A forum within the Society for debate on ethical and legal issues. It informs BGS policy on matters such as Deprivation of Liberty (DoLs) and assisted dying.
BGS Position Statement on Assisted Dying
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"paragraphs_type" ] ] "status" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "created" => array:1 [ 0 => array:1 [ "value" => "1732183104" ] ] "parent_id" => array:1 [ 0 => array:1 [ "value" => "52804" ] ] "parent_type" => array:1 [ 0 => array:1 [ "value" => "node" ] ] "parent_field_name" => array:1 [ 0 => array:1 [ "value" => "field_main_content" ] ] "behavior_settings" => array:1 [ 0 => array:1 [ "value" => "a:0:{}" ] ] "default_langcode" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "revision_default" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "revision_translation_affected" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "field_admin_label" => [] "field_body" => array:1 [ 0 => array:2 [ "value" => """ <h2 class="sidebar-nav">Introduction</h2>\r\n \r\n <p class="larger-text">This statement sets out the BGS position on assisted dying (AD), our priorities for end of life care, and our concerns that effective legal safeguards cannot be created to protect older people from unwarranted harms.</p>\r\n \r\n <div>We urge government caution in proceeding with legalisation and assert our expectation to contribute meaningfully to the development of any future law on assisted dying.</div>\r\n \r\n <div> </div>\r\n \r\n <div>We have supported our statement with detail on rationale, clarifying our use of terminology, our stake holding, how we developed our position and setting out the results of a member survey on assisted dying. We have also set out our views on the importance of personalised care, alternatives to assisted dying, de-medicalisation of dying, conscientious objection, respect for patient autonomy and medical paternalism.</div>\r\n \r\n <h2 class="sidebar-nav">The BGS position on Assisted Dying</h2>\r\n \r\n <div>\r\n \t<table border="1" cellpadding="1" cellspacing="1" style="width:500px;">\r\n \t\t<tbody>\r\n \t\t\t<tr>\r\n \t\t\t\t<td>\r\n \t\t\t\t\t<ol class="larger-text">\r\n \t\t\t\t\t\t<li>The BGS is <strong>opposed </strong>to the legalisation of Assisted Dying in the UK and Crown Dependencies for the reasons outlined in this position statement.<br />\r\n \t\t\t\t\t\t\t </li>\r\n \t\t\t\t\t\t<li>The BGS urges parliamentarians, government and legislators to remain cognisant of the <strong>significant diversity of views on this issue for older people</strong>, and to maintain <strong>diligent focus on the needs of older people</strong> in proceeding with the legalisation of Assisted Dying in the UK and Crown Dependencies.<br />\r\n \t\t\t\t\t\t\t </li>\r\n \t\t\t\t\t\t<li>Many of our members are <strong>not confident that effective legal safeguards could be developed </strong>to protect older people from unwarranted harms.<br />\r\n \t\t\t\t\t\t\t </li>\r\n \t\t\t\t\t\t<li>In taking this position, we acknowledge that a <strong>significant minority of our members are supportive </strong>of the legalisation of Assisted Dying in the UK.<br />\r\n \t\t\t\t\t\t\t </li>\r\n \t\t\t\t\t\t<li> We also recognise that many of our members are undecided, and that members’ attitudes may shift over time.<br />\r\n \t\t\t\t\t\t\t </li>\r\n \t\t\t\t\t\t<li>We recommend that any future UK law on Assisted Dying should <strong>support explicitly any healthcare professionals who object conscientiously</strong> to direct participation in Assisted Dying.<br />\r\n \t\t\t\t\t\t\t </li>\r\n \t\t\t\t\t\t<li>We are committed to reviewing our position statement on a regular basis, either in the event of a change in law in the UK or in three years (2027), whichever comes first.</li>\r\n \t\t\t\t\t</ol>\r\n \t\t\t\t</td>\r\n \t\t\t</tr>\r\n \t\t</tbody>\r\n \t</table>\r\n \r\n \t<h2 class="sidebar-nav">Health and social care context</h2>\r\n \r\n \t<p class="sidebar-nav">Context is highly important to all patient choice and professional decision-making.<sup>1-3</sup> This is no different when considering the issue of Assisted Dying. The current state of care services for older people and wider societal attitudes and behaviours towards them can therefore be expected to impact on the views of patients, their families and professionals on this issue.</p>\r\n \r\n \t<p class="sidebar-nav">Notwithstanding the many exemplary services and examples of good care for older people, the overall picture is one of under-resourcing of health and social care, including the provision of specialist and generalist palliative care.<sup>4,5</sup> In the worst case, the lack of older people’s service resourcing has led to neglectful care in some settings, including abuse<sup>6</sup> and societal negativity about ageing.