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Thu, 29 October 2020

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RCGP members issue legal challenge to Council’s ‘unrepresentative’ and ‘irrational’ decision on assisted dying

Dignity in Dying

6 min read Partner content

Doctors challenge RCGP Council’s decision to remain opposed to assisted dying despite majority support for a change in stance and huge shift in members’ views.

Two eminent members of the Royal College of General Practitioners (RCGP) have today issued a letter calling for the RCGP Council to review its decision to maintain its opposition to assisted dying. The Council’s decision was taken in February this year despite a clear change in the views of its members and a majority of responses to a membership survey demanding the College change its position.

Professor Aneez Esmail and Sir Sam Everington, high-profile members of the RCGP, have alongside the Good Law Project, issued a legal challenge that raises serious concerns that the decision taken by the Council at their meeting on 21st February 2020 was “irrational, failed to take into account relevant factors and took into account irrelevant factors”. The legal challenge has been prepared by solicitors at Bindmans LLP with support from Dignity in Dying.

The RCGP’s Council agreed in June 2019 to survey its members for their views on what position the College should take on the issue of assisted dying and “to assess whether [members’] views have shifted”. A previous survey in 2013 found that 77% of RCGP members preferred the College to oppose assisted dying. The 2019 survey – the largest ever conducted by the RCGP on an issue of public policy –  saw a dramatic change in members’ views, with just 46% agreeing the College should maintain its opposition. Meanwhile doctors who wanted the College to support a change in the law jumped from just 5% in 2013 to 41% in 2019, with 10% preferring the College to take a neutral position.

A poll of 1000 GPs carried out by medeConnect and released today reveals that most GPs believe that the College should not oppose legalisation. When presented with the assisted dying survey results 38% of GPs said the College should now adopt a neutral position on law change, with 20% saying it should support it. Just 35% agreed with the Council’s decision to retain a position opposed to legalisation

Professor Aneez Esmail said: “The RCGP Council’s decision to remain opposed to assisted dying goes against the views of its members and goes against the entire purpose of asking their members at all. The survey was intended to find out if RCGP members had changed their views since 2013 and there is undeniable evidence that they had. Those who backed the College’s position dropped by almost half, alongside an eight-fold increase in those who wanted the College to support a change in the law. If that doesn’t represent a shift in views, what on earth would?

“Promises were made to members and to the RCGP Council that the survey responses would be robustly analysed and compared with previous surveys, but we are now told that the 2013 and 2019 surveys are incomparable. To ignore the express, stated purpose of the survey in favour of maintaining a status quo supported by only a minority of members is unacceptable.

“We have tried to raise these concerns with the RCGP through Council members but have been stonewalled at every turn. Regrettably, we have been left with no alternative but to seek a legal resolution to ensure the College’s leadership does not maintain this unrepresentative stance. The profession deserves a body that represents their views, rather than ignores them.

“Today’s poll shows most GPs disagree with Council’s decision on this issue, giving further evidence that the Council’s decision was out of touch. It’s time for the College to reconsider its unrepresentative position, listen to the membership and adopt a neutral position so that they can truly represent their members and GPs’ views as a whole.”

Sir Sam Everington said: “Perhaps the most worrying thing about the RCGP’s survey has been the lack of transparency in the decision-making process. Far from being straight with their members, the RCGP has resisted every step of the way to explain why they have shifted the goalposts or why their full analysis has not been published.

“We have also found out that a steering group was set up to analyse the results and no details have ever been published about the membership of that group, how they were chosen, their remit, or the reasons for their recommendations.

“All of us in general practice face the most challenging times we have ever known and we need more openness and accountability from our representative body. It is imperative that the leadership at the RCGP gets its house in order, listens to the voices of its members and revisits this undemocratic decision. GPs deserve better than a defensive, opaque establishment that protects a harmful status quo at all costs and without justification.”

Jolyon Maugham, Director of Good Law Project said:  “The RCGP’s decision to ignore the views of the majority of its members does raise real questions around its governance. The lack of transparency around how it came to this decision, and who precipitated it, is further cause for alarm.  As it seems to me, the RCGP is failing in its obligation fairly to represent the views of its members on assisted dying. This issue is one of profound importance, and I do hope it revisits the decision urgently.”

Sarah Wootton, Chief Executive of Dignity in Dying, said: “We know that medical opinion is changing and the RCGP’s own survey has proved that. It’s time for representative bodies to actually represent the diversity of their members’ views. Neutrality is the only right position for medical bodies to take on the subject of assisted dying, allowing them to contribute their expertise to the debate in a balanced way and ensuring that all of their members’ beliefs can be represented, not just the vocal minority who oppose any change in the law. What is the point in asking doctors for their views if they are going to ignore the results?

“All around the world, whether in the USA, Australia, Canada or likely in New Zealand later this year, we have seen that safeguarded, legal assisted dying can be introduced safely. Doctors who do not wish to take part can exercise their conscientious objection, while doctors who respect their patients’ wishes to take control of their deaths can do so under a robust and compassionate law. It is time for the RCGP to listen both to their members and to patients who want a grown-up conversation about assisted dying, not simply avoiding the argument and maintaining their monolithic opposition.”

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