The Royal College of Physicians (RCP) has adopted a neutral position on assisted dying following a survey of its UK fellows and members, reflecting their range of views.
Of the three options, 43.4% of respondents thought the RCP should be opposed to a change in the law on assisted dying, compared to 44.4% when the survey was last conducted in 2014. The percentage wanting the RCP to support a change in the law increased to 31.6% from 24.6%, and 25% thought the RCP should be neutral.
Neutrality reflects the decision taken ahead of the survey by the RCP’s Council, its main professional decision-making body, to require a supermajority of 60% for a position either supporting or opposing a change in the law. Neutrality also reflects the lack of a simple majority for any particular view.
The online survey, carried out between 5 February and 1 March, also asked fellows and members whether they personally support a change in the law on assisted dying. Those supporting such a change increased to 40.5% from 32.3%, while those opposing it fell from 57.5% to 49.1%. The survey was completed by 6,885 respondents from more than 30 specialties.
The percentage of fellows and members saying that if the law changed they would be prepared to participate in assisted dying increased from 21.4% to 24.6%, while the percentage saying no to this fell by a similar amount, from 58.4% to 55.1%.
RCP president Professor Andrew Goddard said:
It is clear that there is a range of views on assisted dying in medicine, just as there is in society. We have been open from the start of this process that adopting a neutral position will mean that we can reflect the differing opinions among our membership.
Neutral means the RCP neither supports nor opposes a change in the law and we won’t be focusing on assisted dying in our work. Instead, we will continue championing high-quality palliative care services.
The RCP defines ‘assisted dying’ as:
- The supply by a doctor of a lethal dose of drugs to a patient who is terminally ill, meets certain criteria that will be defined by law, and requests those drugs in order that they might be used by the person concerned to end their life.
The criteria a patient would have to meet would be defined by the law, and we cannot predict the content of any legislation. Considering past bills, it is likely that two doctors would be required to satisfy themselves that the person making the request
- was terminally ill (defined as having an incurable and progressive condition as a result of which death is reasonably expected within 6 months)
- had the capacity to make the decision to end their life
- had the capability to end their own life
- had been fully informed of their palliative care options
- had a clear and settled intention to end their life which had been reached voluntarily, on an informed basis and without coercion or duress.
The legislation would probably also include a conscientious objection clause for all healthcare professionals. For more information, you can read the Assisted Dying Bill that was considered by Parliament in 2016-17.
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In the 2014 poll there was no majority either way on the question of what the RCP position should be. Council agreed that, following this new poll, the RCP will adopt a neutral position until 60% of respondents say the RCP should be in favour of or opposed to a change in the law. ‘Neutral’ means the RCP neither supports nor opposes a change in the law. By remaining neutral, the RCP can reflect the differing views of its fellows and members in discussions with government and others. In the event, there was no 60% majority for any of the three options, nor was there any simple majority for any of them.
Due to this decision, and following feedback from fellows and members, the questions asked this time were slightly altered from 2014 but were similar enough to be able to track any change in opinion over time.
Responses to the 2019 survey were as follows:
1. What should the RCP’s position be on whether or not there should be a change in the law to permit assisted dying?
a. In favour 31.6%, b. Opposed 43.4%, c. Neutral 25.0%
2. Do you support a change in the law to permit assisted dying?
a. Yes 40.5%, b. No 49.1%, c. Undecided 10.4%
3. Regardless of your support or opposition to change, if the law was changed to permit assisted dying, would you be prepared to participate actively?
a. Yes 24.6%, b. No 55.1%, c. Don’t know 20.3%
The Suicide Act 1961 and the Criminal Justice Act (Northern Ireland) 1966 make it an offence to encourage or assist the suicide of another person. There is no specific prohibition of assisting a suicide in Scottish law, but anyone doing so could be charged with murder or culpable homicide.
The policy for prosecutors in respect of cases of encouraging or assisting suicide, issued by the director of public prosecutions, states that a prosecution is more likely to be required if 'the suspect was acting in his or her capacity as a medical doctor, nurse, other healthcare professional, a professional carer [whether for payment or not], or as a person in authority, such as a prison officer, and the victim was in his or her care'.
A legal challenge was issued in relation to this survey. That challenge was rejected by the high court on 21 March although the claimants are entitled to seek reconsideration of the court’s decision.