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Doctors won’t be disciplined for giving records to patients thinking of assisted suicide, says GMC

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f727 (Published 01 February 2013) Cite this as: BMJ 2013;346:f727
  1. Clare Dyer
  1. 1BMJ

UK doctors who hand over medical records to patients who are contemplating assisted suicide abroad will not face disciplinary action by their regulator for aiding a suicide, the General Medical Council says in new guidance.

The guidance ends uncertainty after legal advice was issued to some doctors that they faced a possible charge of assisting a suicide or disciplinary proceedings just for releasing records to patients who wanted to end their lives abroad. Assisting a suicide is a crime in the United Kingdom carrying a possible jail sentence.

A steady stream of terminally ill people from the UK have sought help at the Dignitas centre in Switzerland, where assisted dying is legal, but the process requires them to produce their medical records. Some doctors have refused for fear of prosecution or professional sanction, even though patients have a legal right to their records under the Data Protection Act.

The GMC’s guidance also makes it clear that doctors will not face disciplinary action for providing medical reports or otherwise helping in a legal action brought by someone seeking the right to an assisted death. Confusion over the issue arose in a case brought in the High Court in London last year by two men who had had a stroke, Tony Nicklinson and “Martin,” who unsuccessfully sought a court ruling that doctors could lawfully help them die.1

Doctors should be prepared to listen to patients who raise the issue of assisted suicide and to discuss the reasons for their request, the guidance says. But “any advice or information they give about suicide should be limited to an explanation that it is a criminal offence for them to encourage or assist a person to commit or attempt suicide.”

New guidance for case examiners and the GMC’s investigation committee says that some acts by a doctor would be “too distant” from encouraging or assisting a suicide for action to be taken. These include providing access to the records of a patient who has made a “subject access request” (a person’s request for information held about them) under the Data Protection Act and providing information or evidence in the context of legal proceedings over assisted suicide.

In guidance on prescribing drugs, issued at the same time, the GMC has dropped plans to allow doctors greater freedom in prescribing off-label or unlicensed drugs in place of more expensive ones.

A previous draft said that doctors could prescribe off-label or unlicensed drugs if they were satisfied “on the basis of authoritative clinical guidance” that the drugs were necessary.2

But, after objections from the Association of the British Pharmaceutical Industry and the Medicines and Healthcare Products Regulatory Authority, the GMC took legal advice. It was told that the European Union’s directive on medicinal products for human use stipulated that unlicensed drugs could be prescribed only where there was a “special need.”

The final guidance says that doctors “may prescribe unlicensed medicines where, on the basis of an assessment of the individual patient, you conclude, for medical reasons, that it is necessary to do so to meet the specific needs of the patient.”

Notes

Cite this as: BMJ 2013;346:f727

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