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This webpage represents a group of doctors who think the RCGP and BMA should maintain opposition to assisted suicide. Thank you for visiting.

We appreciate that deciding which way to vote in the RCGP and BMA polls will be difficult for many, as we seek to respect individual patients’ wishes whilst protecting the safety and wellbeing of the whole of society. There are many strong personal reasons which may lead us to support or oppose assisted suicide as individuals, but the collective voice of doctors shouldn’t be neutralised.

This poll is not about the rights and wrongs of assisted suicide, but whether it should become a new duty for doctors.

This video from the campaign group Care Not Killing outlines some of the concerns about how a change in the law on assisted suicide could impact on patients and GPs, as well as other doctors.

Controversial?

But isn’t neutrality on assisted suicide a reasonable position for medical bodies to take, on a controversial issue that divides its members?

As this blog points out, neutrality actually abdicates the professional responsibility to speak up for vulnerable patient groups and lead the debate on an area of massive professional relevance to doctors. A move to neutrality on assisted suicide would be perceived by Parliament and the general public as doctors dropping opposition to, or even providing tacit support for, a change in the law.

If assisted suicide is legalised, it will mean profound changes for how we all practise medicine – for example, it is likely that clinical guidelines for many terminal or chronic illnesses will require doctors to ask patients whether they would wish to have assistance in taking their own lives at an early stage in planning treatment. This would represent a key change in how we deliver care, and Parliament and the public rightly look to medical bodies like the RCGP and BMA for guidance on issues like this. If you oppose legal changes that would make doctors responsible for assisting suicide, please vote to maintain opposition so that the RCGP and BMA can continue to represent doctors’ concerns – going ‘neutral’ implies we don’t care about the issues raised.

‘During almost 30 years as a GP, I can think of only a handful of patients who asked me to help them die, and over time they all changed their minds once the real issues which prompted the requests were explored and help was given in the areas that made them feel so desperate. You can never in practice restrict a law allowing doctors to end the lives of patients to a single category such as the terminally ill, because any such restriction will then be challenged as discriminatory. Some will say, "what about me, I'm desperately depressed, I want to die, why shouldn't I be allowed to?" I would have been among that number several years ago, so I feel very strongly about this. The slew of proposed assisted suicide laws in recent years show that its advocates are tenacious and GPs must be under no illusions: medical neutrality is nothing of the sort, but rather an essential tool for campaigners who will then say it shows we no longer recognise the many problems with legalised assisted suicide.’
Dr Trevor Stammers
FRCGP, London
‘”Prohibition” to “optional” is a huge shift and is definitely not ethically neutral. Medical ethics involves declining some kinds of patient requests for the good of wider society. This is such a case.’
Dr Naomi Beer
MRCGP, East London
‘At this time of increasing workload pressures in primary care, there seem to be several pragmatic reasons for not changing the College’s position of opposing assisted suicide. The 2013 consultation showed that “a number of GP’s… would feel forced to resign…”. This would exacerbate the current difficulty in retaining GPs. There may be significant workload implications in assessing capacity for those with mental health diagnoses and safeguarding vulnerable groups. Primary care is not resourced for this.’
Dr Gordon Macdonald
FRCGP, Glasgow

Assisted suicide: five reasons for concern

PATIENT SAFETY

We believe that if the law is changed to license doctors to assist death, no amount of clinical safeguards can protect vulnerable patients from potential harm.

Maintaining the safety of all our patients is rightly a foremost priority in clinical practice.

Although most families act fully in the best interests of loved ones, sadly the charity Action on Elder Abuse estimates that as many as a million older people are vulnerable to abuse, and in 2016-7 there were 2,856 convictions for crimes against the elderly.

In 2018, it was revealed that over 450 patients had their lives prematurely ended by medical intervention at Gosport Memorial Hospital on the Isle of Wight.

If doctors are licensed to legally administer lethal doses of medications, detecting criminality and abuse towards vulnerable patients will become even harder than it is at present. Laws need to default to safety.

DUTY OF CARE

Because of the long medical tradition of rejecting interventions designed to cause death, it remains vital that whatever society may decide about assisted suicide, doctors do not administer lethal doses of medication.

Modern medicine traces its roots back to ancient Greece, where doctors in the Hippocratic tradition distinguished themselves from charlatans by taking an oath never to administer a poison. 