<sup>7</sup> Together, these factors can be expected to influence the decision-making and choice of older people, especially towards the end of their lives, but also in ways that may be difficult to identify. <sup>8 </sup>The BGS is concerned therefore that older people may be directly, indirectly or tacitly influenced to choose Assisted Dying because of adverse factors within our society which may be otherwise remediable through positive change in current health and care policy.</p>\r\n </div>\r\n \r\n <h2 class="sidebar-nav">BGS priorities for end of life care</h2>\r\n \r\n <div>In developing this position statement on Assisted Dying, the BGS has identified the following priorities for end-of-life care in the UK which should be addressed before a change in the law is considered:</div>\r\n \r\n <ol>\r\n \t<li><strong>Allowing death due to natural causes at the right time</strong>, instead of continuing unwanted interventions aiming to prolong life. This is distinct ethically from the intentional ending of life, even when life is unquestionably coming to an end.</li>\r\n \t<li><strong>Improving timely recognition of terminal decline</strong> due to underlying disease processes including multimorbidity, advanced dementia and severe frailty. This is consistent with national guidance advocating the timely identification of patients approaching the last 12 months of life to tailor their care according to their individual preferences and wishes.<sup>9</sup></li>\r\n \t<li><strong>Deploying effective health communication systems</strong> to share information regarding individual preferences, including advance care plans incorporating advance decisions to refuse treatment and preferred place of death, also shared with individuals with valid powers of attorney for health and welfare.</li>\r\n \t<li><strong>Enabling holistic, multidisciplinary care services to deliver Comprehensive Geriatric Assessment</strong> focused on multimorbidity, dementia and frailty, with recognition these conditions cannot always be ameliorated.</li>\r\n \t<li><strong>Providing universally accessible, high-quality supportive and palliative care services</strong> making provision for those whose terminal decline is due to multimorbidity, dementia and/or frailty which enable individuals to enjoy naturally enduring life by ameliorating unpleasant physical, psychological and existential symptoms which otherwise cause end of life to be distressing and burdensome.</li>\r\n \t<li><strong>Shifting societal attitudes to de-medicalise death </strong>and supporting wider societal care provision to alleviate distress in terminal disease.</li>\r\n </ol>\r\n \r\n <h2 class="sidebar-nav">Safeguards for older people</h2>\r\n \r\n <div>Many BGS members are concerned that effective legal safeguards to protect older people from unwarranted harms cannot be developed. NHS England defines patient safeguarding as, “protecting a citizen’s health, wellbeing and human rights; enabling them to live free from harm, abuse and neglect”, with those receiving care in their own home and people with physical, sensory and mental impairments in need of most protection. <sup>10</sup> This recognises the patient group of primary concern to us, namely older people, as being among the most vulnerable in society. For these reasons alone the BGS has significant stake in contributing to the debate on Assisted Dying and the development of workable safeguards if AD is legalised in the UK and Crown Dependencies.</div>\r\n \r\n <div> </div>\r\n \r\n <div>Our review of international patient safeguarding precedents in jurisdictions currently permitting AD (most notably in Canada) has identified a rapid erosion of safeguards with a shift in eligibility criteria to include conditions without natural death being foreseeable.<sup>11</sup> By contrast, the Netherlands is considered to have appropriate safeguards and an established review board. Despite this, 0.1% of deaths in 2022 and 0.05% of deaths in 2023 occurring as part of their AD program were deemed to have occurred without fulfilment of due care criteria, meaning relevant safeguards were not observed.<sup>12,13</sup></div>\r\n \r\n <div> </div>\r\n \r\n <div>Our assessment is that <strong>the risk for safeguard failure is at least moderate</strong> in a modern, well-run AD service which we find to be <strong>unacceptable </strong>when considering the needs of older people. Notwithstanding the range of ethical stances presented by our members, the <strong>BGS therefore expects to contribute meaningfully to inform the development of any future law on Assisted Dying, particularly with respect to developing and implementing meaningful and workable safeguards.