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Assisted dying: doctors challenge RCGP’s “irrational” interpretation of poll

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3679 (Published 18 September 2020) Cite this as: BMJ 2020;370:m3679
  1. Richard Hurley
  1. The BMJ

The Royal College of General Practitioners (RCGP) has been threatened with legal proceedings unless it reconsiders its “irrational” decision to continue to oppose any change in UK law to permit assisted dying.

The college had said on 21 February that its 2019 membership survey did not present a mandate to change its stance opposing assisted dying.1 Critics argue that most respondents voted for the college to change its position from opposition and that a neutral position would best reflect the results.

The survey, run by Savanta ComRes from 29 October to 15 December 2019, had 6674 respondents, a 13% response rate. Of these, 47% (3144) said that the RCGP should oppose a change in the law, 40% (2684) said that it should support a change in the law, and 11% (701) favoured a neutral position.

“The College is failing in its obligations to properly represent the views of its members,” says the solicitor’s letter sent on behalf of RCGP members Aneez Esmail and Sam Everington, the non-profit company the Good Law Project, and the pressure group Dignity in Dying.

They accuse the college of “a flawed and unlawful decision making process” that was “irrational, failed to take into account relevant factors and took into account irrelevant factors.”2

The letter says, “With such a polarised result on an important ethical issue there was a fundamental error in treating ‘neutrality’ as a stand-alone third option as opposed to representing the middle ground between two competing, but polar opposite, views with similar levels of support.

“The results in this case clearly supported change in the College’s position and so neutrality is arguably the only logical way of reflecting that change.”

Transparency

Legalisation of assisted dying would, in specific circumstances, permit doctors to prescribe lethal drugs to some terminally ill people for them to take themselves. Some people call it assisted suicide.

The letter accuses the RCGP Council of failing in duties required by the Charities Act 2011 and of lacking transparency, including by not publishing details about members of a steering group it set up to analyse the 2019 survey results.

Esmail said, “The [2019] survey was intended to find out if RCGP members had changed their views since 2013, and there is undeniable evidence that they had.” The college’s 2013 consultation included a survey of 234 members. It found that 77% wanted the college to maintain opposition, 18% wanted it to assume a neutral stance, and 5% wanted it to support a change in the law.3

Esmail added that he and Everington had been “stonewalled at every turn” when they tried to raise their concerns with the RCGP Council.

The RCGP chair, Martin Marshall, said, “We are very disappointed to hear of this action, especially as we were transparent about our methodology and decision making processes from the outset of the consultation.”

Everington commented, “Far from being straight with their members, the RCGP has resisted every step of the way to explain why they have shifted the goalposts or why their full analysis has not been published. GPs deserve better than a defensive, opaque establishment that protects a harmful status quo at all costs and without justification.”

Other polls

A new poll of 1000 GPs by medeConnect, released today, found that 38% favour the RCGP being neutral, 35% favour it being opposed, and 20% favour it supporting regulated assisted dying.2

In 2019 the Royal College of Physicians (RCP) adopted a neutral stance on legalising assisted dying after a survey of its members found that neither opposition nor support won more than a 60% supermajority.4 The RCP’s decision attracted a legal challenge,5 which the High Court dismissed.

References

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