The RCN has a neutral position on whether the law on assisted dying should be changed, reflecting our members' differing views on the issue. But this does not mean we’re silent, the Scottish Bill includes a key role for registered nurses (which is different to the UK Bill).

We therefore have a responsibility to ensure the Bill contains the necessary safeguards to protect nurses and nursing practice. We are working to protect both nurses who may wish to participate in assisting a death under the framework established by the Bill, and those who may not wish to participate. 

Notwithstanding our neutral position on whether assisted dying should be legalised, our position is that the Bill does not sufficiently protect nursing staff. Amendments are needed to the Bill to ensure that, if it is passed by MSPs, nurses are adequately protected. As well as protecting our individual members, we are also mindful of the need to ensure that, if the Bill passes, it results in a high-quality service which does not have a negative resourcing impact on existing, and often struggling, nursing services.

The Bill establishes the role of the “authorised health professional” (AuHP) who, on the day of the assisted death, may provide an eligible individual with an approved substance which they will take to end their life. Registered nurses can take on the role of AuHP if authorised by the doctor who is coordinating the process. This is a different approach to the UK Bill, which provides that only the coordinating doctor, or another doctor they authorise, may provide assistance.

When acting as an AuHP, a registered nurse would be required to undertake a final assessment of the individual’s capacity and be satisfied that they have not been coerced, before providing the individual with the substance. Again, this is a role that would be undertaken by a doctor under the UK Bill.Once satisfied that the individual has capacity and is acting voluntarily, the registered nurse would provide the individual with the approved substance and remain with them until they decide whether to use it and, if so, until the individual has died.

The Bill contains a clause stating that no individual is under any duty to participate in anything authorised by the legislation to which they have a conscientious objection. 

Providing someone with assistance to end their life will require time, in order to provide individuals, and their families, with the necessary care, support and respect. Therefore, in practice, it is likely that registered nurses will in most cases take on this role. Liam McArthur MSP has acknowledged this point when he highlighted that in Australia, over time, nurses have tended to become increasingly involved in the process instead of doctors. 

While the creation of the AuHP role is the most explicit way the Bill will impact registered nurses, we can envisage other ways the legislation will impact nursing roles. For example, nurses may be asked to accompany a doctor when providing assistance, in order to provide end of life care, or may be asked to take on a role coordinating the provision of services locally.