</strong></div>\r\n """ "format" => "full_html" ] ] "field_image" => [] "field_image_position" => [] "field_limit_text_width" => array:1 [ 0 => array:1 [ "value" => "0" ] ] "field_link" => [] "field_original" => array:1 [ 0 => array:1 [ "value" => "0" ] ] "field_palette" => array:1 [ 0 => array:1 [ "value" => "palette-default" ] ] "field_section_description" => array:1 [ 0 => array:1 [ "value" => "Main" ] ] "field_show_to" => [] "field_title" => [] ] "bundle" => "wysiwyg" ] ] "field_member_only" => array:1 [ 0 => array:1 [ "value" => "0" ] ] "field_metatag" => [] "field_published_by" => array:1 [ 0 => array:1 [ "value" => "British Geriatrics Society" ] ] "field_related" => [] "field_related_event" => [] "field_related_resources" => [] "field_resource_authors" => array:1 [ 0 => array:3 [ "target_id" => "6733" "entity" => array:24 [ "tid" => array:1 [ 0 => array:1 [ "value" => "6733" ] ] "uuid" => array:1 [ 0 => array:1 [ "value" => "ed2126fe-4238-40bf-bcb8-b5527adea9f3" ] ] "revision_id" => array:1 [ 0 => array:1 [ "value" => "6733" ] ] "langcode" => array:1 [ 0 => array:1 [ "value" => "en" ] ] "vid" => array:1 [ 0 => array:3 [ "target_id" => "authors" "entity" => array:9 [ "uuid" => "eac7e719-2636-41f2-ba9b-0987de9cdeab" "langcode" => "en" "status" => true "dependencies" => [] "name" => "Authors" "vid" => "authors" "description" => null "weight" => -5 "new_revision" => false ] "bundle" => "taxonomy_vocabulary" ] ] "revision_created" => array:1 [ 0 => array:1 [ "value" => "1712220719" ] ] "revision_user" => [] "revision_log_message" => [] "status" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "name" => array:1 [ 0 => array:1 [ "value" => "British Geriatrics Society" ] ] "description" => array:1 [ 0 => array:2 [ "value" => null "format" => null ] ] "weight" => array:1 [ 0 => array:1 [ "value" => "0" ] ] "parent" => array:1 [ 0 => array:1 [ "target_id" => "0" ] ] "changed" => array:1 [ 0 => array:1 [ "value" => "1712220719" ] ] "default_langcode" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "revision_default" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "revision_translation_affected" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "metatag" => array:2 [ 0 => array:2 [ "tag" => "meta" "attributes" => array:2 [ "name" => "title" "content" => "British Geriatrics Society | British Geriatrics Society" ] ] 1 => array:2 [ "tag" => "link" "attributes" => array:2 [ "rel" => "canonical" "href" => "https://d10upgrade.bgs.org.uk/authors/british-geriatrics-society" ] ] ] "path" => array:1 [ 0 => array:3 [ "alias" => "/authors/british-geriatrics-society" "pid" => "126465" "langcode" => "en" ] ] "publish_on" => [] "unpublish_on" => [] "field_author_link" => [] "field_job_title" => [] "field_metatag" => [] ] "bundle" => "authors" ] ] "field_resource_cover" => [] "field_resource_file" => [] "field_resource_series" => [] "field_resource_sign_up" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "field_resource_summary" => array:1 [ 0 => array:2 [ "value" => "<p>This statement sets out the BGS position on assisted dying, our priorities for end of life care, and our concerns that effective legal safeguards cannot be created to protect older people from unwarranted harms.</p>\r\n" "format" => "full_html" ] ] "field_resource_type" => array:1 [ 0 => array:3 [ "target_id" => "7338" "entity" => array:23 [ "tid" => array:1 [ 0 => array:1 [ "value" => "7338" ] ] "uuid" => array:1 [ 0 => array:1 [ "value" => "54af1aeb-66fd-48cf-b74d-258c81288fad" ] ] "revision_id" => array:1 [ 0 => array:1 [ "value" => "7338" ] ] "langcode" => array:1 [ 0 => array:1 [ "value" => "en" ] ] "vid" => array:1 [ 0 => array:3 [ "target_id" => "resource_type" "entity" => array:9 [ "uuid" => "66f1f752-652f-49e4-8a51-8fce4517fd2f" "langcode" => "en" "status" => true "dependencies" => [] "name" => "Resource type" "vid" => "resource_type" "description" => null "weight" => -6 "new_revision" => false ] "bundle" => "taxonomy_vocabulary" ] ] "revision_created" => array:1 [ 0 => array:1 [ "value" => "1712220742" ] ] "revision_user" => [] "revision_log_message" => [] "status" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "name" => array:1 [ 0 => array:1 [ "value" => "Position paper" ] ] "description" => array:1 [ 0 => array:2 [ "value" => "A position paper is a thing which tells you what position to take on a thing. 