RCN position on assisted dying

Assisted dying remains a highly contentious and much debated topic, both in the public and the medical and nursing arenas. Concerns have been raised regarding compassion, poor management of uncontrolled pain or other symptoms, patient autonomy, care-provider autonomy, the potential for coercion and abuse and the vulnerability of people with disabilities.

The assisted dying debate is complex, involving many legal, ethical, medical, socio-cultural and religious issues.

In July 2009 the RCN’s governing Council voted to move to a neutral stance in relation to assisted dying for people who have a terminal illness.

This move followed an extensive and detailed consultation process with our members. The RCN moved from opposing assisted dying to a position where the College neither supports nor opposes a change in the law to allow assisted dying. We believe that this position rightly reflects our members differing views on the issue.

If during the passage of any parliamentary process there are issues that would relate directly or indirectly to the role of the nurse or nursing practice, we will of course comment on such matters.

The RCN Council commissioned guidance for nurses on assisted dying following the consultation in 2009 called When someone asks for your assistance to die. This was published in October 2011.

The guidance incorporated:

• the law on assisted dying in England, Wales, Northern Ireland and Scotland
• the law on advance decisions
• sources of information on high quality end of life care
• reasons why people may express a wish to die
• responding to a request to hasten death
• scenarios nurses may encounter and suggested responses.

Role of nurses

Regardless of where nurses work or their titles or individual roles, all nurses have a part to play in ensuring that they are able to have difficult conversations with the people they care for and to do everything in their power to address concerns. Building a trusting and supportive relationship with individuals and providing accurate information and appropriate treatment and care is vital to making the last few months and days of life as comfortable as possible, free as far as is possible, from pain and anxiety.

The RCN is aware that this issue is extremely emotive and causes a great deal of anxiety for nurses in all settings and will continue to seek the views of its members on all issues relating to end of life care.