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New guidance for doctors, Treatment and care towards the end of life: good practice in decision making, published 20 May 2010, comes into effect on 1 July 2010.

It expands on the guidance in Consent, patients and doctors making decisions together, which sets out the principles on which good clinical decisions should be based, and provides a framework for good practice when providing treatment and care for patients who are reaching the end of their lives.

The guidance is based on long-established ethical principles, which include Doctors’ obligations to show respect for human life; to protect the health of patients; to treat patients with respect and dignity; and to make the care of their patients their first concern.

For the first time, the GMC has given doctors in the UK guidance on advance care planning for patients nearing the end of life, including how to manage advance requests and refusals of treatment.  The guidance has been updated to reflect concern from patients that they would not receive the treatment and care they would want towards the end of life.  It emphasises to doctors the importance of listening to patients and recording an advance care plan to help ensure that everyone involved in treating the patient can understand and follow their wishes.

The guidance stated that ‘You must not assume that a patient lacks capacity to make a decision solely because of their age, disability, appearance, behaviour, medical condition (including mental illness), beliefs, apparent inability to communicate or because they make a decision that others disagree with or consider unwise’