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A position paper is a thing which tells you what position to take on a thing. A position paper is a thing which tells you what position to take on a thing. A position paper is a thing which tells you what position to take on a thing." ] ] 2 => array:2 [ "tag" => "link" "attributes" => array:2 [ "rel" => "canonical" "href" => "https://d10upgrade.bgs.org.uk/resource-type/position-paper" ] ] ] "path" => array:1 [ 0 => array:3 [ "alias" => "/resource-type/position-paper" "pid" => "127070" "langcode" => "en" ] ] "publish_on" => [] "unpublish_on" => [] "field_machine_name" => [] "field_metatag" => [] ] "bundle" => "resource_type" ] ] "field_section" => [] "field_section_top" => array:4 [ 0 => array:4 [ "target_id" => "13299" "target_revision_id" => "14645" "entity" => array:22 [ "id" => array:1 [ 0 => array:1 [ "value" => "13299" ] ] "uuid" => array:1 [ 0 => array:1 [ "value" => "1NcH-iHq-bbfd-4cc5-bff6-f5362009e68f" ] ] "revision_id" => array:1 [ 0 => array:1 [ "value" => "14645" ] ] "langcode" => array:1 [ 0 => array:1 [ "value" => "en" ] ] "type" => array:1 [ 0 => array:3 [ "target_id" => "faqs" "entity" => array:10 [ "uuid" => "9e9e24b6-e56f-42f6-9674-24f90337604b" "langcode" => "en" "status" => true "dependencies" => [] "id" => "faqs" "label" => "FAQs" "icon_uuid" => null "icon_default" => null "description" => "Migrated from paragraph bundle FAQs" "behavior_plugins" => [] ] "bundle" => "paragraphs_type" ] ] "status" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "created" => array:1 [ 0 => array:1 [ "value" => "1732183104" ] ] "parent_id" => array:1 [ 0 => array:1 [ "value" => "52804" ] ] "parent_type" => array:1 [ 0 => array:1 [ "value" => "node" ] ] "parent_field_name" => array:1 [ 0 => array:1 [ "value" => "field_section_top" ] ] "behavior_settings" => array:1 [ 0 => array:1 [ "value" => "a:0:{}" ] ] "default_langcode" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "revision_default" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "revision_translation_affected" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "field_admin_label" => [] "field_description" => array:1 [ 0 => array:2 [ "value" => "<h2 class="sidebar-nav">Supporting statements, methodology and rationale</h2>\r\n" "format" => "full_html" ] ] "field_faqs" => [] "field_limit_text_width" => array:1 [ 0 => array:1 [ "value" => "0" ] ] "field_palette" => array:1 [ 0 => array:1 [ "value" => "palette-default" ] ] "field_qa" => array:10 [ 0 => array:4 [ "target_id" => "13289" "target_revision_id" => "14635" "entity" => array:19 [ "id" => array:1 [ 0 => array:1 [ "value" => "13289" ] ] "uuid" => array:1 [ 0 => array:1 [ "value" => "Q52IznID-7f5c-4afc-82d9-f36de307b7ca" ] ] "revision_id" => array:1 [ 0 => array:1 [ "value" => "14635" ] ] "langcode" => array:1 [ 0 => array:1 [ "value" => "en" ] ] "type" => array:1 [ 0 => array:3 [ "target_id" => "q_a" "entity" => array:10 [ …10] "bundle" => "paragraphs_type" ] ] "status" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "created" => array:1 [ 0 => array:1 [ "value" => "1732183104" ] ] "parent_id" => array:1 [ 0 => array:1 [ "value" => "13299" ] ] "parent_type" => array:1 [ 0 => array:1 [ "value" => "paragraph" ] ] "parent_field_name" => array:1 [ 0 => array:1 [ "value" => "field_qa" ] ] "behavior_settings" => array:1 [ 0 => array:1 [ "value" => "a:0:{}" ] ] "default_langcode" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "revision_default" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "revision_translation_affected" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "field_admin_label" => [] "field_limit_text_width" => array:1 [ 0 => array:1 [ "value" => "0" ] ] "field_qa_answer" => array:1 [ 0 => array:2 [ "value" => """ <div>Multiple contested terms are used in the Assisted Dying debate. For the avoidance of doubt, the BGS uses the umbrella term Assisted Dying (AD) to refer to health care professionals’ involvement in activities intended to end a patient’s life (adapted from the British Medical Association<sup>14</sup>), specifically:</div>\r\n \r\n <ol>\r\n \t<li><strong>Physician Assisted Suicide (PAS):</strong> where healthcare professionals prescribe lethal drugs within defined criteria at the voluntary request of an adult patient with mental capacity to make this request, to enable them to self-administer the drugs to end their own life; and<br />\r\n \t\t </li>\r\n \t<li><strong> Voluntary Active Euthanasia (VAE):</strong> where healthcare professionals administer lethal drugs within defined eligibility criteria at the voluntary request of an adult patient with mental capacity to make this request with the intention of ending that patient’s life.</li>\r\n </ol>\r\n \r\n <div><em>Note: Current proposed Assisted Dying legislation in the UK and Crown Dependencies makes no provisions for patients who lack capacity or for advance decision making.