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GPs go forth

RCGP should take neutral stance on assisted dying, says peer

Exclusive A Labour peer seeking a change in the law on assisted dying has made a plea to the RCGP to take a neutral stance on the issue.

Lord Charles Falconer - who tabled a private members bill on assisted dying in May and chaired the Commission for Assisted Dying - said that a neutral stance ‘may well be the right stand’ for the college, which has conducted a consultation of its members on the issue.

The Assisted Dying Bill aims to give a small group of very advanced terminally ill patients whose suffering is not adequately alleviated by palliative care the choice to legally end their lives if they wish to.

The RCGP told Pulse that its council would consider the result of the consultation of its members and would make an announcement after a meeting in February next year. The move could lead to the college becoming the first medical college or body to support assisted dying.

Its chair Professor Clare Gerada argued in an article published last year in the British Journal of General Practice that the medical Royal colleges should drop their opposition to legislation that may allow assisted dying for mentally competent adults and take a neutral stance on the issue.

In an exclusive interview with Pulse, Lord Falconer said that given doctors’ divided opinion on the matter, this was the right approach.

Lord Falconer said: ‘My feeling about doctors, having heard evidence to the Commission for Assisted Dying, is that there are some that are very opposed to it and there are some who are very much in favour of it.

‘But the vast majority of GPs just want there to be certainty in the law, they want to know where they stand in relation to it, and they expect the legislators to give the certainty in relation to that. So it may well be that the right stand for the RCGP is to be neutral to it.’

He added: ‘I am in favour of the law being changed. I think it is a matter for individual GPs to decide what they want to do in relation to it.’

Should the bill become law, GPs could be one of two doctors who would be required to sign off a patient’s bid to die by ingesting medication.

‘One of those doctors has to be somebody who is an expert in dealing with the terminally ill, but the other can be any suitable, qualified doctor and that may well involve GPs,’ Lord Falconer explained.

Lord Falconer, who is a practicing barrister, also rebutted any claims GPs would be put at greater risk of legal proceedings as a result. He said that the bill would make it ‘very difficult’ for GPs to face any proceedings in court as long as it was ‘their genuine view’ that this was the patient’s position.

He said: ‘Of course they have to give their genuine view, and of course they have to take reasonable care in relation to it, but as long as they do that they would have absolutely nothing to worry about. It would be no different to any part of their practice as general practitioners.’

Instead he argued it would make the issue much clearer to GPs, who currently face ‘great uncertainty’.

‘I think it is very difficult for general practitioners at the moment to assist somebody to take their own life, and it is probably against the law to assist somebody to go to Switzerland. There is great uncertainty as to what is allowed and what is not allowed,’ he said.

The Assisted Dying Bill is still awaiting scheduling for a second reading in the House of Lords, but Lord Falconer told Pulse that he was not perturbed by its slow progress.

He said: ‘If my bill doesn’t get a second reading in the Lords, or doesn’t become the law, that will be very disappointing. But I am sure that the question is not if the law will change, it is only when the law will change because in practice, the enforcement authorities and the way people are acting - in going to Switzerland - means that the law has been left behind, and it is time for the law to catch up.’

The last attempt to legalise assisted dying was lodged in the House of Lords in 2004 with the Assisted Dying for the Terminally Ill Bill, but this bid finally collapsed in 2006 when 148 to 100 Lords voted against a second reading.

Readers' comments (7)

  • If this became law I suspect that within a very short space of time any doctor objecting to this would be considered 'out of touch' or 'religious fanatic'. Their would soon be pressure to overcome personal beliefs. I would not be able to end someone's life nor should I be expected to. And yes, this is different to gradually increasing drugs to alleviate suffering as a person dies.

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  • Your first anonymous respondent has misunderstood the proposed law. Doctors will not be asked to end a patients life. It is the patient who will have the choice to end their own. This is a matter for the public to decide for themselves and I applaud the RCGP's vote on whether the college should take a neutral stance. It is the duty of a doctor to listen to the patient and this will be easier from a neutral position.
    Dr EA Macdonald

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  • I agree with Dr Macdonald that this is for the public (through their politicians) to decide. However I also think that we as a profession have a responsibility to advise the public on the ethical aspects of the decision, and "neutral" in this sense just means "sitting on the fence" and indecisiveness and a dereliction of our duty.

    We should have an opinion, not just shrug our shoulders and say "I dunno".

    The college should have the backbone to come to a decision and to offer that as evidence for the politicians to chew over.

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  • Lord Falconer's Bill provides both the patient and the doctor with the safeguards that are required to proceed with Assisted Dying for terminally ill patients who find their suffering has become intolerable.
    The RCGP should now move to join the RCN in a position of neutrality on the issue, whilst leading on aspects of safety, education of the profession and codes of practice.

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  • Tom Caldwell

    The RCGP should only adopt a position of neutrality on this issue if it's membership votes for this. As the result of this is due in the early part of next year perhaps Lord Falconer should wait for this rather than offering an opinion which is not his to make.

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  • Dr James Mumford's article in the Spectator this week puts Lord Falconer's claims made here in a very different light. Without any change in the 1967 law, we now have legal abortion for any reason including sex selection at least according to the DPP. Once doctors are legally permitted under to kill the unborn it is difficult to stop it escalating from the original purpose of the law. The same will be true if we legalise assisted suicide.

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  • Lord Falconer is doing his usual slick PR campaigning to support his latest attempt to legalise assisted dying. However he should wait for the outcome of the RCGP consultation. Assisted dying is of course physician assisted suicide, requiring GPs to prescribe lethal doses of medication to their patients, having made an assessment of the patient's mental capacity and wishes. Dutch GPs involved in euthanasia (the logical follow on from physician assisted suicide) find this very stressful I suspect the great majority of doctors in the UK did not go into medicine to kill their patients. Improving palliative care is the right way to go, not asking doctors to effectively kill their patients.

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