Assisted dying: report calls for clearer guidance for doctors

A new report on Assisted Dying (AS) and Assisted Suicide (AS) calls on the BMA and the GMC to provide clearer guidance for doctors who are asked to provide medical records for patients pursuing AD/AS abroad.

The report, published today by the Health and Social Care Committee, states that the current guidance for doctors is unclear, with conflicting recommendations made by the General Medical Council and the British Medical Association.

The report serves as a basis for discussion and debate on AD/AS in future Parliaments. It brings together comprehensive and up-to-date evidence sourced from countries and regions who have already implemented the practice as well as evidence from the public.

“Our report is not intended to provide a resolution to [AD/AS], but we do hope that it will be a significant and useful resource for future Parliamentarians,” the Committee said.

Key points for healthcare professionals

During the investigation, the Committee heard from people who have been involved in assisting a loved one to travel abroad to pursue AD/AS. Many people reported securing a medical report for the person applying from their doctor.

However, the Committee says the guidance for doctors is currently unclear and needs revising. While the GMC says providing a medical record is ‘too distant’ to be considered encouragement or assistance (which is illegal), the BMA says doctors should not write medical reports specifically to facilitate assisted suicide abroad. The GMC and BMA have now been asked to clarify the guidance for doctors.

The report also considered what role medical professionals would play in any system involving assisted dying or assisted suicide. They conclude these details would be determined by Parliament should either system by implemented, but they recommend that any decision to participate (or refuse to participate) should be freely taken by the individual healthcare professional and never imposed on them.

Furthermore, the committee recommend that any such assessments should only be undertaken by professionals who have undertaken necessary training on capacity assessments, particularly in relation to vulnerable groups.

BMA holds a ‘neutral position’ on assisted dying

However, the BMA says the Committee appears to have ‘misunderstood’ the guidance.

Dr Andrew Green, BMA medical ethics committee deputy chair, said: “We are clear that, where a request is made by a patient to access their own medical records under data protection law, doctors should honour this request, regardless of reason. This is the same position as the GMC.

“What doctors should not do is write a medical report specifically for the purpose of facilitating assisted dying abroad. This would leave doctors open to legal action for assisting suicide, and we cannot advise our members to do something that may be illegal under current law.”

Dr Green says the BMA has held a “neutral position” on assisted dying since 2021. This means the union will not actively support or oppose a change in the law, but will continue to represent its members’ views.

“We are glad that the Committee also highlights the need for comprehensive and equal access to high quality end of life care for everyone, and the frustration around current geographic disparities and inequalities, something the BMA has been speaking out on for years,” Dr Green added.

UK a world leader in palliative and end-of-life care, but provision is ‘patchy’

The Health and Social Care Committee make a variety of other recommendations, highlighting the importance of agency and control for patients, as well as high quality, compassionate end of life care.

While the UK is a world leader in palliative and end-of-life care, the Committee says access to and provision of such care is patchy.

The Committee is now calling on the government to ensure universal coverage of palliative and end-of-life services, including hospice care at home, and more specialists in palliative care and end-of-life pain relief. They are also urged to provide more funding for hospices that require it.

Both Jersey and the Isle of Man are currently considering AD/AS, and the Committee concludes that the government should be “actively involved in discussions” on how to approach possible divergence in legislation between jurisdictions.

While the Committee visited regions where assisted dying and assisted suicide have already been implemented, such as Oregon, they say not enough time has passed to make solid conclusions about how the practice is working.

A complex issue

Chair of the Health and Social Care Committee Steve Brine MP said: “The inquiry on assisted dying and assisted suicide raised the most complex issues that we as a committee have faced, with strong feelings and opinions in the evidence we heard.

“We intend the information and testimony we present in our report today to have a lasting legacy and, as we set out in the initial terms of reference, be a significant and useful resource for future debates on the issue. That could still be during this Parliament of course or after the next General Election.

“We’re particularly grateful to those who shared very difficult personal stories. The accounts were enormously helpful to us as we considered the issues involved and I’d like to put my thanks on record.”