In England, the Leadership Alliance for the Care of Dying People’s One chance to get it right (2014) publication highlights the five priorities of care for people in the last few days and hours of life. These themes are reflected in the policy guidance within the other three UK countries and include the need to:

• Recognise the possibility that a person may die within the next few days or hours must be recognised and communicated clearly.
• Communicate sensitive communication should take place between staff and the dying person and those identified as important to them.
• Involve the dying person, and those identified as important to them, should be involved in decisions around treatment and care to the extent that the dying person desires.
• Support the needs of families must be actively and sensitively explored, respected and met as far as possible.
• Plan and do an individual realistic plan of care, which includes food and drink, symptom control, and psychological, social and spiritual support, must be agreed, coordinated and delivered with compassion.

Further information

England

• Leadership Alliance for the Care of Dying People (2014) One chance to get it right
• National Institute for Health and Care Excellence (2015) Care of dying adults in the last days of life
• National Institute for Health and Care Excellence (2017) Care of dying adults in the last days of life 
• National Institute for Health and Care Excellence (2021) End of life care for adults 
• NHS England (2021) Ambitions for Palliative and End of Life Care: A national framework for local action 2021-2026.

Wales

• Welsh Government (2021) Care decisions for the last days of life
• Guidance for health professionals on caring for patients in the last days of life (Welsh language version)
• Welsh Government (2022) Quality statement for palliative and end of life care. 

Scotland

• Scottish Government (2014) Caring for people in the last days and hours of life - Guidance (This is currently being updated nationally.)
• Scottish Government (2015) Palliative and end of life care: strategic framework for action
• Scottish Government (2023) Palliative and end of life care strategy: aims, principles and priorities (A delivery plan of this this new strategy is about to be released in the summer.)
• Scottish Palliative Care Guidelines.

Northern Ireland

•  Department of Health in Northern Ireland (2010) Living matters dying matters.

It is important to acknowledge the current debates taking place on the legislative changes being proposed on assisted dying. Although it remains illegal across the UK and its Crown Dependencies, the debates to change the law are progressing at different stages in some parts of the UK.

Read more on our website about legislation around assisted dying.

Here at the RCN, we take no position on whether Bills should become law (RCN position on assisted dying in the UK and Crown Dependencies). However, we are committed to ensuring that should assisted dying be legalised, the framework is robust and equitable for all involved.

There is a lack of consensus regarding the appropriate terminology in discussions surrounding the legal permissibility of individuals seeking assistance to end their own lives. As a result, various terms are often used – most notably ‘assisted dying’ and ‘assisted suicide’.

Assisted dying

Assisted dying is the most used and understood term and will be used throughout this document. Assisted dying happens when someone who is terminally ill or enduring unbearable suffering asks for, and is provided with, assistance to end their life. Assisted dying is illegal in the UK and Crown Dependencies. It is legal in some other countries, including Spain, Australia and New Zealand (Assisted dying, Royal College of Nursing)

Assisted suicide

This term is commonly used to describe a situation where a doctor or another person assists or encourages a person to end their own life. Assisting or encouraging suicide is an explicit criminal offence in England, Wales, and Northern Ireland. In Scotland, where no legislation addresses assisted suicide, it falls under the law relating to homicide.

Physician-assisted suicide

Physician-assisted suicide occurs when a physician facilitates a patient’s death by providing the necessary means and/or information to enable the patient to perform the life-ending act (for example, the physician provides sleeping pills and information about the lethal dose, while aware that the patient may commit suicide against medical advice (AMA).