</em></div>\r\n """ "format" => "full_html" ] ] "field_qa_question" => array:1 [ 0 => array:1 [ "value" => "Terminology" ] ] "field_section_description" => array:1 [ 0 => array:1 [ "value" => "Terminology" ] ] ] "bundle" => "q_a" ] 1 => array:4 [ "target_id" => "13290" "target_revision_id" => "14636" "entity" => array:19 [ "id" => array:1 [ 0 => array:1 [ "value" => "13290" ] ] "uuid" => array:1 [ 0 => array:1 [ "value" => "QUZyjpEc-4aca-4710-8072-f2bcbc231bfa" ] ] "revision_id" => array:1 [ 0 => array:1 [ "value" => "14636" ] ] "langcode" => array:1 [ 0 => array:1 [ "value" => "en" ] ] "type" => array:1 [ 0 => array:3 [ "target_id" => "q_a" "message" => "Recursion detected." "array_path" => "field_section_top.0.entity.field_qa.0.entity.type.0.entity" ] ] "status" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "created" => array:1 [ 0 => array:1 [ "value" => "1732183104" ] ] "parent_id" => array:1 [ 0 => array:1 [ "value" => "13299" ] ] "parent_type" => array:1 [ 0 => array:1 [ "value" => "paragraph" ] ] "parent_field_name" => array:1 [ 0 => array:1 [ "value" => "field_qa" ] ] "behavior_settings" => array:1 [ 0 => array:1 [ "value" => "a:0:{}" ] ] "default_langcode" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "revision_default" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "revision_translation_affected" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "field_admin_label" => [] "field_limit_text_width" => array:1 [ 0 => array:1 [ "value" => "0" ] ] "field_qa_answer" => array:1 [ 0 => array:2 [ "value" => """ <h4>Background</h4>\r\n \r\n <div>The BGS’s previous position statement on AD was published in July 2015 and was opposed to the legalisation of Assisted Dying in the UK.<sup>15</sup> In 2024, considering advancing debates and proposed UK legislative changes, the BGS reviewed its position statement. Professor Martin Vernon and Dr Andrew Stanners, Co-chairs of the BGS Ethics and Law Special Interest Group, convened a working group (WG) to review current evidence and draft a new position statement.</div>\r\n \r\n <div> </div>\r\n \r\n <div>All BGS members were invited to participate in contributing to the new position statement and the WG was formed from those submitting formal expressions of interest to join. The group comprised colleagues from a range of professional backgrounds including geriatric medicine, clinical academia, general practice, nursing, allied health professions and BGS policy development. There was at least one representative from each of the four UK nations. Within the group there was a diversity of declared professional opinion and positions on AD. However, the WG committed to open collaboration and a shared aim to produce a position statement that was rigorous, informed by evidence and sensitive to the diversity of views existing within the BGS membership.</div>\r\n \r\n <h4>Timeline</h4>\r\n \r\n <table border="1" cellpadding="1" cellspacing="1" style="width:500px;">\r\n \t<thead>\r\n \t\t<tr>\r\n \t\t\t<th scope="col">10 May 2024</th>\r\n \t\t\t<th scope="col">13 June 2024</th>\r\n \t\t\t<th scope="col">11 July 2024</th>\r\n \t\t\t<th scope="col">2 September 2024</th>\r\n \t\t\t<th scope="col">23 September 2024</th>\r\n \t\t\t<th scope="col">24 October 2024</th>\r\n \t\t</tr>\r\n \t</thead>\r\n \t<tbody>\r\n \t\t<tr>\r\n \t\t\t<td>\r\n \t\t\t\t<ul>\r\n \t\t\t\t\t<li>Introductions and declarations of interest.<br />\r\n \t\t\t\t\t\t </li>\r\n \t\t\t\t\t<li>Discussion and review of current BGS position statement.<br />\r\n \t\t\t\t\t\t </li>\r\n \t\t\t\t\t<li>Task allocation and individual research e.g definitions, international contexts, and UK legislation.</li>\r\n \t\t\t\t</ul>\r\n \t\t\t</td>\r\n \t\t\t<td>\r\n \t\t\t\t<ul>\r\n \t\t\t\t\t<li>Feedback and review of information from research tasks.<br />\r\n \t\t\t\t\t\t </li>\r\n \t\t\t\t\t<li>Aims of membership survey agreed.<br />\r\n \t\t\t\t\t\t </li>\r\n \t\t\t\t\t<li>Further task allocation including drafting of survey questions, and key themes for position statement.</li>\r\n \t\t\t\t</ul>\r\n \t\t\t</td>\r\n \t\t\t<td>\r\n \t\t\t\t<ul>\r\n \t\t\t\t\t<li>Review, discuss, and agree on questions for survey.<br />\r\n \t\t\t\t\t\t </li>\r\n \t\t\t\t\t<li>Clarification and further discussion around key themes for position statement.</li>\r\n \t\t\t\t</ul>\r\n \t\t\t</td>\r\n \t\t\t<td>\r\n \t\t\t\t<ul>\r\n \t\t\t\t\t<li>Review of survey results and survey feedback.<br />\r\n \t\t\t\t\t\t </li>\r\n \t\t\t\t\t<li>Discussion and agreement of BGS’s position.</li>\r\n \t\t\t\t</ul>\r\n \t\t\t</td>\r\n \t\t\t<td>\r\n \t\t\t\t<ul>\r\n \t\t\t\t\t<li>Discussion and drafting of position statement. </li>\r\n \t\t\t\t</ul>\r\n \t\t\t</td>\r\n \t\t\t<td>\r\n \t\t\t\t<ul>\r\n \t\t\t\t\t<li>New position statement approved by BGS Trustee Board.</li>\r\n \t\t\t\t</ul>\r\n \t\t\t</td>\r\n \t\t</tr>\r\n \t</tbody>\r\n </table>\r\n \r\n <h4>Survey</h4>\r\n \r\n <div>Surveys conducted by the Royal College of Physicians (2019) and British Medical Association (2020) identified that physicians working in Geriatric Medicine were more likely to be opposed to a change in the law on Assisted Dying.