RCP members drop 13-year opposition to assisted dying

Following a poll of its members, the Royal College of Physicians (RCP) has now adopted a neutral stance on the issue of assisted dying.

Some groups have spoken out against the change, saying a respected medical body’s reputation has been damaged. Others called the decision ‘absurd’.

Under UK law, it is currently illegal to encourage or assist a suicide.

Nearly 7000 doctors voted in the online poll:

  • 43% thought the college should oppose a change in the law
  • 32% wanted the college to support a change 
  • 25% were neutral

As a result, the college has shifted to a neutral stance because neither side achieved a necessary majority of 60%.

This shift by the Royal College of Physicians has no effect on the law and does not bring assisted dying any closer. However, it is symbolic that a respected medical institution should change its stance, which has been warmly welcomed by campaigners aiming to change the law. 

The decision has infuriated those opposed to the change, who argue that it is unreasonable to demand a majority of 60% or above in order to maintain the status quo. 

What are your views? Please do add your comments to this blog.

You can also read the editorial on the RCP’s survey by clicking here

Comments (20) Add yours ↓
  1. Nicola Padel Psychatrist (retired) and psychotherapist

    I have long thought it is inconsistent of doctors to say, as they apparently do in numbers, they would like to be able to end their own lives when terminally ill at a time of their choosing, yet not participate in offering the same to non-medics

    March 29, 2019 Reply
  2. Max Gibbs Retired GP

    Not quite as far as I had hoped but a start in treating people as responsible adults who have a right to make their own decisions with safeguards to protect those who are vulnerable .

    March 29, 2019 Reply
  3. Nick Farmer Podiatrist

    I am glad in one way but still frustrated that they could not think a little deeper and come out in favour of assisted dying. How they could back the Liverpool Pathway which basically meant they could withdraw medication from someone who was suffering so that they would ‘die naturally’ (I use that phrase with contempt) – and NOT assisted dying is beyond me.

    I sometimes think that many of the medical profession and politicians are hard to differentiate. They don’t take into consideration what the public wants – just what they want.

    March 29, 2019 Reply
  4. Irene Lee Physician Trainee CT2

    The topic of Assisted Dying can be very confusing for many including healthcare professionals. The definition of assisted dying can be poorly understood even with in practicing doctors.

    RCP adopting a neutral position reflects the diversity and different opinions of its members. The neutral stance allow clinicians to discuss and debate openly. That is not to say we (as physicians) have move toward supporting assisted dying. It is completely possible that by talking and learning about it, some might gain deeper understanding and perhaps firmer opposition to assisted dying.

    The fear of ostracism has limited free of speech on this topic in medical professions for too long. We need to “catch up” on what the different opinions are to advance in the debate of this topic.

    March 29, 2019 Reply
  5. Martin Johnson Emeritus Professor in Nursing

    Yes. It makes sense that a neutral position be adopted. Like nurses, many of which would want an assissted or even more active end of life option for themselves and their family, are nervous of approving of this in their professional capacity. Perhaps it can be understood, but it doesn’t make sense, especially when other countries are making reasonable progess with little in the way of genuine problems in this respect.

    The Royal College of Nursing, though rarely a leader in cutting edge ethics because it caters to so many constituencies of nursing, has adopted a neutral stance and some ot its notable Fellows are pro assisted dying. I am deslighted that the RCP has follwed suit with a more accurate representation of the diversity of opinion.

    March 29, 2019 Reply
  6. John Jackson Retired GP & occupational physician

    I think we must expect a gradual shift in the opinions of those who are stakeholders in the issue. 57% either wanted a change in the law or did not oppose it. There will always be some doctors who would be prepared to help people to die with dignity when they want to and some doctors who would never be so prepared. The shift in medical opinion is therefore almost irrelevant. The decision is for society. We would hitherto have expected Parliament to make the decision on behalf of society, but now one might have doubts. , .

