British Medical Association will survey members on assisted dying

This follows an announcement from the Royal College of General Practitioners on Saturday (22 June 2019) that it will conduct its own survey of members. The Royal College of Physicians dropped its longstanding opposition to assisted dying in favour of neutrality following a survey of members earlier this year.

Dr Jacky Davis, Chair of Healthcare Professionals for Assisted Dying introduced the motion at the BMA meeting this morning:

“This vote is an important step for the BMA and means that members will be able to express their views on this historic issue. Earlier this year the Royal College of Physicians moved to a position of neutrality on assisted dying following a survey of members and just a few days ago the Royal College of General Practitioners announced it would survey its own members.

“It is becoming clear that there is a wide spectrum of views in the medical profession towards supporting greater patient choice at the end of life, and the policy of medical organisations needs to reflect that. Politicians and patients want to know what doctors think on this issue and we need all views to be heard. Our patients have wanted this choice for decades and we should be pleased that doctors are prepared to engage in the debate.”

Sarah Wootton, Chief Executive of Dignity in Dying:

“This is a welcome move which shows maturity and pragmatism. It will allow the BMA to accurately reflect the views of its 160,000 members across the UK. For many years, the BMA’s opposition has been interpreted as most doctors being opposed to assisted dying, despite this claim never being tested against the views of its membership.

“The Representative Body also acknowledged by a large majority that all patients should have autonomy and access to good quality end of life care, and also recognised that not all patient suffering can be alleviated.

“An assisted dying law would help address these issues, giving choice and compassion to dying people who are suffering unbearably at the end of life while providing robust protection to the rest of society, including doctors. 84% of the British public understand this and support a change in the law, and doctors are catching up.

“Following recent developments in Victoria in Australia and Maine and New Jersey in the US, soon 1 in 4 Australians, 1 in 5 Americans and all Canadians will have access to true choice at the end of life. Yet here in the UK, 0 Britons do. It is clear that this issue is not going away and it is vital that medical organisations provide an open and respectful platform for all views to be heard. What we must ensure is that the most important voices – terminally ill people and their loved ones – remain central in this debate.”

*ENDS*

Notes to editor:

 

For further information and interviews with representatives of Dignity in Dying or Healthcare Professionals for Assisted Dying, please contact Ellie Ball at ellie.ball@dignityindying.org.uk / 0207 479 7732 / 07725 433 025 or Tom Davies at thomas.davies@dignityindying.org.uk / 0207 479 7734

The British Medical Association

·         Following a debate this morning (25 June 2019) at the British Medical Association Annual Representative Meeting in Belfast, the Representative Body voted in favour of all three parts of the following motion:

·         Motion by THE AGENDA COMMITTEE (TO BE PROPOSED BY ISLINGTON DIVISION): That this meeting notes the recent decision by the Royal College of Physicians to adopt a neutral position on assisted dying after surveying the views of its members, and:-

o   supports patient autonomy and good quality end of life care for all patients;

o   recognises that not all patient suffering can be alleviated;

o   calls on the BMA to carry out a poll of its members to ascertain their views on whether the BMA should adopt a neutral position with respect to a change in the law on assisted dying.

The Royal College of Physicians

·         The RCP has been officially opposed to assisted dying since 2006.

·         The last survey conducted in 2014 found that RCP members and fellows had a range of views, but no majority for any particular stance. While a plurality (44%) of its members believed the College should be opposed, a majority believed the College should either be in favour (25%) or neutral (31%).

·         The RCP announced in January 2019 that to better reflect the range of views held, unless a 60% supermajority voted in favour or in opposition to assisted dying in their upcoming survey, the College would adopt a neutral position.

·         In March 2019, it was announced that a judicial review was to be brought against the RCP, challenging its decision to commit to a neutral position on assisted dying unless a supermajority was reached, and attempting to prevent the results of the survey from being published. As of Thursday 21 March 2019, the legal challenge was rejected by the High Court.

·         Research by Dignity in Dying and by Open Democracy revealed that those behind the legal challenge are part of a network of anti-choice activists which has a long history of campaigning for pro-life causes and connections to American pro-life lobbyists.

The Royal College of General Practitioners

·         The RCGP on Saturday ( 22 June 2019) announced that following a discussion at its council meeting it would conduct a survey of its members on assisted dying.

·         The College last consulted its members on the issue in 2013.

·         The result, announced in February 2014, was that the College should not change its stance, and as such, its current position is that it is opposed to any change in the law on assisted dying.

