Assisted Dying: we need universal access to palliative care first

9th September 2019

The British Medical Journal has published a letter from Dr Simon Etkind about the BMA’s recent decision to poll its members on assisted dying.

The proposer of the motion stated that “even if everyone had access to the best hospice care, at least 5000 people a year would die in unrelieved pain.” But access to palliative and hospice care is far from universal; an estimated 92,000 people in England who might benefit from palliative care currently die without access to it.

This is a moving target; need for palliative care is set to rise 42% by 2040 in England and Wales, meaning that if service provision doesn’t change, tens of thousands more people will miss out on high quality care at the end of their lives. Further, the funding of palliative care services remains limited and inconsistent, with hospices receiving only one third of their income from the NHS and needing to raise one billion pounds a year from charitable donations to cover running costs.

The inequity of care provision at the end of life is neglected in the debate about assisted dying. Surely any consideration of a change in stance towards assisted dying should have as a prerequisite a demand for universal access to palliative care.

Etkind SN. Assisted dying: we need universal access to palliative care first. Bmj. 2019;366:l4743. 10.1136/bmj.l4743.