New guidance on assisted suicide from the Royal College of Nursing

shutterstock_50920687 nurse and elderly patient holding hands

Assisted suicide generates debate on a variety of levels – ethical, moral, religious, spiritual, political, cultural, psychological, professional and legal. It is an issue that affects the nursing workforce, both as individuals and as health professionals.

Most people who are approaching the end of their lives in the UK do not ask a health professional to hasten their death, but a minority of individuals do express a readiness or desire to die. Nurses and health care assistants (HCAs) are often the members of staff that patients, and their families and carers, feel comfortable enough to approach and express a desire to actively hasten death. However, such requests can provoke concern for nurses and HCAs as they determine how best to respond professionally and compassionately and continue to support patients in their ongoing care.

This guidance has been developed to support nurses, HCAs, and other health professionals in adult practice who may be asked by patients, or their families or carers, to become involved in assisting suicide. It covers the law on assisted suicide in the UK, as well as the law on advance decisions.

The publication includes information on when and why people express a wish to die and guidance on professional accountability and end of life care, with frequently asked questions to help health professionals respond in such circumstances. It also includes details of further resources available to improve end of life care practice.

Royal College of Nursing Executive Director of Nursing and Service Delivery Janet Davies said:

It’s really important to emphasise that this guidance in no way encourages nurses to raise the issue of assisted suicide with patients, as assisting a suicide remains illegal. However we know that there is a real need to provide support to nurses and healthcare assistants when patients talk about or hint at ending their lives or hastening their deaths.

There are patients who talk about ending their lives as another way of expressing concerns about their condition or their level of pain. Nurses shouldn’t feel that asking them about these comments is giving the impression that they are assisting or encouraging that patient to take their own life. Such conversations might be the only time a patient discusses their worries, and it is an essential part of professional nursing practice to recognise and explore concerns with each and every patient where possible.

When someone asks for your assistance to die: RCN guidance on responding to a request to hasten death (PDF). Royal College of Nursing, 19 Oct 2011.

Nurses will be given new guidance on assisted suicide (audio). BBC News, 20 Oct 2011.