Resolution: Assisted dying

This resolution passed.

Members can view a recording of the debate here.

This is not a debate either ‘for’ or ‘against’ assisted dying.

This resolution proposes that the RCN puts in place a plan to review the RCN’s position statement on assisted dying, to include sharing information relating to assisted dying and the Private Members’ Bill, ‘The Assisted Dying Bill’, that is currently being examined by the Westminster government.

The 2014 statement was developed following consultation with RCN membership. The RCN was the first Royal College to seek its member’s views on assisted dying. Following the consultation, RCN Council voted to move to a position of neutrality to support all members whatever their view. This topic area remains highly emotive and sensitive, and warrants RCN support to its membership.

In 2015, the British Medical Association (BMA) sought the views of its members and the public to understand experiences and perceptions of end-of-life care and physician-assisted suicide. The BMA followed this with a survey of its members in 2021. This led to them moving to a neutral position on physician-assisted dying (Dyson, 2021). Both the BMA project and subsequent survey provided useful evidence relating to the prescribing of drugs for self-administration by eligible patients, and the level of involvement in administration of drugs to end life by the physician. These issues should be explored within the context of nursing.

In addition, in 2020, the Royal College of Physicians published their member survey results, which moved them from a position of opposition to neutral (Royal College of Physicians, 2019). It showed that there’s a clear distinction between the philosophical debate about whether assisted suicide is right or wrong, and the role and purpose of a physician (Royal College of Physicians, 2019). A similar debate is applicable within nursing.

This debate is relevant across the UK. The current Scottish consultation seeks to enable mentally competent adults who are terminally ill to access assistance to end their life at their request (Royal College of Nursing, 2021). Whereas in Northern Ireland and Wales, assisted dying is illegal under section 13 of the Criminal Justice (Northern Ireland) Act 1966 and the Suicide Act (1961) respectively.

There is currently a lack of understanding regarding the impact on nursing, that the current Assisted Dying Bill could have. For example, how it could impact the nursing workforce and the specific details relating to various forms of assisted dying (active, passive, indirect, and
physician-assisted suicide). The RCN should provide space where members can discuss and
receive clarity in matters relating to the Bill and any other forthcoming legislation.

This is an extremely critical issue to debate, to understand the opinion of members regarding the RCN’s current positioning (Royal College of Nursing, 2014). In addition, it would be a useful measure to assess if the pandemic has influenced attitudes to this issue, thinking specifically of how living in a pandemic has led to many considering their own death and mortality in more sharp focus than pre-COVID-19.

We must also consider the health and wellbeing of our workforce. It is vital that appropriate psychological support is in place to address any emotional distress that a change in the law could bring about.

Reading lists for each agenda item can be found here.

References 

Dyson M (2021) End-of-life care and physician-assisted dying project, The British Medical Association is the trade union and professional body for doctors in the UK.  Available at: https://www.bma.org.uk/advice-and-support/ethics/end-of-life/physician-assisted-dying/end-of-life-care-and-physician-assisted-dying-project  (Accessed 13 April 2022).

Royal College of Physicians (2019) Assisted dying: Why the RCP should be opposed.  Available at: https://www.rcplondon.ac.uk/news/assisted-dying-why-rcp-should-be-opposed (Accessed 13 April 2022).

Royal College of Physicians (2019) No majority view on assisted dying moves RCP position to neutral. Available at: https://www.rcplondon.ac.uk/news/no-majority-view-assisted-dying-moves-rcp-position-neutral (Accessed 13 April 2022).

Royal College of Nursing (2014) RCN position statement on assisted dying | Royal College of Nursing. Available at: https://www.rcn.org.uk/about-us/our-influencing-work/policy-briefings/pol-2314 (Accessed 13 April 2022).

Royal College of Nursing (2021) RCN Scotland response to Assisted Dying for Terminally Ill Adults Scotland Consultation | Royal College of Nursing Scotland | Royal College of Nursing. Available at: https://www.rcn.org.uk/about-us/our-influencing-work/policy-briefings/sco-pol-assisted-dying-for-terminally-ill-adults-scotland-consultation-dec-21 (Accessed 13 April 2022).