Doctors should be able to opt out of recommending assisted dying to terminally ill patients, MPs have been told.
Dr Andrew Green, chairman of the British Medical Association’s (BMA) medical ethics committee, said it is important doctors should be able to say they do not want to take part in the process at any stage.
Asked by the committee scrutinising the Terminally Ill Adults (End of Life) Bill if there is a danger some doctors could be reluctant to give a prognosis of six months or less to live, Dr Green said: “There are doctors that would find it difficult to do that, and it’s important that their position is respected.”
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As part of the proposed law, patients will only be allowed to go through with assisted dying if they are expected to die within six months.
Chief medical adviser Professor Sir Chris Whitty also told MPs he thinks doctors who do not feel they can suggest assisted dying as an option to patients should be able to refer them to another doctor.
However, he said if MPs decide that is “not fair on the patient” they need to make a decision on whether doctors should be able to “push it on”.
Patient information service needed
Dr Green also called for an information service to be created to give tailored details about assisted dying and other services such as palliative care.
The retired GP said doctors face a challenge in knowing when to have certain difficult conversations with patients, but also “need to be able to open the door for the patient to go through into a safe space to have those difficult discussions”.
Dr Green said: “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 doctor’s union changed its position from being against assisted dying to a neutral stance.
He said the BMA has not taken a view on whether assisted dying should be provided by the NHS but said there should be a “degree of separation” so it is not “part of any doctor’s normal job to provide assisted dying”.
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Dr Green said this would reassure patients that assisted dying would not just be part of their normal care and 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” in assisted dying, as well as those who would feel alright to participate as they would have “emotional support and proper training”.
Training for nurses essential
Professor Nicola Ranger, chief executive of the Royal College of Nursing (RCN) told MPs it was “absolutely vital” for the chief nursing officer to be part of any guidance on care because nurses provide “the majority” of end-of-life care.
She said training nursing staff would be essential as they would need to be “very vigilant around anyone feeling that they’re a burden” and therefore opting for assisted dying.
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The nurse said access to quality palliative care is not “as good as it needs to be” and said it is “possible” that 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 system that doesn’t leave anyone in distress.”
The assisted dying bill was voted through by MPs last year and the details are now being scrutinised by a committee of MPs on both sides of the argument.
