Doctors and healthcare professionals say greater clarity would be required on eligibility criteria, capacity and safetuarding if assisted dying was to be legalised, according to a new survey.
The Royal College of Physicians and Surgeons of Glasgow, which has a neutral stance on the principle of assisted dying, surveyed its UK Members on the practicalities of implementing the Terminally Ill Adults (End of Life) Bill, applicable to England and Wales, and the Assisted Dying for Terminally Ill Adults Bill in Scotland, should they become law.
The survey’s 635 respondents were split over whether they would support or oppose the relevant legislation’s implementation.
Around two in five (41%) said they either ‘completely supported’ or were ‘leaning towards supporting’ the bill, while around half (49%) said they were either ‘leaning towards opposing’ or ‘completely opposed’ the bill in its current form.
However, the majority felt there would be challenges around the bills’ practical implementation.
Among the findings:
- Three in five (59%) respondents felt assessing a patient’s voluntariness – that is, ensuring they were not being coerced into a decision – would pose a ‘major challenge’, and one in four (26%) thought it would be a ‘minor challenge’.
- Almost one in two (48%) respondents said assessing capacity would pose a ‘major challenge’, while about one in three (35%) said it would be a ‘minor challenge’.
- Nearly half of respondents (45%) said they had ‘major concerns’ regarding the McArthur Bill’s definition of terminal illness, while two in five (40%) had ‘major concerns’ regarding the Leadbeater bill’s definition of terminal illness. The remaining respondents were split between having ‘minor concerns’ and ‘no concerns’ about the definitions.
- Overall, confidence that current professional standards and oversight will ensure safe implementation of the bill is low. Only about one in three (35%) of respondents were ‘very’ or ‘moderately’ confident.
- Almost two in three (64%) felt the method of assisted death should be addressed in the legislation.
- Over half of respondents (55%) were ‘not very’ or ‘not at all’ confident that the bills provide sufficient legal protection for professionals involved in assisted dying.
Dr Morven McElroy, Honorary Secretary at the Royal College of Physicians and Surgeons of Glasgow, said: “As a College, we have a neutral position on the principle of assisted dying. However, with two bills currently under discussion, it was important for us to ask our Members for their views on the practicalities of implementing the bills should they become law.
"While doctors and healthcare professionals have a range of views on the principle of assisted dying, all are deeply concerned for the wellbeing of their patients. The survey has shown that if the bills were to become law, there is a strong need for greater clarity to protect both patients and doctors.
"Respondents to the survey were particularly concerned about the challenges of assessing whether a patient has made their decision voluntarily, and their capacity to make that decision.
"They also told us that greater clarity would be needed on the role of the clinician and their right to choose whether to take part in an assisted dying service, along with safeguards for people with disabilities and current workforce preparedness, and the impact on palliative care services.
"These are complex issues that require particularly careful consideration and discussion.”
Respondents were also asked if they would be willing to discuss assisted dying with eligible patients. The majority (34%) of respondents said they would discuss the option with patients, while 29% said no and 14% said they were not sure.
Although some respondents reported willingness to discuss assisted dying with eligible patients (34%), only 18% of those surveyed said they would be willing to prescribe drugs to a patient to self-administer to assist in their own death. Just 16% would be willing to directly help a patient self-administer drugs to assist in their own death.
About the survey
The survey was conducted by the Diffley Partnership to understand the views of the College’s UK Fellows and Members on the practicalities of assisted dying if there was a change in the law.
The survey received 635 responses from physicians, surgeons, dental surgeons, GPs, nurses and allied health professionals.