A leading end-of-life charity and provider of hospice care has published a worrying report highlighting that “nearly one in three people in England die with [an] unmet need for palliative care”.
The report, published by Marie Curie, found that around 170,000 people die each year in England with “both significant levels of unaddressed symptoms and concerns and inadequate access to sufficient care from GP services” – approximately one person every three minutes.
The report also estimates that, in the next 25 years, unmet palliative care needs are expected to rise by 23%, meaning an additional 40,000 people are expected to die with unmet palliative care needs in 2050 compared to 2025.
Matthew Reed, the chief executive of Marie Curie, said, “The mark of a civilised society is how we look after the most vulnerable. There’s no reason why in an advanced economy we can’t get this right. End-of-life care is not a surprise – we’re all going to need it one day. We should be planning as a society for how we get that right for people”.
Reed stated that, for the majority of people, palliative care remains “chaotic and unplanned”.
A palliative care crisis is not the context to introduce assisted suicide into, experts argue
The report found that, in 2022, around 248,000 adults living with terminal illness in England had unaddressed symptoms and concerns at the end of life.
These findings come in a context where Parliament is considering legalising assisted suicide in England and Wales. The Terminally Ill Adults (End of Life) Bill, which would legalise assisted suicide in England and Wales for those with a prognosis of six months or less, is currently undergoing scrutiny at Committee Stage in the House of Lords.
Professor Katherine Sleeman, the Laing Galazka Chair in Palliative Care at King’s College London, raised concerns about this, saying, “Legalisation of assisted death in a context where services are fragmented, and one in three dying people don’t get the care they need, is a huge risk”.
“We risk people choosing assisted dying simply because of lack of high-quality care. That is not what any of us would consider to be a true choice”, she added.
Speaking during the second session of the Terminally Ill Adults (End of Life) Bill select committee in the House of Lords, Professor Mumtaz Patel, President of the Royal College of Physicians, one of the largest medical royal colleges, shared her fears that people could choose assisted suicide because of lack of palliative care provision and inequity of services.
“What I really fear is that people are making, sometimes, these choices because of the lack of provision around good palliative care. Going back to the inequity of services, it feels really wrong and a lot of our members and fellows talk about that. Just where the disadvantaged populations are, there is service underprovision and then that inequity and gap is just going to get wider and wider” she said.
Spokesperson for Right To Life UK, Catherine Robinson, said “It is incredibly worrying that we may soon be in a position where assisted suicide services are fully provided for, but end-of-life care is not being accessed by hundreds of thousands of people each year who desperately need it. It is conceivable that in these circumstances, individuals may choose to end their lives due to unmet end-of-life care needs”.
“Even supporters of assisted suicide should recognise the deeply perverse incentives such a system would create. In light of this report, Peers who are unsure about the assisted suicide Bill must reject it”.
