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Keep Assisted Dying Out of Healthcare

Assisted Dying and the Role of Mainstream Healthcare

KADOH provides evidence on why assisted dying should be separate from mainstream healthcare

Keep Assisted Dying Out of Healthcare

FAQs

Some healthcare professionals are firmly set in their views for or against legalising assisted dying. However, if assisted dying were to be legalised, there are many healthcare professionals who are deeply concerned about the danger to patients of embedding assisted dying in healthcare, and the considerable impact such proposals would have on their team, their service, and the NHS.

Doctors are trained to share decisions with patients, explain what treatments can work, make clear any risks, and share important decisions with a multidisciplinary team who ensure the decisions are recorded and monitored. Excpet for immediate emergencies, doctors are not trained to make life or death decisions in isolation. In addition, few doctors are trained or have experience in detecting manipulation, coercion and abuse.
This contrasts with medically assisted dying where doctors make decisions in isolation with no monitoring and are rarely reviewed.

All jurisdictions that allow assisted dying, monitor a few cases after the patient has died and only if the doctor has declared the death formally. In some jurisdictions between a fifth and nearly half of assisted deaths are never reported. In addition, it is the same doctors who provide the only data to inform practice.

A socio-legal panel would include a minimum of a healthcare professional (with at least 10 years experience of end-or-life decisions), a social worker and/or psychologist with at least 10 years experience that includes detecting coercion and manipulation, a legally accountable lawyer with at least 10 years experience and an administrator to record the decision-making process. The panel could request further advice and reports if needed and could travel and respond to urgent cases.

If a socio-legal model was adopted, the UK would be the first country in the world to evaluate the individual’s request from a wide clinical, legal and social perspective. It would approve assisted dying in advance of the death, and monitor each decision. This would make it the safest assisted dying jurisdiction in the world.

Yes, but only about the patient’s medical condition. Doctors already write reports on many clinical issues.
If the socio-legal model was adopted there would be a statutory separation between those assessing  the assisted dying request and those enabling the assisted death. 

There are mechanisms that would allow drugs to dispensed without a doctor, if this was approved by the socio-legal panel.

Assisted dying is not a medical treatment and the majority of doctors do not want to participate, even if they agree with its legalisation. Only 1-2% of doctors in Canada, Oregon and Australia take a direct part in assisted deaths.

On the contrary.
Having the socio-legal panel decide on eligibility frees healthcare professionals to focus all their efforts and resources on caring for patients throughout their life, including providing bereavement care for relatives afterwards.

A socio-legal model would need an assisted dying authority to oversee the appointment of the panels, monitor decisions and ensure good practice.
This could be modelled on the Parole Board which also has multi-disciplinary panels to make important clinical, legal and social decisions. Overall costs would be similar, but because of savings in care a socio-legal model would be cost-neutral.

No.
All decisions would be made by the socio-legal panel.
If the panel does not feel able to make the decision then this would be referred to the courts, in the same way that difficult clinical decisions are already referred.

The statutory assisted dying authority would appoint navigators who would liaise with non-profit providers. The providers would be registered and approved by the statutory authory. They could be existing assisted dying charities.

Any members of assisted dying provders would not be allowed to have any links with the assisted dying authority or socio-legal panels and vice versa.