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GMC guidelines on end-of-life decision making are a welcome development for patient choice and control, but avoid critical question around helping patients to die

The General Medical Council (GMC)
has today launched guidelines for doctors on how to treat and care for patients
who are approaching the end of their lives. These guidelines
comprehensively cover how doctors must approach legally binding Advance Decisions
to refuse treatment at the end of life, but fail to address how doctors should
respond to terminally ill patients’ requests for help to die, if they are
suffering at the end of their lives.

Sarah Wootton, Chief Executive of
Dignity in Dying said:

“By placing the patient at the
heart of the decision making process, these guidelines will be a welcome
development for greater patient choice at the end of life. They make it
clear that not only shoulddoctors respect patient’s end-of-life decisions, but they must adhere to valid
Advance Decisions to refuse treatment at the end of life.

“A study of end-of-life decision
making found that in just under 3,000 cases, over a third involved the
decisions where the doctor’s expectation or intention was to hasten the end of
life by withholding or withdrawing treatment or by giving pain relief.[1] In these situations it is
crucial that the framework set out in the GMC guidelines is in place to ensure
that, wherever possible, the patient’s wishes are at the centre of the
decisions made.

“However, the same research has
also found that one in ten people requested help from their doctor to hasten
their death1. The GMC’s guidelines fail to address this issue
for either health professionals or their patients. Following Debbie Purdy’s
legal victory, the Director of Public Prosecutions (DPP) issued prosecution
guidance on assisted suicide, and made it clear that explaining the law on
assisted suicide and legal options at the end of life was not considered
encouraging or assisting a suicide. The guidelines need to go further and
advise doctors on how to react to this specific request, with sensitivity and
within the constraints of the current law, given that there is no doubt they’ll
be asked.”

Dr Ann McPherson, Dignity in
Dying Patron, former GP and cancer patient said:

“The guidelines need to address
the issue of assisted dying. As a GP I have been asked on several
occasions to help people to die, and we should be able to talk to patients
about their options at the end of life without contravening the law.”


Notes to

About Dignity
in Dying:

  • Dignity in Dying campaigns for greater choice,
    control and access to services at the end of life. It advocates providing
    terminally ill adults with the option of an assisted death, within strict
    legal safeguards, and for universal access to high quality end-of-life
  • Dignity in Dying has over 25,000 supporters and
    receives its funding entirely from donations from the public.
  • Surveys consistently show that at least 80% of
    the UK population supports a change in the law on assisted dying.


  • The guidance will come into effect from 1 July

Compassion in

Compassion in Dying provides
Advance Decisions free of charge at:


For all media enquiries, please
contact Jo Cartwright on 020 7479 7737 / 07725433025 or at

[1] Seale C
(2009) Hastening death in end-of-life care: A survey of doctors Social Science & Medicine69(11): 1659-66