RCN launches guidance for nurses on assisted suicide
Published: 20 October 2011
The RCN today (October 20) launched new guidance for nurses and healthcare assistants on how to respond requests from patients related to assisted suicide.
The guidance, When someone asks for your assistance to die: RCN guidance on responding to a request to hasten death, sets out the legal position for healthcare workers. The document reinforces that assisting a suicide is illegal but also provides practical examples of how to deal with difficult conversations and deliver good quality end of life care.
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.”
The guidance covers the legal situations in England, Scotland, Wales and Northern Ireland, where assisting another person to commit suicide is an offense. The guidance draws on the experiences of nurses working in all areas of care, and was commissioned by RCN Council in 2009. The guidance aims to support the relationship between patients and nurses and protect the vulnerable.
Topics covered by the guidance include –
• The law on assisted suicide in England, Wales, Northern Ireland and Scotland
• The law on advance decisions
• Sources of information on high quality end of life care
• Reasons why people may express a wish to die
• Responding to a request to hasten death
• Scenarios nurses may encounter and suggested responses
Janet Davies added:
“The RCN has worked with nurses in all fields, experts in medical ethics and legal advisors to be sure that this guidance is clear and comprehensive and that by working with it, nurses can improve their practice and perform their important roles in delivering excellent end of life care to patients and their families. There is more than just kindness in delivering personalised, compassionate care, and nurses working in all areas of care would benefit from having the confidence and expert knowledge to deal with these scenarios.
“There is only one chance to get the care right at the end of someone’s life, and nurses have to be empowered to give compassion in the right way and recognise that each individual has complex physical and emotional needs. The unique position of nurses, spending time with patients and families in all healthcare settings, means that they are the ones who can really explore the feelings of both patients and families.
“Being able to respond to the need for reassurance, realistic information and good pain relief is at the heart of letting any patient have a good death. However, nurses need help to communicate with patients and families so that everyone is clear what treatment and care is part of dignified palliative care, and that the intention of those caring for people is clear when pain relief is administered.
“More than anything, what nurses want to see is a situation where they are able to provide dignified end of life care, where concerns about pain, suffering or loss of control can be discussed and managed. For this to happen, end of life care has to be prioritised and patients should expect the same level of dignified and expert care wherever they die.
“We also know that the experience of patients and families can be improved at a distressing time where people discuss their wishes in advance in terms of what treatment should be offered towards the end of life. By adopting the approaches outlined in this guidance, nurses can help patients to discuss and explore their feelings, a crucial element of nursing, without being concerned that their actions will be misinterpreted.”
The RCN’s guidance will be available for download from October 20th at www.rcn.org.uk/publications
Ends
Notes for Editors
1. RCN Council voted to move to a neutral position on assisted suicide in 2009. This means that the RCN does not lobby for or against a change in the law in relation to assisted suicide.
2. For further information, interviews or illustrations please contact the RCN Media Office on 0207 647 3633, press.office@rcn.org.uk or visit http://www.rcn.org.uk/newsevents/media
3. The Royal College of Nursing (RCN) is the voice of nursing across the UK and is the largest professional union of nursing staff in the world. The RCN promotes the interest of nurses and patients on a wide range of issues and helps shape healthcare policy by working closely with the UK Government and other national and international institutions, trade unions, professional bodies and voluntary organisations