Exclusive: One in four GPs prepared to assist patients seeking assisted dying

Exclusive Just under one in four GPs would be prepared to be involved in assisted dying to its completion, a new Pulse survey has revealed.

However, the results of a survey of 601 GPs showed that the profession remains divided on the issue, with 37% in support of the Assisted Dying Bill and 39% against, while 24% said they felt neutral about it.

The draft legislation, which would allow terminally ill adults to end their lives, was backed by MPs in a vote in November and has gone through the report stage, with MPs debating amendments and voting on proposed changes at its third reading tomorrow (Friday 16 May).

Under the current bill, two doctors would first need to assess the person seeking assisted dying and provide sign-off, but it states that doctors are not under ‘any duty’ to raise assisted dying with patients or to ‘participate in the provision of assistance’ if they do not wish to do so.

Pulse’s poll found that 24% of GPs would be prepared to be involved in assisted dying to its completion, while 56% said they would not want to be involved and 19% that they did not know at this stage.

And 41% also said that if assisted dying is introduced, GPs should be involved in broaching the possibility with palliative care patients.

However, GPs told Pulse that should the legislation go ahead, assisted dying should not be part of core GP workload but be introduced as a separate service, with the RCGP and the BMA both echoing this.

Luton GP partner Dr Paul Singer told Pulse: ‘Overall I do not object to the concept of assisted dying in appropriate circumstances but any legislation needs to adequately protect against coercion for those who could be at risk and has to be accompanied by assurance of adequately resourced palliative care services in all regions.’  

Dr Jim Lawrie, a GP partner in East London, said that assisted dying should be seen as a ‘specialist area of work’.

He told Pulse: ‘I think that discussing assisted dying will be more complex and difficult than the “do not resuscitate” forms we currently complete.

‘I have seen patients loose trust in some doctors, after they raised “do not resuscitate” forms at the wrong time.

‘I think this new work should not be bolted on to the current GP workload, but seen as a specialist area of work, needing communication, safeguarding and medico-legal training, to ensure the new work is done safely for patients and their families.’

The RCGP moved to a position of ‘neither supporting nor opposing’ assisted dying, after a vote of its council members in March.

RCGP chair Professor Kamila Hawthorne said: ‘This poll shows that GPs have widely differing, deeply personal, and strongly held views about assisted dying.

‘What is clear is that no GP should be obliged to participate in delivering assisted dying services if and when they become legal and there should be a right to refuse to participate on any grounds.

‘We would want to see statutory protections making it unlawful to discriminate against any doctor on the basis of their decision to, or not to, participate in the assisted dying process.

‘Should assisted dying become legal, it is also imperative that palliative care must be strengthened to ensure patients can have the best possible care at or near the end of their lives, without feeling as though assisted dying is their best or only option.’

The BMA has previously reiterated its ‘neutral’ position on the issue of assisted dying, but has emphasised the need for ‘absolute freedom of choice for doctors as to whether they participate or not’.

BMA medical ethics committee chair Dr Andrew Green said: ‘These results speak to the fact that, as in wider society, there are a range of views on assisted dying among the medical profession.

‘This was demonstrated in our own member survey in 2020, which was then reflected at our annual conference in 2021 when representatives voted for the BMA’s policy to be one of neutrality.

‘While we, as an organisation, are neutral on the issue of assisted dying – that is whether the law should change or not – we have been engaging with legislation to ensure doctors are represented on a number of key issues.

‘These include that only those doctors who choose to “opt-in” to provide assisted dying will be expected to participate, and that doctors should not be compelled – or indeed barred – from initiating discussions on the issue.’

He also said that the union has been ‘clear’ that any future assisted dying provision should be offered via a separate service to the core GMS contract.

While giving evidence to the committee stage, England’s chief medical officer Professor Chris Whitty told MPs that GPs will require additional training to be able to fully support patients should the assisted dying bill pass.