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All pharmacists should have the right to choose whether or not they take part in the assisted dying process, the Royal Pharmaceutical Society (RPS) in Scotland has said.
In its response to a consultation on the Scottish Parliament’s Assisted Dying for Terminally Ill Adults (Scotland) Bill — introduced by Liam McArthur MSP on 27 March 2024 — RPS Scotland said “the ability of pharmacists (and other healthcare professionals) to express their right to conscientiously object is of vital importance”.
It added that while it is “neutral” on the issue of assisted dying, it sees “a risk with the Bill as drafted that pharmacists may be compelled to support a process which they may have moral, ethical or religious objections to”.
McArthur’s proposals would allow terminally ill adults in Scotland who are eligible to lawfully request, and be provided with, assistance by healthcare professionals to end their own life.
RPS Scotland said that section 18 of the Bill “puts the burden of proof for conscientious objection on the individual”, which “may privilege some healthcare professionals (e.g. those who evidence a connection to a faith-based group), over others”.
It added that it is “vital” that an opt-in section is written into the Bill, which “would enable pharmacists and other healthcare professionals to support the process if they were comfortable to do so but would not compel anyone to be involved if they felt uncomfortable”.
This “would not only support individual healthcare professionals but would ensure the best patient care and experience”, it added.
RPS Scotland pointed out that the role of pharmacists in the procedure should be “clearly articulated”, noting that they are one of three healthcare professionals eligible to accompany the coordinating medical practitioner, alongside doctors and nurses, but that “it is not clear what is expected of pharmacists as part of this process”.
It also noted what it called “a significant gap in the Bill” in the section on the ‘method of dying’, saying: “There is a risk that the substance which is given to someone so they can end their own life either does not work or produces an unforeseen circumstance; for example, the person may choke on or vomit the substance.
“As the Bill is currently drafted, a healthcare professional would be unable to intervene in circumstances which have the potential to be extremely physically uncomfortable and/or emotionally distressing.
“It is important that all the potential clinical scenarios are thought through in detail before the legislation is passed to limit any physical or emotional discomfort for the patient and healthcare professionals who will be involved in the process.”
Earlier in August 2024, Community Pharmacy Scotland published its response to the Bill, in which it said it “partially” supports it, but noted that, in relation to the method of dying, “it is unclear from the Bill that this responsibility will even fall to community pharmacy as the prescribing, dispensing and disposal of any voluntary assisted dying substance is not touched on, in any detail, in the Bill from a pharmacy perspective”.
It also said: “More detail on the role of the wider primary healthcare team, including community pharmacists, is required in future stages of the Bill.”
The Pharmacists’ Defence Association (PDA) previously expressed its views on pharmacists’ choice to be involved in assisted dying in response to a Health and Social Care Select Committee’s inquiry into assisted dying in 2023.
In its response in January 2023, the PDA said that its focus would be on “the implications… on healthcare workers including pharmacists, and their rights to follow their conscience” should legislation be introduced into the UK.
A spokesperson for the PDA told The Pharmaceutical Journal: “The PDA’s position is that the right of autonomy for pharmacists (and other healthcare workers) to exercise their conscience must be protected in any future legislation.”
The consultation period on the Bill has now closed.
