Are GPs neutral or not? The royal college’s controversial switch to neutrality on assisted dying

This is Prospect’s rolling coverage of the assisted dying debate. This page will be updated with the latest from our correspondent, Mark Mardell. Read the rest of our coverage here

21st March

5pm

The Royal College of GPs has shared a letter they sent to the editor of the Times explaining why the 66-strong council voted the way it did:

“Dear Sir,

Neither your coverage [Doctors insist they are not neutral on assisted dying, 18 March] nor letter [Assisted Dying, 18 March] present an accurate picture of our survey.

We asked members a second question we hadn’t asked previously; what the RCGP should do if none of the three options - whether to oppose, to support, or to neither oppose nor support assisted dying being legal - received over 50% of the vote. This ended up being the case.

In response, 49.8% of members said the College should move to a position of neither supporting nor opposing assisted dying, while only 23.8% said the College should take the position with the highest number of votes (this would have meant retaining our longstanding opposition).

We understand GPs have strongly held and widely differing views about assisted dying, and we are sorry that some are unhappy with our new stance. However, the decision to move from our previous position of opposition was not taken lightly and was made after comprehensive and considered debate – both at local and national level - during which many views were heard and due process was followed.

Our new position allows us to represent the views of all of our members as we focus on ensuring that any changes to the law protect the interests of all patients and healthcare professionals, and that palliative care is appropriately resourced.

Professor Kamila Hawthorne, Chair, Royal College of GPs”

12pm

Switching to a position of neutrality is hardly the boldest conceivable move on any subject, but when the topic is assisted dying it is enough to enrage opponents. Some doctors have responded with a traditional expression of establishment outrage: a stiff letter to the Times, accusing their professional body of a “grossly misrepresentative” stance.

It is little wonder: the Royal College of General Practitioners (RCGP) has voted to soften its position, despite a survey of members showing no great enthusiasm for change. As the Spectator’s Steerpike writes: “It transpires that, among members, there was actually a striking drop – from 40 per cent in a previous 2019 survey to now 33.7 per cent in 2025 – in the number of those who wanted their group to support the legalisation of assisted dying. There was, moreover, a slight increase in the percentage of members who said the RCGP should oppose legalisation from 47 per cent in 2019 to 47.6 per cent now.”

Indeed, nearly half Royal College of GP members surveyed wanted the college to remain opposed to assisted suicide (47.6 per cent) rather than support it with strong caveats (33.7 per cent). Yet despite this consistent opposition, the governing council pressed on with its decision.

The RCGP which describes itself as the “professional home” for “more than 54,000 GPs worldwide”, voted to switch from opposing a change in the law to one of neither supporting nor opposing assisted dying being legal.

After the vote Kamila Hawthorne, chair of the Royal College of GPs, said: “Today’s discussion and our recent survey of our members, have clearly shown that GPs have widely differing and strongly held views about assisted dying—we care deeply about our patients. This is a highly sensitive personal, societal and legislative issue, and we need to be in a position to represent the views of all of our members and patients; shifting to a position of neither opposing nor supporting assisted dying being legal will allow us to do this best.”

Which I take to mean that it would be tricky to be in the position of sticking out like a sore medical thumb as the last remaining big professional body to still oppose a change in the law. But the reaction to the survey is distinctly odd. The RCGP’s news release states that 39 per cent of the college’s general council voted that the RCGP should oppose assisted dying being legal and 61 per cent voted that the RCGP should move to a position of neither supporting nor opposing assisted dying being legal. Of the 66 council members, no one abstained and no one voted that the RCGP should support assisted dying being legal.

That is despite the survey before the vote, where 47.6 per cent of respondents said that the RCGP should oppose assisted dying being legal, 13.6 per cent said that the RCGP should move to a position of neither supporting nor opposing assisted dying being legal and 33.7 per cent said that the RCGP should support assisted dying being legal, subject to an appropriate regulatory framework and safeguarding processes

So, curiously the ruling council voted for the least popular option.

Perhaps the low take-up convinced the council that only a small minority felt moved enough to answer the question; there were just under 8,779 responses out of the more than 53,000 members. It does mean they can now campaign on details as set out in their list of concerns:

[assisted dying] should be seen as an additional specialised service that GPs and other healthcare professionals may opt to provide with additional training, and not part of core general practice
it should be a standalone service that will need to be separately and adequately resourced;
there should be a right to refuse to participate in the process on any grounds as well as statutory protection making it unlawful to discriminate against, or cause detriment to, any doctor on the basis of their decision to, or not to, participate in the assisted dying process;
work should be undertaken to define standards and training for those involved in delivering assisted dying services; and crucially
it should not have a negative impact on funding for palliative care services in any way.

Hawthorne continued: “As well as ensuring there are robust safeguards in place to protect patients, the College will work to ensure that no GP feels as though they have to participate in delivering assisted dying services—and that these services are provided separately to core general practice. We will also be clear that funding should not be diverted from general practice—or palliative care services—in order to deliver these services.”

This was clearly not sufficient for some. The change prompted more than 250 GPs to sign a letter to the Times, arguing that “assisted dying undermines public understanding of and access to palliative care, puts vulnerable populations at risk of self-coercion or abuse, and drives societal biases that devalue certain lives. We find assisted suicide incompatible with our values as doctors: to promote and preserve life, and to be worthy of our patients’ trust. We will not be involved in its provision and remain committed to easing suffering at the end of life through proactive, compassionate and holistic palliative care. We regret the RCGP’s stance and find it grossly misrepresentative of GPs’ attitudes to assisted dying.”

Cudgels have been raised by the usual suspects, both pro and anti, but this is significant because it was the last medical college to remain opposed—according to the Express “it follows similar moves from opposition to neutrality by medical bodies including the Royal College of Anaesthetists (2024), the Royal College of Surgeons (2023), the British Medical Association (2021), and the Royal College of Physicians (2019).” I have asked the leadership of the RCGP for an interview—I’ll let you know if and when they reply.

18th March

There are three things I need to tell you about Parkinson’s. They aren’t exactly closely guarded secrets, but not many people know them.

Firstly, a lot of us seem to wake at three in the morning and can’t go back to sleep.

Secondly—and maybe this is the drugs rather than the condition—but it can give you bursts of creativity. So it’s not unusual for me, if I do get a full night’s sleep, to wake up to marvellous poetry from my friend and fellow Movers and Shakers podcast host, Gillian Lacey-Solymar. Her poems are usually upbeat, often light, often amusing.

The third thing? Well, Parkinson’s can make you brood on the end and on death.

Last Saturday, I woke to another wonderful poem from Gillian. It wasn’t light or amusing. But I hope you enjoy it nevertheless.

Coming to conclusions

What if? (1)

What if there is no cure

What if it eludes our science

Perplexes our scientists

Escapes our knowledge

What then?

Back to where we started once again

What if? (2)

What if the non-existent deity