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RCN guidance on assisted dying

more: Medical Opinion, Opinion, Medical Opinion/Opinion

15th May 2009

Two key questions that require answers...

Two key questions that require answers...

The Royal College of Nursing, which has been meeting this week in Harrogate, is planning to issue 'guidance' to nurses on the subject of assisted suicide. This will, according to General Secretary Peter Carter, 'make it clear what advice nurses can give in these situations'. There has been, we are told, 'a surge in requests from seriously ill patients and their relatives for information about assisted suicide'. The guidance, says Mr Carter, 'would include guidance on the current law and would keep the nurse up to date with the relevant mental health and end of life care available for someone who is deemed suicidal'.

All this seems reasonable enough, but there are two questions that are left hanging in the air. Why should there be 'a surge' in requests for information about assisted suicide at this time? And why, as is reported, is the RCN planning to postpone the issue of its guidance until after the conclusion of its current consultation with members on the subject of assisted suicide?

It is not entirely surprising that people are becoming more worried about dying and death these days. Over the last year or two they have been subjected to a veritable barrage of 'human interest' stories about seriously ill people ending their lives, often accompanied by the clear but unfounded sub-text that the law is keeping people alive against their will. These messages come not only from Philip Nitschke ('Dr Death') and his 'suicide testing kits' or from Ludwig Minelli, who proclaims that suicide is 'a marvellous possibility for a human being'. They emanate also from our home-grown euthanasia lobby, which is attempting as we write this to sabotage a Government Bill (the Coroners and Justice Bill, now before Parliament) designed to increase protection for vulnerable people against being encouraged or assisted to commit suicide, by trying to create loopholes to legalise it.

Part of the campaign is to heighten public anxiety about death and dying as a preliminary to persuading worried people to support a change in the law to give them what are euphemistically being called 'choices' or 'options'. Assisted suicide is being presented as an 'insurance policy', in much the same way as unscrupulous salesmen prey on the fears of householders to take out insurance that they don't really need. The fears, that many people already have about becoming chronically or terminally ill, need rather to be allayed by careful and sensitive exposition of the facts, putting these fears in proportion, not by media hype presenting exceptional cases as typical.

Nor is it clear why, if the RCN considers that its 'guidance' is necessary, its issue should have to wait until the results of the College's consultation on assisted suicide are known. What possible link could there be between the two exercises? It is not as if the content of the guidance could depend on the result of the consultation. The law on assisting suicide will not depend on that, nor will the knowledge that nurses need to have in order to deal with potentially suicidal patients. It is to be hoped that this postponement is not planned in order to give what should be impartial and objective guidance for nurses a political spin. The Department of Health has already said that there is currently no advice to nurses on 'on something (assisted suicide) that is illegal'.

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