Source · Select Committees · Health and Social Care Committee
Recommendation 5
5
Deferred
Paragraph: 40
Issue revised guidance for doctors on providing medical reports for assisted dying abroad.
Conclusion
We also heard about the documentation which has had to be secured as part of the application, including a medical report for the person applying. We note that the General Medical Council’s guidance for Investigation Committees assessing a doctor’s fitness to practice following an allegation of a doctor’s encouragement or assistance in suicide, sets out that that providing access to a patient’s records where the request is made in accordance with the Data Protection Act 1998, should be considered lawful or too distant from being considered encouragement or assistance. However, the BMA’s guidance recommend that doctors should not write medical reports specifically to facilitate assisted suicide abroad. Although it is not illegal to provide medical reports in this circumstance, it does not seem to be entirely clear to doctors what they are allowed to do. We would welcome revised guidance from the GMC and the BMA enabling doctors to assist their patients.
Government Response Summary
The government states it does not plan to establish a national strategy for death literacy and outlines existing palliative and end-of-life care strategies and training, but does not address the recommendation for revised guidance from the GMC and BMA on doctors assisting with medical reports for assisted suicide abroad.
Paragraph Reference:
40
Government Response
Deferred
HM Government
Deferred
We do not plan to establish a national strategy for death literacy. However, the Government’s inclusion of palliative and end of life care in wider strategies will continue to drive the conversation and reduce the taboos associated with death and dying. For example, inclusion in the forthcoming Major Conditions Strategy, the new Visiting Legislation, DWP’s Special Rules for End-of-Life changes and the Chief Medical Officer for England’s recent report on healthy ageing. In addition, there is a comprehensive suite of free training on palliative and end of life care available (e-ELCA) for health and care professionals. As stated in the report, the Palliative and End of Life Care Policy Research Unit will focus on how best policy-makers can respond to a range of issues across palliative and end of life care, including key issues that emerged during the pandemic such as quality of care and disparities in access to services in different settings. It will also include research into understanding the barriers to discussing palliative and end of life care and the wider role of society in supporting people who are dying and those important to them. The Voluntary Community and Social Enterprise (VCSE) Health and Wellbeing Alliance (HW Alliance) is a partnership between DHSC, NHS England, the UK Health Security Agency and sector representatives. This partnership works together to: drive transformation of health and care systems; promote equality; address health disparities; and help people, families and communities to achieve and maintain wellbeing. The HW Alliance has previously commissioned a number of projects investigating disparities in accessing palliative and end of life care. These include cross-cutting considerations at the end of life, digital inclusion, and barriers for those likely to be in the last year of life without a life-limiting diagnosis. Palliative and End of Life Care Strategic Clinical Networks are in place in every NHS England region, supporting the delivery of personalised high-quality palliative and end of life care for all, irrespective of age, area, condition or setting. Led by a core team, the networks combine the experience of clinicians, service commissioners and patients to improve the delivery of care to patients across primary, secondary and tertiary settings, including social care and the voluntary sector. In addition, there is a wealth of national guidance for commissioners and healthcare professionals, including: • NHS England has published statutory guidance and services specifications to support commissioners with palliative and end of life care provision. • NHS England’s Children’s palliative and end of life care service specification. • NHS England’s guidance on addressing palliative and end of life care needs for people living with heart failure. • Care Quality Commission’s (CQC) guidance on Planning for the Future. • The Universal Principles of Advance Care Planning. • National Institute of Clinical Excellence (NICE) Quality Standards on Adult end of life care • National Institute of Clinical Excellence (NICE) Quality Standards on Children’s end of life care.