One of the most significant topics in health care right now is the issue of assisted dying. In England and Wales, the Terminally Ill Adults (End of Life) Bill – or the ‘assisted dying bill’ as it’s more commonly known – is currently progressing through the UK Parliament.

The topic is garnering considerable public discussion with MPs soon to vote again on the bill on 16 May. Different legislation is also progressing in Scotland where MSPs are scheduled to vote on the broad principles of the Scottish bill on 13 May, while separate legislation is also progressing in Jersey and the Isle of Man. On the Isle of Man following a vote at the House of Keys in favour of the bill, the bill can now be sent for Royal Assent. This means that the Isle of Man could be the first place in the British Isles where assisted dying will be made available to residents.

The RCN holds a neutral position on the subject of assisted dying which allows us to represent and support all nursing staff, no matter what their views on the subject are. Despite this, we continue to work on influencing legislation across the UK to ensure that should it become law, nursing staff and their views are represented and that any change of policy is workable practice. A debate of this magnitude would be lacking without the insight and expertise of nursing.

We want to ensure that nursing staff, patients and the public are protected by any legislation with the implementation of appropriate safeguards. This is essential to maintaining public trust and confidence in both the health care profession and end-of-life care. This is why the RCN’s General Secretary and Chief Executive Nicola Ranger appeared in front of the parliamentary committee to give evidence about the changes we want to see in the bill that applies to England and Wales, while RCN Scotland Director Colin Poolman gave evidence in Scotland.

Nicola spoke about our recommendations, including the need for nursing leadership to be formally recognised within the governance structures of the bill. She made the case that the Chief Nursing Officers should have a clear role in shaping the guidance that will underpin the bill’s implementation.

Professor Nicola Ranger also highlighted the bill’s failure to ensure that nursing staff receive appropriate training. She argued that without adequate preparation, nurses could face difficult ethical and practical challenges in supporting patients and families.

In addition, the RCN’s Chief Nursing Officer, Lynn Woolsey, and the RCN’s policy and public affairs department have met with the bill’s proposing MP, Kim Leadbeater - as well as bill committee members who oppose assisted dying - for more in-depth discussions on what the proposals could mean for nursing policy. Further key elements raised included nursing leadership, nursing governance and the role of nursing staff as the constant presence for patients.

Nursing staff can read a full explainer about the bill in England and Wales and the RCN’s recommendations, as well as information about the separate bill in Scotland here. In Northern Ireland, assisting someone to die is a crime, and there is no proposed legislation to change this.

Whatever the outcome of the bill, we know that nursing staff have, and will continue to have, a truly unique role in end-of-life care – which is why we are updating our guidance and support resources regarding end-of-life care and assisted dying.

Nursing staff are the backbone of health care, often spending the most time with patients and their families, being the point of contact to listen to questions or concerns. Nursing staff create and develop therapeutic relationships with patients, enabling open and honest conversations about care preferences, prognosis and patient priorities.

This is in addition to everyday care delivery for patients who are at the end-of-life stage, including pain management, physical and emotional care, family care, and ensuring privacy and dignity for patients. It is vital that nursing staff get the support they need in order to play this key role.

Work is currently ongoing to update our resources which will be available in a digital format later in the year. These will outline the current law on assisted dying as well as exploring when and why people express a desire to die, as well as guidance for nursing staff on responding to a direct request from a patient about assisted dying.

Whatever role and setting you work in, conversations about the end of life are likely to arise at some point in your practice. The increased focus on future and advance care planning at the end of life - and wider public awareness of the need to think ahead about such issues - means you may find these types of conversations happening more often.

We want our members to feel supported and have the knowledge on how to communicate effectively with patients and also know where they stand in terms of the law.