New information service ‘would reassure medics and patients on assisted dying’
The British Medical Association and Royal College of Nursing were among witnesses giving evidence to MPs.
An official information service should be set up for patients who want to know more about an assisted dying service if a law comes into force to legalise it, a doctor has told MPs.
Dr Andrew Green, chairman of the British Medical Association’s medical ethics committee, called for such a service to be provided to give tailored information about assisted dying and other services such as palliative care.
Dr Green said there is a challenge for doctors in knowing when to have certain conversations with patients, but that they also “need to be able to open the door for the patient to go through into a safe space to have those difficult discussions”.
And he said that medics should be able to opt out of offering assisted dying.
He told MPs on the committee scrutinising the Terminally Ill Adults (End of Life) Bill: “We actually believe it’s important that patients should be able to access personalised information.
“We would like to see an official information service set up that patients could go to either as a self-referral or as a recommendation from their GPs or other doctors.”
In 2021, the BMA – the doctors’ union – shifted from a position against assisted dying to one of neutrality.
He said the BMA had not taken a view on whether an assisted dying service should be provided by the NHS but said there should certainly be a “degree of separation” so that it is not “part of any doctor’s normal job to provide assisted dying”.
Dr Green said this would reassure patients that assisted dying would not just be part of their normal care and that if they were interested in it there would be “proper quality, proper audit attached to it”.
He said it would also reassure doctors “who didn’t want to have any part” of assisted dying, as well as medics who would feel OK to participate, in that they would have “emotional support and proper training”.
He said the existence of an information service could allow doctors to direct, but not refer, patients towards it.
And he added: “The provision of information would be very useful, because in a situation where a doctor was unwilling to have an initial discussion with the patient, it would provide a way for the patient to get that information which was in no way obstructive.”
Dr Green was asked if there was a danger that doctors would be reluctant to provide a prognosis of six months or less to live, if they thought that that would make the patient eligible for assisted dying.
He replied: “That is why it’s important that doctors should be able to opt out of any stage of this. There are doctors who would find it difficult to do that, and it’s important that their position is respected.”
Meanwhile, the chief executive of the Royal College of Nursing (RCN) said it is “absolutely vital” for the chief nursing officer to be part of the drawing up of any guidance on care because nurses provide “the majority” of end of life care.
Professor Nicola Ranger said training for nursing staff will be key as they will be the ones needing to be “very vigilant around anyone feeling that they’re a burden” and therefore opting for assisted dying.
She stressed that skills in caring for someone wanting assisted dying and those wanting palliative care are “not lumped together”.
Prof Ranger said access to good palliative care is not “as good as it needs to be” for everyone, and described it as “possible” someone might request assisted dying in the absence of adequate care.
But she added: “What we would want to strive to do is have a have a system that doesn’t leave anyone in distress.”
Meanwhile, England’s chief medical officer Professor Sir Chris Whitty said he was “relieved” to see the Bill as it is proposed to “stick with” the Mental Capacity Act 2005.
Some MPs have expressed concerns around being sure someone has capacity to decide to have an assisted death.
Sir Chris said this legislation is already used on a daily basis by doctors across the country who know and understand it, and added that it has been tested in the courts.
He said: “My own view is that starting with this is the sensible thing to do. That doesn’t mean there couldn’t be arguments or some additional points around it.”
Sir Chris added: “I think people should move away from the Mental Capacity Act with some caution, because I think it will cause as many problems as it solves. And it’s not clear to me what the problem is that people are trying to solve by doing this.”
