The Royal College of Nursing has become the only major medical institution to drop its opposition to assisted suicide to neutral meaning. It now says that it will neither support nor oppose a change in the law.
The Royal College of Nursing (RCN), Britain’s leading nursing union representing 400,000 members, is the only one inside the medical profession to have the change of policy in relation to assisted suicide. The shift comes as the Populus survey for The Times showed public support for a change in the law to allow doctors to help terminally ill people end their lives.
The consultation on the issue reached 175,000 of RCN members and of the 1,200 responses, although the majority supported assisted suicide the margin was very narrow so after discussion the Council switched to a neutral position. Nine per cent of respondents were neutral, 40 per cent opposed assisted suicide and 49 per cent supported it, with one per cent not recording a position, The Daily Telegraph reports.
RCN chief executive Dr Peter Carter said:
‘The split in responses shows that there is no overwhelming support among nurses for either opposing or supporting a change in the law.
‘We fully support the common themes that came through the consultation, namely maintaining the nurse/patient relationship, protecting vulnerable patients and making sure there is adequate investment in end-of-life care.’
He said the shift to the neutral stance would allow nurses who were asked about it to engage in dialogue with patients but added:
‘That must not be confused with us being proponents of assisted suicide.’
The decision comes weeks after doctors in the British Medical Association voted against backing legal reforms to allow families to assist suicides.
However, Christian Nurses and Midwives (CNM) stated the shift in RCN’s policy would send ‘the wrong signals to the vulnerable’.
Steven Fouch, the CNM secretary, questioned whether the college should have altered its position based on the views of a relatively small number of its members. He said:
‘While we welcome the consultation process, by the RCN's own admission, only half its membership were reached, of those less than 1% responded, and less than half of those expressed a desire to shift policy either in favour or towards neutrality.
‘It’s probably about 600 members who’ve actually stated publicly that they’d like to see a change in the law, so it's impossible to say if that's representative of what the Royal College's members actually feel and believe.
He said that the CNM did not believe that the profession should step back from actively opposing changes to the law.
Vicky Robinson, a consultant nurse who looks after terminally ill patients, said:
‘The public now will see, with the Royal College of Nursing having changed its stance on this issues, that nurses perhaps will be more comfortable in having these discussions with them, when in fact we are not prepared at all.
‘I see my professional body as the body that is responsible to uphold the law of the land. To say that they now are neutral based on less than one per cent of the vote from its members, I think is a political act. It leaves me very, very cold and worried about what is going on in RCN council.’
(See the Daily Telegraph article of nurses Vicky Robinson and Ray Greenwood)
Dr Peter Saunders, of Care Not Killing said:
‘This move is really quite bizarre. The number of respondents, 1,200, represents less than one third of 1 per cent of the RCN’s 390,000 members and we are told that less than half were even reached by the consultation.
‘This is surely no basis for a shift in the stance of the RCN in this highly controversial issue.’
Melanie Phillips, a columnist for Daily Mail and correspondent for The Spectator, said in relation to the RCN’s policy shift:
‘People’s deepest fears are being manipulated to make a change in the law to permit assisted suicide appear virtually inevitable. Although all poll results must be taken with a pinch of salt, it isn't surprising that the numbers supporting such a change have risen.
‘For this relentless campaign has played ruthlessly upon the nightmarish possibility of having to face dreadful suffering without being able to end it. Few of us are entirely free of such fears; those who have distressing medical conditions may understandably be terrified of such a prospect.
‘However, it is not necessarily founded in medical fact.’
She said that the change would ‘send us down a slippery slope, which could lead all the way from assisted suicide to euthanasia by lethal injection, from helping the terminally ill to end their lives to killing people suffering from Alzheimer's or depression’.
(See the Daily Mail commentary)
Lady Campbell, speaking at the recent debate on Lord Falconer's amendment to the law in the House of Lords, warned:
'Those of us who know what it's like to live with a terminal condition are fearful the tide has already turned against us.'
Assisted dying, she said, was 'to abandon hope and ignore the majority of disabled and terminally ill people'.
(See Daily Telegraph report)
In 2004, RCN rejected the legalisation of assisted suicide and active voluntary euthanasia. It then said that a consultation of its members had received an ‘overwhelming response’ opposing Lord Joffe’s Assisted Dying for the Terminally Bill and ‘reaffirm[ing] the core principles which lie at the heart of nursing: valuing life and ensuring patients are well cared for.’ (emphasis added). The College condemned the notion that some lives were ‘not worth living’.
(See Medical News report)
In 2005, the British Medical Association (BMA) had also dropped its opposition to assisted suicide after a debate at its annual representatives meeting, but switched back the following year after a backlash from appalled members. BMA said the law should remain as it and refused to back calls to lift the threat of prosecution from friends and relatives who accompany loved ones abroad to die.
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On 27 July 2009, immediately after the RCN's decision, the Nursing & Midwifery Council (NMC) has responded in strong terms. The NMC recognised that assisted suicide is an important and emotive issue for healthcare professionals and for members of the public. However, it said that as the statutory regulator for nurses and midwives, its core purpose is to safeguard the health and well-being of the public.
(See Medical News report)
It said that the NMC's statutory duty is to remind nurses and midwives that they must practice within their Code of Professional Conduct and within the context of national laws. The law does not allow assisted suicide. Currently, aiding and abetting suicide is a crime punishable by up to 14 years' imprisonment.
Kathy George, NMC Chief Executive & Registrar, said commenting on the RCN's decision:
'Despite the RCN's move to a neutral position on assisted suicide, nurses and midwives are personally accountable for their actions and must act lawfully at all times. This is clearly stated in their code of professional conduct. Assisting the suicide of a patient is against the law'.
RCN is now planning to meet Scottish pro-euthanasia MP Margo MacDonald to discuss proposals on legalising assisted suicide. Ms MacDonald, who has Parkinson's disease, is planning to introduce a bill to legalise assisted suicide in Scotland in the autumn.
(See the Guardian report)
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