Assisting suicide has been prohibited by all international codes of medical ethics since then, including being forcefully repudiated by the World Medical Association in September 2019.

It is opposed by all national medical associations globally except those in Canada and the Netherlands. Meanwhile in the UK, it is opposed by key institutions including the BMA. If society wishes to legislate for assisted suicide, doctors should not be involved in providing it.

THE THE MESSAGE THIS WOULD SEND

Patients with frailty, terminal illness, cognitive impairment or significant multi-morbidity are at particular risk of having a low view of their own value and importance to others. If we change the law to allow assisted suicide, we acquiesce with the view that some lives don’t deserve full legal protection.

Currently, the 1961 Suicide Act prohibits actively encouraging or assisting someone else to commit suicide, because as a society we recognise that all lives matter.

Patients with terminal illnesses are particularly vulnerable to depression and suicidal ideation, but with proper support can be helped to move to a better place and view the future with hope.

We must continue to support a law that says that all patients matter equally; and that society doesn’t agree that any lives would be better off ended.

Respecting Colleagues

As a profession, we need to stand with our colleagues in palliative and geriatric medicine who are deeply concerned about the implications of assisted suicide for their clinical practice and the patients they look after and avoid dividing teams on this deeply personal issue.

The Association of Palliative Medicine polled its members in 2015 on their views on assisted suicide. 82% were personally opposed to legal change, and 73% felt that legalisation would adversely affect palliative care services.

The British Society of Geriatrics is also formally opposed to the legalisation of assisted suicide, believing that “the best way for physicians to help these vulnerable people is to maximise their independence and health, rather than assisting with their expressed wish to die.”

There are many within the profession who are deeply opposed to assisted suicide, and its legalisation would create divisions within teams and the risk that individuals may feel pressurised or even bullied into acting against their consciences.

THE RISK OF INCREMENTAL EXTENSION

If legalised, there is a significant risk that clinical indications for assisted suicide would be broadened far wider than currently intended, perhaps even for patients suffering from mental ill health or simply old age.

Whilst some campaigners for assisted suicide state they want to see assisted suicide legalised only for patients with a prognosis of 6 months or less, others go further, such as My Death My Decision, and those supporting disabled man Paul Lamb in his current court application.

Indeed, it would be difficult to argue that restricting assisted suicide to the terminally ill is not discriminatory. Only a complete prohibition on medical involvement in assisted suicide will protect the wider population we serve.

Regardless of your personal views on assisted suicide, if you are persuaded by the arguments set out here of the negative impact of assisted suicide for our patients and profession, please vote for continued RCGP and BMA opposition to assisted suicide – the RCGP poll closes on 13 December and the BMA poll is due to be launched early in 2020. There is the option to express personal opinions, including personal support for legalisation, further down in the RCGP survey.

Positioning statement

Why we oppose assisted suicide:

  • OPPOSE does not mean we want people to suffer at the end of life, we continue
    • To uphold the rights patients already have to say ‘no’ to treatment, 
    • To insist that patients have proper symptom control, and 
    • To maintain patient’s rights to change their minds about their preferences in care, even to the point of death.
  • OPPOSE protects the profession, so:
    • No-one will be forced to act against their principles
    • The UK’s world-leading experts in Palliative Care are listened to.
  • OPPOSE allows patients to feel confident that
    • Doctors will not attempt to hasten death under any circumstance.
    • They will be cared for in the best way possible until their natural death
    • That clinical need always out-weighs money in deciding what is best for the patient.

We support:

  • High quality palliative care that supports disabled people, the terminally ill and their families
  • Access to mental health services to tackle depression and demoralisation that can occur after diagnosis
  • Financial help to ensure patients do not feel that they are a burden
  • Further research into how patients can best be looked after.

Get involved

If you are a doctor or medical student and would like to be kept up to date with the campaign and possibly get involved with future projects, please fill in the form below.

About us

The ‘Our duty of care’ campaign is run by practising doctors who are deeply concerned about the risks to patients and clinical services if assisted suicide is legalised. We initially formed in early 2019 to oppose the Royal College of Physicians’ move to neutrality on assisted suicide, which is currently subject to legal challenge.  

We have been partly supported, both financially and logistically, by Care Not Killing, an alliance of individuals and organisations opposed to a change in the law on assisted suicide.

To contact us please email info@ourdutyofcare.org.uk