All RCGP members should be balloted on assisted dying

Dr Hartropp states that the RCGP Patient Participation Group (PPG) were consulted and that ‘a clear majority were in favour that the RCGP should move to neutrality”

However, this brief summary of the group’s discussion is highly misleading - in that it does not show the true position or nuances surrounding PPG’s debate, that centred around the two questions:

Whether the College should or could have a collective view on an ethical issue; and
What should the College’s position be on assisted dying.

Collective view on ethical issues:

The Group was appreciative of the way that the College Council facilitated local discussions addressing the ethical issues around the assisted dying debate by deciding to consult with its constituent bodies and stakeholders rather than just holding a simple ballot of college membership.

The PPG members felt consensus was very important on important ethical issues such as this, and agreed that if consensus could not be reached on an issue, then this fact must be stated as such. A majority of the lay members (the GPs who are part of the group did not express any opinion to the group) agreed that it was indeed possible for the College, as a membership organisation, to have a collective view on ethical matters.

However, the Patient Partnership Group, like several other consulted groups, was unable to come to any consensus on the issue of assisted dying. Consequently, when a vote was taken, the members of the Group expressed their own personal positions, and this, by definition, meant that the Patient Partnership Group did not decide by “a clear majority” that the RCGP should move to neutrality.

In actual fact, four members voted in favour of neutrality, three members in favour of opposition, and the two clinicians refrained from voting so as not to sway the Group’s decision one way or the other. Significantly, no members of the Group voted in favour of a change in the law on assisted suicide. Dr Hartropp – please take note.

On Assisted dying:

I am well aware, from my own personal experience, that assisted dying involves intensely personal decisions by patients, their carers and healthcare professionals. Ever since I became a lay member of PPG, I have had to declare a personal interest in the College’s assisted dying debates because my wife, after being diagnosed with terminal lung cancer and a brain tumour in early 2008, suffered such extreme pain that we joined the Dignitas organization at the outset of her final illness.

Fortunately, the palliative care provided by our GP practice and the community palliative care team was able to identify a suitable drug regime that offered her reasonable respite and pain control. My wife and I were in constant discussions with our family during this time about the pros and cons of assisted dying or continuing with palliative care, and about a month before she eventually died, we finally made the decision to withdraw from Dignitas.

My personal family experience demonstrates that there is no clear-cut Yes or No answer to assisted dying, but I am thankful that my GP did persuade my wife and I to try the path of palliative care rather than proceed straightaway to Dignitas.

There will no doubt be great public interest in the outcome of the House of Lords free vote debate on the Assisted Dying Bill in July 2014, and I look forward to reading the full debate in Hansard.

I hope this sets the record straight regarding the RCGP’s PPG involvement in this debate.

Harvey Ward,
Chair,
RCGP Patient Partnership Group,
30 Euston Square,
London NW1

I am grateful to Dr. Baker, as Chair of the RCGP, for personally taking part in the debate on Assisted Dying.

In her letter, she states that in the RCGP consultation, "responses were achieved from 1,700 members from all 4 nations of the UK".

But, she then quotes figures from only the direct responders, some 235 (0.48%) of the total membership, of whom just 181 (out of the total membership of 49,000) wished to maintain opposition. She avoids mention of the other 1,479 (87%) members who took part in the consultation through their faculties, of whom 40-50% voted to move the RCGP to neutrality or support. Figures cannot be exact because 8 faculties produced no numerical data.

Additionally, because the RCGP devolved responsibility for the consultation to each of its 32 faculties, a variety of methodologies was used, leading to the resultant data being flawed. For instance, the only contribution from the 3 London faculties (6,000 members) was a debate on Assisted Dying which just 25 members attended (just 0.4% of their membership). A vote was recorded as though representing all of the membership of these 3 London faculties.

Wessex and Yorkshire faculties (4,400 members) each used email surveys and achieved a mere 6 responses each (0.3% membership),which again was presented as though from the full membership of those faculties.

Dr. Baker also avoids any mention of the response from the Patient Participation Group, who were also consulted, where a clear majority were in favour that the RCGP should move to neutrality.

Once more, I urge the RCGP to undertake an open and fair ballot of all its 49,000 members and submit the analysis for external scrutiny. Only in this way will the true voice of the full membership of the College be heard.