The Royal College of Surgeons (RCS) has changed its stance on assisted suicide from opposed to neutral after less than 10% of its members signalled their support for the legalisation of assisted suicide.
The RCS has been opposed to assisted suicide since 2014, which they describe as “prescribing life ending drugs for terminally ill, mentally competent adults to administer themselves after meeting strict legal safeguards”. However, in 2021, the RCS commenced a review of its position and earlier this year carried out a survey among its membership.
Of 17,631 members, only 3,268 took part in the survey. Of those who took part, 52% (1,699) were supportive of making assisted suicide legal in the UK. Therefore, less than 10% of the total membership support making assisted suicide legal in the UK.
In relation to the role of doctors in assisted suicide, 23% of those who took part in the survey believed that doctors should be present when a patient ends their own life.
The lowest support for a change in the law to make assisted suicide legal was among Black or Black British respondents with 21% in support, and with 24% in support among those who listed Arab as their ethnicity.
The highest support among specialisms came from surgeons who performed dental surgery with 64% in support, and the lowest support came from neurosurgeons with only 39% in support.
Doctors are trained to heal not to take life
The report included comments from people who completed the survey.
A specialty trainee in Otolaryngology (ENT) surgery said “We should focus efforts on better palliative care and support for people with chronic and terminal illness to alleviate suffering rather than ‘copping out’ and facilitating ending of life”.
A number of respondents were concerned about the risks to vulnerable patients and the potential for abuse if assisted suicide were to be made legal.
One respondent said “It is impossible to fully rule out the possibility that the person is motivated by pressure from others, or an altruistic desire to avoid being a burden to their family or the wider community”.
These concerns were also raised by a consultant in Trauma and Orthopaedic Surgery who said they had “significant concerns vulnerable people may be persuaded they should end their life – or people that feel a burden on others (often wrongly) feel they should end their life to help others”.
Many also felt that performing assisted suicide was against the role of doctors who are there to ‘do no harm’, with an SAS Grade Surgeon commenting that “doctors are trained to heal not to take life”.
Another consultant in Trauma and Orthopaedic Surgery said “Our aim as medical professionals should be to offer the best possible treatments to our patients. To cure disease, to alleviate suffering, to help with symptom control, not to end the lives of people”.
Their reasons for making assisted suicide legal are not concerned with ‘terminal illness’
As a result of the review and survey, the RCS has changed its view to neutral in regard to assisted suicide for people who are mentally competentand terminally ill. On its website, it says “This means we will neither support nor oppose attempts to change the law”.
The RCS makes a distinction between “assisted dying” and “assisted suicide”, where in the former case, the person who is ending their life is thought to be terminally ill, and in the latter case, the person who is ending their life is not thought to be terminally ill.
However, the two most common reasons given by surgeons who answered the survey in support of making “assisted dying” legal, equally apply to assisted suicide and euthanasia. 39% said patients should have “choice/autonomy/control” and 38% said patients “should not have to suffer/experience poor quality of life”. These reasons for making assisted suicide legal do not make reference to whether or not a patient is terminally ill.
Assisted suicide, whether a patient is terminally ill or not, is currently illegal in the UK.
Almost 1 in 5 Canadians said “isolation or loneliness” was a reason for wanting to die
Assisted suicide and euthanasia are legal in a number of countries including the Netherlands and Canada where 10,064 Canadians ended their lives by assisted suicide or euthanasia in 2021. This accounted for 3.3% of all deaths in the country and an increase of 32.4% from the previous year.
17.3% of people in Canada who ended their lives this way cited “isolation or loneliness” as a reason for wanting to die. In 35.7% of cases, patients believed that they were a “burden on family, friends or caregivers”.
Similarly, in Oregon, which UK assisted suicide campaigners, Dignity in Dying, regularly cite as a model for rolling out legislation to the UK, among the end-of-life concerns listed by those who ended their lives, almost half (46.4%) of those who ended their lives reported being concerned about being a “[b]urden on family, friends/caregivers”, and 6.1% said they were concerned about the “[f]inancial implications of treatment”.
A study in Ireland found that almost three-quarters of people over 50 who had previously expressed a wish to die no longer had that desire two years later.
A survey conducted earlier this month of a thousand adults in Canada found 27% would support “poverty” being a reason for euthanasia and 28% would support “homelessness” being a reason for euthanasia.
Right To Life UK spokesperson Catherine Robinson said “It is disappointing that the RCS has adopted a so-called ‘neutral’ position on assisted suicide, when less than 10% of their members signalled their support for the legalisation of assisted suicide. This will be seized on by assisted suicide campaigners to claim that a move to ‘neutrality’ signals it is time we made assisted suicide legal”.
