What are the key current issues, what do you need to know, and what can you do?

Westminster

Immediately on the heels of three successive sets of 'assisted dying' proposals being put before the House of Lords - where they have failed to make headway - Labour MP Rob Marris, having won the Commons Private Members' Bills ballot in the Commons, brought Lord Falconer's bill before MPs. Following the first legislative debate on assisted suicide in the lower house for 18 years, MPs rejected the Assisted Dying (No. 2) Bill by a massive 330-118 on 11 September.

Senior physician Baroness Finlay's Palliative Care Bill was drawn 9th in the Lords 2015-16 bill ballot, and Care Not Killing looks forward to supporting her efforts to improve access to palliative care.

Access to Palliative Care Bill [HL] 2015-16

Courts

A judicial review of the Director of Public Prosecutions' decision to amend her guidance for assisted suicide prosecutions was allowed to go forward on 28 April.

Poor care

Requests for euthanasia and assisted suicide are extremely rare when patients' needs, including physical, social, psychological and spiritual needs, are properly met. Building on the excellent tradition of palliative care that we have in this country and making palliative care more readily accessible to all who need it are of the greatest importance, and poor practice must be identified and improved.

Concerns relating to to a current care issue are often best put through your GP, who will best understand the personal and local factors in the case, and who is best placed to make contact with the necessary individuals or bodies. Complaints regarding poor care should, according to the seriousness and circumstances of the case in hand, be directed to the relevant employer or health trust, to the General Medical Council (regarding doctors), to the Nursing and Midwifery Council (regarding nurses and midwives) or to the Care Quality Commission. You can also seek to bring further attention to instances of poor care by contacting the Department of Health, your MP or Members of the House of Lords.

Maintaining medical opposition

Healthcare professionals have consistently been opposed to legalising practices which their experiences tell them are uncontrollable, unethical and unnecessary. None of the major medical bodies have contradicted this view and a change in the law is formally opposed by the British Medical Association, the Association for Palliative Medicine, the British Geriatric Society, the World Medical Association and the Royal Colleges of Physicians, General Practitioners and Surgeons of England. Only the Royal College of Nursing is officially neutral, while the Royal Colleges of Psychiatrists and Physicians of Edinburgh have specifically declined to state a position.

Medical opposition has been frequently reaffirmed as the threats to vulnerable people and the medical profession which serves them loom larger. Recent examples include the RCP in 2010, the BMA in 2012 and the RCGP in 2011 and 2014, when 77% of respondents to "one of the most comprehensive consultations the College has ever undertaken" favoured maintaining collegiate opposition. Such opposition must be maintained.

Media bias

Media outlets have access to people's homes and lives on a daily basis, and have a responsibility to portray serious issues such as these with impartiality and caution. Yet all too often, publishers and broadcasters happily give a free platform to campaigners for legal change (for example...) and high-profile advocates within the media use their abuse their position (for example...), while contempt shown for guidelines laid down by major health bodies like the World Health Organisation and the Samaritans to guard against suicide contagion - the 'Werther effect' - extends to drama and fiction (for example...). Some do better than others, as with ITV's treatment of the issue in 2011; they were strongly advised to aim for a similar balance in a January 2014 Coronation Street storyline. The BBC, on the other hand, has consistently failed to present euthanasia and assisted suicide with the objectivity required of a national broadcaster. From news anddocumentaries to soap, drama and comedy, the Corporation has justifiably been called a 'cheerleader for assisted suicide'.

If you consider a portrayal or report about assisted suicide, euthanasia or other end of life issues to be biased or in breach of media guidelines, you can complain to the broadcaster (e.g. BBC) or newspaper; to regulators like Ofcom; or to your MP or Members of the House of Lords (especially where the bias concerns the license fee payer-funded BBC). Social media is a useful way of engaging with others during or shortly after a broadcast or as soon as a media story has been published. On Twitter, be sure to include our handle: @CNKAlliance.

Liverpool Care Pathway

Despite successive audits demonstrating that the vast majority of those who have been placed on the pathway when hours or days away from death benefited from the relief of symptoms such as pain, anxiety and nausea, serious failings and abuses in the application of the protocol have become increasingly apparent. CNK, like many major healthcare organisations (including the BMA) and individual healthcare professionals, has defended the purpose and principles of the Pathway while identifying flaws in its application, and we have been a party to high level discussions on its future. The Neuberger Review established by the Government reported in July 2013, and a new Leadership Alliance (LACDP) has been established to respond to the Review's conclusions. The consultation concerning proposed outcomes and guiding principles for a successor protocol run by the LACDP (read CNK's submission) closed on 31 January 2014, and resulted in a new approach focusing on 'Five new Priorities for Care'.