In November I wrote about the perils of doctors’ representative bodies actively opposing a change in the law on assisted dying. I warned that it risks further embedding a ‘doctor knows best’ attitude that is patronising at best, and dangerous at worst. It alienates us from the vast majority of the public – and our patients – who support a change in the law to allow terminally ill patients greater choice and control at the end of their lives.
Back then the RCGP was surveying its members for their views on this issue, in order to measure any shift in opinion since the last survey in 2013 and to ascertain whether this should warrant a change from its current stance of opposition.
The results of this survey were announced on 21 February and they are staggering. The proportion saying the college should oppose assisted dying has dropped dramatically from 77% to 47%, and those saying the college should support a change in the law has risen sharply from 5% to 40%. Some 11% backed the college taking a neutral stance and 2% abstained.
However, the RCGP has taken the decision to remain officially opposed to any change in the law. This is despite over half of respondents (51%) disagreeing with this position.
Public support for a change in law
How the college has come to the same decision as 2013 based on such vastly different numbers, I cannot understand. Since then, the assisted dying debate has moved forward leaps and bounds in the UK and overseas, inside and outside our profession, and the 2019 survey results reflect this. Yet it appears the RCGP is stuck in the past, wilfully ignorant of this progress.
Since 2013, public support for a change in the law has risen to an all-time high of 84%. Countless high profile cases which illustrate the suffering inflicted by the current law have hit the headlines, including Bob Cole, whose journey to Dignitas was documented on front pages and TV screens; Noel Conway, who fought in the courts for over two years against the unjustness of the current law; more recently Ann Whaley, who was investigated by police over her plan to accompany her dying husband to Switzerland; and Mavis Eccleston, who endured a murder trial after her terminally ill husband ended his own life at home.
In the last seven years, six more jurisdictions in the US and two Australian states have legalised assisted dying, and New Zealand looks set to follow suit pending a public vote in September. Now over 100m people worldwide know that if they are terminally ill, mentally competent and meet other strict eligibility criteria, they have the option to die on their own terms.
In the same period the Association of British Neurologists and the Royal College of Physicians have decided to neither campaign for or against assisted dying (joining 16 other medical organisations in the UK to either be neutral or have no position on the topic), and the Royal Pharmaceutical Society has updated its policy with greater detail on how future legislation might work in practice. Notably, not one UK medical organisation has shifted its stance towards opposition to assisted dying.
Why medical organisations should be neutral
The RCGP’s decision to remain officially opposed despite these developments and despite being at odds with the views of its own members, risks damaging the college’s credibility in this debate and its reputation more widely. This could have been an opportunity to lead, to be ahead of the curve of inevitable progress rather than trailing behind, but instead the council has taken the cowardly way out.
My position, and that of a great number of doctors, is clear: we should contribute constructively to this debate, but our representative bodies should not campaign for or against assisted dying. I hope the BMA bears this in mind when debating a potential change in policy at their Annual Representative Meeting in June, following their own assisted dying poll which closed last week.
But above all, we must remember the most important voices in this debate: our terminally ill patients who are denied a meaningful say over their deaths under the current law, and their loved ones who must choose between breaking it and watching them suffer.
- Dr Norris is a GP in Yorkshire and a member of Healthcare Professionals for Assisted Dying