SJT Textbook: When a Patient Seeks Advice or Information About Assistance to Die
Assistance to Die GMC Guidance
This assistance to die GMC guidance explains how UK doctors must respond lawfully and compassionately when patients ask about assisted dying, while never facilitating suicide.
🎥 Video Lesson (YouTube)
🎧 Podcast Lesson (Spotify / Apple / Amazon)
🎯 THE CORE PRINCIPLE
In the UK, it is a criminal offence to encourage or assist suicide. When a patient asks about ending their life or seeking assistance to die, doctors must balance compassionate care, respect for autonomy, and strict legal boundaries. The request often signals untreated physical, psychological, social, or spiritual distress.
Doctors must listen carefully, explore the patient’s reasons for the request, assess for depression, pain, fear, or loss of dignity, and ensure optimal palliative care. They may explain the legal position clearly and honestly, but must never provide advice, support, or practical steps that could facilitate suicide.
In MSRA SJT questions, high-scoring answers demonstrate empathy, lawful boundaries, exploration of suffering, palliative care referral, capacity assessment, and meticulous documentation.
Assistance to die GMC guidance strictly prohibits any facilitation of suicide.
⚡ HIGH-YIELD ACTIONS (What Scores Points)
1. Listen calmly and compassionately to the patient’s concerns.
2. Clarify what the patient is asking and their underlying reasons.
3. Assess capacity for the discussion and decisions.
4. Explain clearly that assisting suicide is illegal in the UK.
5. Provide accurate information about lawful alternatives, including palliative care.
6. Explore physical, psychological, social, and spiritual distress.
7. Refer early to palliative care and MDT support.
8. Continue all appropriate treatment and symptom control.
9. Offer emotional support and involve those close to the patient with consent.
10. Document the discussion, assessment, and plan clearly.
MSRA SJT frequently tests breaches of assistance to die GMC law.
• Providing information on obtaining assisted dying abroad as facilitation
• Acting on a patient request without addressing distress
• Ignoring signs of depression or suicidal ideation
• Withdrawing care because of the request
• Failing to document the discussion
These traps either breach the law, abandon the patient, or avoid professional responsibility.
💬 MODEL PHRASES (Use These in SJT Logic)
* “I cannot assist with ending life, but I can support you fully.”
* “There are lawful options to manage symptoms and distress.”
* “I will involve palliative care for additional support.”
* “We can continue to review and adapt your care.”
Requests about assistance to die GMC usually signal untreated distress.
L – Listen with empathy
I – Identify distress
S – Support fully
T – Tell the law clearly
E – Explore alternatives
N – Never assist suicide
C – Capacity assessment
A – Advance care planning
R – Refer to palliative care
E – Everything documented
📋 QUICK FAQ
Is assisted dying legal in the UK?
No. Assisting or encouraging suicide is a criminal offence. Can a patient refuse life-prolonging treatment even if that leads to death?
Yes. A capacitous patient can lawfully refuse treatment. Should I discuss assisted dying if a patient raises it?
Yes. You should listen, explain the law, and explore their concerns. Must I continue treating a patient who asks about assisted dying?
Yes. You must continue to provide compassionate, appropriate care. Should I refer to palliative care?
Yes. This is a key high-scoring action.
Palliative care referral is a core response in assistance to die GMC scenarios.
📚 GMC ANCHOR POINTS
• Legal prohibition – Assistance in Dying Guidance
• Respect for life – Good Medical Practice
• Advance care planning – End of Life Guidance
• Capacity – Mental Capacity Act 2005
• Symptom control – Palliative Care Standards
💡 MINI PRACTICE SCENARIO
A terminally ill patient asks if you can help them end their life to avoid suffering. Best action: Explain that you cannot assist with ending life, explore their distress, and involve palliative care urgently. Why: The law prohibits assistance in suicide, but the duty to provide compassionate care remains.
Capacity assessment is essential under assistance to die GMC guidance.
🎯 KEY TAKEAWAYS
✓ Assisting suicide is illegal in the UK
✓ Requests usually signal unmet distress
✓ Compassionate listening is essential
✓ Explain the law clearly
✓ Palliative care referral is high-yield
✓ Continue full supportive care
✓ Document everything carefully
🔗 RELATED TOPICS
* → Treatment and Care Towards the End of Life
* → Mental Capacity and Best Interests
* → Decision Making and Consent
* → Palliative Care
* → Duty of Candour
📖 FULL PRACTICE QUESTIONS
Example SJT — Best of 3 (8 options; choose three)
A patient with advanced disease asks, “Can you help me die?”
Options:
A. Tell them how assisted dying works abroad
B. Explain that you cannot assist but will continue care
C. Explore why they are feeling this way
D. End the consultation to avoid legal risk
E. Refer to palliative care
F. Ignore the request
G. Document the discussion
H. Provide medication doses that could be lethal
Correct three: B, C, E
• B: Explains lawful boundary with compassion.
• C: Explores underlying distress.
• E: Addresses symptom and support needs.
Why others are weaker/wrong:
• A/H: Facilitate suicide.
• D/F: Abandon the patient.
• G: Important but supportive rather than primary.
Example SJT — Rank 5 (best → worst)
A patient requests information about ending their life.
Options:
A. Explore concerns and involve palliative care
B. Explain the legal position clearly
C. Avoid the conversation
D. Provide details on assisted dying overseas
E. Give instructions on how to hasten death
Ideal order: A (1) > B (2) > C (3) > D (4) > E (5)
• A/B: Compassionate, lawful, supportive.
• C: Avoidant but not illegal.
• D/E: Facilitate unlawful action.
- GMC — When a Patient Seeks Advice or Information About Assistance to Die
https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/when-a-patient-seeks-advice-or-information-about-assistance-to-die