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GMC launches consultation on assisted suicide

Responses to inform guidance for doctors accused of helping a patient to die

Caroline White

Tuesday, 07 February 2012

The General Medical Council has launched a consultation on assisted suicide, with the aim of developing guidance to handle cases where doctors have been accused of helping a patient to die.

The responses will inform guidance  that is intended to help case examiners to make clear and consistent decisions about how the GMC should respond to allegations against doctors, and whether the case merits referral to a Fitness to Practise hearing.

The move was prompted by a working group of GMC Council members who felt that not only was guidance for internal decision makers needed, but also that people considering seeking assistance from doctors and doctors themselves understood the likely implications.

To date, the regulator has investigated few cases involving allegations against doctors assisting in a death. In the last 10 years, there have been three cases, one resulting from a conviction for assisting suicide in British Columbia. None of the cases arose from a conviction for assisting suicide in the UK.

The GMC’s chief executive, Niall Dickson made it clear that the move did not signal the regulator’s support, or otherwise, for assisted suicide, but was merely an attempt to clarify the interpretation of the existing legislation.

“This is a complex and sensitive issue. Nothing in the draft guidance changes the law on assisting suicide; neither should it be taken to imply that the GMC supports or opposes a change in that law. Encouraging or assisting suicide remains a criminal offence and the guidance reflects the law on the subject,” he said.

“We recognise that there are a range of actions which would contravene the Suicide Act—from providing information to a patient to helping someone to travel to Dignitas. Some of these actions may not lead to criminal charges, but may still lead to complaints about a doctor’s fitness to practise.”

He added: “Doctors, patients and others may also find it helpful if we set out clearly how we will consider complaints in this area.”

The consultation is open to all, and the regulator is particularly keen to hear from those who are, or have been, affected by these issues.

When the Investigation Committee or case examiners consider an allegation they must decide whether there is a realistic prospect of establishing that a doctor’s fitness to practise is impaired to a degree that calls their registration into question.

The draft guidance sets out the existing legislation and ethical principles which underpin all GMC guidance as well as some of the things doctors might have done in order to encourage or assist a suicide and the factors that should be considered in deciding whether the allegations should be referred to a fitness to practise panel.

These include whether the doctor actively encouraged a patient to end his/her own life, provided information on particular methods to use, or gave them practical assistance, as well as issues of dishonesty in documenting prescriptions and financial gain.

Sarah Wootton, who heads up Dignity in Dying, which campaigns for a change in the law on assisted suicide, said that currently doctors found it difficult to know how they should respond to patients considering an assisted death. The Director of Public Prosecutions’ (DPP) guidelines had sparked confusion over what constituted assistance for healthcare professionals, she added.

"We hope that the GMC's guidance will offer much needed clarity to doctors and their patients on what is currently a grey area of law and practice. At present different medical bodies interpret the DPP guidance on assisted suicide differently; causing uncertainty for health professionals and potentially greater suffering for patients at a time when they need their doctors' support the most,” she said.

"It is essential that doctors feel able to have conversations with dying patients who want to choose an assisted death about their choice and the alternatives, with the support of their regulatory bodies,” she emphasised.

The consultation runs until May 4; a final version of the guidance is expected in the summer.

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