Patients must be known personally to GP for assisted dying sign-off, Lords propose
Amendments to the assisted dying bill which require a GP to have known a terminally ill person for two years, and to have seen them at least six times, are set to be debated by lawmakers.
The proposed amendments to the Terminally Ill Adults (End of Life) Bill said ‘that the patient be known personally to a doctor for two years through having been seen for at least six appointments’.
Tabling the amendments, crossbench peer Baroness Lawlor said: ‘First, I propose that the patient be known personally to a doctor for two years through having been seen for at least six appointments.
‘Secondly, I propose that the doctor submits a letter to the assessment panel on the patient’s physical and mental health during that period, and a prognosis.
‘Thirdly, I stress that the doctor, as we see their involvement in this Bill, may be the patient’s GP, but that is not required; the doctor may be the first doctor, but, given Clause 11(8), this is unlikely, and it will probably not be the second doctor. The important point is that a medically qualified practitioner knows the patient over time and can write an assessment for them.’
The clause referred to by Baroness Lawlor says that if the doctor who witnessed the first declaration dies or is otherwise unable to continue as the ‘coordinating doctor’, then a replacement doctor can assume their responsibilities, with the agreement of the terminally ill patient.
Debate over the amendments is set to resume in January 2026. The assisted dying bill was voted through in the House of Commons by MPs in June and is currently being scrutinised by the House of Lords.
Data from NHS Digital shows individual patients have 5.88 appointments per year on average.
Other amendments which proposed proving GP continuity of care in the process were tabled but not ‘moved’ to debate – meaning they are not set to be debated and voted on.
Amendments 20 and 21 proposed that there be evidence of an ‘established relationship’ between GP and patient with four GP appointments plus a home visit during the 12-month period.
The debate included contributions by Baroness Gerada, a practising GP and former RCGP chair who was recently made a crossbench peer.
Baroness Gerada said mandating periods to establish a relationship between GP and patient was ‘arbitrary’, arguing it is often ‘with the primary healthcare team that the individual has a relationship rather than with an individual’.
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’.
And the RCGP moved to a position of ‘neither supporting nor opposing’ assisted dying after a vote of its council members in March.
In May, before the bill passed the House of Commons, a Pulse survey exclusively revealed just under one in four GPs would be prepared to be involved in assisted dying to its completion.
England’s chief medical officer has previously said GPs will require additional training to support patients, if the bill does pass.
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READERS' COMMENTS [7]
Please note, only GPs are permitted to add comments to articles
Er what if the regular GP doesn’t want to be involved as the bill allowed?
What planet do these people live on?
So many rules and regulations, tickboxes and hoops that by the time it is all done the person will be long dead. Utterly removed from reality and this will do more harm than any good.
Absolutely SG Amendments 20 &21 while well meaning are totally unrealistic. Given news articles around Hospice finances recently perhaps a better EOL care service is the answer??
There are over 1100 amendments put forward, mainly by a group of 20 ‘antis’ and featuring Baroness Finlay the hospice director who is staunchly against the bill and determined to kill it by procedural methods. She claims assisted dying would not be needed if hospices had enough funding but forgets that where assisted dying is legal in the world, 80% of those applying for it are already under hospice care.
What the Lords are amply demonstrating is that this country can no longer develop efficiently. We are becoming so tied up in petty regulations we can barely innovate. Just look at the HS2 railway mess and the current state of the NHS. Its pathetic.
We have an explosion of elderly ahead who will languish in care homes- this bill will ensure when they and their families face financial ruin they will kill themselves or the state will choose death for them. As doctors we will be encouraged to participate..1930s German history lesson anyone? It is offensive that so much effort is spent by politicians on this when palliative care is often awful in hospitals for those who are desperate to live and love life to its end. Doctors should speak out that this bill is unsafe and will be abused by those in power in future whatever the safeguards now.
Just watch the Japanese film ‘Plan 75’ and be very scared indeed..
https://m.youtube.com/watch?v=K4VaoNCsj_0
Legislation will produce an expensive bureaucratic nightmare that will be effectively unavailable to all but a tiny few.
Fortunately a painless, dignified, mess-free, reliable and prompt death is available to anyone with a little ingenuity; inert gas asphyxia. There’s even a Wikipedia page.