<sup>16,17</sup> However, the last time the BGS membership was surveyed on the issue was over twenty years ago.<sup>18</sup> BGS WG consensus was that historical data from surveys conducted by other organisations, while informative, could not be utilised to reflect adequately the diverse, multi-professional views of current BGS membership, and that a BGS survey should be developed to inform the new position statement with the following aims:</div>\r\n \r\n <ol>\r\n \t<li>Establish the professional views of respondent BGS Members on the legalisation of Assisted Dying.</li>\r\n \t<li>Understand the views of respondent BGS members on what position BGS should take on the legalisation of Assisted Dying.</li>\r\n \t<li>Understand whether respondent BGS members would be willing to engage professionally in the processes of Assisted Dying for eligible individuals in the event of a change in UK law.</li>\r\n \t<li>Understand the level of confidence among respondent BGS members that effective safeguards could be developed to protect the interests of older people in the event of a change in UK law on Assisted Dying.</li>\r\n </ol>\r\n \r\n <h4>Survey design, administration and utilisation</h4>\r\n \r\n <div>The BGS-hosted survey was distributed to all members for anonymised response and utilised a pragmatic design to sample respondent views on specific key thematic issues identified by the WG. Time and resource constraints limited the scope and scale of the exercise which was intended to be informative but not exhaustive. Specifically, the survey was not intended as a membership referendum on the legalisation of Assisted Dying, nor was it intended to be a research exercise. The necessary and intentional limitations of its content and methodology are acknowledged by the WG and drew additional, helpful free-text responses from members which have been considered carefully when drafting the new position statement.</div>\r\n \r\n <div> </div>\r\n \r\n <div>One issue raised by members related to question 9 of the survey, which asked the following:</div>\r\n \r\n <div> </div>\r\n \r\n <div style="margin-left: 40px;"><strong><em>‘What should the British Geriatrics Society's position be (supportive or opposed) on a change in UK law on Assisted Dying for eligible individuals?’</em></strong></div>\r\n \r\n <div> </div>\r\n \r\n <div>The question permitted only a binary response and was intentionally included in that format, after careful consideration by the WG, on the basis that proposed legislation is itself binary (to permit or prevent activities) and there can be no ‘neutral’ legal position on the matter of Assisted Dying.</div>\r\n \r\n <div> </div>\r\n \r\n <div>The WG were in consensus in wanting to understand specifically respondents’ answers to the question of whether the BGS should be supportive or opposed to legalisation of Assisted Dying to gauge the level of support or objection. It is fully accepted that this approach is contentious and lacks nuance, a point raised vigorously by some respondents. The WG understand the view that this approach may be methodologically flawed but nonetheless are in consensus that the survey output remains informative.</div>\r\n \r\n <div> </div>\r\n \r\n <div>With these caveats in mind, the data outputs of the survey have been considered by the WG and utilised descriptively to inform the current BGS position statement. For transparency both the survey and its raw data outputs without interpretation are available from the BGS on request for others to draw their own conclusions. </div>\r\n \r\n <div> </div>\r\n \r\n <div>\r\n \t<h4>Survey summary outcomes</h4>\r\n \r\n \t<div>The survey was conducted throughout August 2024 with the following summary outcomes:</div>\r\n \r\n \t<h6>Demography</h6>\r\n \r\n \t<ul>\r\n \t\t<li>A total of 775 responses were received (15.5% of BGS membership) which is a high response rate for a BGS survey of this kind.</li>\r\n \t\t<li>The majority (74%) were from England</li>\r\n \t\t<li>63% were female and 35% were male</li>\r\n \t\t<li>50% were consultant geriatricians</li>\r\n \t\t<li>86% were independent prescribers</li>\r\n \t\t<li>46% declared their religion as Christian and 39% declared no religion</li>\r\n \t\t<li>74% declared their ethnicity as white (English, Welsh, Scottish, Northern Irish or British)</li>\r\n \t</ul>\r\n \r\n \t<h6>Respondent views on a change in UK law on Assisted Dying (PAS and VAE)</h6>\r\n \r\n \t<ul>\r\n \t\t<li>For <strong>PAS</strong>, 50% were opposed, 33% were supportive and 17% were undecided on a change in UK law</li>\r\n \t\t<li>For <strong>VAE </strong>55% were opposed, 27% were supportive and 18% were undecided on a change in UK law</li>\r\n \t</ul>\r\n \r\n \t<h6>Respondent views on BGS position