems that it is not in the public interest to bring forth a prosecution. 

GPs Public Opinion 

In January 2019 poll of 1,005 GPs, conducted by medeConnect, found that 33% of GPs opposed a change in the law on assisted dying, while 32% supported it, and 34% were neutral or did not know whether assisted dying should be legalised.

A number of medical bodies have either not taken, or have adopted a neutral stance on assisted dying including The Royal College of Physicians, The Royal Society of Medicine, The Royal College of Nursing, and The Royal College of Psychiatrists. 

Recent Developments 

In July, two members of My Death, My Decision living with different conditions that mean they are facing incurable suffering separately applied to the High Court to challenge the UK’s law on assisted dying. Paul Lamb, who is paralysed from the neck down, and Phil Newby, who suffers from motor neurone disease, both argue that the UK’s absolute prohibition infringes their human rights to a private and family life. Paul Lamb and Phil Newby are being supported by My Death, My Decision. 

In June, the British Medical Association and Royal College of GPs announced that they would poll their members on assisted dying. Their announcement follows the Royal College of Physicians ending their long-standing opposition to assisted dying and adopting a neutral position in March 2019. 

About My Death, My Decision

My Death, My Decision is a grassroots non-profit that campaigns for a balanced and compassionate approach to assisted dying in the UK. We believe that everyone deserves access to excellent palliative care but that adults of sound mind, who are either terminally ill or facing incurable suffering, should have the right to a peaceful, painless, and dignified death. Through the work of our members, supporters, patrons, and activists we help to broaden the public debate on assisted dying and seek to secure changes in the law.

Read more about how nearly 90% of the public support an inclusive change in the law. 

Read more about how one Briton a week now ends their life in Switzerland. 

Read more about My Death, My Decision’s campaign for an inclusive change in the law:

http://www.mydeath-mydecision.org.uk/