New GMC guidance on end-of-life care

21 May 2010

DOCTORS must discuss treatment options with patients who are likely to die within 12 months, the GMC has announced.

New guidance from the regulator, Treatment and care towards the end of life: good practice in decision making, requires GPs to draw up advance care plans for dying patients. The guidance also stresses the importance of doctors listening to patients and their families as well as good communication within the healthcare team.

The GMC encourages “early, sensitive discussion and planning about how best to manage the patient's care” in order to avoid emotional distress or conflict between doctors and patients.

A spokeswoman said: “Doctors now need to identify patients for whom advanced care planning might be appropriate. They need to start thinking about who the patients are, and how to have a sensitive conversation with them about their future care.”

The GMC warned doctors their registration would be at risk if they ignored the guidance, which states: “You must, therefore, be prepared to explain and justify your actions.” It also says doctors must “start from a presumption in favour of prolonging life and must not be motivated by a desire to bring about the patient’s death.”

But it recognises the issue is complex and adds: “There is no absolute obligation to prolong life irrespective of the consequences for the patient, and irrespective of the patient’s views.”

The new guidance has been backed by the BMA. Dr Tony Calland, chair of the BMA’s ethics committee, said: “We believe the GMC’s new guidance is clear about the need to work with the patient or where appropriate their relatives or advocate to ensure that they are treated fairly, with dignity and without prejudice.”

Mayur Lakhani, a GP and chair of the National Council for Palliative Care and the Dying Matters Coalition, said: “The emphasis that the GMC's new guidance puts on the need for open and honest conversations between doctors, people approaching the end of life, and those close to them is very welcome.”

Read the guidance here:

Treatment and care towards the end of life: good practice in decision making