Frontline healthcare staff will require additional training to be able to fully support patients should the assisted dying bill pass, England’s chief medical officer has told MPs.
This week (29 January), MPs heard evidence and advice from experts as part of the committee stage of the bill, which would allow terminally ill adults to end their lives.
The proposed legislation, which was introduced as a private members bill and backed by MPs in November, requires the participation of two doctors who assess terminally ill adults and sign off on the decision.
When asked about specific training for healthcare staff should the bill pass, chief medical officer for England Professor Sir Chris Whitty said that GPs taking part in all stages of the process would require additional training.
Professor Whitty said: ‘I think it is much more likely that a very large number of doctors and nurses may get involved in the very earliest stages, because someone may raise an issue with their GP, with their nurse, with their consultant, and they need to have the basic understanding for that.
‘When it comes to the more detailed later stages, that, in my view, will require some specific training.
‘And I think there will be a gradation, in my view, of doctors – ones that are happy to have the general initial conversation, ones who are happy to have the structured conversation that follows, and a minority of those who will be happy to go on to take part in the final stages.
‘It is very important that both the wishes of the patient are respected, and that is the central point of this, we must start with someone in their last six months of life and their immediate family, what’s good for them.
‘But we must also make sure that the wishes of healthcare professionals around this area are absolutely protected.’
Chief executive and general secretary of the Royal College of Nursing (RCN) Professor Nicola Ranger and chief nursing officer (CNO) for England Duncan Burton also gave evidence.
They said it was ‘absolutely vital’ that nurses are included within the education and training that would be created if assisted dying legislation is introduced in the UK.
Professor Ranger told the parliamentary committee scrutinising the bill that it was ‘pertinent’ that nursing staff can ‘build on the skills they already have’ to deliver the end-of-life care that each patient needs through the right education and training.
And if passed, Professor Ranger said nursing staff would have to be ‘very vigilant around anyone feeling that they’re a burden’.
‘Our job is to be vigilant and to refer safeguarding anywhere where we think there is any form of abuse,’ she told the committee.
She added that there would be a difference between the care nurses provide patient’s seeking assisted dying, and those receiving palliative care.
And Professor Ranger said it was ‘absolutely vital’ that the CNO played a ‘key part’ in drawing up guidance going forward, given the central role of nurses in delivering end-of-life care.
BMA ethics committee chair Dr Andrew Green, a retired GP, also gave evidence to the committee.
The BMA has previously reiterated its ‘neutral’ position on the issue of assisted dying, but emphasised the need for ‘absolute freedom of choice for doctors as to whether they participate or not’.
Dr Green said: ‘It’s important that doctors should be able to opt out of any stage of this. There are doctors who would find it difficult to do that, and it’s important that their position is respected.’
He also emphasised that doctors involved in the later stages of the process would need specific ‘capacity and coercion’ training.
He added: ‘Certainly we would expect capacity and coercion training to be part of the specialised training that doctors who opt in would go for, and I would anticipate that the general safeguarding training should be sufficient for other doctors who would only be involved at that very early stage.’
It comes as the RCGP has launched a survey to establish a position on assisted dying following the bill’s progress in Parliament.
The RCGP is in the process of reviewing its position on whether or not assisted dying should be legal across the UK and its survey is open to all members who are eligible to work or have previously worked as a GP in the UK, one of the Crown Dependencies or the Republic of Ireland.
Meanwhile, the Royal College of Physicians (RCP) also has a ‘neutral position’ on assisted dying, which was adopted in 2019 following a member survey.
However, the RCP said it will consider how it will engage with the parliamentary process regarding ‘issues around implementation’.
A version of this story was first published on our sister title Pulse and Nursing in Practice.