on a change in UK law on Assisted Dying (PAS and VAE)</h6>\r\n \r\n \t<ul>\r\n \t\t<li>For <strong>PAS </strong>60% responded that BGS should be opposed, and 40% responded that BGS should be supportive of a change in UK law for eligible individuals</li>\r\n \t\t<li>For <strong>VAE </strong>66% responded that BGS should be opposed and 34% responded that BGS should be supportive of a change in UK law for eligible individuals</li>\r\n \t</ul>\r\n \r\n \t<h6>Respondent views on professional engagement with the process of Assisted Dying (PAS and VAE) in the event of a change in the UK law</h6>\r\n \r\n \t<ul>\r\n \t\t<li>For <strong>PAS </strong>52% were not willing, 27% were willing and 21% were undecided on professional engagement with the process</li>\r\n \t\t<li>For <strong>VAE </strong>60% were not willing, 21% were willing and 19% were undecided on professional engagement with the process</li>\r\n \t</ul>\r\n \r\n \t<h6>Respondent views on confidence in development of effective safeguards for Assisted Dying (PAS and VAE) in the event of a change in the UK law</h6>\r\n \r\n \t<ul>\r\n \t\t<li>For <strong>PAS </strong>50% either disagreed or strongly disagreed, 35% either agreed or strongly agreed and 15% were undecided about effective safeguards</li>\r\n \t\t<li>For <strong>VAE </strong>53% either disagreed or strongly disagreed, 30% either agreed or strongly agreed and 17% were undecided about effective safeguards</li>\r\n \t</ul>\r\n </div>\r\n """ "format" => "full_html" ] ] "field_qa_question" => array:1 [ 0 => array:1 [ "value" => "How we developed our position statement" ] ] "field_section_description" => array:1 [ 0 => array:1 [ "value" => "How we developed our position statement" ] ] ] "bundle" => "q_a" ] 2 => array:4 [ "target_id" => "13291" "target_revision_id" => "14637" "entity" => array:19 [ "id" => array:1 [ 0 => array:1 [ "value" => "13291" ] ] "uuid" => array:1 [ 0 => array:1 [ "value" => "6szecbGL-96da-4c55-b35a-8eb97ea3f16e" ] ] "revision_id" => array:1 [ 0 => array:1 [ "value" => "14637" ] ] "langcode" => array:1 [ 0 => array:1 [ "value" => "en" ] ] "type" => array:1 [ 0 => array:3 [ "target_id" => "q_a" "message" => "Recursion detected." 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"array_path" => "field_section_top.0.entity.type.0.entity" ] ] "status" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "created" => array:1 [ 0 => array:1 [ "value" => "1732183104" ] ] "parent_id" => array:1 [ 0 => array:1 [ "value" => "52804" ] ] "parent_type" => array:1 [ 0 => array:1 [ "value" => "node" ] ] "parent_field_name" => array:1 [ 0 => array:1 [ "value" => "field_section_top" ] ] "behavior_settings" => array:1 [ 0 => array:1 [ "value" => "a:0:{}" ] ] "default_langcode" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "revision_default" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "revision_translation_affected" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "field_admin_label" => [] "field_description" => array:1 [ 0 => array:2 [ "value" => "<h2 class="sidebar-nav">Acknowledgements</h2>\r\n" "format" => "full_html" ] ] "field_faqs" => [] "field_limit_text_width" => array:1 [ 0 => array:1 [ "value" => "0" ] ] "field_palette" => array:1 [ 0 => array:1 [ "value" => "palette-default" ] ] "field_qa" => array:1 [ 0 => array:4 [ "target_id" => "13300" "target_revision_id" => "14646" "entity" => array:19 [ "id" => array:1 [ 0 => array:1 [ …1] ] "uuid" => array:1 [ 0 => array:1 [ …1] ] "revision_id" => array:1 [ 0 => array:1 [ …1] ] "langcode" => array:1 [ 0 => array:1 [ …1] ] "type" => array:1 [ 0 => array:3 [ …3] ] "status" => array:1 [ 0 => array:1 [ …1] ] "created" => array:1 [ 0 => array:1 [ …1] ] "parent_id" => array:1 [ 0 => array:1 [ …1] ] "parent_type" => array:1 [ 0 => array:1 [ …1] ] "parent_field_name" => array:1 [ 0 => array:1 [ …1] ] "behavior_settings" => array:1 [ 0 => array:1 [ …1] ] "default_langcode" => array:1 [ 0 => array:1 [ …1] ] "revision_default" => array:1 [ 0 => array:1 [ …1] ] "revision_translation_affected" => array:1 [ 0 => array:1 [ …1] ] "field_admin_label" => [] "field_limit_text_width" => array:1 [ 0 => array:1 [ …1] ] "field_qa_answer" => array:1 [ 0 => array:2 [ …2] ] "field_qa_question" => array:1 [ 0 => array:1 [ …1] ] "field_section_description" => array:1 [ 0 => array:1 [ …1] ] ] "bundle" => "q_a" ] ] "field_section_description" => array:1 [ 0 => array:1 [ "value" => "Acknowledgements" ] ] "field_title" => [] ] "bundle" => "faqs" ] 2 => array:4 [ "target_id" => "13303" "target_revision_id" => "14649" "entity" => array:22 [ "id" => array:1 [ 0 => array:1 [ "value" => "13303" ] ] "uuid" => array:1 [ 0 => array:1 [ "value" => "FIcATB5C-2a0d-4b77-a7b3-3dc056a62bec" ] ] "revision_id" => array:1 [ 0 => array:1 [ "value" => "14649" ] ] "langcode" => array:1 [ 0 => array:1 [ "value" => "en" ] ] "type" => array:1 [ 0 => array:3 [ "target_id" => "faqs" "message" => "Recursion detected." "array_path" => "field_section_top.0.entity.type.0.entity" ] ] "status" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "created" => array:1 [ 0 => array:1 [ "value" => "1732183104" ] ] "parent_id" => array:1 [ 0 => array:1 [ "value" => "52804" ] ] "parent_type" => array:1 [ 0 => array:1 [ "value" => "node" ] ] "parent_field_name" => array:1 [ 0 => array:1 [ "value" => "field_section_top" ] ] "behavior_settings" => array:1 [ 0 => array:1 [ "value" => "a:0:{}" ] ] "default_langcode" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "revision_default" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "revision_translation_affected" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "field_admin_label" => [] "field_description" => array:1 [ 0 => array:2 [ "value" => "<h2 class="sidebar-nav">References</h2>\r\n" "format" => "full_html" ] ] "field_faqs" => [] "field_limit_text_width" => array:1 [ 0 => array:1 [ "value" => "0" ] ] "field_palette" => array:1 [ 0 => array:1 [ "value" => "palette-default" ] ] "field_qa" => array:1 [ 0 => array:4 [ "target_id" => "13302" "target_revision_id" => "14648" "entity" => array:19 [ "id" => array:1 [ 0 => array:1 [ …1] ] "uuid" => array:1 [ 0 => array:1 [ …1] ] "revision_id" => array:1 [ 0 => array:1 [ …1] ] "langcode" => array:1 [ 0 => array:1 [ …1] ] "type" => array:1 [ 0 => array:3 [ …3] ] "status" => array:1 [ 0 => array:1 [ …1] ] "created" => array:1 [ 0 => array:1 [ …1] ] "parent_id" => array:1 [ 0 => array:1 [ …1] ] "parent_type" => array:1 [ 0 => array:1 [ …1] ] "parent_field_name" => array:1 [ 0 => array:1 [ …1] ] "behavior_settings" => array:1 [ 0 => array:1 [ …1] ] "default_langcode" => array:1 [ 0 => array:1 [ …1] ] "revision_default" => array:1 [ 0 => array:1 [ …1] ] "revision_translation_affected" => array:1 [ 0 => array:1 [ …1] ] "field_admin_label" => [] "field_limit_text_width" => array:1 [ 0 => array:1 [ …1] ] "field_qa_answer" => array:1 [ 0 => array:2 [ …2] ] "field_qa_question" => array:1 [ 0 => array:1 [ …1] ] "field_section_description" => array:1 [ 0 => array:1 [ …1] ] ] "bundle" => "q_a" ] ] "field_section_description" => array:1 [ 0 => array:1 [ "value" => "References" ] ] "field_title" => [] ] "bundle" => "faqs" ] 3 => array:4 [ "target_id" => "13304" "target_revision_id" => "14650" "entity" => array:25 [ "id" => array:1 [ 0 => array:1 [ "value" => "13304" ] ] "uuid" => array:1 [ 0 => array:1 [ "value" => "668hVUYP-e6f8-47c8-b411-e5d59d7b40d6" ] ] "revision_id" => array:1 [ 0 => array:1 [ "value" => "14650" ] ] "langcode" => array:1 [ 0 => array:1 [ "value" => "en" ] ] "type" => array:1 [ 0 => array:3 [ "target_id" => "wysiwyg" "message" => "Recursion detected." "array_path" => "field_main_content.0.entity.type.0.entity" ] ] "status" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "created" => array:1 [ 0 => array:1 [ "value" => "1732183104" ] ] "parent_id" => array:1 [ 0 => array:1 [ "value" => "52804" ] ] "parent_type" => array:1 [ 0 => array:1 [ "value" => "node" ] ] "parent_field_name" => array:1 [ 0 => array:1 [ "value" => "field_section_top" ] ] "behavior_settings" => array:1 [ 0 => array:1 [ "value" => "a:0:{}" ] ] "default_langcode" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "revision_default" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "revision_translation_affected" => array:1 [ 0 => array:1 [ "value" => "1" ] ] "field_admin_label" => [] "field_body" => array:1 [ 0 => array:2 [ "value" => """ <h2 class="sidebar-nav">Appendix</h2>\r\n \r\n <p>The raw anonymised data collected from the BGS member survey on assisted dying is available on request. Please email Lucy Aldridge, BGS Policy Coordinator, at l.aldridge@bgs.org.uk to request this information as a Microsoft Excel document. </p>\r\n """ "format" => "full_html" ] ] "field_image" => [] "field_image_position" => [] "field_limit_text_width" => array:1 [ 0 => array:1 [ "value" => "0" ] ] "field_link" => [] "field_original" => array:1 [ 0 => array:1 [ "value" => "0" ] ] "field_palette" => array:1 [ 0 => array:1 [ "value" => "palette-default" ] ] "field_section_description" => array:1 [ 0 => array:1 [ "value" => "Appendix" ] ] "field_show_to" => [] "field_title" => [] ] "bundle" => "wysiwyg" ] ] "field_side_section" => array:2 [ 0 => array:4 [ "target_id" => "13305" "target_revision_id" => "14651" "entity" => array:23 [ "id" => array:1 [ 0 => array:1 [ "value" => "13305" ] ] "uuid" => array:1 [ 0 => array:1 [ "value" => "ZeRRcqO--86fe-4378-a263-0a84008cd746" ] ] "revision_id" => array:1 [ 0 => array:1 [ "value" => "14651" ] ] "langcode" => array:1 [ 0 => array:1 [ "value" => 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