RCP response to health and social care select committee assisted dying/assisted suicide inquiry

The health and social care select committee launched its ‘Assisted dying/assisted suicide’ inquiry on 5 December 2022. The RCP worked with the Association for Palliative Medicine to respond to the inquiry’s call for written submissions of evidence, including urging the committee to consider ‘assisted dying’ and ‘euthanasia’ as two distinct practices and issues with very different considerations.

Our main points were:

• The current size of the physician workforce in general, and in palliative medicine specifically, is inadequate to provide palliative and other care.
• Specialist end of life care for all should be an NHS commitment. More dedicated funding for palliative care services would increase the number of people who had access to them.
• If the law were changed to permit assisted dying, the government would need to develop a dedicated assisted dying service. Any such service would need additional and specific funding. It would be perverse if that funding was made available without additional funding for palliative care.
• There is mixed professional opinion on whether or not there should be a change in the law to permit assisted dying. The RCP expects that any change in the law to permit assisted dying would state that healthcare professionals would not be under any duty to participate in anything authorised by the legislation.
• If the law were to be changed, physicians would be at risk of moral and psychological injury, even if they conscientiously objected. This would have an impact on the need for occupational health services.
• The RCP would expect that a request for an assisted death could only come from the person who wanted to die, that they would have the capacity to make that decision and ability to end their own life, that they would have been fully informed of their palliative care options and had their care and support needs fulfilled, and that they had voluntarily reached a clear and settled intention to end their own life.
• Every case would need to be taken on its own merits and a clinical assessment made by doctors in consultation with the person requesting an assisted death. But clinical evidence cannot extend to whether someone has made a decision with, or without, coercion or duress. Protection from coercion is a matter for the police and legal system. Doctors do not have the powers or skills to adequately assess all aspect of coercion.

The RCP position on assisted dying:

Following a 2019 poll of its members, the RCP adopted a neutral position on whether there should be a change in the law to permit assisted dying. This means the RCP neither supports nor opposes a change in the law to permit assisted dying.

Regrettably, this position was interpreted by some as suggesting that the RCP was either indifferent to legal change or supportive of a change in the law. So that there could be no doubt, we clarified that the RCP does not support a change in the law to permit assisted dying at the present time.

We reiterated that the RCP has an important role in informing the societal debate on this issue, and is keen to do so. While the ultimate decision on assisted dying rests with society through Parliament, professional and clinical issues pose significant challenges to the success of any future legislation.

Our written evidence includes the data collected from the 2019 poll and data on palliative medicine consultants from the RCP’s 2021 census. If called upon to appear before the committee, RCP representatives will make clear that the RCP is neither in favour of nor opposed to a change in the law.

If you have any questions or would like more information, please contact us via policy@rcplondon.ac.uk