    March 29, 2019 Reply
  7. Dr Eleri Wilson-Davies Consultant Medical Virologist

    I am so grateful to the Royal College of Physicians for their new enlightened stance. Along with the majority of the public, I want to have assisted dying available to those in need, with the appropriate checks and balances. Multiple sources are now available, evidencing the success of protections for the vulnerable, while protecting the rights of those who would suffer at the end of their life.
    My beloved father received a fatal diagnosis, resulting in a mad scramble to apply to Dignitas. Due to the risk to my licence to practice medicine, I was entirely excluded from the process. My father was relatively lucky in the end. He had a fall and died after 36 hours in a reduced conscious state. Despite his two fatal diagnoses he was not eligible for help to end his life, even in his final hours, despite his wishes. The wonderful physicians who cared for him were definitively confident that he was not experiencing any pain. I was however aware that we continue to learn about the experience of pain in the reduced conscious state.
    One day I hope that the NHS can offer greater empathy for those of us, who know that our right to avoid suffering at the end of our lives, can be successfully balanced with protecting the vulnerable in our medical and justice systems.

    March 29, 2019 Reply
  8. Jenny Lingenhult Physiotherapist, community

    I come across patients with progressive, end of life conditions who express feeling abandoned and missing not having a discussion about death and dying with their doctor.
    Like in many professions there can be a fear of topics where there is no intervention or help to offer at the end of it.

    In the majority of cases legalising assisted dying is likely to give patients some comforting knowledge that they can be in control, also at then of life and help doctors have a more open discussion wih their patients- which is likely to help ease their fears.
    Assisted dying adds options for those who call for them but does not take anything away from those who prefer to continue with status quo and suffer till the end.
    It is only right for the RCP to reflect the wishes in the population, including their membership, better.
    It is my hope that legalising assisted dying will help easing psychological pain in patients, which is understandable, at the end of life.

    March 29, 2019 Reply
  9. Joan Mashall Miss

    Perhaps all these young qualified doctors should consider the percentage of senior citizens, who happen to be able to decide for themselves, if they want to continue a life of pain and misery?

    Dogs, horses and all other animals are given more help than human beings…

    It would also help the NHS to be able to help the younger generation and also stop all these new nursing homes from ripping off the NHS and the residents in them… one day they will see for themselves but too late for us.

    March 29, 2019 Reply
  10. Rinske Goettsch Counsellor/Psychotherapist

    I am very disappointed with these results. The British attitude to assisted dying scares me about growing older in this country which I have adopted as my second home. I am Dutch and in the Netherlands it’s illegal to encourage, but legal to assist suicide. Even though there’s an ongoing ethical debate, as it should be in my opinion, it seems to be successful and fits with the Dutch trait of autonomy. Not having a say in deciding when my suffering has become insufferable seems illogical, nonsensical and not humane. To me, assisted suicide, or euthanasia, is all about autonomy. This includes the autonomy of a doctor who doesn’t wish to be part of it but I strongly believe that the government should make it possible for doctors who are supportive of assisted dying.

    March 29, 2019 Reply
  11. Simon Kenwright Retired Physician

    I have been a long time supporter for some form of assisted dying but voted for the RCP to adopt a neutral position as this seems appropriate given the strongly divergent opinions in the College. The past 50 years have seen so many ways in which we can prolong dying that we need to stand back and ask what we are hoping to achieve and discuss this openly with patients who are terminally ill. Evidence shows that the majority of those expressing interest in ADTI do not choose this option , but are re-assured by knowing it is there and the doctor caring for them can discuss it with them. As doctors we also need to think through the grey areas of the problem. The competent dying patient who wishes to die by refusal of treatment or hydration and nutrition is entitled to be assisted in this with symptom palliation by their medical advisers , even though the intention is suicide. The doctors may be happy that their own motive is palliation but perhaps we should be realistic about what we are helping the patient to achieve. It is a long time since we jettisoned those aspects of the Hippocratic Oath (which most of us will not have taken anyway) as regards abortion and urological surgery and it is time to bring this next aspect in line with 21st century care. It is good news that 1 in 4 RCP voters would be prepared to help patients in this way so that should not be a stumbling block as sometimes suggested.

    March 29, 2019 Reply
  12. Rosalind Kent General Practitioner (retired)

    Faced with a painful or distressing death, for example from motorneurone disease, I would welcome the opportunity to choose when to end my own life with dignity, before the onset of the more distressing symptoms. I cannot think of any loving spouses who would want to deny their partner this choice. I think that the part religion has to play is with the individual conscience of the religious, not with the general rule, forcing agnostics to follow rules they do not believe in. After all, how do the religious KNOW they are right?