Other medical bodies

·         Royal College of Nursing, Royal College of Nursing Scotland, Royal College of Psychiatrists and Royal Pharmaceutical Society all hold a neutral stance on assisted dying.

·         Other medical bodies with an opposed stance on assisted dying include Association for Palliative Medicine, Royal College of Physicians of London and Royal College of Surgeons of England.

·         General Medical Council, General Pharmaceutical Council, Royal College of Anaesthetists, Royal College of Obstetricians and Gynaecologists, Royal College of Paediatrics and Child Health, Royal College of Physicians of Edinburgh, Royal College of Surgeons of Edinburgh hold no stance on assisted dying.

The law on assisted dying in the UK

·         Assisted dying is prohibited in England and Wales under the Suicide Act (1961), and in Northern Ireland under the Criminal Justice Act (1966) which states that anyone who “encourages or assists a suicide” is liable to up to 14 years in prison. There is no specific crime of assisting a suicide in Scotland, but it is possible that helping a person to die could lead to prosecution for culpable homicide.

·         In February 2010, following the Debbie Purdy case, the Director of Public Prosecutions (DPP) issued the prosecuting policy on cases of ‘Encouraging or Assisting Suicide’. It covers actions that happen in England and Wales, even if the death happens abroad. The policy includes a list of public interest factors that will influence whether or not someone is prosecuted for assisting suicide. The policy states that in cases of encouraging or assisting suicide, prosecutors must apply the public interest factors in making their decision about whether or not to prosecute. A prosecution will usually take place unless the prosecutor is sure that there are sufficient public interest factors against it.

·         A prosecution is less likely if the person made a voluntary, informed decision to end their life, and if the assister was wholly motivated by compassion.

·         A prosecution is more likely if the person ending their own life was under 18, lacked capacity to make an informed decision about ending their life or was physically able to end their life without assistance. The assister is more likely to be prosecuted if they had a history of violence or abuse against the person they assisted, were unknown to the person, were paid by the person ending their own life, or were acting as a healthcare professional.

The true cost of the current law

·         Currently, every 8 days[1] someone travels to Switzerland from Britain for a legal  assisted death – a process which costs £10,000 on average[2] and often causes people to die earlier than they would have wanted in order to be well enough to make the journey.

·         Polling has found that over half (53%) of Brits would consider travelling abroad for an assisted death if terminally ill and two-thirds (66%) would consider breaking the law to help a loved one do so, yet only a quarter (25%) would be able to afford it[3]. A further 300 terminally ill people end their own life in the UK every year[4].

International developments

·         Assisted dying as an option for terminally ill, mentally competent adults in their final months of life is legal in eight US jurisdictions: Oregon (1997), Washington, Vermont, Montana, the District of Columbia, California, Colorado and Hawaii (January 2019). New Jersey (April 2019) and Maine (June 2019) voted to introduce assisted dying laws which will come into effect in the coming months.

·         Victoria became the first Australian state to legalise assisted dying for terminally ill people in June 2019. The Government of Western Australia plan to introduce an Assisted Dying Bill in their state Parliament in the second half of 2019.

·         Canada legalised medical aid in dying (MAID) in June 2016.

·         New Zealand is currently considering an End of Life Choice Bill which is due to have a second recoding on Wednesday 26 June 2019.

About Dignity in Dying

·         Dignity in Dying campaigns for greater choice, control and access to services at the end of life. It campaigns within the law to change the law, to allow assisted dying as an option for terminally ill, mentally competent adults with six months or less to live – something supported by 84% of the public[5].

·         Dignity in Dying does not provide practical assistance or advice in ending life, nor does it provide enquirers with the contact details of organisations who do so.

[1] Estimated using publicly available figures from Dignitas and figures supplied through private correspondence with the Life Circle (Eternal Spirit) facility.

2 The True Cost: How the UK outsources death to Dignitas  – Dignity in Dying, November 2017.

3 Polling conducted by YouGov, August 2017.

4 A Hidden Problem: Suicide by terminally ill people – Dignity in Dying, October 2014.

5 Polling conducted by Populus, March 2019.

[1] Estimated using publicly available figures from Dignitas and figures supplied through private correspondence with the Life Circle (Eternal Spirit) facility
[2] The True Cost: How the UK outsources death to Dignitas  – Dignity in Dying, November 2017
[3] Polling conducted by YouGov, August 2017.
[4] A Hidden Problem: Suicide by terminally ill people – Dignity in Dying, October 2014.
[5] Polling conducted by Populus, March 2015.