Palliative care is often touched upon in the debate around ‘assisted dying’ as the proposals brought forward in the UK relate to patients with a terminal illness.

Proponents of assisted suicide argue that the provision of palliative care could act in tandem with an assisted suicide law. They contend that those who want ongoing care could access it, whilst those who want an assisted death could choose this. We would strongly dispute this assertion.

There is a real danger that assisted suicide could undermine the quality of care available on the NHS. Budgets are already stretched, and an ageing population will put increasing pressure on services. By contrast, providing for an ‘assisted death’ is far less burdensome. Cash-strapped NHS trusts could come under pressure to incentivise assisted dying as a way of easing pressure on the service.

The provision of assisted suicide alongside palliative care would also present an ethical dilemma. On one hand, doctors would be striving to protect and preserve life, ensuring a comfortable natural death. On the other, medics would be empowered to deliberately assist in ending a life through lethal drugs. These two competing ethics cannot coexist. There danger of mission creep is profound.

Furthermore, changing the law to allow assisted suicide in the context of a currently unacceptable level of palliative care provision could lead to a ‘postcode lottery’ where patients in some areas feel enabled and empowered to live, helped by an excellent level of care, and others feel that ‘assisted dying’ is the only path for them, pushed towards this choice by a lesser level of care.

We strongly believe that the better solution is investing in palliative care with a view to ensuring that every patient in the UK can access the help and support they need at the end of life. We must also invest in a culture change, countering fear and misunderstanding about the end of life. The reason some patients consider an assisted death is due to fear of what the future holds.

A Better Way

Cicely Saunders International (CSI), an organisation fighting for better care at the end of life, notes that many people did not access the palliative care they needed during 2020 and sets out several changes necessary to “secure high quality palliative care for everyone who needs it in the future”.

As a campaign, we endorse CSI’s recommendations and would call on legislators to work toward them, rather than take the dangerous step of ‘assisted dying’.

  1. Provide palliative care expertise in hospitals, care homes, hospices and at home
  2. Make joined up care a reality
  3. Empower patients and carers to have greater choice and control
  4. Invest in community care services
  5. Provide healthcare professionals and carers with high-quality palliative care training
  6. Use outcome measures to embed a system of continuous learning and improvement
  7. Fund world-leading research into palliative care

Read the full CSI report here.