Volume 1

Assisted Dying for the Terminally Ill Bill (HL) / Select Committee on the Assisted Dying for the Terminally Ill Bill.

  • Great Britain. Parliament. House of Lords. Select Committee on the Assisted Dying for the Terminally Ill Bill.
Date:
2005
Catalogue details

Licence: Open Government Licence

Credit: Assisted Dying for the Terminally Ill Bill (HL) / Select Committee on the Assisted Dying for the Terminally Ill Bill. Source: Wellcome Collection.

    91/152 (page 89)
    Responsibilities of Physicians We have already addressed (Paragraphs 247 to 248) the important need for explicit wording in any future bill to define precisely the actions which a doctor may or may not take after a patient has signed a declaration and requested assisted suicide or euthanasia. But it is necessary also to consider the position of doctors who have conscientious objections to assisted suicide or voluntary euthanasia. Clause 7 of the present Bill seeks to deal with this issue, providing as it does that “no person shall be under any duty... to participate in any diagnosis, treatment or other action... to which he has a conscientious objection” (Clause 7(1)) and that, if either an attending or consulting physician has such an objection when confronted with a patient who is seeking his services under the Bill, “he shall take appropriate steps to ensure that the patient is referred without delay” to an attending or consulting physician “who does not have such a conscientious objection” (Clause 7(2)(3)). We have already pointed out (Paragraph 32) that, in the light of concerns expressed by the Joint Committee on Human Rights* that Clauses 7(1) and 7(2) “give rise to a significant risk of violation of Article 9(1) of the ECHR”, Lord Joffe has proposed to amend this section of his Bill in such a way as to remove the obligation on physicians with a conscientious objection to refer patients in the way proposed. We recommend that such an amendment should be reflected in any successor bill. Conscientious objections could however arise not only from doctors but also from other health care professionals, including nurses and pharmacists. The present Bill however is rather narrowly drawn on this point. We suggest therefore that any new bill should reflect, in addition to the revision of Clause 7 which Lord Joffe has proposed for his own Bill, the need to protect the interests of all members of the clinical team. In particular, it should seek to address such situations as that in which, for example, a nurse with conscientious objections is asked by a patient to raise with a doctor on his or her behalf a request for assisted suicide or voluntary euthanasia. It has also been drawn to our attention that care of the terminally ill is often carried out by multidisciplinary teams and that a number of doctors, nurses and other health care professionals could be involved, and might feel themselves implicated, in any action taken under the terms of the Bill to respond to a request for assisted suicide or euthanasia. Dr Vivienne Nathanson, for the BMA, told us that in many cases, such as, for example, in spinal injury cases, “you are not talking about one doctor, you are talking about teams of doctors, and I think there would be great difficulty in deciding who was, if you like, the primary care doctor and decision-maker, because the nature of these teams is that they work as equals” (Q 299). The GMC told us that its own guidance indicates that it should be clear at any one time who has responsibility for patient care (Q 339). It added that, while in theory this issue did not present insurmountable obstacles, the practical implications could be more complex (Q 340). Any new bill would therefore need to be drafted in such a way as to cater satisfactorily for such situations— for example, if the doctor with primary responsibility for a terminally ill patient wished to respond to a request for assisted suicide or voluntary