On 31st January 2013, the GMC issued an advice factsheet to doctors on how to handle a situation when a patient seeks advice about ending their life. This was published at the same time as separate guidance for its case examiners and the investigation committee to use when considering allegations that doctors have been involved in encouraging or committing suicide.
The factsheet was written specifically for doctors, to bring together existing guidance from “Good Medical Practice” and “Treatment and Care towards the end of life: good practice in decision making”. It makes it clear that doctors must adhere to the law and codes of practice relevant to their work and that doctors must limit any advice they give to patients who wish to discuss assisted suicide to an explanation that it is a criminal offence to encourage or assist a patient to commit or attempt suicide.
The GMC recognises that doctors may need to listen and discuss the reasons for a patient’s request and explore the patient’s understanding of their current condition, care plan and assess their current palliative care needs. An integral aspect of end of life care is advance care planning and doctors will need to discuss with patients what care they would, or would not wish in the event that they lose capacity to make their own decisions. However, there is a reminder that doctors do not have to provide treatment that will not be of overall benefit to the patient, or which will cause harm.
Nothing in the GMC guidance precludes doctors from prescribing medicines or treatment to alleviate pain or other distressing symptoms which may present at the end of life. Indeed, doctors have a duty to provide such care and the MDU advises that this care should be provided in line with the appropriate clinical guidance on pain management.
While patients nearing the end of their lives regularly seek advice from doctors about end of life care, very few may wish to discuss assisted suicide, which is illegal in the UK. The issues involved can be complex and the MDU advises members to contact the 24-hour advice line to seek advice on specific cases.
This guidance was correct at publication 01/03/2013. It is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.