    March 29, 2019 Reply
  13. Dr Deborah Gilham GP retired

    I believe patients with terminal illnesses should have the option to have a compassionate and dignified end to their lives at a time and place of their choosing. To deny them this when the means are possible is cruel. However good palliative care is it does not prevent all suffering. For those who do not agree to assisted dying they need not take this option but they should not prevent others ending their lives when they have decided they have had enough.

    March 29, 2019 Reply

    It’s an important and very welcome move. Why can I end the suffering of my pets but not my own should I want to? The law must change.

    March 30, 2019 Reply
  15. Peter Lachmann Emeritus Professor of Immunology

    The RCP action is to be applauded as a positive step in the debate on this contentious issue.

    However restricting the discussion to those with less than six months to live omits the possibly even greater problem of those with extreme neurological (or other) diabilities (for example locked-in syndrome) who may suffer terribly for many years.

    It is also worth remembering that in the era when households had coal gas cookers the whole problem was much less as very little assistance was needed for those wishing to end their lives – and certainly not from doctors.

    March 31, 2019 Reply
  16. Bridget Jeffery psychotherapist

    I have worked in the NHS for over 30 years and I have absolutely no idea why so many doctors appear to challenge the right of a terminally ill individual with mental capacity to decide the timing of their death. I am also very puzzled by the fact that health professionals in general are encouraged to promote autonomy and self determination and yet one of the most significant decisions is left to doctors. Dr Henry Marsh in his book Do no harm puts it very succinctly when he states that “there are worse things than death” and I for one wholeheartedly agree with him. At a personal level dying doesn’t greatly bother me but the way in which I die absolutely terrifies me. I have worked with many terminally ill individuals over the years and have heard of some wonderful deaths and some absolutely shocking and barbaric deaths. I think it is appalling that the act of choosing a compassionate death is the remit of those with savings in excess of £10,000 who are able to pay to travel to Switzerland. Surely this is terribly discriminatory and in my opinion the sooner the law changes the better.

    March 31, 2019 Reply
  17. Katie Moss Rheumatology consultant

    This is a step in the right direction to enable autonomous adults to make the right decision for them at the end of life. I think this is the right way forward, provided that safeguards are put in place to protect the vulnerable.

    April 2, 2019 Reply
  18. Mike Kirby Professor

    There comes a time when many patients need help related to chronic, painful and degrading illness, they should have the right to choose a dignified way out, as long as safeguards are in place to protect the vulnerable.
    The RCP was right to ask opinion, although it could have been done in a better way.

    April 4, 2019 Reply
  19. Dr David Turner GP

    I do not understand how some health professionals would not want to afford the same dignity at the end of life to a patient, as they would to a family pet.
    The fact patients cannot choose to ask a doctor to help end their suffering is an example of how, in this country, some aspects of health care are still stuck in the dark ages.
    This debate needs to move forward and quickly.
    How many more patients with appalling irreversible diseases must spend their final hours and days making the journey to Switzerland to find the end to life they choose , before we as a profession wake up to the idea end of life care is not failed medicine?

    April 18, 2019 Reply
  20. Stuart Hutchison GP

    Dr.Davis says that we can learn from AD laws operating around the world. This is what is happening around the world:

    Netherlands – Bondewijn Chabot “The patron saint of euthanasia” wrote in 2017, along with 220 medical colleagues, decrying the unchecked and rapidly rising use of the euthanasia law against the mentally ill and the demented. “Euthanasia practice is running amok…I don’t see how we can get the genie back in the bottle.”

    Belgium – 65 psychiatrists and psychologists wrote to change the current law, saying that it was promoting the “trivialisation” of euthanasia, promoting “death as therapy”, undermining the entire field of mental health.

    Dr.Davis says there is no need to focus on hypothetical fears. I would argue that these fears are real and current.

    In the USA some patients with limited insurance have been offered AD as a cheaper “therapy” for their cancer. In Oregon up to 60% of patients said their decision for AD was because of degrees of burden on their carers/relatives.

    June 11, 2019 Reply

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